DOCUMENT CODE

PMOA-AINRI-01132023

TITLE REVISION NO. PAGE

ACCIDENT/INCIDENT/NEAR MISS REPORT AND 0 1 OF 2
INVESTIGATION
PREPARED BY: REVIEWED BY: EFFECTIVITY DATE NEXT REVIEW DATE
01/12/2023
ROEL R. DOCENA REZON A. MANAL
CASCOR Safety Officer PPA Chief Safety Officer

DATE OF INCIDENT/TIME REPORT NO.

01/13/2023
LOCATION OF INCIDENT UNIT CONCERNED
TMO MASAO Roro Ramp

INJURY/ILLNESS PROPERTY DAMAGE OTHER ACTUAL OR POTENTIAL LOSS

INJURED’S NAME PROPERTY DAMAGE TYPE

N/A RORO ramp N/A
PART OF BODY DAYS NATURE OF DAMAGE COST
N/A LOST Crack N/A
N/A
NATURE OF INJURY/ILLNESS COST/ESTIMATED/ACTUAL NATURE OF LOST
N/A Waiting for the assessment N/A
OBJECT/EQUIPMENT/SUBSTANCE/INFLICTING OBJECT/EQUIPMENT/SUBSTANCE/INFLICTING OBJECT/EQUIPMENT/SUBSTANCE/RELATED
HARM HARM N/A
N/A Vessel ramp
PERSON IN MOST CONTROL OF ITEM PERSON IN MOST CONTROL OF ITEM PERSON IN MOST CONTROL
N/A Capt. Vincent Estoro- Vessel Master N/A
DESCRIBE HOW THE EVENT OCCURRED
At around 1050H of January 13, 2023, the operation supervisor, Alfredo Paler jr., along with SG Vestil LA, noticed the cracked portion of the
roro ramp concrete cement, where the ramp of the vessel being placed, friction of the vessel ramp to the roro ramp concrete cement causes
the minor cracks of the roro ramp, this incident happened while M/V Filipinas Butuan loading and unloading cargoes.

DEFINE IMMEDIATE CAUSES, WHAT SUBSTANDARD ACTION AND CONDITIONS CAUSED, COULD HAVE CAUSED OR CAUSE THE EVENT
1.Rough/Strong sea current and waves.

.
CODING OF IMMEDIATE CAUSES, CHECK ALL APPLICABLE
Substandard actions such as using defective equipment and improper lifting are common examples. Substandard conditions such as housekeeping
Restricted access and poor illumination are also common examples. Identify all those which had some bearing on the incident, then ask the question - WHY?

UNSAFE ACTIONS UNSAFE CONDITIONS

1. Operating equipment w/o authority  1. Inadequate guards of barriers

2. Failure to warn 2. Inadequate or improper protective equipment

3. Failure to secure 3. Defective tools

4. Operating at improper speed 4. Congestion or restricted action

5. Making safety device inoperable 5. Inadequate warning system

6. Removing safety devices 6. Fire and explosions hazards

7. Using defective equipment 7. Poor housekeeping disorder

8. Using equipment improperly 8. Hazardous environment conditions

gases, dusts, smokes, fumes, vapours
9. PPE properly
9. Noise exposure
10. Improper loading
10. Radiation exposure
 11. Improper placement

12. Improper lifting 11. High or low temperature exposures

13. Improper position for task 12. Inadequate or excess illumination

14. Servicing equipment 13. Inadequate ventilation

15. Horseplay

16. Under influence of alcohol and/or other drugs

*OTHERS

DOCUMENT CODE
PMOA-AINRI-01132023

TITLE REVISION NO. PAGE

ACCIDENT/INCIDENT/NEAR MISS REPORT AND 0 2 OF 2
INVESTIGATION
PREPARED BY: REVIEWED BY: EFFECTIVITY DATE NEXT REVIEW DATE
1/13/2023
ROEL R. DOCENA REZON A. MANAL
CASCOR Safety Officer PPA Chief Safety Officer

CORRECTIVE ACTION
What immediate action should be done to correct the incident/accident:
1. Report forwarded to CASCOR management and PPA.

DATE OF IMPLEMENTATION RESPONSIBLE PERSON(S) SIGN OFF WHEN COMPLETED

1/13/2023 CASCOR SO & Mgmt.
PREVENTIVE ACTION
What should be done to control the basic cause(s)?
1. Emphasize proper placement of vessel ramp relative to loading and unloading of cargoes.

DATE OF IMPLEMENTATION RESPONSIBLE PERSON(S) SIGN OFF WHEN COMPLETED

1/13/2023 CASCOR SO & Mgmt.
FOLLOW-UP/REVIEW OF EFFECTIVENESS

FINAL ACTION RESPONSIBLE PERSON SIGN OFF WHEN COMPLETED