HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

GUIDANCE NOTES

OBJECTIVES HAZARD IDENTIFICATION RISK MATRIX

EFFECT OF CONTROL ACTIONS BASED ON RISK ASSESSMENT

MEASURES IDENTIFIED RISKS APPROVALS

FAQ

RISK ASSESSMENT DETAILS

INFORMATION INPUT WORKSHEET

Page I 1 SF-23
Original: Vessel Edition No.3 / Rev.No. 2
Copy: Synergy Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

Risk assessment is a decision making

tool utilize for
- Identification of hazards & consequences,
- Application of control measures to reduce
risk,
- Assessment of residual risks so that
appropriate consequential actions can be
taken for planning and carrying out the task
safely

Control measure hierarchy for each hazard

Page I 2 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

Hazard Identification

A condition or action that has the potential for an unplanned release

What is a HAZARD? of, or unwanted contact with, an energy source that may result in
harm or injury to people, property, or the environment.

ENERGY HAZARDS SITUATION HAZARDS

Page I 20 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

ENERGY HAZARDS

Page I 20 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

Page I 20 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

SITUATIONAL HAZARDS

Page I 20 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

Understanding the effect of Control Measures

COMMON ERROR IN ASSESSING THE IMPACT OF CONTROL MEASUTRES:

Any control measure established for risk mitigation either reduces the 'likelihood' or the 'Consequence' severity.
Note: Users may sometimes not fully understand how these control measures work, which can lead to a misunderstanding of which aspect is being
improved. As a result, the assessment of 'existing risk' or 'modified risk' may be inaccurate.
Page I 20 SF-23
EXAMPLE:
Original: While working aloft ship staff is wearing safety harness.
Vessel
Edition No.3 / Rev.No. 2
Copy: Synergy
Safety harness in this case is reduces frequency of his fall from height. However even after wearing the harness, if he falls, then the severity of the Date: 06-Nov-23
 COMMON ERROR IN ASSESSING THE IMPACT OF CONTROL MEASUTRES:
HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM
Any control measure established for risk mitigation either reduces the 'likelihood' or the 'Consequence' severity.
Note: Users may sometimes not fully understand how these control measures work, which can lead to a misunderstanding of which aspect is being
improved. As a result, the assessment of 'existing risk' or 'modified risk' may be inaccurate.
EXAMPLE: While working aloft ship staff is wearing safety harness.
Safety harness in this case is reduces frequency of his fall from height. However even after wearing the harness, if he falls, then the severity of the
injury is going to remain the same. Thus, by using harness, likelihood is changing but not severity.
EXAMPLE: While working aloft soft cushions are placed under the working area.
This control measure alone does not affect the frequency of falls. However, if a person falls then the severity of injury can be less due to cushions.
Thus, this control measure is affecting the severity, not likelihood.

Page I 20 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

Consequences Minor Marginal Substantial Critical

Permanent total disability
Injury First Aid Case RWC, MTC LWC (PTD), Permanent partial
disability (PPD)

Failure of Primary Spill into sea greater than 1

containment. Spill bbl and less than or equal to
10 barrel.
contained on deck. Spill
quantity greater than 1 BBL.
OR
Spill into sea. less than or
Failure of Primary OR
containment. Spill equal to 1 barrel Uncontrolled release of toxic
gases greater than 10m3
contained on deck.
OR and less than or equal to 50
Liquid Spill quantity Uncontrolled release of
Environment Loss less than or equal to 1 toxic gases less than and m3. (or equivalent in ton)
Spill into sea less than or
BBL equal to 1 m3 (or
equivalent in ton) Uncontrolled release of toxic equal to 10 barrels.
gases less than and equal to 1
m3. (or equivalent in ton) OR
OR
Uncontrolled release of toxic
Emission of SOx gases for
gases greater than 10m3 and
more than 1-hour duration
after EGCS failure ** less than or equal to 50 m3
(or equivalent in ton)

Damage to own or Damage to own or external Damage to own or external Damage to own or external
external property with property with estimated property with estimated property with estimated
Asset / Property Loss*
estimated actual cost actual costing between actual cost between 100,000 actual costing between
up to to 10,000 USD. 10,000 and 100,000 USD. and 1000,000 USD. 1000,000 and 3000,000 USD.

