o

Safety Management System (SMS) Manual 

Kona International Airport at Keahole (KOA) 

January 2009

 

i 

Safety Management System (SMS) Manual 

Kona International Airport at Keahole 

Table of Contents

Section Page 

Introduction.................................................................................................... i 

i. Copyright ........................................................................................... ii 

ii. Control of SMS Documents............................................................... ii 

RECORD OF AMENDMENTS.................................................................... ii

1.0 SAFETY POLICY AND OBJECTIVES........................................... 1 

1.1 The Need for Safety Management Systems (SMS)............... 1 

1.2 HDOT-A Safety Policy (Mission) and Goals........................ 2 

1.3 Safety Objectives ................................................................... 3 

2.0 ORGANIZATION FOR SAFETY.................................................... 6 

2.1 Organizational Structure ........................................................ 6 

2.2 Safety Roles and Responsibilities.......................................... 6 

2.2.1 Airports Administrator............................................... 6 

2.2.2 SMS Safety Advisor................................................... 6 

2.2.3 Engineering Branch.................................................... 8 

2.2.4 Airports District Manager .......................................... 9 

2.2.5 SMS Safety Officer.................................................... 9 

2.2.6 Safety, Security and Certification Specialist.............. 10 

2.2.7 Airport Operations Control Section ........................... 10 

2.2.8 Maintenance Section .................................................. 11 

2.2.9 ARFF Section............................................................. 12 

2.2.10 District Engineer ........................................................ 12 

2.2.11 Air Traffic Control Tower.......................................... 12 

2.2.12 Tenants at the Airport ................................................ 12 

2.3 Airport Safety Committee...................................................... 13 

2.3.1 Roles and Responsibilities......................................... 13 

2.3.2 Membership of the Committee .................................. 14 

2.3.3 Airport Safety Committee Meetings.......................... 14 

2.4 Overview of Airside Safety Responsibilities......................... 15 

3.0 SAFETY RISK MANAGEMENT..................................................... 18 

3.1 Introduction............................................................................ 18 

3.2 Responsibilities...................................................................... 18 

3.3 The Safety Risk Management (SRM) Process....................... 19 

3.3.1 Identify the Hazard..................................................... 19 

3.3.2 Describe Existing Controls ........................................ 22 

3.3.3 Determine the Risk..................................................... 22 
 

ii 

Safety Management System (SMS) Manual 

Kona International Airport at Keahole 

Table of Contents (Cont'd.)

Section Page 

3.3.4 Evaluate the Risk ................................................................... 23 

3.3.5 Determine Action and Implement .......................................... 24 

3.3.6 Document the Safety Risk Assessment.................................. 26 

4. SAFETY ASSURANCE.................................................................... 27 

4.1 Introduction............................................................................ 27 

4.2 Employee Reporting System.................................................. 27 

4.3 Non-Punitive Reporting Policy .............................................. 28 

4.4 Trend Analysis....................................................................... 28 

4.5 Airfield Accidents and Incidents – Mandatory Reporting..... 29 

4.6 Accident Investigation ........................................................... 29 

4.7 Systematic Reviews ............................................................... 29 

4.8 Safety Oversight..................................................................... 30 

4.9 Safety Audits.......................................................................... 30 

4.10 Record Keeping...................................................................... 31 

5.0 SAFETY PROMOTION - COMMUNICATIONS........................... 32 

5.1 Safety Communication Policy ............................................... 32 

5.2 The Airport Safety Committee............................................... 32 

5.3 SMS Policies .......................................................................... 32 

5.4 SMS Manual .......................................................................... 32 

5.5 Safety Management Bulletins and Posters............................. 33 

5.6 AOA Employee Recognition ................................................. 33 

5.7 Safety Meetings...................................................................... 34 

5.8 Ramp Safety Campaign ......................................................... 34 

6.0 SAFETY PROMOTION – TRAINING............................................ 35 

6.1 Training Policy....................................................................... 35 

6.2 SMS Training......................................................................... 35 

6.3 Specialized Airside Tenant Safety Training .......................... 35 

List of Appendices 

Appendix 1.0: Risk Evaluation Guide 

Appendix 2.0: Employee Safety Report 

Appendix 3.0: Accident and Incident Report Form
Safety Management System 

Kona International Airport at Keahole 

i 

INTRODUCTION 

In February 2007 the Federal Aviation Administration (FAA) issued Advisory 

Circular, AC 150/5200-37, Introduction to Safety Management Systems (SMS) for 

Airport Operators, to introduce the concepts of Safety Management Systems 

(SMS). The FAA has also opened a rulemaking project to consider formal 

requirements for SMS at certified airports. In support of this rulemaking effort, 

the FAA has initiated a pilot program to assist selected airports in the 

development of an SMS specific to their situation and operations, and to share in 

the future their acquired experience on SMS development and implementation 

with other airports and the FAA. 

The State of Hawaii Department of Transportation Airports Division (HDOT-A) 

decided to take a leadership role in the development and implementation of SMS 

at the Kona International Airport at Keahole (KOA) by participating in the FAA 

pilot program. 

The FAA has specified that SMS should apply only to those areas of the airport 

that are subject to FARs Part 139 dealing with the airport’s airside Thus, the 

Safety Management System described in this document addresses aviation safety 

on the airside area of the airport. The SMS does not include safety within any 

rented, leased, or other space under the control of parties other than HDOT-A. It 

does not include any activities within the passenger terminal building and all 

landside areas of the airport. 

Furthermore, it does not include safety regulations and procedures relating to 

employee safety. These are addressed by the Hawaii Occupational Safety and 

Health (HIOSH) standards and HDOT-A’s Employee Safety and Health Program. 

The SMS Manual is a sub-set (supporting document) to the Airport Certification 

Manual (ACM). 
Safety Management System 

Kona International Airport at Keahole 

ii 

Safety Management System 

Kona International Airport at Keahole 

i. Copyright 

This manual and the information contained herein is the exclusive property of the 

State of Hawaii Department of Transportation Airports Division (HDOT-A). It 

must not be reproduced in whole or in part or otherwise disclosed to any third 

parties without the prior written consent from HDOT-A. 

ii. Control of SMS Documents

The SMS Safety Officer at KOA established under the Safety Management 

System (SMS) at the Airport shall be responsible for controlling the preparation, 

verification, revision and distribution of the SMS Manual and related SMS Forms. 

RECORD OF AMENDMENTS 

Amendment No. Subject Updated By Date 

08-001 1.2 Policy, page 2 KOA ADM October 29, 2008 

(example) 

 
Safety Management System 

Kona International Airport at Keahole 

1 

1.0 SAFETY POLICY AND OBJECTIVES 

1.1 The Need for Safety Management Systems (SMS) 

The intent of SMS is to improve aviation safety. The elimination of aviation 

accidents is a desirable goal. However, no human activity or human-made system 

can be guaranteed to be absolutely safe. Failures and errors will occur, in spite of 

best efforts to avoid them. Although major air disasters are rare events, a whole 

range of incidents occur more frequently. Ignoring these underlying safety 

hazards could pave the way for an increase in the number of more serious 

accidents. 

The air transportation industry’s future viability may well be predicated on its 

ability to sustain the public’s perceived safety while traveling. The management 

of safety is therefore a prerequisite for a sustainable aviation business. 

The application of SMS at an airport can contribute to this effort by increasing the 

likelihood that airport operators, and other stakeholders, will detect and correct 

airside safety problems before they result in an accident or incident. 

There are many clear benefits of establishing and implementing an SMS. These 

benefits include: 

a) Prevent and Reduce Injuries to Airline Passengers and Airport 

Personnel 

Properly planned and executed SMS anticipates and addresses safety issues before 

they lead to an incident or accident during airside operations that can injure 

passengers and employees working at the airport. An SMS also provides the 

management of the airport with the ability to deal effectively with aviation 

accidents and incidents so that valuable lessons are learned and applied to 

improve safety. 

b) Reduce the Economic Impact of Accidents 

The costs of a major accident at, or near, the airport, with injuries to people and 

damage to property, can threaten the financial viability of the airport. Direct costs 

are the obvious costs for rectifying, replacing or compensating for injuries and 

airport property damage. There are also other costs which may not be as obvious, 

may be delayed over time and may eventually be higher than direct costs. 
Safety Management System 

Kona International Airport at Keahole 

2 

These other costs could include: 

 Loss of revenues if flights are cancelled or airlines cease operations at the 

airport; 

 Legal and damage claims; 

 Cost of replacing and compensating injured employees; 

 Increased insurance claims or denial of insurance coverage; 

 Clean-up of the accident site; 

 Cost of internal and government investigations; and 

 Loss of use of equipment. 

1.2 HDOT-A Safety Policy (Mission) and Goals 

The Airports Administrator for the State of Hawaii has recognized the need for, 

and benefits of, an effective SMS for the Kona International Airport (KOA). 

