Submit a Near Miss
Vessel
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ARCTIC HAWK
TUG ADMIRAL
TUG ALERT
TUG ATTENTIVE
TUG AWARE
TUG BULWARK
TUG CAVALIER
TUG CENTURION
TUG CHIEF
TUG COMMANDER
TUG CRUSADER
TUG ENDURANCE
TUG GAUNTLET
TUG GLADIATOR
TUG GOLIAH
TUG GUARD
TUG GUARDIAN
TUG GUARDSMAN
TUG GUIDE
TUG HUNTER
TUG INVADER
TUG KAVIK RIVER
TUG KUPARUK RIVER
TUG LEADER
TUG MARINER
TUG MARS
TUG MASTER
TUG NANUQ
TUG NAVIGATOR
TUG PROTECTOR
TUG PT BARROW
TUG PT OLIKTOK
TUG PT THOMPSON
TUG RANGER
TUG RESPONSE
TUG SAG RIVER
TUG SATURN
TUG SCOUT
TUG SEA BREEZE
TUG SEA HORSE
TUG SEA PRINCE
TUG SEA VENTURE
TUG SEA VICTORY
TUG SEA VOYAGER
TUG SPARTAN
TUG STALWART
TUG TANERLIQ
TUG TIOGA
TUG VALDEZ STAR
TUG VALOR
TUG VIGILANT
TUG WARRIOR
Home Port
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Anchorage
Valdez
Seattle
Bay Area
LALB
San Pedro
San Diego
Lake Charles
Jacksonville
Miami
Prudhoe Bay
Other
Person Submitting
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Date & Time (24hr)
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Month
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Day
Year
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Hour
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10
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30
40
50
Minutes
Description
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Primary Root Cause
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Please Select
Communication - Misunderstood
Communication - No Communication
Communication - Not Timely
Communication - Turnover Needs Improvement
Complex System - Monitoring Too Many Factors
Corrective Action Needs Improvement
Equipment - Not Available
Equipment - Controls Need Improvement
Equipment - Difficulty
Equipment - Display Needs Improvement
Equipment - Environment Not Considered
Equipment - Labels Need Improvement
Equipment - Maitenance Needs Improvement
Fatigue
Housekeeping
Human Performance Difficulty
Improperly Secured Gear
JSA/Personal Safety Check Not Performed
Lack of Oversight
Lack of Training
Natural Disaster / Sabotage
Non Fault Tolerant System
Oversight/Audits Need Improvement
Procedure - Followed Incorrectly
Procedure - Missing
Procedure - Needs Improvement
Procedure - Not Used/Followed
Quality Control
Tool Selection - Needs Improvement
Training Needs Improvement
Weather
Work Direction - Preparation Needs Improvement
Work Environment - Cramped Quarters
Work Environment - Crew Coordination Lacking
Work Environment - Lighting
Work Environment - Noise
Work Environment - Wet/Slick
Factors Preventing the Incident
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Please Select
CoWorker Involvement
Drills on Hazard
Equipment Inspection Program
Inspection Rounds
JSA
Preventative Maintenance Program
Procedures
Quality Control
Repeat Occurrence
Safety Meeting
Situational Awareness
Characteristics
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Please Select
Near Collision
Near Damage/Breakdown
Near Disruption of Operation
Near Fall Overboard
Near Fire/Explosion
Near Flooding
Near Grounding
Near Injury / Threatened Personal Safety
Near Loss of Tow
Near Pollution/Spill
Near Steering Loss/Propulsion
Safety Meeting Report
Unexpected Equipment Failure
Weather Factors
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Please Select
Dry/None
Fog
Gail Force Winds
Heavy Seas
Hurricane
Ice
Overcast
Rain
Snow
Windy
Injury/Risk Type
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Please Select
Abrasion
Amputation
Arm
Back
Body
Burn
Chemical Burn
Contusion
CTD
Cut Scrapes
Dermatitis
Ear
Electrocution
Equipment Damage
Eye
Foot
Finger
Hand
Head
Hearing
Heat
Hernia
Inhalation
Irritation
Knee
Laceration
Leg
Lungs
Neck
Pulls Strains
Puncture
Shoulder
Slips Trips Falls
Sprain
Strain
Tendonitis
Torso
Wrist
Location of Near Miss
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Please Select
Access/Egress
Bridge
Cargo Manifold
Confined Space
Deck Exterior
Deck Machinery
Engine Space
Fidley
Flamable Storage Locker
Galley
HEad
Interior Space
Lazarette
Stateroom
Storage Space
Wheelhouse
Operations During Near Miss
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Please Select
Access/Egress
Cargo Ops
Petro Ops
Confined Space Ops
Dockside
Drills/Training
Engine Room Maintenance
Exterior Maintenance
Forklift Ops
Fuel/Lube Transfer
Galley Work
General Operations
Inspections
Make/Break Tow
Mooring Ops Arrival
Mooring Ops Departure
Offshore Towing
Painting/Chemical Use
Power Tool Use
Security Rounds
Ship/Barge Assist
Supply/Grocery Ops
Tank Vessel Escort
Traffic
Underway - Light
Underway - Towing
Vessel Docking/Undocking
Waste Handling
Working Aloft
Immediate Action Taken
*
Long Term Preventative Action
*
Lessons Learned
*
Request Contact/Advice From:
SSQE
Marine Operations
Materials Management
Engineering
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