Flag: Flag has been changed within past 6 months? : The last flag inspection (date, port):
Deadweight (max assigned), If vessel has multiple DWTs, please insert each DWT
Vessel’s delivery date:
Vessel's operation at the time of the inspection:
Product(s) being handled:
Vessel’s type:
Hull type:
Name of vessel's operator:
Date current operator assumed responsibility for the vessel:
Date of last port State control inspection:
Port of last PSC inspection: Vessel detained? Any deficiency?
Name of Classification society: Issued On: Expired On: Class has been changed within past 6 months? If yes the date of change and previous class name:
Date the last special survey was completed: ESP // Evaluation report , related to special survey : Ultrasonic thickness measurement details: Date the last INTERMIDIATE survey:
last under hull inspection were completed:
Date of departure from the last class-credited dry-dock/repair period Any unscheduled dry docking/ repair were carried: If yes, insert the dates: from: to:
External ISM Audit
Last visit by done by Marine superintendent: Last visit by Technical superintendent:
Last internal ISM audit date: How many NCN? How many obs?
Master's review interval: Last Master’s review carried out Company’s response:
CAP: (dates / details):
Common working language on board:
Where the vessel carries chemicals, has a formal programme of regular and appropriate medical examinations for personnel been implemented?
What was the Operator's defined maximum level of blood alcohol content?
What was the recorded frequency of unannounced drug testing?
What was the recorded frequency of unannounced alcohol testing?
What was the date of last unannounced on-board alcohol test?
What was the date of last unannounced drug and alcohol test undertaken by an external agency? // Company: // Port:
UKC policy
Last magnetic compass shore adjustment: Company: Master Deviation table Last gyro compass shore adjustment: Company: Place:
Company name who is supplying the paper charts:
Company name who is supplying nautical publications & other publication:
Company name who is supplying digital publications:
Digital publications available on board:
Company name who is supplying weekly NTM:
Company name who is supplying ENC:
Company name who is supplying AIO:
Describe how the NTM’s are received?
Describe how the AIO’s are received:
ECDIS maker/ model:
ECDIS manufacturer: How many ECDIS units? ECDIS software version:
Which is primary means of navigation?
Which is back up?
How navigation warnings are applied to the ENCs? :
Who is the safety officer?
Safety meetings were conducted monthly? Last done:
Last near miss date: Number of near misses per month: No. of Unsafe Acts - Last incident date: Last accident date:
Last emergency drill date: Specify drill name:
Last fire drill date:
Last abandon drill date:
Last lifeboat water borne and manoeuvred in water:
Who is security officer?
How many blowers are provided for pump room? If one blower, there is a spare motor available? Spare motor storage location:
Is fixed gas detection system provided for: - water ballast tanks: - void spaces: - pump room :
Last on board inspection/ calibration date for all system :
Last shore inspection/ calibration date for Pump Room system: Ballast tank and void space
Last shore calibration date for each portable gas instruments:
Hot work designated place:. Last hot work date outside designated place:
Last life boat annual inspection date:
Last life boat 5 yearly periodic test date:
Which life boat is designated as rescue Boat: Is a dedicated rescue boat?
Liferafts last annual service date:
Last pressure test carried out for the immersion suits:
Last Deck foam analyses date: Analyses ok?
Which fixed firefighting system (foam or CO2?) is provided for.
CO2 / last shore tested: last hydro test:
Foam / last shore tested: last hydro test:
Which areas are protected by hyper mist? Last shore tested:
Emergency fire pump last tested:
Last annual shore service of portable fire extinguishers:
Last annual shore service of SCBA:
Last air quality test of SCBA compressor:
Last annual shore service of EEBD:
Vessel is fitted with connections from E/R sludge tank to Slop Tanks? If yes please describe the connection (not permanent) Last disposal date of engine room oily water or sludge to a cargo or slop tank:
SOPEP class approval date:
Vessel Response Plan (VRP) USCG approval date:
Name of the OPA-90 Qualified Individual (QI) :
VOC management plan class approval date:
Ballast lines pass through cargo and/or Bunker tanks?
Bunker lines last pressure test date:
Vessel is fitted with Pump room? How many blowers?