It is HDOT-A policy to provide the highest reasonable standard of safety within 

KOA by identifying and minimizing those risks arising from airport activities 

which could contribute to aviation accidents and incidents. This is the mission of 

the SMS 

HDOT-A and the Airports District Manager (ADM) at KOA are committed to 

implementing SMS at KOA to achieve the following goals: 

 All KOA employees involved in airside operations will understand the 

hazards and risks in airside operations; 

 All KOA personnel involved in airside operations will receive proper initial 

and recurrent training to do their jobs safely in order to protect themselves, 

other workers, passengers, cargo, aircraft and equipment; 

 Proper procedures and adequate equipment and facilities will be in place for 

safety; 

 All KOA employees will be able to report aviation safety concerns, issues, 

incidents and accidents without fear of negative personal consequences or 

reprisal; 

 When safety concerns are identified, they will be analyzed and appropriate 

action will be taken through a safety risk management process; 

 All KOA employees working airside will be updated on safety issues by their 

management; 
Safety Management System 

Kona International Airport at Keahole 

3 

 Safety information will be effectively exchanged among all key tenants at 

KOA; and 

 Continual improvements to airside safety will be made. 

The means to achieve these goals are addressed through subsequent sections 

dealing with SMS processes. 

Furthermore, HDOT-A will continue to adopt explicit safety standards which 

comply with statutory obligations and meet, or exceed, FAA regulations and 

standards. 

HDOT-A will develop a culture among all managers and staff which fosters an 

increasing understanding of the importance of safety in all of its activities and the 

resultant responsibilities of each individual. HDOT-A will provide the 

environment, support and training necessary to achieve this goal. 

1.3 Safety Objectives 

Safety objectives are measurable targets that provide direction and guidance for 

safety management activities. The safety objectives to be implemented for the 

first year of operations under SMS are as follows: 

1. Safety hazards identified during airport self inspections: In the first year, 

KOA will collect and analyze relevant data through trend analysis (e.g., type 

and quantity of Foreign Object Debris (FOD) and then set objectives each 

succeeding year (e.g., enhanced FOD reduction program in cargo area). 

2. Airside safety violations: KOA will develop and approve an enforcement 

program, train all Airport, tenant and contractor personnel operating on the 

Airport Operating Area (AOA) to ensure that they are aware of the 

enforcement program, and implement the enforcement program. 

3. Aircraft bird strikes: KOA’s wildlife control contractor will record the actual 

number of bird strikes as a baseline. KOA will monitor developments near or 

on airport lands and review and approve related development plans to limit the 

potential of bird strikes. 

4. Incursions of vehicles, aircraft, or pedestrians on movement areas: With a 

reported one incursion in the past four years, the objective is to not to have 

any incursions. 

5. Number and type of accidents and incidents on the AOA including the 

controlled movement area involving air carrier aircraft and/or ground 

vehicles: This has not been an issue at KOA but activities on the congested 

ramp provide the potential for accidents. KOA will remind all operators on 
Safety Management System 

Kona International Airport at Keahole 

4 

the ramp of hazards and safety by conducting annual safety meetings. KOA 

will also implement an Enforcement Plan for Airside Operations (as per 

Objective 2). 

6. Operable time of lighting systems: As per the targets in the ACM, Section 14, 

KOA will collect the relevant data, store on a data base and produce quarterly 

and annual reports outlining to what extent the targets have been achieved. 

7. Training: KOA will record the number of airside based employees who have 

received safety and SMS related training and maintain a record in each 

employee’s personnel file. KOA will receive from the managers of airlines, 

fuelers or other firms operating on the AOA a record of any additional safety 

training provided by the companies to further safety on the ramp. 

8. Non-punitive safety reports: The objective in the first year is to implement 

non-punitive reporting and determine how well it works, and then to suggest 

and implement possible improvements for year two. 

9. Safety Risk Management: The objective in the first year is to conduct safety 

risk assessments of specific safety concerns and issues raised during the 

development of the SMS Manual. The action plans resulting from these 

assessments will be prioritized for action. Safety Risk Management 

procedures are detailed in Section 3. 

The sources of the data related to these objectives include the following: 

1. Trends in Airport Self 

Inspections 

Airport Maintenance 

2. Airside Safety Violations Airport Operations Control 

3. Aircraft Bird Strikes Air Traffic Control 

4. AOA Incursions Air Traffic Control 

5. Accident and Incidents on the 

AOA 

Airport Operations Control 

6. Operable Time of Lighting 

Systems 

Airport Maintenance 

7. Training Airport Operations Control 

8. Non-Punitive Reporting The SMS Safety Officer 

9. Safety Risk Management and 

Safety Action Plans 

The SMS Safety Officer 

The process for the annual update of these objectives includes the following steps: 

1. The SMS Safety Officer meets with other KOA managers to review the 

achievements of measurable objectives and to determine which objectives are 
Safety Management System 

Kona International Airport at Keahole 

5 

still relevant, how they should be revised and what new objectives may be 

required to address new safety concerns. 

2. The annual review includes the analysis of trends in self-inspections, bird 

strikes, incursions and accidents/incidents to determine if action is needed to 

reverse negative trends and make improvements. Measurable objectives for 

example would be to reduce incidents of wildlife on the airfield by 10%, 

decrease violations by 20% while maintaining diligent surveillance. 

3. The setting of objectives should determine the sources of the data to be 

collected to measure achievement of the objectives and who will be 

responsible for collecting and reporting the data to the SMS Safety Officer. 

4. The objectives and data collection schemes should be documented for 

approval by the Airports District Manager. 

5. The SMS Safety Officer then monitors actual performance in meeting the 

approved objectives. 
Safety Management System 

Kona International Airport at Keahole 

6 

2.0 ORGANIZATION FOR SAFETY 

2.1 Organizational Structure 

Responsibility for safety at KOA includes both the Airports Division and KOA 

organizations. The organizational structures for safety at the Airport Division and 

KOA are depicted in Exhibits 2.1 and 2.2. 

2.2 Safety Roles and Responsibilities 

This section describes the role and responsibilities of key participants at the 

Airports Division and KOA for aviation safety. 

2.2.1 Airports Administrator 

The responsibilities of the Airports Administrator for SMS include: 

 Approval of SMS safety policies and SMS plans for each State airport; 

 Periodic reviews and updates of HDOT-A SMS safety policies; 

 Ensuring that financial and human resources required for proper execution of 

SMS are available at airports in Hawaii; and 

 Appointment of a SMS Safety Advisor at the Division. 

2.2.2 SMS Safety Advisor 

The SMS Safety Advisor is responsible for: 

 Providing advice to airport SMS Safety Officers and the Divisional 

Engineering Branch on SMS practices particularly the hazard identification 

and safety risk assessment process; 

 Providing advice in the data bases that should be established for State of 

Hawaii airports for conducting trend analysis of safety concerns, hazards, 

incidents and accidents; 

 Providing advice to airport SMS Safety Officers on establishing and updating 

airport SMS including safety objectives; 

 Developing SMS and related safety training material and programs that can be 

used by State airports; 
Safety Management System 

Kona International Airport at Keahole 

Exhibit 2.1. Division Organization Structure 

AIRPORTS DIVISION 

Airport Administrator 

OAHU 

DISTRICT 

MAUI 

DISTRICT 

ENGINEERING BR ANCH 

Engineering Programs 

Manager 

STAFF 

SERVICES 

BRANCH 

INFORMATION TECHNOLOGY 

OFFICE 

VISITOR 

INFORMATION 

PROGRAM OFFICE 

ARFF ST AFF 

Airports Fire Chief 

CERTIFICATION, 

SECURITY & SAFETY 

STAFF 

Cert, Securit y, & Safet y 

Specialist 

SMS SAFETY 

 ADVISOR 

AIRPORTS 

OPERAT ION OFFICE 

Airports Operation s 

Offi

GENERAL AVIAT ION 

STAFF 

General Aviation Officer 
Safety Management System 

Kona International Airport at Keahole 

8 

 Monitoring implementation of the SMS at each airport; 

 Conducting periodic audits of the safety plans and programs of tenants at 

HDOT-A airports; 

 Developing and implementing SMS programs at smaller HDOT-A airports; 

and 

 Collecting relevant safety information from each airport and preparing a 

corporate safety report annually. 

Exhibit 2.2. KOA Organization Structure for Safety 

2.2.3 Engineering Branch 

The Engineering Branch is responsible for conducting formal hazards 

identification and safety risk management assessments whenever new equipment 

AIRPORTS 

DISTRICT MANAGER 

ASSISTANT

AIRPORT SUPERINTENDENT DISTRICT ENGINEER

SAFETY, SECURITY & 

CERTIFICATION SPECIALIST 

ARFF SECTION 

Airport Fire 

Commander 

OPERATIONS 

CONTROL SECTION 

Ops. Control 

Superv isor 

MAINTENANCE 

SECTION 

General Construction 

& Maintenance 

Superv isor

FAA AIR TRAFFIC 

CONTRACT

SMS SAFETY OFFICER 
Safety Management System 

Kona International Airport at Keahole 

9 

is being planned or installed, or when new facilities are being constructed that 

may have an impact on safety at FAR Part 139 airports in Hawaii. 

