Issued By: SQM

Approved by: MD
Form No: S132
RISK ASSESSMENT / ACTION PLAN FORM Ver. No.: 05
Issue Date:Jan '16

Ships / Dept. Name: M.T. LEOPARD RA No. Rev No. 0 Date: 12.01.2020

Alternate methods of
Work / Activity Details: Cargo Tanks Doping,Adding Additives work considered1
Yes ✘ No N.A

* ADDITIVES TO ADDED TO SHORE TA

SECTION 1: RISK ASSESSMENT TABLE

Decision to proceed with work

New Severity of Consequence
For Completion or Additional
Severity of Consequence **

New Likelihood Rating (B1)

Residual Risk ( A1 x B1 )
(after additional control)
(after additional control)
Agreed time frame

Control Measures
(Refer Table 1)

(Refer Table 1)
Likelihood **

Risk Level **
Rating ( A )

Rating ( B )

Rating (A1)
(AxB)

(Y/N)
Sr. Existing Control Additional Controls Person
Sub task / Activity Hazards Identified
No. Measures Required Responsible

ENGAGE BRAIN
BEFORE
Properly trained HANDS ,ALL CREW
PREPARATION
personnel. MSDS for TO WEAR PPE , Prior
MANUAL HANDLING
additives is to be CARGO DOPING &
1- Personal Injury. provided before taking
3 3 9
PLAN MUST BE
CO
during
3 1 3Y
additives/equipments PREPARED BY THE ops
onboard. SUPPLIER AND
COMMUNICATED TO
THE MASTER.
Crew is to take no
Proper monitoring of
part in the operation,
the work while in
only by properly Prior
progress.Use of
Additives doping Inhalation, contact trained personnel. In &
2 3 3 9 proper CO 3 1 3Y
with eye/skin case of accidental during
PPE ,equipment.
spill SOPEP ops
Reference to the
equipment shoul be
equipment manual.
standby at all time.
 Issued By: SQM
Approved by: MD
Form No: S132
RISK ASSESSMENT / ACTION PLAN FORM Ver. No.: 05
Issue Date:Jan '16

Under standing of
Supervision by duty cargo doping plan. Prior
Additives doping Pollution/ Spill on officer at all the time. Operation should be &
3 4 2 8 CO 3 1 3Y
deck Use of SOPEP carried out by during
equipment and PPE. authorised competent ops
person only.

Under standing of
Prior commencement
cargo doping plan.
of operation key
Operation should be Prior
Max concentration of meeting with doping
Additives doping carried out by &
4 additive should not be team and there after 3 3 9 CO 2 2 4Y
authorised competent during
more than 1% briefing the ship staff
person only. Tank ops
about the safety
wise calculation with
procedures.
ullage sheet.

Fire precaution should

Fully enclosed
be followed, fire Prior
operation. Regular
Additives doping Flammable extinguishers and fire &
5 5 2 10 gas check of the CO 4 1 4Y
gas/vapours fighting equipments to during
atmosphere where
be in the state of ops
operation is going on.
readiness.

PREESURE CAN
TANKS TO BE PPE TO BE USED AT During
6 Depressurzing tanks CAUSE INHALATION 3 4 12 CO 2 2 4Y
DEPRESSURIZED ALLTIMES ops
OF VAPOURS

CONFUSION / NO EXTRA
EDUCATION AND
Monitoring crew DISTURBANCE PERSONS
7 4 3 12 TRAINING ON CO Cont. 2 2 4Y
opeartion DURING DOPING STANDING NEAR
SAFETY
OPS TANK

Following Emergency Equipment to be tested and kept standby for use during emeregency situation while this operation is in progress (describe equipment here): COMPLY WITH S106,
PERSONAL GAS METER.

Notes
1. Describe alternate method of work : ADDING TO SHORE TANKS

2. For evaluation of Severity of Consequence / Likelihood to People, Environment and or Property / Commercial to arrive at ratings of (A) & (B), refer to Table 1 as applicable.

3. At any time if residual risk or newly envisaged / potential risk score is more than 15 implying a High Risk, the Job is not to be undertaken. If in progress, Job is to be aborted with due precautions to ensure no further risk
exist. In the event of an emergency situation is developing or likely to develop, the relevant checklist in the Office Contigency Plan Manual / Emergency Checklist is to be refered to and suitable actions taken.
 Issued By: SQM
Approved by: MD
Form No: S132
RISK ASSESSMENT / ACTION PLAN FORM Ver. No.: 05
Issue Date:Jan '16

Comments:
12.01.2020
Head of Department Date

Reviewer's Comments:
12.01.2020
Name / Position / Signature Date
TABLE 1: RISK MATRIX

(Severity of) Consequence - A Likelihood (of Consequence) (Severity of) Consequence

TABLE 1
● fatality or a case of Total Permanent
Negligible Minor Major Severe Catastrophic Disability.

● serious loss of reputation which is

Rating 1 2 3 4 5 more frequently than 10% devastating for trust and respect.
Very Likely Catastrophic
of the time/cases
● considerable economic loss which cannot be
restored.
Very Likely 5 5 10 15 20 25
● more than 5 m3 to sea.
Likelihood (of Consequence) - B

● a case of Partial Permanent Disability.

Likely 4 4 8 12 16 20
● serious loss of reputation that will influence
trust and respect for a long time.
occurs between 1% and
Likely Severe
10% of the time/cases
● large economic loss more than US$100,000
that can be restored.
Unlikely 3 3 6 9 12 15
● 1 to 5 m3 to sea.

● more than 1 LTI resulting from this task.

Highly
2 2 4 6 8 10
Unlikely ● reduction of reputation that may influence
trust and respect.
occurs between 0.1% and
Unlikely Major
1% of the time/cases ● economic loss between US$10,000 and
Almost NIL US$100,000 which can be restored.
1 1 2 3 4 5
Chances
● less than 1 m3 to sea

● less than 1 LTI resulting from this task

● small reduction of reputation in the short run.

Colour Risk Score ( A x B ) Classification Action
Highly occur less than 0.1% of
Minor
Unlikely the time/cases ● economic loss up to US$10,000 which can
Do not undertake task. If be restored.
operation is already in
Red 16 - 25 High
progress, abort and ● sheen on sea: evidence of loss to sea
inform Office.

Job to be under taken ● First Aid Case with no loss of time

Amber 12 - 15 Warning
only with Office Approval. ● no effect on reputation.
Almost NIL never heard within the
Negligible
Chances industry ● negligible economic loss which can be
restored.

● nil to sea: contained onboard

 ● First Aid Case with no loss of time

● no effect on reputation.
Almost NIL never heard within the
Negligible
Job can be under taken Chances industry ● negligible economic loss which can be
restored.
by Ship Staff with direct
Blue 8 - 10 Medium
supervision of Master ● nil to sea: contained onboard
and/or Chief Engineer.

Job can be under taken

Green 1-6 Low
by Ship Staff.