INSPECTION CLOSED-OUT FORM

Ships Name LPGC GAS AURORA

(Nama Kapal)
Ship Owner/Operator
PT. BAHARI NUSANTARA
(Pemilik/Pengelola Kapal)
Date | Port of Inspection 25 September 2021 Amurang
(Tanggal | Pelabuhan Inspeksi)

Observation
VIQ / SSSCL Ref.
(Temuan)
The operator’s representative or person familiar with the company’s SMS and
responsible for its implementation should visit the vessel approximately six-month
2.4
intervals, however there is no evidence that suprintendent has visit the vessel in the
last six months.
Root Cause Tidak diketemukan record suprintendent visit saat inspeksi diatas kapal.
(Akar Masalah)
Corrective Action Telah tersedia record suprintrendent visit diatas kapal.
(Tindakan Perbaikan)
Preventive Action Nahkoda agar tetap memastikan record suprintendent visit tetap tersedia diatas
(Tindakan Pencegahan) kapal.
Close-Out evidence might be; documents, procedures, photos, certificate, service report, delivery order, etc.)
(Bukti tindak lanjut dapat berupa; dokumen, prosedur, poto, sertifikat, laporan kerja, bukti pengiriman, dll.)

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 INSPECTION CLOSED-OUT FORM
Ships Name LPGC GAS AURORA
(Nama Kapal)
Ship Owner/Operator
PT. BAHARI NUSANTARA
(Pemilik/Pengelola Kapal)
Date | Port of Inspection 25 September 2021 Amurang
(Tanggal | Pelabuhan Inspeksi)

Page 2 of 2