2.2.4 Airports District Manager 

The responsibilities of the Airports District Manager (ADM) for SMS at KOA 

include: 

 Approval of safety policy and goals; 

 Approval of the SMS for KOA; 

 Chairing the Airport Safety Committee; 

 Approving Safety Action Plans if beyond the authority of the manager 

responsible for taking action; 

 Periodic reviews and updates of the SMS, safety policy and goals for KOA; 

and 

 Deploying financial and human resources, within the ADM’s control, for 

proper execution of the SMS. 

2.2.5 SMS Safety Officer 

This person is responsible for administering and implementing the SMS at KOA. 

The role of the SMS Safety Officer in administering and implementing SMS is as 

follows: 

 Participating in the Airport Safety Committee, as the Secretariat; 

 In consultation with other KOA managers, develop and propose annual safety 

objectives for approval by the Airports District Manager; 

 Measuring safety performance in relation to safety objectives; 

 Taking the lead role in safety risk management assessments of hazards, 

incidents and accidents to determine action required; 

 Conducting trend analysis of safety concerns, hazards, incidents and accidents 

and determining action required, in consultation with other airport staff; 

 Ensuring appropriate action is taken in response to safety concerns, hazards, 

incidents and accidents; 

 Keeping records of all safety related reports, incidents and accidents, and 

conducting trend analysis; 

 Providing and coordinating safety promotion; 

 Ensuring the provision of safety training for airport employees and tenants 

located or working in the AOA; 
Safety Management System 

Kona International Airport at Keahole 

10 

 Implementing a non-punitive reporting system; 

 Ensuring that safety audits are conducted when required; 

 Controlling the preparation, verification, revision and distribution of the SMS 

Manual and related SMS Forms; and 

 Annual review of the safety policy and safety objectives. 

2.2.6 Safety, Security and Certification Specialist 

The Safety, Security and Certification Specialist is responsible for participating in 

FAA certification inspections and ensuring correction of deficiencies. He is also 

responsible for implementing the Employee Health and Safety Program at KOA 

and ensuring the Kona meets security regulations as set out by the Transportation 

Security Agency. 

This person should participate in the Airport Safety Committee. 

2.2.7 Airport Operations Control Section 

Key duties of the Airport Operations Control Section that have an impact on 

aviation safety are listed below: 

 Conducting inspections of the runways, taxiways, ramps and aprons to check 

for FOD, wildlife, obstructions and other hazardous conditions; 

 Patrols of airport operational areas to monitor and control, as required, the 

movement of aircraft, vehicles and support personnel; 

 Staffing and operating the Airport Operations Control Center; 

 Assigning aircraft to gates when required (e.g., when a preferential gate is 

occupied as a result of delays in departures of another aircraft or early 

arrivals); 

 Distributing Notice to Airmen (NOTAMs). These may be prepared by the 

District Airport Manager, the Airport Operations Supervisor or the General 

Construction and Maintenance Supervisor; 

 Supervising contract security services who: 

 Implement the airport badging and vehicle identification program, and 

related driver training and testing described subsequently; 

 Conduct perimeter patrols; and 

 Provide terminal, landside and airside policing. 

The role of the Airport Operations Control Section in administering and 

implementing the SMS would include: 
Safety Management System 

Kona International Airport at Keahole 

11 

 Participating in the Airport Safety Committee; 

 In consultation with the SMS Safety Officer, set annual safety objectives and 

provide relevant performance data to the SMS Safety Officer; and 

 Participating in Safety Risk Management Assessments as and when required 

per Section 3. 

2.2.8 Maintenance Section 

The Maintenance Section has important responsibilities that impact aviation 

directly. It is responsible for: 

 Maintaining the concrete and asphalt integrity of all runways, taxiways and 

ramp to provide a high level of physical safety; 

 Daily, weekly, monthly and random inspections of runways and taxiways, 

beacon and wind sock, airfield lighting, fencing and vegetation growth; 

 Implementing wildlife control on the AOA if and when required; 

 Maintaining runway and taxiway paint markings; 

 Runway rubber removal maintenance to comply with FAA standards; 

 Monitoring all runways, taxiways, and ramps for prevention of FOD 

accidents; 

 Maintaining service roadway system to provide easy access around the airfield 

without interfering with air traffic; 

 Installation, cleaning and replacement of signs on all AOA and access roads 

for safety to prevent vehicle and aircraft accidents; 

 Maintaining the perimeter fence line to prevent wildlife from entering the 

AOA to provide for safe aircraft operations; 

 Maintaining all airfield lighting for runways, taxiways, and ramps for safe 

aviation operations; and 

 Maintaining emergency generator for airfield lighting. 

For SMS, the Maintenance Section’s responsibilities include: 

 Participating in the Airport Safety Committee; 

 In consultation with the SMS Safety Officer, set annual safety objectives and 

provide relevant performance data to the SMS Safety Officer; 

 Participating in Safety Risk Management Assessments as and when required 

per Section 3.0; and 

 Reporting on the status of repairs tied to work order system. 
Safety Management System 

Kona International Airport at Keahole 

12 

2.2.9 ARFF Section 

The Aircraft Rescue and Fire Fighting (ARFF) Section is responsible for ensuring 

ARFF training and operations at the airport in accordance with FAA regulations. 

ARFF personnel are also responsible for conducting inspections of fuel 

farm/storage and mobile fuelers in accordance with FAR Part 139. Furthermore, 

they are responsible for reporting aircraft incidents when the ATC tower is not in 

operation. 

For SMS, ARFF’s responsibilities would include: 

 Participating in the Airport Safety Committee; 

 In consultation with the SMS Safety Officer, set annual safety objectives (e.g., 

fueling inspections) and provide relevant performance data to the SMS Safety 

Officer; and 

 Participating in Safety Risk Management Assessments as and when required 

per Section 3. 

2.2.10 District Engineer 

The District Engineer is responsible for monitoring and inspecting the work of 

contractors and vendors and ensuring that they follow construction practices that 

provide safe airside operations. As part of SMS, the District Engineer will 

participate in the Airport Safety Committee and Safety Risk Management 

assessments. If appropriate, he will also participate in the annual setting of safety 

objectives. 

2.2.11 Air Traffic Control Tower 

The FAA contracted Air Traffic Control tower is responsible for air traffic control 

at and near the airport from 6:00 AM to 10:00 PM, as well as vehicle control on 

the movement areas through prescribed protocols. As part of SMS, they will 

report all incursions on the movement areas to the SMS Safety Officer. They also 

participate in the Airport Safety Committee and participate in KOA’s Safety Risk 

Management assessments when the assessments deal with hazards or incidents on 

the movement areas. 

2.2.12 Tenants at the Airport 

Tenants at KOA such as the airlines, general aviation and FBO’s have full 

accountability and authority for safety within their respective area of operation. 

As part of their safety responsibilities, air carriers are required to have in place 

safety training and safety plans subject to audit by KOA. 
Safety Management System 

Kona International Airport at Keahole 

13 

2.3 Airport Safety Committee 

2.3.1 Roles and Responsibilities 

With regard to safety, the Airport Safety Committee is a body of expertise to 

address and provide advice on safety issues at KOA. 

The specific terms of reference for the Airport Safety Committee regarding 

aviation safety are as follows: 

1. Provide a forum to discuss aviation safety matters affecting the Airport and its 

users; 

2. Help identify hazards and risks and advise on safety measures to improve 

safety, for example; 

- apron congestion 

- FOD 

- airside vehicle operations 

- noise and jet blast 

3. Review safety practices and procedures and recommend any necessary 

changes, for example: 

a. Revised vehicle operating procedures or vehicle lanes 

b. Escorts of arriving and departing passengers 

c. Revision of training frequency and implementation of refresher training 

4. Review airport safety rules (regulations); 

5. Review reports on safety hazards/risks, incidents and accidents and action 

taken, or proposed; 

6. Review audit reports and action taken or proposed; 

7. Provide advice on methods to develop and promote apron safety awareness 

initiatives, such as poster campaigns and safety presentations/exhibitions; 

8. Promote airside discipline; 

9. Provide advice on safety measures to be incorporated in airport expansions or 

modifications; and 

10. Review any runway incursions and recommend any changes to operating 

procedures. 

The existence of the Airport Safety Committee does not substitute for the safety 

management arrangements made by individual organizations represented on the 

committee. 
Safety Management System 

Kona International Airport at Keahole 

14 

2.3.2 Membership of the Committee 

The Airport Safety Committee (ASC) consists of senior managers representing 

their organizations with the capacity to make decisions and deploy resources. The 

following organizations are included: 

 The Airports District Manager (Chairperson); 

 The SMS Safety Officer (Secretary); 

 The Maintenance Supervisor; 

 The Safety, Security and Certification Specialist; 

 The Operations Supervisor; 

 The District Engineer; 

 The ARFF Fire Commander; 

 The Control Tower Manager; 

 The station managers for the major airlines at KOA; 

 A member of the general aviation (GA) tenant community (GA Council); and 

 A manager from each of the fixed based operators (FBO’s). 