Last ODME test on board:
ODME is operational? Any malfunctions in the past?
Water ballast management plan approval date:
Water ballast tanks are provided with tank dome?
Water ballast tanks are provided with sighting ports?
Last oily water separator test:
Is the oily water separator fitted with an automatic stopping device?
SEEMP approval date:
Company procedures for carry out regular inspections of cargo tanks interval: Last done: Water ballast tanks, void spaces, trunks and cofferdams inspection interval: Last done:
Did vessel had carried Annex II cargoes? Last date:
Which cargo tanks are designated heavy weather ballast tanks?
Last heavy weather ballast taken date:
Damage stability manual class approval date:
Damage stability is included in class approved loading computer?
Vessel is also contracted with class Emergency Response Services?
Emergency Response Services name: Validity date of the Emergency Response Services:
Loading computer class approval date:
Frequency of accuracy of the load computer testing:
Are cargo and/or ballast tanks free of sloshing or other restrictions? :
Present cargo require inhibitor? :
Cargo tanks coating:
Last test date of cargo pumps and ballast pumps:
Last date of cargo lines last pressure test, 150% of its rated working pressure: At what pressure?
Last inert gas line pressure test date:
Last test date cargo pump emergency shut down:
Last test date of cargo and ballast valves:
How many UTI are on board? Last UTI shore calibration date:
Last cargo tank high level and overflow alarms test date:
Last date ullage, temperature and pressure comparison with remote system: Ullage: Temperature: Pressure:
Are vapour locks, where fitted, calibrated and certified by a recognised cargo inspection organisation? : . Date :
Last date pump room bulkhead seals gas tight inspection/maintenance:
Cargo pump room gas monitoring system last calibration date by shore:
Last annual shore service of SCBA required by IBC Code:
Last monthly inspection date on board of safety equipment required by IBC Code:
Last shore service of EEBD:
Are filter type respirators on board? :
Type of foam covering cargo area (alcohol or protein base?):
Vessel is using its own cargo hoses? Hoses number: Last pressure tested:
Last Class hose handling crane load test date (every 5 years): Last Class annual inspection date of hose handling crane: Ship has a single centreline mounted crane at the manifold? Ship-to-ship transfer is planned for this port? Last STS operation done: Cargo tank heating system type:
Last pressure tested: Steam Line: Inert Gas System type (IGG, Nitrogen or Flue Gas)? Last non-return valve overhaul date: Last Oxygen calibration date for IGS: Deck water seal type (dry/semidry/wet): Any crude oil washing has been planned for this port?
COW manual class approved date: The vapour return manifolds can be utilised at single buoy moorings?
Vessel is fitted with bow stoppers?
Break holding capacity of mooring winches:
Mooring winches motive power (steam, hydraulic, electric):
If vessel is equipped for mooring at SPM meet recommendations in MEG 3rd edition?
Is a straight lead of the pick up rope to storage drum?
Vessel is fitted with a hydraulically operated bow stopper?
Which deck officer is qualified person for handling distress communications?
Radio equipment availability ensured by duplication of equipment? :
Radio equipment enrolled with a shore based maintenance services?
Who is the SBM provider?:
Machinery space is certified for unmanned operation?
If machinery space is being operated manned, are there sufficient engineers on board?
Is the dead man alarm fitted? Set for how many minutes?
Does the operator subscribe to a fuel, lubricating &hydraulic oil testing programme? Contracted company name for FO (MGO): Frequency of analysing tests for FO(MGO) Last analyses date for FO (MGO): Contracted company name for LO: Frequency of analysing tests for LO: Last analyses date for LO:
Is the vessel able to safely comply with SECA/ECA legislation?
PMS is computerised? : PMS name: PMS Class approval date: Covering all the areas of vessel?
Is fitted an engineer's call Set for how many minutes?
Last on load emergency generator test date:
Last quick closing valve system test date:
Engine room emergency stops for ventilation fans test date:
Are diesel engines high & low pressure fuel delivery pipes jacketed or screened?
Last emergency steering gear test date:
Last Oil mist detector test:
Ship security plan approved day: SSO: Certificate issued date: Last Security drill: Last SSAS test:
