INSPECTION CLOSED-OUT FORM

Ships Name
GRACE POSEIDON
(Nama Kapal)
Ship Owner/Operator PT. BAHARI NUSANTARA
(Pemilik/Pengelola Kapal)
Date | Port of Inspection
18 November 2021 BALIKPAPAN
(Tanggal | Pelabuhan Inspeksi)

Observation
VIQ / SSSCL Ref. (Temuan)

4.25 Annual performance test certificate of EPIRB was found expired on 29-04-2021
Root Cause Diketemukan Annual performance test certificate of EPIRB expired saat inspeksi
(Akar Masalah) diatas kapal.
Corrective Action Telah dilaksanakan Annual performance test EPIRB diatas kapal.
(Tindakan Perbaikan)
Preventive Action Mualim II agar segera melaporkan ke head office jika masa annual test EPIRB telah
(Tindakan Pencegahan)
mendekati masa expire.
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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