2.3.3 Airport Safety Committee Meetings 

At KOA, there is an Airport Operators Committee (AOC) that meets monthly and 

includes many of the same members as the ASC. The members of this committee 

meet at least quarterly to deal solely with safety issues as described above. and the 

committee is then designed the ASC for that purpose. It is anticipated that the 

FAA will periodically review the minutes of the ASC as part of its role in 

ensuring effective implementation of the SMS. The ASC may meet more 

regularly if warranted and called for by any one member. 

The Airport Safety Committee (ASC) is chaired by the Airports District Manager. 

The SMS Safety Officer will provide Secretariat services to the committee. 

The SMS Safety Officer will prepare and distribute meeting agendas in a timely 

manner together with any relevant papers for members’ consideration. All 

members may submit potential agenda items. 

There will be a full distribution of minutes of meetings. Any actions arising from 

meetings will be annotated in the Minutes and these action items will remain in 

the minutes until the required action is completed. The SMS Safety Officer will 

monitor action items being taken and review progress made by those responsible 

for taking action. 
Safety Management System 

Kona International Airport at Keahole 

15 

The Committee may from time to time establish and nominate special Working 

Groups to consider and report on particular safety issues such as FOD, bird strikes 

and apron congestion. 

2.4 Overview of Airside Safety Responsibilities 

Everyone working airside has a role to play in ensuring the safety of people, 

aircraft, vehicles and equipment. For example, anyone working airside should 

report any potential hazards that they see. 

A summary of key responsibilities and accountabilities for airside safety have 

been listed for KOA Management, ATC, the airlines, ground handlers, fixed base 

operators and fueling companies in Exhibit 2-3. The list is meant to provide for 

illustrative purposes only and may not capture all aviation activities on the AOA. 
Safety Management System 

Kona International Airport at Keahole 

16 

Exhibit 2.3. Key Responsibilities and Accountabilities 

Airport Infrastructure and 

Services 

Aircraft Operations Passenger Movement

KOA Management, Operations & Maintenance 

Provide safe infrastructure and services including: - well maintained runways, 

aprons, taxiways and other maneuvering areas, and equipment 

- fully functioning runway, 

taxiway and apron lighting 

- runway and apron markings and 

signage 

Ensure wildlife and bird control. Provide adequate apron flood lighting. Ensure provision of adequately trained and equipped Emergency Fire and Response services. Implement Safety Management System. Safe storage of hazardous materials. Sweep runways as required. Safe construction of facilities. Report to FAA on condition of movement areas. Daily inspections of FOD on runways, taxiways and aprons. 

Observe that safe practices are being followed. Pickup any FOD. Provide and empty FOD bins. Provide safety vests to all HDOT-A airport airside employees. Provide noise protection to airport employees. Ensure that all airside personnel are using safety vests and ear protection. 

Support airlines in passenger movements by monitoring guidance provided by airlines/grouhandling firm agents 

Airport ATC Report on conditions of the 

movement area and related areas to the SMS Safety Officer. Monitor hazard beacons and airside lights and report outages 

Provide guidance for aircraft landing and departure. Control aircraft movement on airfield movement area. 
Safety Management System 

Kona International Airport at Keahole 

Exhibit 2.3. Key Responsibilities and Accountabilities (Cont’d.) 

 Airport Infrastructure and 

Services 

Aircraft Operations Passenger Movemen

Airlines, Ground Handlers, aircraft owners & FBOs 

Report any safety concerns or potential hazards to SMS Safety Officer

Servicing of the aircraft. FOD inspections on aprons. Pickup any FOD. Provide safety vests, noise protection and other safety equipment to employees. Pilot in Command has overall responsibility for safety of aircraft and passengers. Ensure that cell phones are not used within 50 feet of a refueling aircraft Enforce no smoking on apron with employees and passengers Remove garbage and grooming waste from apron as soon as possible after collection Employees are not to run on apron Provide training of marshallers Ensure that marshallers are in place at least 5 minutes before commercial aircraft arrival Marshall aircraft in and out of parking stands. 

Lead passengers safely and from aircraft by moexpeditious and safe roueither to the terminal or passenger bus. Monitor passenger route aircraft and report/correany hazards that may develop. Warning passengers not run, to walk in designatareas, not to smoke, not use cell phones within 5feet of refueling operations, not to throw trash, etc. Monitor passenger movement prior to aircrengine start and aircraft movement. 

Fueling Companies 

Report any safety concerns or potential hazards to airport SMS Safety Officer. 

Provide training in safe fueling of aircraft. Establish and implement policies and practices for safe fueling and fuel storage. Pickup any FOD. Clean up small fuel spills. Reporting large fuel spills more than 5 gallons to KOA. Where more than one vehicle is used ensure that the operations are coordinated. 

 
Safety Management System 

Kona International Airport at Keahole 

18 

3.0 SAFETY RISK MANAGEMENT 

3.1 Introduction 

Risk is a by-product of doing business. Not all risks can be eliminated, nor are all 

conceivable risk elimination measures economically feasible. The risks and costs 

inherent in aviation require a rational process for decision-making. Daily, 

decisions are made in real time, weighing the probability and severity of any 

adverse consequences implied by the risk against the expected gain of taking the 

risk. This process is known as “risk management”. For the purposes of this 

manual, risk management can be defined as follows: 

 Risk management. The identification, analysis and elimination (and/or 

mitigation to an acceptable or tolerable level) of those hazards, as well as the 

subsequent risks, that threaten airport operations. 

In other words, risk management facilitates the balancing act between assessed 

risks and viable risk mitigation. Risk management is an integral component of 

safety management. It involves a logical process of objective analysis, particularly 

in the evaluation of the risks. 

The Safety Risk Management (SRM) process is important because it can: 

 Minimize the risk of an accident before any harm is done; 

 Supply useful information for the development and implementation of 

measures to control safety and minimize the possibility of accidents; 

 Determine if existing or planned safety measure are adequate; and 

 Provide KOA and HDOT-A management with valuable information about 

potential hazards and dangers that may be under estimated or overlooked in 

daily operations. 

3.2 Responsibilities 

KOA’s SMS Safety Officer will take the lead role in Safety Risk Management 

(SRM) analysis for operational issues at KOA. The SMS Safety Officer will enlist 

other KOA staff, selected tenants and ATC where appropriate to provide a wide 

perspective and expertise in conducting the SRM analysis. A committee should be 

created where warranted. This committee would be designated the Safety Risk 

Assessment Team. 

The District Engineer will be responsible for conducting Safety Risk Management 

when new facilities, equipment or systems are planned or being installed. The 
Safety Management System 

Kona International Airport at Keahole 

19 

District Engineer will work with the Engineering Project Manager at the Division 

where appropriate. Additionally, the District Engineer will keep the SMS Safety 

Officer informed of these projects 

3.3 The Safety Risk Management (SRM) Process 

The SRM Process is summarized schematically in Exhibit 3.1 and described 

below. 

Exhibit 3.1. Safety Risk Management Process 

3.3.1 Identify the Hazard 

A hazard is an event, condition or situation that could result in an accident 

involving aircraft, equipment and people. 

Identify The Hazard 

An event, condition on situation that 

could cause an accident 

Describe Existing Controls 

Procedures, rules, equipment, 

systems 

Determine The Risk 

Consequences of an accident. 

Likelihood of the accident 

Ev aluate The Risk 

Acceptable or not 

Document 

Determine Action and 

Yes Implement 

No 
Safety Management System 

Kona International Airport at Keahole 

20 

There are numerous ways to identify hazards. The mechanisms at KOA include 

the following: 

1. As a result of aviation safety concerns raised by the Airport Safety Committee 

(ASC) that requires further analysis before action can be taken. For example, 

the ASC concludes that established practices, procedures, equipment or 

facilities are not as safe as they could be, but further analysis is deemed 

necessary before taking action. 

2. In response to safety issues identified during safety meetings with KOA 

employees. 

3. Trend analysis conducted by the SMS Safety Officer. More specifically a 

negative trend in safety significant data indicates a possible hazard. (See 

Section 4.4 for more detail). 

4. Employee Safety Reports. The identification of hazards is the responsibility 

of all airport employees and organizations. (Section 4.3). 

