MSI SHIPPING SERVICES Form : 106

Page 1 of 6
Prepared By : HSSQE Revision 0 Date:15.06.2023
Approved By : Head of MSI

Probability / Consequence
RISK ASSESMENT Likelihood / Severity
Significant
Probability Insignificant Minor Major Critical
Ship Name Sr.No Description
Level (1) (2) (4) (5)
(3)
Very
1
Unlikely
1 2 3 4 5

Work Activity 2 Slight 2 4 6 8 10

3 Feasible 3 6 9 12 15

Hazard Identification Analyse/ Review Possible Consequences Controls Required 4 Likely 4 8 12 16 20

/Assess- What IF ?
5 Very likely 5 10 15 20 25
a. Select the expression for probability/likelihood which most applies to the hazard. (1st column)
b. Select the expression for consequence/severity which most applies to the hazard. (1st row)
Decision c. Cross reference using the above table to determine the level of risk. e.g. the probability/likelihood =
slight, and consequence/severity = Major, then risk level 8

Very Low Risk Acceptable Risk – Work Proceeds Normal – Risk Factor= <=2
Acceptable Risk – Work Proceeds Normal – Risk Factor=
Monitor / Review
Low Risk >2<=8
Implement
(Who is responsible / Next Review / By Whom) Medium Risk Acceptable Risk – Exercise Caution with these Hazards – Risk Factor= >8<=12
Unacceptable Risk – Work Cannot Proceed Till Further measures taken– Risk
High Risk
Factor = >12<=15
Has Office Concurrence Obtained for Risk Level of more than 15 (VERY HIGH Unacceptable Risk – Work Cannot Proceed Till Further measures taken– Risk
Very High Risk
Factor = >15
RISK) NO

Review Date Last Review dt: Routine / Non routine Severity & Likelihood Guide Click Here
Hazard Associated with Likely- Risk Additional Control Rqd
No. Possible Consequences Existing Controls / Safe Guards Severity
Activity hood Level (Y/N)
0 No
0 No
0 No
0 No
0 No
0 No
0 No
0 No
For Risk Level 15 and over, work must not be undertaken until Risk level is reduced to acceptable level; Office permission must be taken.
 MSI SHIPPING SERVICES Form : 106
Page 2 of 6
Prepared By : HSSQE Revision 0 Date:15.06.2023
Approved By : Head of MSI

Hazard Additional Controls to reduce risk as low as reasonably practicable Likely Responsible Remedial action due
Severity Risk
No hood Person date
(ALARP) for risk level more than 12 Date Completed
0
0
0
0
0
0
0
0
0
0
0
0

0 Chief Officer / Chief Engineer/Superintendent Master Date

Completed form to be filed in Ships File - Master 6.8
 SEVERITY TABLE

Event Category Severity (consequence)

First aid cases (FAC), e.g. cuts / wounds / bruises / sprains. Minor
People
Discomfort or ill Health.
Environment Spills contained on board and having no impact on environment
Insignificant
Minor Equipment Failure with insignificant consequences causing
Property
delay of less than 3 hours
Process No or very limited disruption. Financial Loss < $3000
Injuries including Medical Treatment Cases, Restricted Work
People
Cases / Temporary short term illness
Spill with little or no environmental impact. Low possibility that law
Environment would be broken and none or little possibility of damage to MSI’s
Minor reputation
Equipment failure with minor consequence, causing delay of 3
Property
hours to 1 day.
Minimal disruption to business activities. Financial Loss >$3,000 < $
Process
50,000
Severe injuries requiring hospitalization and repatriation, loss of
People body parts, major burns, permanent loss of sight in one eye. Work-
related disorders like asthma / Deafness.
Spill with Local environmental impact, moderate possibility that law
Environment
Significant broken and potential for long term impact
Fire, grounding or collision, equipment failure or the vessel being
Property
disabled for 1 day up to 1 week
Some significant disruption to business activities. Violations,
Process
Penalties or Fines. Financial loss >$50,000 <$500,000,
An Injury which results in loss of life, permanent disability or loss of
People sight in both eyes. Severe illness like Cancer or life shortening
diseases.
Spill causing Regional environmental impact, likely to receive
Environment
warning / fine and could affect reputation of MSI.
Major
Major incidents where there is major fire or explosion, significant
Property collision or grounding, major equipment failure, the vessel being
severely disabled more than 1 week to 1 month.
Major disruption to business activities. PSC Detention. Financial
Process
loss >$ 500,000 <$ 5 million

People Multiple fatalities. Severe illness (e.g. Cancer) to multiple personnel

Spill to water or atmosphere with pollution and major long term

Environment impact on the environment and could severely affect reputation of
MSI.
Catastrophic
Major fire or explosion, Collision or Grounding or stranding major
Property equipment / engine failure, the vessel being severely disabled
greater than 1 month
Severe disruption to business activities for an extended period.
Process
Financial loss >$ 5 million

LIKELIHOOD TABLE
A B
Likelihood of
Occurrence
Likelihood of
Occurrence Incident last
No. of incidents in Fleet
occurred on a ship
Very Likely < 3 months ago >50 /year
Likely 1 year ago 50 / year
Feasible 3 year ago 15 / year
Slight 5 year ago 5 / year
Very Unlikely > 5 year ago < 5 / year
Value

C
Value

5
4
3
2
1