Notable interruption,
disturbance or
deviation from normal LOP issued to vessel for not
functioning leading to meeting charter party
Disruption to Business Off Hire of any vessel Fleetwide ban by charterer
significant requirements, excluding off-
consequences. hire.
No LOP or notice
received.

Written warnings or official

complaints from authorities
for regulatory non-
An investigation by
Verbal warning or compliance. authorities results in
official complaints from moderate penalties or
Minor vessel sanctions ie: Vessel Detention by Port state
Regulatory Compliance authorities for sanctions on the company ie:
regulatory non restriction on vessels for control fleetwide restriction on
entering the port for the
compliance calling a country/port for a
specified duration. specified duration.
Fines on vessel imposed by
authorities.

National negative media International negative

Reputation Damage No Coverage Regional or local coverage
attention. industry media attention.

Unsuccessful attempted
of theft Theft incident where Stowaway onboard, Theft Ship used for smuggling,
property value was < USD incident where property value sabotage, and criminal
Security Incidents Unauthorized boarding 5000 was > USD 5000 attempt.

Cyber Attacks Unsuccessful hijack attempt

Loss of security passes

Remote Never Heard in the Industry Very Low Very Low Low Low
L Unlikely Heard in the Industry
I Very Low Low Low Medium
K
E Occasional Has happened in the
organization or more than Low Low Medium High
L once per year in the industry
I
H Likely Has happened at the
location or more than once Low Medium High High
O per year in the organization
O
D Almost Has happened more than
Certain once per year at the location Medium High High Very High

Guidance Notes:

* Asset / Property loss: The cost referred to in this section is the cost incurred for repairs, technicians, spare parts used and inspections/surveys. Variable service
costs such as tuggage, salvage, external consultants and legal liability are to be ruled out for loss classification determination.

** Emission of SOx gases – Applicable when SOx emission is not meeting the standard due to EGCS malfunction.

Page I 20 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

Catastrophic

Fatality

Major spill greater than 10

Bbls into the sea
OR
Uncontrolled release of
toxic gases greater than
50m3 (or equivalent in
ton)

Damage to own or external

property with estimated
actual costing more than
or equal to 3000,000 USD

Loss or suspension of DOC

An investigation by
authorities resulting in
severe penalties or
sanctions on company ie:
prohibition on trading for a
specified duration

International negative
mainstream media
attention.

Vessel Hijacking

Bomb or terror attack

Medium

Medium

High

Very High

Very High

pections/surveys. Variable service

Page I 20 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

Existing Risk Actions

Maintain identified existing and recovery control measures. Existing risks after control measures are acceptable. Further risk
Very Low control measures is not mandatory

Maintain identified existing and recovery control measures. Existing risks after control measures are acceptable. Further risk
Low control measures is not mandatory
Maintain the risk at ALARP.

Medium Ensure available control measures are maintained while performing task. Verify implementation of control measures
frequently.
Further risk control measures is not mandatory

Substantial effort should be made to reduce the risk further.

High
The vessel shall endeavour to establish a best practice to further reduce the risk. These best practices shall be recorded in the
'further risk control measures' section. The vessel shall then assess the modified risk with established best practices.

These risks are unacceptable and carrying out task is prohibited. Substantial improvements in risk controls are necessary so
that the risk controls are reduced to ALARP. The work activity should be halted until risk controls that are implemented reduce
Very High the risk so that modified risk is no longer remain ‘very high’. If it is not possible to reduce the risk the work should remain
prohibited.

Page I 20 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

PLANNED ROUTINE TASKS

Existing Risk Approving Authority

Very Low Head of Department

Low Head of Department

Medium Master

High Marine manager & QHSE superintendent

Very High Work is Prohibited.

NEW, NON ROUTINE, UNPLANNED TASKS

New Task - Tasks for which vessel does not have any procedure, onboard level 2 risk assessment or risk
assessment in sample risk assessment database from office.

Page IAll
20 such tasks need SF-23
Original: Vessel
office approval
Copy: Synergy Edition No.3 / Rev.No. 2
prior to initiating Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

All such tasks need Unplanned Task - Unforeseen task that was not identified in the work plan for the day. Such tasks shall include any
office approval task having significant risk.
prior to initiating
the tasks
Non- Routine Task - Tasks that are performed infrequently or for the first time. They do not form a part of the
PMS. Routine work not forming part of PMS are excluded from this category.