5. As the result of a significant accident or incident. 

The Safety Risk Management Process will also be applied when: 

1. The airport is undergoing significant change such as increases in air services 

or contraction in services; 

2. Major changes are planned, including changes to equipment, runways and 

taxiways, airfield systems, key personnel, ground operations, air traffic 

control operations, staffing levels, etc; 

3. When new equipment or systems are being installed; and 

4. When new facilities are going to be constructed on the airside. 

The identification of hazards needs to consider a wide range of factors that may 

not be immediately obvious including: 

 Design factors, including equipment and task design; 

 Procedures and operating practices, including their documentation and 

checklists, and their validation under actual operating conditions; 

 Communications, including the medium, terminology and language; 

 Personnel factors, such as policies for recruitment, training and remuneration; 

 Organizational factors, such as the compatibility of operational and safety 

goals, the allocation of resources, operating pressures and the corporate safety 

culture; 

 Work environment factors, such as ambient noise and vibration, temperature, 

and lighting; and 
Safety Management System 

Kona International Airport at Keahole 

Exhibit 3.2. Potential Airside Hazards 

Aircraft Operations and Servicing 

Vehicle Operations Actions of Individuals Airport Infrastructure a

Services 

 Jet blast and noise  Prop wash  Fuel spills  Grounding  Bonding  Spills  Improper parking  Improper marshalling  FOD  Apron  Congestion  Noise  Lack of protective 

pylons around aircraft 

 Lack of chocks when 

aircraft parks 

 Disposal of grooming 

waste 

 Taxiing too fast  Failure to respond to 

ATC directions 

 Erratic driving  Driving too fast  Mechanical Condition  Condition of brakes, 

tires 

 Improper parking  Parking in aircraft 

operations areas 

 Blocking fuel truck 

when fueling 

 Improper grounding of 

equipment 

 Leaving vehicle 

unattended and engine running 

 Lack of hazard lights  Lack of radios or 

communication equipment 

 Lack of coordination 

between vehicles during aircraft servicing 

 Lack of reverse alarms  Lack of guidance on 

reversing 

 Failure to yield right of 

way to aircraft and pedestrians 

 Oil spills on apron 

and/or in passenger walkways 

Employees  Running on ramp  Lack of safety protective equipment  Riding baggage carts  Riding in rear of pick-up trucks  Lack of training  Using equipment in an improper 

manner 

 Ignoring aircraft hazard beacons  Improper checking around aircraft 

during departure marshalling 

 Ignorance of meaning of apron 

markings 

 Smoking on ramp  Use of cell phone within 50 feet of a 

refueling operation 

 Improper guidance to passengers  Throwing trash and/or equipment on 

apron 

 Failure to use FOD bins  Under the influence of drugs or alcohol Passengers  Failure to follow guidance  Wandering on apron  Smoking  Use of cell phone within 50 feet of a 

refueling operation 

 Throwing trash on apron  Running on apron Others  Individuals on airside without 

authority 

Airport facilities  Poor runway condition  Poor apron condition  Failure of one or all runwa

lights 

 Poor illumination of apron 

lights 

 Lack of FOD bins  Lack of fire extinguishers  Lack of training for staff  Poor apron marking visibi Construction on airside 

Fire Service 

 Lack of training in aircraft 

fighting 

 Lack of appropriate equipm

for fuel/aircraft fires

 Lack of training in fuel 

facilities

Maintenance Garage  Improper storage of hazard

materials 

 Improper storage of equipm

and supplies 

 Lack of vehicle maintenanAir Traffic Control  Obstruction to visibility of 

movement areas 

 Lack of visibility for taxiw

entrances to runway
Safety Management System 

Kona International Airport at Keahole 

22 

 Regulatory oversight factors, including the applicability and enforceability of 

regulations; the certification of equipment, personnel and procedures; and the 

adequacy of surveillance audits. 

The AOA of any airport can have numerous hazards that may bring about 

accidents or incidents if not properly mitigated or prevented. Exhibit 3-2 provides 

examples of typical potential airside hazards. This exhibit should not be 

considered as a complete list of potential hazards but only as examples of some of 

the hazards that may occur. 

3.3.2 Describe Existing Controls 

Once a hazard has been identified or reported, the SMS Safety Officer (or the 

District Engineer) and the Safety Risk Assessment Team (if one is warranted) 

need to describe the controls that are currently in place associated with the hazard 

(e.g., driver training programs, airport self-inspections, airport markings and 

signage) to assist in determining the risks of the hazard and action strategies to 

reduce the risk. 

3.3.3 Determine the Risk 

The next step is to determine the risks of the hazard. 

A risk is the chance (great or small) that people or aircraft will be harmed or 

damaged by a hazard; i.e., risk that an accident will happen. Risk is measured in 

terms of possible consequences of the accident (the severity of the accident) and 

the probability that the accident could happen. 

Consequences (severity of the potential accident) 

In determining a risk, consequences of a potential accident are assessed. The 

consequences used in this rating are presented below along with a guide to their 

application. 

RATING EXAMPLES (one or more resulting conditions) 

Minor No, or very, limited financial loss or personal injury. Only 

1 or 2 individuals involved. Very limited, or no, damage to 

aircraft, vehicles, facilities or equipment. Minor operational 

delays. First aid treatment may be required. People could be 

off work for several days due to injury. 

Moderate Repairs to damaged aircraft, equipment, facilities or 

vehicles. Operational delays. Medical treatment required in 

hospital or emergency clinic. Significant cost to individuals 

involved. Some media attention. 
Safety Management System 

Kona International Airport at Keahole 

23 

Major Extensive repairs or replacement of aircraft, equipment, 

facilities or vehicles. Major operational delays. Extensive 

injuries to a number of people. Possible death of 1 or 2 

individuals. Strong media attention, loss of public 

confidence. 

Catastrophic Aircraft destroyed. Multiple deaths, extensive injuries. High 

profile media attention. Severe loss of public confidence. 

Risk Probability 

The second consideration in risk assessment is the probability of the hazard 

causing an accident or injury. There essentially is no meaningful quantitative data 

for conducting SRM at an airport using numerical methods. Thus, a qualitative 

approach is required. This provides a formalized and consistent approach to 

assessing safety risks. 

The relative rankings of the probability for use in this analysis by the Safety Risk 

Assessment Team are given below

RATING EXAMPLES 

Rare Accident not expected to happen under most normal 

circumstances. Very unlikely. 

Possible Might or could occur at some time in the future. 

Likely Will probably occur with some certainty in the future.

3.3.4 Evaluate the Risk 

There will always be risks involved in aviation operations. Some risks can be 

accepted, some can be eliminated, while others can be reduced to acceptable 

levels. 

Once the probability and the consequences of a possible accident have been 

assessed, the next step is to evaluate the relative rating of the risk by using the 

following matrix. 

Risk Assessment Matrix 

 Potential Consequences 

Probability Minor Moderate Major Catastrophic 

Rare Low Low Medium Medium 

Possible Low Medium High High 

Likely Medium Medium High High 
Safety Management System 

Kona International Airport at Keahole 

24 

The risk ratings used in the matrix are defined as follows: 

High risk: A high risk is unacceptable. Management needs to take immediate

action to mitigate or eliminate the hazard for an existing condition. For planned 

changes to equipment, systems, operations, etc. management, the change cannot 

be implemented unless the potential hazards are further mitigated to medium or 

low levels. 

Medium risk: Management will react to mitigate or eliminate the hazard as 

expeditiously as possible within existing resource constraints. In the short term, 

the risk is tolerable. 

Low risk: This level of risk is considered acceptable and no further action is 

required unless the risk can be reduced further, or eliminated, at little or no effort. 

Factors that may be considered when evaluating risk, particularly whether a risk is 

acceptable are as follows: 

 Managerial. Is the risk consistent with KOA’s and HDOT-A’s safety policy 

and objectives? 

 Affordability. Does the risk defy cost-effective resolution? 

 Legal. Does the risk conform to current FAA regulatory requirements? 

 Cultural. How will the airport’s employees and other stakeholders view this 

risk? 

 Market. Will KOA’s competitiveness relative to other airports be 

compromised? 

 Political. Will there be a political price to pay for not reducing or eliminated 

the risk? 

 Public. What will be the reaction of the media or special interest groups 

regarding the risk? 

In undertaking the evaluation of risk, the Risk Evaluation Guide provided in 

Appendix 1.0 will be used. This will be completed for any formal assessment of 

risks and hazards as required by Section 3.2 above as well as any reported safety 

hazards. 

3.3.5 Determine Action and Implement 

If the SMS Safety Office (or the District Engineer) and the Safety Risk 

Assessment team have determined that the risk is acceptable then no further 

action is required other than documenting the previous Safety Risk Assessment 

steps. 
Safety Management System 

Kona International Airport at Keahole 

25 

If a risk is deemed high or medium, the KOA manager, under whose 

accountability the hazard exists, will be responsible for taking action or 

developing recommendations to mitigate or eliminate the hazard. The accountable 

KOA manager should consider a range of options depending upon the outcome of 

the risk evaluation. The accountable manager may want to seek advice from the 

Safety Assessment Team and SMS Safety Officer as appropriate. The potential 

solutions could include: 

 An infrastructure solution including such options as rehabilitation, 

reconstruction or new facilities; 

 Changes or modifications to equipment or maintenance programs; 

 The issuance of Airport Safety Directives that could include consideration of 

changes to operating procedures and/or new procedures; 

 Airport Safety Guidelines that could include such items as limiting exposure 

to the risk, increased surveillance of the hazard or activities associated with it, 

improved supervision, targeted safety advice etc.; 

 Safety training which could include the provision of new on-site training 

programs and/or modifications to existing safety training programs; 

 Provision of safety information and the provision of specific safety brochures, 

posters, etc.; and 

 Restrictions on an individual’s right and ability to work on the airside. 

When required, the accountable KOA manager working with the SMS Safety 

Officer will prepare a Safety Action Plan outlining planned risk reduction 

measures, with specific target dates and responsibilities of key participants. If 

required and time allows, final approval of the plan shall be given by the Airports 

District Manager. The accountable KOA manager will be responsible for ensuring 

that the Safety Action Plan is implemented 

Where the Safety Action Plan involves expenditures beyond the authority of the 

Airports District Manager, the recommendations will be forwarded to the Airports 

Administrator at the Division for consideration and action. 

