An Thanh Nam Transport Co., Ltd.

Minh Phu Co.,Ltd Safety Management System

Initial Risk Assessment Worksheet ( Version 00 / 2023.12.04 ) Page : /

Ship Name : Record No. : Date :
Task Description of the targeted task Hazard associated with the
ID No targeted work with numerical ID
number
D07 Replenishing fresh water 1. Slip or fall cause injury
2. Connecting was not in good
order on joint’s pipe or plug,
resulting in the hose unsteady
moving
3. Oily deck cause pollution
3. Unsuitable pressure and tools
cause crew into danger
Safety measures already in place Significant risks Further assessment
Identified Y/N required Y/N
Crew should wear appropriate Low Risk N
protective clothing, safety helmet, non-
slippery boots / shoes.
Make sure all connection secured, then Low Risk N
open supply pump
1. Before replenishing fresh water, Low Risk N
check and clean all deck to prevent
pollution into sea.
2. Avoid pumping over-flow, and
always keep monitoring
Check frequently during replenishing Low Risk N
fresh water and keep pressure normal
and crew monitor always.

The use of this table, which must be combined with SMS with respect to paragraph of the risk assessment. Any work or operation planed shall first refer to the
paragraph of the SMS and envision what hazard may be associated. After that, you may judge whether the risk of activity is significant, if the identification code
appears “ No ” then go ahead for the work/operation, if “ Yes “ , then proceed to “ Detailed Risk Assessment and add more effective strengthening measures upon
the base of the measures already in the place until gaining the code of “ N “，otherwise captain shall report company and prohibit the work

Chief Officer : Chief Engineer : Master :