RISK LEVEL APPROVAL AUTHORITY

Low/Medium Marine or Technical Superintendent of the vessel
High Marine Manager & QHSE superintendent

Page I 20 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

Frequently asked Questionares

Serial No. Questions Understanding

Level 1 Risk assessment is carried out mentally. No formal recordkeeping is
necessary.
What is the difference between level 1 and level 2 Risk
1
assessment
Level 2 Risks assessment is formal risk assessment that suppose to be
documented on company's prescribed form or software
Level 2 risk assessments is required under the following circumstances

- When the risk associated with the task is significant,

Under what circumstances, level 2 Risk assessments are
2
required - Atleast for tasks given in the Health and safety manual 'Occupational Hazard and
Safety Risk Assessment’ and Appendix 1’

- For New, unplanned, and non-routine tasks

Negative. All level 2 risk assessments need not require office approval. Level 2 risk
assessments require office approval under following circumstances:

- When the existing risk is 'High or Very High'

3 Do all level 2 risk assessment need office approval
- When the task is new, non-routine and unplanned
- Proposing the work on critical equipment that renders them unavailable even for a
shorter duration.
- Task-specific requirements where office approval is explicitly mentioned in SMS
Existing Control Measures - Control measures in place to prevent the occurrence
of inadvertent events due to hazards.
These are taken from the instruction or guidance given in company SMS and/or
precautions required as per general seamanship practices.

Recovery Measures - Measures in place to reduce the consequence if an

inadvertent event takes place; eg. Placing of fire extinguishers, stretchers, Rescue
davits etc.
These are taken from the instruction or guidance given in company SMS and/or
precautions required as per general seamanship practices.
What is the difference between 'existing control measure', Further Control Measures - Control measures not covered in SMS. They are
4
'recovery measure' and 'further control measure' 'Best practices' or measures taken from local procedures

EXAMPLE:
Activity: To Carry out painting of lifeboat while at sea. Ship staff have to step
beyond the safety railing towards ship side.

Existing control measure: Ship staff using safety harness that is attached to strong
point
Recovery control measure: Ship staff wearing life vest while working beyond railing
Further control measure: Artificial temporary ship side railing rigged using
scaffolding to provide additional protection.

Page I 20 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

Existing Risk - Residual Risk with existing control and recovery measures in
place.
What is the difference between 'Existing Risk' and
5
'Modified Risk'
Modified Risk - Final Risk after applying further risk control measures to Existing
risk

The worst possible outcome from the inadvertent event shall be considered for the
mentioned hazard. This will enable the user to choose the stringent consequences
that will eventually influence the risk (Risk = Consequences x Likelihood).
What degree of consequences shall be considered for the
6
identified hazards EXAMPLE: During risk assessment for ‘Enclosed Space Entry’, if ship staff
identifies the consequence for slipping on the ladder as ‘fracture’ rather than the
worst possible consequence ‘fatality’.
Then, as per the company matrix, consequence severity will be chosen in the
‘Substantial’ category instead of ‘Catastrophic’. This will eventually reduce the risk
level and leave ship staff with the wrong estimation of risk

At what frequency vessel shall carry out risk assessment

7
review? After carrying out any task, vessel shall review the level 2 risk assessment that
they used to update it with the newly identified hazards, consequences and control
measure.

Can vessel use old level 2 risk assessments prepared No level 2 risk assessment shall be used by the vessel unless it has been reviewed
8
onboard in last 6 months

How vessel can inform office for identified new hazard Vessels can notify new hazard or control measures to office through monthly
9
and control measures manual review form (SF-03).

Sample risk assessments are level 2 risk assessments prepared by office

10 What is sample risk assessments provided by the office?
personnel for the guidance of ship staff.
Negative. Risk assessments in sample database are generic and do not cover the
Is level 2 risk assessments in the sample risk local hazards that may be present on the respective vessels. Therefor ship staff
11 assessments database in ready-to-use state for the ship are expected to use them as guidance only.
staff? Vessels have to develop the ship specific level 2 risk assessments using the
sample database.
The vessel must not downgrade the 'existing risk' set by the office in risk
While preparing the ship-specific level 2 risk assessment
assessment for any hazard.
using risk assessment from sample database, can vessel
12
alter the 'existing risk' set by the office for a aprticular
They can establish the 'further control measure' to have a lower 'modified risk'.
hazard.
How vessel can demonstrate that control measures The officer responsible for the safe operation shall make the entry of date and time
13 mentioned in the level 2 risk assessment are in the risk assessment 'working sheet', whenever the control measures are
implemented onboard confirmed in place.