If a hazard and its associated risks are primarily the responsibility of a tenant, the 

tenant will be responsible for developing their own Safety Action Plan when 

requested by the SMS Safety Officer or the Airports District Manager. 

The SMS Safety Officer will monitor implementation and provide regular (at least 

quarterly) written updates on the status of Safety Action Plans to the Airports 

District Manager and the Airport Safety Committee. 
Safety Management System 

Kona International Airport at Keahole 

26 

3.3.6 Document the Safety Risk Assessment 

The application of the Safety Risk Management assessment will be documented 

by the SMS Safety Officer or the District Engineer. Any resulting Safety Action 

Plans will be documented by the accountable KOA manager. The documentation 

will be stored and maintained by the SMS Safety Officer in hard copy and 

electronic copy if computer software is used. 
Safety Management System 

Kona International Airport at Keahole 

27 

4. SAFETY ASSURANCE 

4.1 Introduction 

SMS Safety Assurance augments existing KOA practices and procedures to 

ensure airport safety including: 

 The airport self-inspection program; 

 The wildlife hazard management plan; 

 Storage and handling of fuel; 

 The Airport Certification Manual (ACM); 

 The Airport Emergency Plan (AEP) included in the ACM; 

 Airport condition reporting including the issuance of NOTAMS; 

 Accident and incident reporting, as part of pedestrian and ground vehicle 

control programs; and 

 Construction safety plans. 

4.2 Employee Reporting System 

This section of the SMS addresses non-punitive employee reporting, systematic 

safety reviews, safety oversight and auditing. 

To further enhance airport safety by identifying safety hazards, all employees of 

KOA working on the AOA are encouraged to report any accidents, incidents, 

potential hazards or safety concerns that they observe or are involved in. 

Examples include: a driver not stopping for passengers, airside personnel 

potentially exposed to jet blast, FOD receptacles not emptied, vehicles left 

unattended on the apron, confusing signs, poor lighting, etc. 

KOA employees are encouraged to prepare a written Employee Safety Report 

using the form provided in Appendix 2.0. The form is available from the SMS 

Safety Officer. The employee should submit the Employee Safety Report to the 

SMS Safety Officer. An employee may also make a verbal report to the SMS 

Safety Officer who will assist in preparing the written Safety Report. If the 

employee wishes his or her name to be confidential for any reason, then this 

should be indicated on the Employee Safety Report. 

The SMS Safety Officer will investigate the concern or hazard and provide a 

response to the initiator of the report. If necessary, a Safety Risk Management 

Assessment will be conducted. 
Safety Management System 

Kona International Airport at Keahole 

28 

4.3 Non-Punitive Reporting Policy 

The purpose of any investigation of an accident, incident or safety hazard is to 

establish the facts and cause, and, where necessary, take measures to prevent 

further occurrences. HDOT-A believes that free and full reporting of incidents 

and accidents is a primary aim and that every effort will be made to avoid action 

that may inhibit reporting. 

HDOT-A Management will not take any disciplinary action against an employee 

reporting a safety incident or accident even if a reported incident or accident 

indicates an unintentional mistake by the employee. 

This reporting policy does not apply to criminal acts, deliberate violations of 

safety regulations and safe operating procedures, or gross negligence. 

If requested by the employee, the Employee Safety Report will be treated in 

confidence. In this case, HDOT-A and its employees will not disclose the name 

of the person submitting a safety report unless required to do so by law. The SMS 

Safety Officer will de-identify the Employee Safety Report before initiating any 

investigation or action. All personnel and organizational names are removed from 

the report. Dates, times and related information which could be used to infer an 

identity are either generalized or eliminated. 

4.4 Trend Analysis 

Trend analysis is an important mechanism to determine changes in safety over a 

given period of time. Trend analysis is conducted to determine if conditions or 

situations are getting better, getting worse or staying the same. The SMS Safety 

Officer is responsible for analyzing and interpreting safety performance data. The 

key data that is monitored is described in Section 1.3, Safety Objectives, and 

includes: 

 Safety deficiencies identified during Airport Self-Inspections by type of hazard 

and location (e.g., pavement, lighting, markings, signage); 

 FOD by type and location on the AOA; 

 Airside safety violations (by class of violation); 

 Number and type of accidents and incidents on the Airport Operating Area 

(AOA) involving air carrier aircraft, ground vehicles, passengers and workers 

on the AOA. Causes should also be tracked; 

 Number of bird strikes; 

 Reports of wildlife on the AOA by type and location; 

 Operable time of lighting systems; 
Safety Management System 

Kona International Airport at Keahole 

29 

 Number of aborted landings/takeoffs per year due to airfield hazards; 

 Number of airside based employees who have received safety and SMS related 

training (initial and refresher training); and 

 Number of safety hazards reported through non-punitive safety reports. 

The sources of these data and responsibilities for data collection were outlined in 

Section 1.3. 

In order to monitor and analyse trends, the SMS Safety Officer will set-up a data 

base to record the data described above on a monthly basis. The SMS Safety 

Officer will then use this data to determine trends through graphing the data over 

time. 

4.5 Airfield Accidents and Incidents – Mandatory 

Reporting 

The SMS Safety Officer on behalf of HDOT-A is responsible for ensuring that a 

Mandatory Safety Report is prepared for accidents and incidents on the AOA. The 

SMS Safety Officer should prepare the report with the input of those that 

witnessed or observed the incident or accident. 

The Airport’s Mandatory Safety Reporting does not eliminate any regulatory 

requirements for reporting that have been imposed by the FAA and the State of 

Hawaii on third party operators at the airport such as an airline or the air traffic 

control tower. 

4.6 Accident Investigation 

All accidents and incidents on the AOA require investigation. On behalf of 

HDOT-A, the SMS Safety Officer will undertake an investigation of all accidents 

or occurrences using the Accident and Incident Report Form contained in 

Appendix 3.0. The SMS Safety Officer will enlist whatever technical expertise 

that is required within KOA. If necessary, the Police Department will participate 

in the investigation. 

4.7 Systematic Reviews 

Systematic review allow for assessing adherence to KOA’s safety policy and 

achievement of safety objectives. Systematic reviews are the responsibility of the 

SMS Safety Officer in consultation and coordination with the other KOA 

departments. Systematic reviews include the following activities: 
Safety Management System 

Kona International Airport at Keahole 

30 

 On-going trend analysis of accidents, incidents, self-inspection reports, 

NOTAMs, condition reports through information provided by the 

Maintenance Department, Employee Safety Reports, and investigation of 

accidents and incidents; 

 Periodic assessments of the achievement of safety objectives; and 

 Review of the proceedings of the Airport Safety Committee, safety risk 

assessments and safety audits. 

Based on the lessons learned from these reviews (either individual or collective), 

the outputs of the systematic reviews could include a wide range of 

recommendations such as new Safety Risk Management Assessments, revisions 

to SMS safety policies and objectives, SMS practices and responsibilities, 

revisions to operational or maintenance practices, systems, facilities or equipment. 

Although the SMS Safety Officer is required to make an annual review of the 

SMS safety policy and objectives, recommendations based on systematic reviews 

can be made whenever considered appropriate. 

4.8 Safety Oversight 

Safety oversight is the responsibility of the Airports District Manager. Safety 

oversight includes periodic reviews of how well the SMS is working, whether 

safety policies and objectives are still relevant, negative trends in safety 

indicators, etc. 

4.9 Safety Audits 

The Airports District Manager will determine if and when safety audits are 

required in response to unresolved safety issues. 

There are two types of safety audits that could be undertaken at the Airport. 

The first type of safety audit is an internal audit of KOA AOA activities and 

includes the safety functions undertaken by: 

 Airport Operations; 

 Maintenance; 

 Contractors; and 

 ARFF. 

The other safety audits are external audits of the functions that are undertaken by 

the KOA tenants such as the airlines, FBO’s or contractors. 
Safety Management System 

Kona International Airport at Keahole 

31 

The above audits may be undertaken by KOA or HDOT-A, by a specialist 

external auditor appointed by HDOT-A or by another airport operator retained by 

HDOT-A. 

Tenants may also undertake independent safety audits of their operations at the 

Airport. The SMS Safety Officer should arrange with each of these organizations 

so that KOA is provided with copies of the audits and the relevant safety plans. 

