Accident Incident Near Miss Rpt Form
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ALAM MARITIM (M) SDN BHD
(394243-P)
ATTACHMENT 2.0 ACCIDENT/INCIDENT REPORT VESSEL: SETIA GAGAH
Date: 20.09.2007
Note:
It is the Master’s duty to see that this report is completed truthfully immediately after each accident / incident together with extract of the Official Log Book and any other information and forward these to the Company. Failure to comply with this instruction could involve the Master in either Marine Law or he may be held responsible for any consequences arising from the omission or delay in submitting this report. Type of Accident/Incident: Vessel Position: Lat: 05˚28.3’N Vessel Status: Steaming
Anchored
Date: 20.09.2007 Long: 105˚26.0’E Berthed
Other
√
Brief and accurate description of Accident/Incident: This accident happened while ship a/s Sarku samudera @ Tinggi A. At 2150 Hrs Sarku Samudera Giving instruction to a/s @ port side to lift last cargo from our vessel. Before that our ship just only Snatching to offload d/cargoes. While ship was in placed (a/side), suddenly ship was slightly pitching And rolling. This action was caused our ship hitting Sarku Samudera boat landing.
Probable causes: STRONG CURRENT AND HIGH SWEEL
No. of Person(s) Injured and Extend of Injuries:
NIL Damages to ship, gears, equipment, environment:
STEEL FENDER @ PORT SIDE (DENTED) Damage to 3rd Party’s:
Master’s Signature/Date/Stamp:
Form: AIR
Revision: 0
Witness Signature/Date:
Effective Date: 30.06.2007 Custodian: DPA/Master Page 1 of 1
PM-02-6
(394243-P)
ATTACHMENT 2.0 ACCIDENT/INCIDENT REPORT VESSEL: SETIA GAGAH
Date: 20.09.2007
Note:
It is the Master’s duty to see that this report is completed truthfully immediately after each accident / incident together with extract of the Official Log Book and any other information and forward these to the Company. Failure to comply with this instruction could involve the Master in either Marine Law or he may be held responsible for any consequences arising from the omission or delay in submitting this report. Type of Accident/Incident: Vessel Position: Lat: 05˚28.3’N Vessel Status: Steaming
Anchored
Date: 20.09.2007 Long: 105˚26.0’E Berthed
Other
√
Brief and accurate description of Accident/Incident: This accident happened while ship a/s Sarku samudera @ Tinggi A. At 2150 Hrs Sarku Samudera Giving instruction to a/s @ port side to lift last cargo from our vessel. Before that our ship just only Snatching to offload d/cargoes. While ship was in placed (a/side), suddenly ship was slightly pitching And rolling. This action was caused our ship hitting Sarku Samudera boat landing.
Probable causes: STRONG CURRENT AND HIGH SWEEL
No. of Person(s) Injured and Extend of Injuries:
NIL Damages to ship, gears, equipment, environment:
STEEL FENDER @ PORT SIDE (DENTED) Damage to 3rd Party’s:
Master’s Signature/Date/Stamp:
Form: AIR
Revision: 0
Witness Signature/Date:
Effective Date: 30.06.2007 Custodian: DPA/Master Page 1 of 1
PM-02-6
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