Page I 20 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

S.No (Synergy / Vessel / Year/ S.no): SYNERGY / SAVO/2025

Vessel Name / Office Name: SAKURA VOYAGER

Location: At Anchorage

Date of carrying out level II RA: 2/5/2025

Expected Date and Time of activity: 2/5/2025

Expected duration of the activity: 0-4 Hours

Office Approval Required?(See More 2 &3) Yes

Risk Assessment Reviewed On: 2/4/2025

Asset Activity: Others

Asset Condition: Loaded

Risk Assessment required for: Maintenance of Critical Equipment

Nature of Work: LIFE BOAT LOWERING AND MANOEUVRING IN WATER

Area of Work LIFE BOAT DECK - PORT & STBD (A-DECK)

Concurrent activity affecting main activity(Refer NONE

SIMPOS HSM 14.1 and SMM 7.2.2 )

Man Over Board - Checklist

Injury - Checklist
Worst Case Scenario and (Contingency Manual
Ch05: Response Measure Checklist)
Others

Approved by Marine Yes Technical NA QHSE NA

Page I 20 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

Activity Step Hazard Consequence Existing Control Measure (Control measures in place to Recovery Measures Existing Risk Further Risk Control Measures Modified Name / Date and
(Job Scope break (Hazards associated with each (Worst Possible outcome from prevent the occurrence of inadvertent events due to (Measures in place to reduce the consequence if (Residual (Control measures not covered in SMS. They are Risk Signature (PIC-Ensuring
activity step. Hazard inadvertent event because of hazard. inadverent event take place; eg. Placing of fire Risk with 'Best practices' adopted or measure taken (Final Risk the control measures
down and placed from local procedures) are in place)
sequentially) identification shall focus on its mentioned hazard) extinguishers, stretchers, Rescue davits etc. existing after
affect to people, environment, (These are taken from the SMS and/or precautions required control and applying

Hazard Review Date

asset & reputation) as per general seamanship practices) (These are taken from the SMS and/or precautions recovery further risk
Sr. No required as per general seamanship practices) measure in control
place) measures)

Consequences

Consequences

Modified Risk
Existing Risk
Likelihood

Likelihood
Substantial
Work/rest hours mgmt. Crew to be GANESAN

Unlikely
Job description understand by all crew

Low
Fatigue Miss communication adequately rested prior undertaking NONE SATHEESH /
who involved. 04-02-2025
this job. HSPP Ch 2 / F317

Substantial
Job familiarisation / training, Briefing
GANESAN

Unlikely
Injury to person and prior job,Tool box meeting as per

Low
Human Error Supervising by senior officer NONE SATHEESH /
property HSPP Ch 1 Monitoring and
LOWERING OF 04-02-2025
supervision by Responsible person.
LIFE BOAT /
1 RESCUE BOAT
AND

Substantial
MANOEUVRING GANESAN

Unlikely
Extreme temperatures Cold / Heat strokes

Low
Use proper PPE - HSPP CH 2 Job is carried out in fair weather NONE SATHEESH /
(cold, heat) 04-02-2025

Incorrect operation of Backup walkie talkie kept stby & spare

release gear Communication to be tested prior battery stby

Substantial
undertaking the job. Suffcicient
GANESAN

Unlikely
Communication walkie talkie to be carried.Biefing of

Low
NONE SATHEESH /
Failure operation well understood by all 04-02-2025
personnel involved, Secondary
means established.

Very Low
GANESAN

Unlikely
Minor
Inadequate Unsafe operation Check Lighting prior operation. Job will carried in day hrs NONE
Lighting/Darkness SATHEESH /
Comply with PMS 04-02-2025

Substantial
Use proper PPE. Ensure operating GANESAN

Unlikely
Slippery / unsafe Slips & Trips Antiskid surface on boat deck, & safety

Low
area is clear of oil/grease stains, salt NONE SATHEESH /
surface (on boat deck) shoee grip should check.
patches. Ref HSPP CH 2.14 04-02-2025

LOWERING OF
LIFE BOAT /
2 RESCUE BOAT

Substantial
Read Manufacturers manual &
Lack of Familiarity Injury to person and GANESAN

Unlikely
AND Company procedures thoroughly - Before carried out job training has

Low
MANOEUVRING with Life boat davit damage to property NONE SATHEESH /
control / equipment Ensure all familiar with procedures. given and only trained crew involved. 04-02-2025
Regular training and drills.

