SEAQUEST SHIPMANAGEMENT Issue: 1/15.02.

2015
Approved:    QAR
SAFETY MANUAL Revision: 0/15.02.2015
Document: S-09 FORMS Page: 1 of 1

514052690.doc

REF:
MAINTENANCE DEFECT REPORT (Office Use)
Vessel: Report No: Issue Date:

Reported By: (Name / Position) Repair to be effected Repair Due :

 In Service  Urgent
 Out of Service  Routine (ASAP)
 Dry Dock  Next Dry Dock
Equipment Type, Location, Manufacturer and Serial No (as necessary) Defect identified by
 Third Party
 Company Staff
DESCRIPTION OF REPAIR SPECIFICATION ROOT CAUSE ANALYSIS
 Drawings / photographs / Sketches attached
PEOPLE RELATED
11 Lack of Personal Capability
12 Physical/mental stress
13 Lack of knowledge
14 Lack of Skills
15 Improper motivation
RESOURCES RELATED
21 Inadequate System Design
SPARES/SUPPLIES REQUIRED TO COMPLETE REPAIR (please indicate requisition Nos as applicable)
22 Inadequate Purchasing
23 Inadequate Maintenance
24 Inadequate tools/equipment
25 Normal wear and tear
MONITORING RELATED
31 Inadequate work standards
32 Inadequate Procedures
33 Inadequate Supervision
34 Inadequate Communication
35 Beyond Company’s Control
Auxiliary Work required (please Required Contractor Auxiliary Work Required Required Contractor
specify if required) Yes No Yes No (please specify if required) Yes No Yes No
Staging Sludge Removal / Disposal
Localised Cleaning for Hot Work Insulation Removal / Refit / Renew
Temporary Ventilation HP Washing
Temporary Lighting Grit Blasting
Cranage / Transportation Painting
Tank Washing Testing
Gas Freeing Access
INITIAL OFFICE FOLLOW UP / COMMENTS Date :

By:

Signature:

RELATED OFFICE STAFF REVIEW & COMMENTS Date :

Actions required to avoid recurrence Yes No N/A
Instructions to be forwarded to Vessel / Fleet Yes No N/A Review
Other (Specify) or comment: By:
Signature:

FINAL REVIEW & CLOSING OUT OF REPORT : Date:

 Above actions implemented satisfactory, report is CLOSED, records attached
 New Non Conformity/Deficiency Report Issued (report REF:____________)
Other comments : SM/DPA
Signature: