MANAGEMENT OF CHANGE
Dolphin Atlantic, Inc. — Safety Management System
SECTION 1
General Information
| 1. | MOC Number |
Generating…
Override:
|
| 2. | Date Initiated | |
| 3. | Initiator / Department | |
| 4. | Status | |
| 5. | Date Closed |
SECTION 2
Description of Change
SECTION 3
Justification for Change
| Event | Triggering Event Description | Category |
|---|
SECTION 4
Scope
Describe the breadth of the change: Departments/functions affected; Aircraft, systems, processes involved; External parties impacted.
| Department | Impacts / Functions Affected / Processes Involved / External Parties Impacted |
|---|
SECTION 5
Hazard Identification & Safety Risk Assessment
| Risk / Hazard | Consequence | Likelihood | Severity | Initial Risk | Mitigation / Control | Res. Likelihood | Res. Severity | Residual Risk | Status |
|---|
Risk Matrix Reference — SMS Manual §3.12 & §3.13
| Likelihood \ Severity | E — Catastrophic | D — Hazardous | C — Major | B — Minor | A — Negligible |
|---|
High: E5, D5, C5, E4, D4, E3
Medium: A5, B5, C4, B4, D3, C3, E2, D2, E1
Low: all others
SECTION 6
Safety Impact & Human Factors Assessment
SECTION 7
Risk Control Measures
List procedural or administrative controls, updated SOPs, checklists, or manuals. Link each control to the hazard it addresses.
| Hazard Ref | Risk Control | Risk / Hazard | Responsible Party | Due Date | Status |
|---|
SECTION 8
Stakeholder Approval / Sign-Off
SECTION 9
Communication Plan
Select all communication types that apply. Each type can have multiple entries -- use "+ Add" to log additional recipients, briefings, or instances.
REMARKS
Additional Remarks
SIGNATURE
Initiator Signature
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