Substantial
Poor condition of GANESAN
Unlikely

embarkation ladder / Man Overboard Check before use -Maintain as per Backup ladder and Lifebuoy stby at Low
NONE SATHEESH /
shackles PMS working place 04-02-2025
Substantial

Vessel movement GANESAN

Unlikely

Damage lifeboat hull Job not to be undetaken unless v/l is Job to be carried out in fair weather
Low

(Rolling, NONE SATHEESH /

and property steady and is in calm waters. and at anchor.
Pitching,Swell) 04-02-2025

Page I 20 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

Activity Step Hazard Consequence Existing Control Measure (Control measures in place to Recovery Measures Existing Risk Further Risk Control Measures Modified Name / Date and
(Job Scope break (Hazards associated with each (Worst Possible outcome from prevent the occurrence of inadvertent events due to (Measures in place to reduce the consequence if (Residual (Control measures not covered in SMS. They are Risk Signature (PIC-Ensuring
activity step. Hazard inadvertent event because of hazard. inadverent event take place; eg. Placing of fire Risk with 'Best practices' adopted or measure taken (Final Risk the control measures
down and placed from local procedures) are in place)
sequentially) identification shall focus on its mentioned hazard) extinguishers, stretchers, Rescue davits etc. existing after
affect to people, environment, (These are taken from the SMS and/or precautions required control and applying

Hazard Review Date

asset & reputation) as per general seamanship practices) (These are taken from the SMS and/or precautions recovery further risk
Sr. No required as per general seamanship practices) measure in control
place) measures)

Consequences

Consequences

Modified Risk
Existing Risk
Likelihood

Likelihood
Life boat not moving
out of its stowed Life boats to be moved out of its
position evenly stowed position weekly as per

Substantial
because of getting Slowly lower the life boats

Medium
requirement. L/B to be lowered to GANESAN

Unlikely

Unlikely
Critical
stuck in position as a Damage lifeboat hull Weekly L/Boat Inspection carried out. form the resting

Low
result of which the and property water level without personnel and And record verified. horn ,maintian equal sight on SATHEESH /
wire can slip of the picked up. During lowering monitor lowering of Lifeboat 04-02-2025
falls causing boat to that the life boats are evenly moviing
imbalance and out of its stowed position
LOWERING OF damage to equipment
LIFE BOAT /
3 RESCUE BOAT
AND
MANOEUVRING

L/B to be lowered to water level Before Lowering Life boat

Substantial
Medium
Equipment failure Injury. Damage. Loss without personnel and picked up. below deck level life boat to be GANESAN

Unlikely

Unlikely
Critical

Low
(lifeboat davit / Upon confirmation of all in order send Painter made fast lowered and picked up on SATHEESH /
motor, sheaves, etc), of life. crew and relaunch the boat. Cams embarkation deck. All part 04-02-2025
positioning to be checked . checked for smooth operation

Substantial
GANESAN

Unlikely
Malfunction / failure Damage to the boat & Check prior operation. Test limit

Low
Same to be done NONE SATHEESH /
of limit switches davit switch as per schedule. 04-02-2025

Lifeboat lowered till

Marginal
Medium
LowerL/B without personnel first - GANESAN

Unlikely

Unlikely
Critical
Malfunction of brake Injury. Damage. Loss Call for immediate medical attention . embarkation deck without any

Low
of life. Brake lining inspection / renewal as First Aid kit to be always available crew and checked whether SATHEESH /
per PMS 04-02-2025
brake holding or not

Marginal
Medium
Launch boat regularly as per GANESAN

Unlikely

Unlikely
Critical
Failure of onload Call for immediate medical attention . Check for SSD pins and smooth

Low
release mechanism schedule . Carry out maintanence as First Aid kit to be always available operation of the same SATHEESH /
per PMS. Ref Tech Manual CH 3.5 04-02-2025
LOWERING OF
LIFE BOAT /
4 RESCUE BOAT
AND
MANOEUVRING

Marginal
Medium
Unlikely SSD pins to be removed only GANESAN

Unlikely
Critical
Accidental operation Injury to person and Brief all personnel before Drill -Hold Call for immediate medical attention .