4.10 Record Keeping 

The following records will be kept by the SMS Safety Officer for at least three 

years: 

1. The original SMS Manual and subsequent revisions; 

2. Annual reviews of the SMS policy and safety objectives conducted by the 

SMS Safety Officer; 

3. Data collected and analyzed in support of the safety objective identified in 

Section 1.3; 

4. Employee Safety Reports; 

5. Completed Safety Risk Management Assessments and associated Safety 

Action Plans noting completion of action items; 

6. Completed Accident and Incident Analysis Forms; 

7. Minutes of the Meetings of the Airport Safety Committee; 

8. Minutes of Safety Meetings; 

9. Safety audit reports; 

10. Safety Bulletins; 

11. Description of Training Programs, who attended and when; and 

12. Description of promotional activities. 

All mandatory incident and accident reports will be kept for at least 10 years 

unless there is a legal action outstanding, or anticipated, regarding an incident or 

accident, and then they will be kept until the legal action is disposed of. 
Safety Management System 

Kona International Airport at Keahole 

32 

5.0 SAFETY PROMOTION - 

COMMUNICATIONS 

5.1 Safety Communication Policy 

HDOT-A is committed to ensuring that all KOA personnel working airside at the 

Airport are informed about the safety polices and objectives, how well the airport 

is meeting safety objectives, results of accident and incident investigations, new 

safety practices, and other matters dealing with safety. 

Safety Communication will be achieved through a number of mechanisms 

described below. 

5.2 The Airport Safety Committee 

As previously described in detail, the Airport Safety Committee (ASC) provides 

an essential partnership between Airport Management and airside tenants to share 

safety information and provide advice regarding safety in AOA operations. This 

committee meets at least quarterly and minutes of the meeting will be distributed 

to all participants. 

The minutes of the meetings will also be summarized and communicated to 

airside personnel through Safety Management Bulletins. 

5.3 SMS Policies 

The SMS Safety Policy and the Employee Non-Punitive Reporting Policy will be 

displayed in poster formats in prominent and highly visible areas within KOA 

facilities. The policies will also be posted on the KOA website. 

5.4 SMS Manual 

The SMS Manual is available for review by all KOA employees working on the 

AOA in the SMS Safety Officer’s office and posted on the KOA website. The 

SMS Manual will be provided to all new employees during orientation. All 

airport airside employees must read the document and complete a test to ensure 

that they have understood the key elements of the manual. 
Safety Management System 

Kona International Airport at Keahole 

33 

5.5 Safety Management Bulletins and Posters 

The SMS Safety Officer will issue brief periodic Safety Bulletins. The topics of 

these Safety Bulletins will include, for example: 

 Announcement of the new, or revised, SMS Manual and its highlights and 

where copies can be obtained or reviewed; 

 Summaries of the minutes of Airport Safety Committee meetings, particularly 

action items; 

 Results of incident and accident investigations emphasizing lessons learned 

and action to be taken to reduce potential hazards; 

 Announcement of new work practices and procedures; and 

 New safety rules that must be followed. 

The SMS Safety Officer will issue the Safety Bulletins to each airside tenant and 

to each KOA employee working on the AOA. 

The SMS Safety Officer will, as appropriate, prepare and display safety posters 

dealing with such topics as: 

 Voluntary and mandatory reporting; 

 Safety rules that must not be violated; and 

 Safety goals and indicators. 

5.6 AOA Employee Recognition 

In order to promote a safety culture at the Airport, KOA will institute a 

recognition program for employees of KOA, FBOs and airlines to honor an 

individual working on the AOA that makes a significant contribution to safety at 

the Airport. The award may be based on identifying and correcting a significant 

airside hazard, working over the course of the year in a safe and efficient manner, 

providing safety leadership to other airside employees, etc. 

To be considered for this award, employees may be nominated by their peers or 

Airport Management. The employee’s direct superior will endorse the nomination 

and forward to the SMS Safety Officer. 

The award will be presented at the annual safety meeting of the New Year. 
Safety Management System 

Kona International Airport at Keahole 

34 

5.7 Safety Meetings 

At the beginning of each year, the SMS Safety Officer will hold an annual safety 

meeting with all KOA AOA staff. The purpose of this meeting is to: 

 Report on safety performance in meeting safety objectives; 

 Summarize the initiatives and action taken, or planned, to address safety 

concerns and potential hazards; 

 Report on lessons learned and action taken as a result of any incidents and 

accidents; and 

 Discuss in an open forum the safety concerns that any of the participants 

might have. 

The SMS Safety Officer will provide Minutes of the Annual Safety Meeting to 

the Airport Safety Committee for distribution to their AOA employees. 

In addition to the annual safety meeting, the SMS Safety Officer may from time 

to time throughout the year conduct appropriate safety meetings to discuss safety 

issues at KOA as required. 

5.8 Ramp Safety Campaign 

KOA will establish a ramp safety campaign highlighted by Ramp Safety Week 

where the Airport and the tenants highlight a ramp safety issue and promote 

reduction of the hazard as well as cultural changes with ramp personnel. 

To augment this one week targeted safety campaign, the Airport will also sponsor 

several safety awareness days during the year highlighting specific airside hazards 

such as FOD, fuel spills, etc. 
Safety Management System 

Kona International Airport at Keahole 

35 

6.0 SAFETY PROMOTION – TRAINING 

6.1 Training Policy 

HDOT-A is committed through training to provide all of its employees working 

on the AOA with the skills and competencies to recognize and minimize aviation 

safety. 

KOA already has a number of training programs required by CFR Part 139 

including: driver training, inspection techniques and ARFF training. 

6.2 SMS Training 

As part of the training of new KOA employees working on the AOA, the SMS 

Safety Officer will provide an SMS training program. The curriculum includes: 

 The need for SMS; 

 HDOT-A safety policies and objectives; 

 Organization for safety – role and responsibilities; 

 Safety risk management – including human and organizational factors; 

 Safety assurance; and 

 Safety promotion. 

Re-current SMS training will be provided and tested during the annual reapplication for the AOA identification badge. 

The SMS Safety Officer will record that a SMS training session has been given to 

an employee. This record will be kept by the SMS Safety Officer and placed in 

the employee’s personnel file. 

6.3 Specialized Airside Tenant Safety Training 

Each airside tenant at the Airport will provide specialized training in operational 

procedures and safety procedures applicable to their function at the airport. 

Examples include: fueling procedures, aircraft chocking, aircraft push-back, 

aircraft power back, escorting of arriving and departing passengers, movement 

and parking of aircraft service vehicles upon aircraft arrival and departure, aircraft 

marshalling, etc. 
Safety Management System 

Kona International Airport at Keahole 

36 

Each airside operator will submit a record of the training to their employees to the 

SMS Safety Officer annually. 

The Airport recognizes that many of the airside operators already provide this 

training and keep records of their training. 
Safety Management System 

Kona International Airport at Keahole 

APPENDIX 1.0 

RISK EVALUATION GUIDE 
Safety Management System 

Kona International Airport at Keahole 

DEPARTMENT OF TRANSPORTATION 

AIRPORTS DIVISION 

RISK EVALUATION GUIDE 

Potential Hazard - a description of the hazard that has the potential to damage aircraft, vehicles, equipment & systems; and to cause injury & death 

Existing Controls – a description of existinprocedures, equipment, training, etc. in place 

Date Prepared: Prepared By: Signature: Date: Potential Outcomes & Accident – a description of the possible direct & intermediate results of the hazard and the possible accident: conditions that could lead to the accident

Consequences of the Accident Happening  Minor  Moderate  Major  Catastrophic 

Likelihood of the Accident Happening  Rare  Possible  Likely 

Ev   
Safety Management System 

Kona International Airport at Keahole 

APPENDIX 2.0 

DEPARTMENT OF TRANSPORTATION 

AIRPORTS DIVISION 

EMPLOYEE SAFETY REPORT 
Safety Management System 

Kona International Airport at Keahole 

Appendix 2.0-1 

Employee Safety Report 

Name: ______________________________________________ 

Organization Position: ___________________________________ 

Do you want your report to be treated as confidential? Yes ____: No_____ 

[Name and position to be removed by the SMS Safety Officer if requested by 

the employee] 

PART A 

TO BE COMPLETED BY THE PERS ON IDENTIFYING THE 

HAZARD 

Please fully describe the Hazard, Incident or Accident 

. 

Date of occurrence: ___________________ Time: _____________ 

Location: _________________________ 

Description:_____________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________ 

In your opinion, how often does this hazard exist or take place 

Not Frequently Very Frequently 

1 2 3 4 5 
Safety Management System 

Kona International Airport at Keahole 

Appendix 2.0-2 

PART B 

TO BE COMPLETED BY T HE SMS S AFET Y OFFICER UPON 

INVES TIGAT ION OF THE HAZARD 

The report has been de-identified and entered into the company database 

Signature: ______________________ Date: ___________________ 

Name___________________________ 

Based on investigation of the hazard: 

Describe the hazard(s): 

How frequently does the hazard exist or occur? 

What are the possible sources of the hazard? 

What are the possible consequences (accidents) that could result from the 

hazard(s)? 

Minor Moderate Major Catastrophic 

Why? 

What is the likelihood of the accident that could result from the hazard(s)? 

Rare Possible Likely 

Why? 

What action is required to ELIMINATE or CONTROL the hazard and 

PREVENT injuries or damage? 

Resources Required: 

_______________________________________________________________ 
Safety Management System 

Kona International Airport at Keahole 

Appendix 2.0-3 

Responsibility for action: 

_______________________________________________________________ 

Referred to ______________________ for further action. 

Signature: Date: 

Appropriate Feedback given to staff. 

