PART A-FORM 006 NEAR MISS REPORT

COMPANY INTEGRATED MANAGEMENT SYSTEM – CIMS

VESSEL: OKYROE DATE OF REPORT: 11.09.2013

(A separate report must be completed for each identified near miss)
DATE/ TIME AND LOCATION OF NEAR MISS:
11.09.2013 / 09:25-PAINT ROOM-SAMPLE LOCKER
VESSEL'S LOCATION AT TIME OF NEAR MISS: FREEPORT ANCHORAGE
WEATHER CONDITIONS AT TIME OF NEAR MISS: CLOUDY SKY,GENTLE BREEZE RIPPLED SEA
Give full details below using as much space as needed to give a complete description of the near miss, i.e., where, when, how it
happened and who was involved, what was the cause in your opinion and what action has been taken
DESCRIPTION OF NEAR MISS

During the routine inspection was found that one plastic bottle with a Fuel oil cargo samples has a leakage from
the cap causing an oily spot on the sample locker shelf.

RESULTS OF SHIPBOARD INVESTIGATION INTO CAUSE

The cap was not properly tightened.

DETAILS OF ANY CORRECTIVE & PREVENTIVE ACTION TAKEN SO FAR

The cap was tightened. All sample bottles was re-checked. Oil spot cleaned.

Name of person who identified Near Miss: PUMPMAN: PEROY ALLAN

Witness Report(s) attached:

No:001 D
Number these reports if more than one near miss reported on the same day

Version: 01.00
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