Seapeak · SHI Geoje Shipyard · SP3180P / FM2391P
Near Miss Report
SN2656–2660 · LNG Newbuilding Project
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👤 Submitter
Complete all required fields and submit to the HSE representative.
A. General Information
Required
B. Severity & Potential Impact Assessment
Required
Refer to Incident and Near Miss – Severity Classification Matrix (SP1031G). Level 4–5 = High Potential — requires Site Manager & Project Manager involvement.
C. Near Miss Details
Required
Attach photos of hazards where possible without risking yourself (max 5 photos).
D. Root Cause Analysis
HSE / Investigation
Refer to Root Cause Tool (RF1476G). To be completed by Superintendent – HSE following investigation.
E. Corrective Actions & Closure
HSE / Site Manager
Closure required within 60 days of report date. Extension requires Site Manager approval.
Project Manager must approve closure by email. Attach email in SharePoint as objective evidence.
F. Audit Trail & Status History
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