Signed Date 

Control Num ber _______ HDOT- Form SMS 1 
Safety Management System 

Kona International Airport at Keahole 

APPENDIX 3.0 

DEPARTMENT OF TRANSPORTATION 

AIRPORTS DIVISION 

ACCIDENT AND INCIDENT REPORT FORM 
Safety Management System 

Kona International Airport at Keahole 

Appendix 3.0-1 

ACCIDENT AND INCIDENT REPORT 

To be completed by the SMS Safety Officer for all accident and incidents and 

safety violations which could endanger people, aircraft, vehicles, or equipment? 

Name of person that completed this report: 

Organization and Position: 

Telephone number: 

Date of Accident/Incident/Safety Violation: 

Time: 

Location: 

Date of Report: Report Number: 

Airport Police Report Number (where applicable)__________________________ 

Names of Witnesses 

Witness 1 

Name: 

Address: 

Telephone: 

Witness 2 

Name: 

Address: 

Telephone: 

Witness 3 

Name: 

Address: 
Safety Management System 

Kona International Airport at Keahole 

Appendix 3.0-2 

Telephone: 

Details 

Details of the accident/incident/safety violation: (Include details of people 

involved, aircraft, vehicles, and equipment. Include details of what took place that 

contributed to the accident /incident) 

__________________________________________________________________ 

__________________________________________________________________ 

__________________________________________________________________ 

__________________________________________________________________ 

__________________________________________________________________ 

__________________________________________________________________ 

__________________________________________________________________ 

__________________________________________________________________ 

Details of any injuries: 

__________________________________________________________________ 

__________________________________________________________________ 

__________________________________________________________________ 

Details of any damage to aircraft/vehicles/equipment/facilities: 

__________________________________________________________________ 

__________________________________________________________________ 

__________________________________________________________________ 

__________________________________________________________________ 
Safety Management System 

Kona International Airport at Keahole 

Appendix 3.0-3 

KONA INTERNATIONAL AIRPORT - ACCIDENT/INCIDENT 

ANALYSIS 

SECT. 1 OPERATIONAL ACTIVITY AND RESULT 

RESULT OF ACCIDENT 

( ) AIRCRAFT DAMAGE 

( ) VEHICLE DAMAGE 

( ) EQUIPMENT DAMAGE 

( ) PERSONNEL INJURY 

( ) OTHER ______________________________ 

IMPACT OF ACCIDENT ON OPERATIONS 

( ) AIRCRAFT ARRIVAL DELAY 

( ) AIRCRAFT SERVICING 

( ) AIRCRAFT TURNROUND 

( ) AIRCRAFT DEPARTURE DELAY 

( ) VEHICLE OUT OF SERVICE 

( ) AIRCRAFT DELAY 

( ) EQUIPMENT OUT OF SERVICE 

( ) OTHER ______________________________ 

SECT. 2 CONTRIBUTING FACTORS CHECKLIST 

Instructions on completing this section: 

1 Mark each contributing factor. 

2 For each factor not contributing, mark ‘N/A’ 

3 Provide brief narrative for each contributing factor 

A. INFORMATION 

Provide copies of all relevant work cards; procedures; maintenance manuals; 

operation orders; instructions etc and append to this report. Determine through 

interviews with those involved and/or witnesses whether the information was: 

( ) Not understandable 

( ) Unavailable/inaccessible 

( ) Incorrect 

( ) Conflicting with other directions or information 

( ) Other 

Specify exactly what information was inadequate or led to the incident 
Safety Management System 

Kona International Airport at Keahole 

Appendix 3.0-4 

B. EQUIPMENT/TOOLS/PARTS 

Provide a list of equipment/tools in use at the time of the accident. Determine 

through interviews with those involved and/or witnesses whether the 

equipment/tools/parts were: 

( ) Unsafe 

( ) Inappropriate to task 

( ) Inaccessible 

( ) Could not be used in intended environment 

( ) Unreliable 

( ) No instructions for use 

( ) Mis-calibrated 

( ) Too complicated 

( ) Unavailable 

( ) Incorrectly labeled 

( ) Other (explain) 

Specify exactly what equipment, tool, or part, failed, was inadequate or led to the 

incident 

C. AIRCRAFT/EQUIPMENT/VEHICLE DESIGN 

Determine through interviews with those involved and/or witnesses whether the 

aircraft/equipment/vehicle was: 

( ) Too Complex 

( ) Not accessible 

( ) Not user friendly 

( ) Was a confusing variation between models/variants 

( ) Other (explain) 

D. MAINTENANCE ERROR 

Determine through interviews with those involved and/or witnesses what 

procedures were followed and compare to written maintenance instructions. 

Highlight any areas where tasks carried out deviated from written maintenance 

procedures 

E. JOB/TASK/ACTIVITY 

Determine through interviews with those involved and/or witnesses the actual 

job/task/activity underway at the time of the accident. Highlight any distractions 

that may have been present. 

F. QUALIFICATIONS/SKILLS 
Safety Management System 

Kona International Airport at Keahole 

Appendix 3.0-5 

Determine from interviews with those involved and /or witnesses the 

qualifications of the individual(s) involved in the accident. Check 

KOA/Concessionaire/Contractor training records for the individual involved 

G. FACTORS AFFECTING INDIVIDUAL PERFORMANCE 

Determine if any of the following factors were involved in the accident 

Aircraft ground equipment 

( ) Improper installation 

( ) Equipment not installed 

( ) Wrong part installed 

( ) Wrong orientation 

( ) Improper location 

( ) Repetitive or monotonous task 

( ) Complacency 

( ) Complex or confusing task 

( ) Inadequate planning/prioritization 

( ) New task or task change 

( ) Different from similar tasks 

( ) Boredom 

( ) Other (explain) 

Individual Qualifications 

( ) Proficiency/experience level and years of experience 

( ) Task knowledge 

( ) Process knowledge 

( ) System Knowledge 

( ) Other (explain) 

Individual Human Factors 

( ) Physical health (including sight/hearing) 

( ) Peer pressure 

( ) Fatigue 

( ) Body size/strength 

( ) Time constraints 

( ) Significant life changes 

( ) Alcohol/drugs/medication 

( ) Other 

Explain in point form how these factors may have lead to the 

incident:_______________________________ 
Safety Management System 

Kona International Airport at Keahole 

Appendix 3.0-6 

H. ENVIRONMENT AND FACILITIES 

Determine if any of the following were present during the time leading up to the 

accident or at the time of the accident: 

( ) High noise levels 

( ) Vibration 

( ) Distractions/interruptions (e.g. cell phone use) ( ) Cleanliness 

( ) Hazardous/toxic substances 

( ) Power sources 

( ) Inadequate ventilation 

( ) Dark 

( ) Unsafe work area 

( ) Hot 

( ) Cold 

( ) Humidity 

( ) Rain 

( ) Wind 

( ) Fog 

( ) Low visibility 

( ) Inadequate lighting 

( ) Other 

Explain in point form how these factors may have lead to the 

incident:___________________________ 

I. ORGANIZATIONAL ISSUES 

Determine from interviews with those involved in the accident and their 

supervisor(s) the following: 

( ) Amount of supervisory support provided 

( ) Company policy re activities underway during the accident 

( ( ) Morale Issues within the company 

( ) Other 

Explain in point form how these factors may have lead to the 

incident:_____________________________ 

J. SUPERVISION 

Determine from discussion with individual involved/witnesses/ and the involved 

employee’s immediate supervisor: 

( ) How planning/organization of tasks was undertaken 

( ) How tasks were prioritized 

( ) How delegation/assignment of task was undertaken 

( ) What supervisors expectations were, and if these were realistic 

( ) the amount of supervision provided 

( ) Other 
Safety Management System 

Kona International Airport at Keahole 

Appendix 3.0-7 

Explain point form how these factors may have lead to the 

incident:______________________________ 

K COMMUNICATION 

Determine from interviews with those involved in the accident and their 

company’s supervisory chain of command whether the following types of 

communications were adequate: 

( ) Between departments 

( ) Between shift and supervisor 

( ) Between people 

( ) Between supervisor and manager 

( ) Between shifts 

( ) Other 

Explain in point form how these factors may have lead to the 

accident:____________________________ 

L. ANY OTHER FACTORS 

Provide a description of any other factor not listed above that may have lead to 

the accident 

SECT. 3 RECOMMENDED CORRECTIVE ACTIONS 

A. CURRENT PROCEDURES /OR POLICIES: 

 

Are there any current procedures and/or policies in KOA intended to prevent the 

accident, but didn’t? 

B. RECOMMENDED CORRECTIVE ACTIONS 

List recommended corrective actions: 

( ) New or modified operational instructions. Specify: 

( ) New or modified company regulations. Specify: 

( ) New or modified inspection schedules. Specify: 

( ) New or modified engineering/maintenance/training manuals. Specify: 

( ) New or modified inter-company communications procedures. Specify: 

( ) Any other changes or proposed new instruction/regulation or policy document. 

Specify: 
Safety Management System 

Kona International Airport at Keahole 

Appendix 3.0-8 

C. OTHER CORRECTIVE ACTIONS SUGGESTED 

Signature: Date:______________________

Control Number _______ HDOT- Form SMS 2