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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

LR/IMO NO:

CURRENT NAME:

PREVIOUS NAME (IF ANY):

CLASS SOCIETY:

FLAG:

PORT OF REGISTRY:

HEAD OWNER:

ADDRESS OF HEAD OWNER:

P & I CLUB:

ADDRESS:

 

 

 

Phone:.......................Fax:......................

MASTER OR OWNER/MANAGER REPRESENTATIVE

.................................................. ................................................... ...................
Name Signature Date

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

INSURANCE CO. (Hull & Machinery)

ADDRESS:

 

 

 

Phone:.......................Fax:...................

MANAGER OR OPERATOR:


  

ADDRESS OF MANAGER:

 

 

Phone: .......................Fax: .................

DATE OPERATOR/MANAGER ASSUMED:

  

RESPONSIBILITY FOR SHIP:

  

SUMMER DEADWEIGHT:

  

SUMMER DRAFT:

  

AVERAGE LOADED SPEED:

  

YEAR BUILT:

  

LENGTH OVERALL X BREADTH:

  

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:

1. Certification Documentation and Information

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

2. Crew Management

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

3. Lifesaving Equipment

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

4. Firefighting Equipment

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:

5. Mooring Equipment

ARE MOORING ROPES AND WIRES IN GOOD CONDITION YES/NO
ARE ANCHORS AND CABLES IN GOOD CONDITION AND OPERATIONAL YES/NO

ADDITIONAL REMARKS:

6. Bridge Equipment and Procedures

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:

7. Engine Room Steering Gears & Pollution Prevention

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

8. Hull and Accommodation

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: 27 February, 2013