Low
of release gear damage to property First Aid kit to be always available when vsl is just above the SATHEESH /
regular Training sessions water level 04-02-2025

Page I 20 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

Activity Step Hazard Consequence Existing Control Measure (Control measures in place to Recovery Measures Existing Risk Further Risk Control Measures Modified Name / Date and
LOWERING OF
(Job Scope break (Hazards associated with each (Worst Possible outcome from prevent the occurrence of inadvertent events due to (Measures in place to reduce the consequence if (Residual (Control measures not covered in SMS. They are Risk Signature (PIC-Ensuring
'Best practices' adopted or measure taken the control measures
LIFEand
down BOAT /
placed activity step. Hazard
identification shall focus on its
inadvertent event because of
mentioned hazard)
hazard. inadverent event take place; eg. Placing of fire
extinguishers, stretchers, Rescue davits etc.
Risk with
existing from local procedures)
(Final Risk
after are in place)
4 RESCUE BOAT
sequentially) affect to people, environment, (These are taken from the SMS and/or precautions required control and applying

Hazard Review Date

AND asset & reputation) as per general seamanship practices) (These are taken from the SMS and/or precautions recovery further risk
Sr. No MANOEUVRING required as per general seamanship practices) measure in control
place) measures)

Consequences

Consequences

Modified Risk
Existing Risk
Likelihood

Likelihood
Boats to be lowered into water

Very Low
Marginal
Medium
Wire to be inspected and maintained GANESAN

Unlikely

Remote
Critical
Parting of falls/ wire Injury. Damage. Loss and Renewed as per PMS. Ref Tech
Call for immediate medical attention . level without any person on SATHEESH /
of life. First Aid kit to be always available board and avoid jerks and 04-02-2025
Manual Ch 3.5 kinks to falls while lowering

Substantial
Additional length of guide rope to be
GANESAN

Unlikely
Free movement of Injury to person and tied to the hook. Same can be held Call for immediate medical attention .

Low
NONE SATHEESH /
hooks after releasing damage to property prior alligning the boat with the First Aid kit to be always available
04-02-2025
hooks.

Substantial
Responsible officer to carry out all GANESAN

Unlikely
LOWERING OF Failure to secure the Call for immediate medical attention .

Low
LIFE BOAT / Lifeboat flooding checks prior launching the boat. NONE SATHEESH /
plugs First Aid kit to be always available 04-02-2025
5 RESCUE BOAT Duties to be checked and carried out.
AND
MANOEUVRING

Engines to be tested during weekly.

Substantial
Same maintained as per PMS. Test engines prior lowering. Use of oars GANESAN

Unlikely
to bring boat alongside. Responsible

Low
Failure of engines Unable to Manoeuver Engineer to be familiar with the NONE SATHEESH /
engineer to be in the boat team. Call 04-02-2025
operation and maintanence of the LB for shore assistance if needed
engine. Ref Tech Manual CH 3.5

Substantial
Sufficient crew to be available. GANESAN

Unlikely
Improper operation & All crew available for the drill. Rested in

Low
Inadequate crew Priority to be given to launching SATHEESH /
handling of boat. advance. 04-02-2025
/lowering boats. Ref HSPP CH 1

Substantial
Lifebuoy with line to be standby for
Improper Donning of GANESAN

Unlikely
L/Jackets , Immersion Drowning if fall in Training sessions/Drill Posters in use. Call for immediate medical

Low
SATHEESH /
suit's water accidently Crew Quarters .Check before entry attention . First Aid kit to be always 04-02-2025
available
LOWERING OF
LIFE BOAT /
6 RESCUE BOAT
AND Responsible officer to carry out all
MANOEUVRING checks prior hoisting the boat.Ensure

Marginal
Medium
Boat to lowered just above GANESAN

Unlikely

Unlikely
Critical
Hooks not locked Injury to person and cams are in correct position. Hoist Call for immediate medical attention .

Low
properly damage to property water level and hooks to be SATHEESH /
the boat above waterlevel and confirm First Aid kit to be always available tested 04-02-2025
all in order before picking it up
completely.

