Please fill out the below form to submit the Marine SWMS.
Marine SWMS
Date
Job Number:
CLIENT DETAILS
Company/Client Name:
*
Contact Number:
*
ADDITIONAL HAZARDS/SPECIAL PRECAUTIONS/CONTROL MEASURES (to be completed where review may be necessary to determine)
*
Yes
No
Hazard 1
Job Task Potential Hazard 1
Description of Hazard 1
Hazard 1 - Risk Likelihood
A Almost Certain
B Likely
C Possible
D Unlikely
E Rare
Hazard 1 - Risk Consequences
1 Insignificant
2 Minor
3 Moderate
4 Major
5 Catastrophic
Hazard 1 - Risk Score
L Low
M Moderate
H High
E Extreme
Hazard 1 - Control Measure (those provided and those required)
Hazard 1 - Control Measure Risk Likelihood
A Almost Certain
B Likely
C Possible
D Unlikely
E Rare
Hazard 1 - Control Measure Risk Consequences
1 Insignificant
2 Minor
3 Moderate
4 Major
5 Catastrophic
Hazard 1 - Control Measure Risk Score
L Low
M Moderate
H High
E Extreme
Hazard 1 - Responsible for verifying actions complete
Hazard 2
Job Task Potential Hazard 2
Description of Hazard 2
Hazard 2 - Risk Likelihood
A Almost Certain
B Likely
C Possible
D Unlikely
E Rare
Hazard 2 - Risk Consequences
1 Insignificant
2 Minor
3 Moderate
4 Major
5 Catastrophic
Hazard 2 - Risk Score
L Low
M Moderate
H High
E Extreme
Hazard 2 - Control Measure (those provided and those required)
Hazard 2 - Control Measure Risk Likelihood
A Almost Certain
B Likely
C: Possible
D Unlikely
E Rare
Hazard 2 - Control Measure Risk Consequences
1 Insignificant
2 Minor
3 Moderate
4 Major
5 Catastrophic
Hazard 2 - Control Measure Risk Score
L Low
M Moderate
H High
E Extreme
Hazard 2 - Responsible for verifying actions complete
Hazard 3
Job Task Potential Hazard 3
Description of Hazard 3
Hazard 3 - Risk Likelihood
A Almost Certain
B Likely
C Possible
D Unlikely
E Rare
Hazard 3 - Risk Consequences
1 Insignificant
2 Minor
3 Moderate
4 Major
5 Catastrophic
Hazard 3 - Risk Score
L Low
M Moderate
H High
E Extreme
Hazard 3 - Control Measure (those provided and those required)
Hazard 3 - Control Measure Risk Likelihood
A Almost Certain
B Likely
C Possible
D Unlikely
E Rare
Hazard 3 - Control Measure Risk Consequences
1 Insignificant
2 Minor
3 Moderate
4 Major
5 Catastrophic
Hazard 3 - Control Measure Risk Score
L Low
M Moderate
H High
E Extreme
Hazard 3 - Responsible for verifying actions complete
Hazard 4
Job Task Potential Hazard 4
Description of Hazard 4
Hazard 4 - Risk Likelihood
A Almost Certain
B Likely
C Possible
D Unlikely
E Rare
Hazard 4 - Risk Consequences
1 Insignificant
2 Minor
3 Moderate
4 Major
5 Catastrophic
Hazard 4 - Risk Score
L Low
M Moderate
H High
E Extreme
Hazard 4 - Control Measure (those provided and those required)
Hazard 4 - Control Measure Risk Likelihood
A Almost Certain
B Likely
C Possible
D Unlikely
E Rare
Hazard 4 - Control Measure Risk Consequences
1 Insignificant
2 Minor
3 Moderate
4 Major
5 Catastrophic
Hazard 4 - Control Measure Risk Score
L Low
M Moderate
H High
E Extreme
Hazard 4 - Responsible for verifying actions complete
Hazard 5
Job Task Potential Hazard 5
Description of Hazard 5
Hazard 5 - Risk Likelihood
A Almost Certain
B Likely
C Possible
D Unlikely
E Rare
Hazard 5 - Risk Consequences
1 Insignificant
2 Minor
3 Moderate
4 Major
5 Catastrophic
Hazard 5 - Risk Score
L Low
M Moderate
H High
E Extreme
Hazard 5 - Control Measure (those provided and those required)
Hazard 5 - Control Measure Risk Likelihood
A Almost Certain
B Likely
C Possible
D Unlikely
E Rare
Hazard 5 - Control Measure Risk Consequences
1 Insignificant
2 Minor
3 Moderate
4 Major
5 Catastrophic
Hazard 5 - Control Measure Risk Score
L Low
M Moderate
H High
E Extreme
Hazard 5 - Responsible for verifying actions complete
ACKNOWLEDGEMENT 1
Name 1
*
Signature 1
*
Clear
ACKNOWLEDGEMENT 2
Name 2
Signature 2
Clear
ACKNOWLEDGEMENT 3
Name 3
Signature 3
Clear
ACKNOWLEDGEMENT 4
Name 4
Signature 4
Clear
ACKNOWLEDGEMENT 5
Name 5
Signature 5
Clear
ACKNOWLEDGEMENT 6
Name 6
Signature 6
Clear
ACKNOWLEDGEMENT 7
Name 7
Signature 7
Clear
ACKNOWLEDGEMENT 8
Name 8
Signature 8
Clear
ACKNOWLEDGEMENT 9
Name 9
Signature 9
Clear
ACKNOWLEDGEMENT 10
Name 10
Signature 10
Clear
ACKNOWLEDGEMENT 11
Name 11
Signature 11
Clear
ACKNOWLEDGEMENT 12
Name 12
Signature 12
Clear
Submit
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