CEYLON SHIPPING CORPORATION LTD.

REVISION
HEALTH SAFETY SECURITY ENVIRONMENTAL NO : 01
DATE 30.03.16
MANAGEMENT SYSTEM
ISSUED : DPA
CORRECTIVE ACTION REQUEST CCF 008 APPROVED : TM

Ref. No.:…………………………………………..
To: Date:

NCR No.: CAR No.:

The problem:

Results of investigation/analysis:

Corrective action required:

Target date:

DPA Signature & date:

Action Taken:

Responsible person: Signature & date:

Verification by: Master/Chief Engineer/Superintendent (State evidence seen):

Satisfactory / Not Satisfactory

(Delete one) Verified by: Signature & date: