Ship’s Name : KM Indira

CHECK LIST FOR HIGH PLACE

Voyage :
WORKING
Date : 15 Nov 2023
Description of work : Repair Boom Crane

No. of workers : 025 Person in charge : 2nd Engineer

Check
No. Check Items
Yes No
1 Workers shall wear regulated uniforms and safety belts.

2 Workers shall not have acrophobia and they shall not be an apprentice.

3 For rope, test its load by using 4～5 times as heavy as weight that may be used.

4 Sufficiently let down Bosun chair or stay rope of stage to the floor.
When working near radar, air whistle, radio antenna, inform the officer on watch
5 or the radio officer. Block off the power of the relevant machine, and attach the
sign board saying ”In operation, Do not operate“.
When working in a funnel, take actions to reduce discharge of poisonous gas or
6
smoke.
7 Notice : Do not pass under the place where the work above is performed.
Make proper measures not to drop tools in use, and then use the tools.
8
(e.g.: tool bag, suspending line, etc.)
9 In case of working outboard, use life jackets.

Other

Specially requested matters :

Function Person in charge Head of dept. Approved by (Master)

Name Al Mukaddi Darwis Anton Ashari
Signature
Date 15 November 2023 15 November 2023 15 November 2023

KSE-080(0/2010.7.15) INDIMATAN LINES

KSE-080(0/2010.7.15) INDIMATAN LINES