Substantial
Responsible officer to carry out all GANESAN
Unlikely
Failure to Damage to the
Low
checks prior launching the boat. Assess the damage & Carry out repairs SATHEESH /
remove/clear lashings lifeboat & lashing 04-02-2025
Duties to be checked and carried out.

Page I 20 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23
 HAZARD IDENTIFICATION AND RISK ASSESSMENT FORM

Activity Step Hazard Consequence Existing Control Measure (Control measures in place to Recovery Measures Existing Risk Further Risk Control Measures Modified Name / Date and
(Job Scope break (Hazards associated with each (Worst Possible outcome from prevent the occurrence of inadvertent events due to (Measures in place to reduce the consequence if (Residual (Control measures not covered in SMS. They are Risk Signature (PIC-Ensuring
activity step. Hazard inadvertent event because of hazard. inadverent event take place; eg. Placing of fire Risk with 'Best practices' adopted or measure taken (Final Risk the control measures
down and placed from local procedures) are in place)
sequentially) identification shall focus on its mentioned hazard) extinguishers, stretchers, Rescue davits etc. existing after
affect to people, environment, (These are taken from the SMS and/or precautions required control and applying

Hazard Review Date

asset & reputation) as per general seamanship practices) (These are taken from the SMS and/or precautions recovery further risk
Sr. No required as per general seamanship practices) measure in control
place) measures)

Consequences

Consequences

Modified Risk
Existing Risk
Likelihood

Likelihood
Foundation bolts inspection before Before taking weight on hooks,

Marginal
Medium
GANESAN

Unlikely

Unlikely
Critical
Weakened Release Injury. Damage. Loss use -. Regular thorough inspection of Call for immediate medical attention . thorough inspection of the

Low
SATHEESH /
Hook Foundation bolts of life. boat as per PMS. Ref Tech Manual CH First Aid kit to be always available foundation bolts and hook to 04-02-2025
3.5 carryout

Self lowering wire to be adjusted to

Substantial
Incorrect length/ Damage / correct length. Same to be tried out GANESAN

Unlikely
Correct adjustment of the wire. Assess

Low
adjustment of Self entanglement of the after the first installation. Optimum the damage, renew if required. SATHEESH /
LOWERING OF lowering wire self lowering wire 04-02-2025
LIFE BOAT / turns to to be taken on the drum to
7 RESCUE BOAT activate the movement of the brake.
AND
MANOEUVRING

Substantial
Call for immediate medical attention . GANESAN

Unlikely
Strong winds , sea Injury to person and Local weather forecast to be

Low
swells damage to property First Aid kit to be always available, SATHEESH /
assessed in advance Repairs if damage to the boat. 04-02-2025

Danger which can

Boat team to be seated with fastened

Substantial
arise due to wakes Uncontrolled The traffic around the vessel is to be seatbelts if suspect any unusual GANESAN

Unlikely
from other passing

Low
ships / water crafts movements of boat.
Injury to boat crew.
monitored and the personnel alerted movement of lifeboat. Call for
immediate medical attention . First Aid
SATHEESH /
04-02-2025
during the launching accordingly
of lifeboats kit to be always available

Capt. Sumeet K Meraiya

Risk Assessment done by GANESAN SATHEESH - C/O Approved By

Task Commencement Time Task Completed Time

HAZARD IDENTIFICATION AND RISK ASSESSMENT WERE DISCUSSED / BRIEFED TO THE FOLLOWING CREW MEMBERS ( Applicable to level 2 RA only)

Name Rank Signature Name Rank Signature Name Rank Signature

2OFF UTKARSH 4E
BHARAT SATHESHKUMAR OS
SHEJEER NAZEER 3OFF HARINDER ETO AFSHAN OLR
AJIT S RATHORE 3OFF JEEVAGAN PMN BIJU OLR
CDT KIRAN
SATYAM AB JOMEN OLR
CE RAJA
BALWANT SINGH AB DATTA RAM CH.CK
2E SARABJIT
SRI CHANDRA AB DILIP BHIM GS
3E GANAPATHI
RAMESHKUMAR OS

Page I 20 SF-23
Original: Vessel
Copy: Synergy Edition No.3 / Rev.No. 2
Date: 06-Nov-23