Bulk Cargo Inspection Report

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THE FOLLOWING INFORMATION REGARDING THE VESSEL

".........................................................." IS LODGED IN

SUPPORT OF THE SINGLE VOYAGE PERMIT APPLICATION.

ON THE BASIS OF THIS INFORMATION WE BELIEVE THE

VESSEL IS SUITABLE FOR THE INTENDED VOYAGE.

MASTER OR OWNER/MANAGER REPRESENTATIVE

Signature: ................................................. Date ....................

Name: ..........................................................

Company: .....................................................

Note: Further information should be provided under additional remarks
for items where a NO response has been indicated.

VESSEL PARTICULARS

ISM/DOC PARTICULARS

SAFETY MANAGEMENT CERTIFICATE (ISM)
ISSUED BY:
DATE:
DATE OF EXPIRY:
DATE OF LAST ANNUAL SURVEY:
DOCUMENT OF COMPLIANCE
ISSUED BY:
DATE:
DATE OF EXPIRY:
DATE OF LAST ANNUAL SURVEY:

CERTIFICATE OF REGISTRY
NUMBER
DATE OF ISSUE
ISSUE BY
SAFETY EQUIPMENT CERTIFICATE
ISSUED BY
DATE OF ISSUE
DATE OF EXPIRY
DATE OF LAST ANNUAL SURVEY (IF APPLICABLE)
SAFETY RADIO CERTIFICATE
ISSUED BY
DATE OF ISSUE
DATE OF EXPIRY
DATE OF LAST ANNUAL SURVEY (IF APPLICABLE)
SAFETY CONSTRUCTION CERTIFICATE
ISSUED BY
DATE OF ISSUE
DATE OF EXPIRY
DATE OF LAST ANNUAL SURVEY (IF APPLICABLE)
LOADLINE CERTIFICATE
ISSUED BY
DATE OF ISSUE
DATE OF EXPIRY
DATE OF LAST ANNUAL SURVEY (IF APPLICABLE)
IOPP CERTIFICATE
ISSUED BY
DATE OF ISSUE
DATE OF EXPIRY
DATE OF LAST ANNUAL SURVEY (IF APPLICABLE)
IS FORM A PERMANENTLY ATTACHED	YES / NO
TRIM AND STABILITY BOOK AND LOADING MANUAL
APPROVED BY
DATE OF APPROVAL
INTERNATIONAL TONNAGE CERTIFICATE
ISSUED BY
DATE OF ISSUE
IS REGISTER OF LIFTING EQUIPMENT PROPERLY COMPLETED AND UP TO DATE	YES / NO
ISSUED BY
IN RESPECT OF ANY OF THE FOREGOING CERTIFICATES ARE THERE ANY CONDITIONS/ QUALIFICATIONS NOTED	YES / NO
IF YES PROVIDE DETAILS:
PORT STATE CONTROL
DATE OF LAST PORT STATE CONTROL INSPECTION
PORT AND INSPECTION AUTHORITY

MANNING LEVELS
DATE OF MINIMUM MANNING CERT
ISSUED BY
MINIMUM MANNING	OFFICERS ____________ RATINGS___________
ACTUAL MANNING	OFFICERS ____________ RATINGS___________
NATIONALITY	OFFICERS ____________ RATINGS__________
WHAT IS THE OPERATIONAL LANGUAGE USED ON BOARD

OFFICERS	MASTER	MATE	CH ENG	1ST ENG
CERTIFICATE HELD
ISSUING AUTHORITY
PROFICIENT IN ENGLISH	YES/NO	YES/NO	YES/NO	YES/NO
ARE REMAINING OFFICERS SUITABLY QUALIFIED				YES/NO

ARE LIFEBOATS LIFEBOATS EQUIPMENT LOWERING EQUIPMENT LIFERAFTS AND EQUIPMENT AND ASSOCIATED ITEMS IN GOOD CONDITION	YES/NO
ARE PILOT LADDERS AND HOISTS IN GOOD CONDITION	YES/NO
ARE OVERSIDE ACCOMMODATION LADDERS AND GANGWAYS IN GOOD CONDITION	YES/NO
ADDITIONAL REMARKS

ARE FIRE MAINS PUMPS HOSES NOZZLES & DETECTION SYSTEMS IN OPERATIONAL ORDER	YES/NO
IS EMERGENCY FIRE PUMP FULLY OPERATIONAL	YES/NO
ARE STARTING INSTRUCTIONS CLEARLY DISPLAYED	YES/NO
ARE FIRE APPLIANCES LOCATED IN COMPLIANCE WITH FIRE PLAN	YES/NO
IS SHIP/SHORE FIRE CONNECTION READILY AVAILABLE	YES/NO
ADDITIONAL REMARKS:

ARE MOORING ROPES AND WIRES IN GOOD CONDITION

YES/NO

ARE ANCHORS AND CABLES IN GOOD CONDITION AND OPERATIONAL

YES/NO

ADDITIONAL REMARKS:

IS BRIDGE AND NAVIGATIONAL EQUIPMENT OPERATIONAL	YES/NO
ARE 'NAVIGATION AND BRIDGE ORGANISATION MANUAL' AND STANDING ORDERS AVAILABLE	YES/NO
ARE THERE UP-TO-DATE CHARTS FOR THE INTENDED VOYAGE	YES/NO
ADDITIONAL REMARKS:

ARE ALL ITEMS OF MAIN AND AUXILIARY MACHINERY FULLY OPERATIONAL	YES/NO
ARE ENGINE ROOM BILGES CLEAN AND FREE OF OIL AND OILY WATER SEPARATOR AND CONTROL SYSTEM IN GOOD WORKING CONDITION	YES/NO
IS OIL RECORD BOOK COMPLETE AND UP TO DATE	YES/NO
ARE ENGINE ROOM EMERGENCY STOPS/SHUT-OFFS OPERATIONAL & CLEARLY MARKED	YES/NO
IS EMERGENCY ESCAPE ROUTE CLEARLY MARKED AND UNOBSTRUCTED	YES/NO
IS CONDITION OF THE EMERGENCY GENERATOR OR BATTERIES SATISFACTORY	YES/NO
ARE EMERGENCY STEERING GEAR CHANGEOVER PROCEDURES CLEARLY DISPLAYED IN STEERING FLAT AND ON BRIDGE	YES/NO
ADDITIONAL REMARKS

ARE LOADLINES AND OTHER HULL MARKINGS CORRECTLY MARKED AND CLEARLY INDICATED	YES/NO
ARE ALL DECK OPENINGS SCUPPERS ETC APPEAR TO BE WATER TIGHT AND PROPERLY SECURED	YES/NO
ARE WATERTIGHT DOORS (INCLUDING PACKING) PORTHOLES WINDOWS DEADLIGHTS VENTS AND AIRPIPES ON FREEBOARD DECK IN GOOD CONDITION AND FITTED WITH CLOSING DEVICES.	YES/NO
ARE SHIPSIDE AND OTHER GUARD RAILS IN SATISFACTORY CONDITION	YES/NO
IS GENERAL HULL CONDITION SATISFACTORY	YES/NO
IS GENERAL CONDITION OF DECK AND FITTINGS SATISFACTORY	YES/NO
ADDITIONAL REMARKS:

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Last Updated: 8 June, 2006