ISSUE STATUS: 3

CONDITION SURVEY REPORT FOR THE UNITED KINGDOM MUTUAL STEAMSHIP ASSURANCE ASSOCIATION (BERMUDA) LIMITED

(Photograph of Ship)

Dates of Survey: Place of Survey: Next Port of Call: Vessel Status : IMO No: Classification Society: Survey Company: Surveyor Name: Preliminary / Full Report : No. of pages: Surveyors Ref. Number: Number of Listed Defects: ETD: ETA: LADEN / LIGHT / BALLAST / UNDER REPAIR UK Club Ref:

ISSUE STATUS: 3

CONTENTS OF PRELIMINARY AND FULL REPORTS (TO BE INCLUDED AS APPROPRIATE)

Section INTENDED ACTUAL

P = Preliminary report, F = Full report (Item Numbers) ( ) = As applicable. Cover Page List of Items not Surveyed: Contents Page General Particulars (1 TO 15) Assessment of Vessel (1 to 10) Overall Comments on the Condition of the Ship Management (ISM & STCW)
(1 to 11)

Comments P X X F X X X X X X X X X X X P F

A B C D E F G H

X X X X X

References and Records(1 to 24) Publications (1 to 9) Class and Statutory Certificates Expired or Due to Expire in Next Three Months: (1 to 33) Manning and Management (1 to
15)

J K L M N P Q R X X X X

X X X X X X X X X X X

Organisation / Management
(1 to 10)

Navigation (Items 1 to 36) Communications (Items 1 to 10) Firefighting equipment and Lifesaving Appliances. (1 to 23) Engineroom and Machinery
(1 to 28)

Condition of Hull (1 to 13) General Condition of the Other Areas (1 to 5) Ultrasonic Readings of Hatch Covers: List of Photographs and Captions List of defects and suggested actions

ISSUE STATUS: 3

A (continued) CONTENTS OF PRELIMINARY AND FULL REPORTS (TO BE INCLUDED AS APPROPRIATE) Type Designator Ship Type : (Item Numbers)
INTENDED ACTUAL

Comments

F (X) (X) (X) (X) (X) (X) (X) (X) (X) (X)

General Cargo Dry Bulk Carrier Reefer Cellular Container Passenger Ro/Ro OBO / OREOIL Tanker Chemical Tanker Gas Tanker Offshore Supply

ST1 (1 to 51) ST2 (1 to 47) ST3 (1 to 62) ST4 (1 to 54) ST5 (1 to 71) ST6 (1 to 28) ST7 (1 to 29) ST8 (1 to 64) ST9 (1 to 27) ST10 (1 to 39)

ST11 (1 to 20) Vessel Dredgers Other Items ST12 (1 to 34)

(X)

(X) (X)

NOTE : Sections C, K, L, M, N, P, Q, R, ST1 TO ST12 require certain items to be given a rating. The ratings are : 1. Excellent , 2. Good , 3. Satisfactory , 4. Below Standard and 5. Unacceptable. Ranges of ratings are not to be given (e.g. 3 4), but rather a specific rating (e.g. 3). Where ratings of 3, 4 or 5 are given, an explanation is also required. Where the box has been shaded in no rating is required. Where the box has a Y / N (Yes / No), delete one to leave the appropriate answer to the question no rating required.

ISSUE STATUS: 3

LIST OF ITEMS NOT SURVEYED

ISSUE STATUS: 3

GENERAL PARTICULARS

Name of Vessel:

Flag and Port of Registry:

Previous Names

Type of Vessel:

Trading Area: Gross Tonnage: (date of measurement for GT): DWT / TEU/Passenger Capacity Construction: Date and Place

Owner:

10

Operators: Date Operator Assumed Responsibility: Classification Society:

11

12

13

Date of last Dry Docking: Date of last Special Survey Hull / Machy Date of next Special Survey Hull / Machy

14

15

ISSUE STATUS: 3

OVERALL ASSESSMENT OF VESSEL (RATING). 1. Excellent 2. Good 3. Satisfactory 4. Below Standard 5. Unacceptable Rating Comment Cargo worthiness:

Safety Awareness/Management

Safety Equipment:

Pollution Prevention:

Operational Performance:

Service / Maintenance:

Compliance with Minimum Safe Manning:

STCW:

ISM

10

Compliance with SOLAS

11

Compliance with ISPS

Comments required if a rating is 3, 4 or 5. Ranges of rating, e.g. 2 to 3, are not to be given; specific ratings only (e.g. 2).

ISSUE STATUS: 3

D OVERALL COMMENTS ON THE CONDITION OF THE SHIP

ISSUE STATUS: 3

E ISM Subject 1 2 3 4 ISM Compliance Copy of Document of Compliance. (DOC) Safety Management Certificate: (SMC) Safety Management System on Board. (SMS) Are Internal Audits Correctly Conducted and Recorded Are Records Maintained of Non Conformities, Accidents and Hazardous Occurrences? Are Maintenance Programmes and Inspections of Ship Recorded? Are Measures Provided to Promote the Reliability of Equipment, the Failure of which may Result in Hazardous Situations?

MANAGEMENT Detail Comments

Dated: Issued By: Dated: Issued By: Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

STCW Are records maintained and available regarding: 9 10 11 Crew Familiarisation (Including Prior Sailing)? Training Carried Out on Board? Emergency Drills and Exercises? Yes/No Yes/No Yes/No

ISSUE STATUS: 3

REFERENCES AND RECORDS

Are the following on board and, if appropriate, in regular use? 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Deck Log Book: Engine Log Book Bell Book: Oil Record Book Part 1: Oil Record Book Part 2 Oily Water Monitor Sounding Book: Radar Log: Compass Error Book: Chronometer Rate Book: Masters Order Book: Company Regulations Procedures/Guidelines: Company Instructions to Master: Stress Calculator: Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N

15

Records/Printouts to Show Use of Stress Calculations:

Y/N

16 17 18 19 a 19 b 19 c 20 21 22

Approved Grain Stability Book: Loading/Stowage/Discharge Plan (Actual), including stability & stress calculations.: Approved Cargo Securing Manual Deck Maintenance Record Book: E.R. Maintenance Record Book: Is a planned maintenance system in operation Permit to Work System, including hot-work and enclosed space entry:: Medical Log Safety Committee minutes

Y/N Y/N Y/N Y/N Y/N Y/N

Y/N Y/N Y/N

ISSUE STATUS: 3

23 24 25

Personnel accident record : Port / Flag State Inspection Records (note outstanding deficiencies). US Water Pollution:

Y/N Y/N Y/N

COMMENTS

ISSUE STATUS: 3

PUBLICATIONS

Are the following on board and in use, as appropriate FOR ALL SHIPS Y/N COMMENT

SOLAS (1997 Consolidated) 1 + 1996, 1997/98 Amendments 2 3 4 Loadline Regulations IAMSAR Manual Volume 3; Mobile facilities Standard Marine Navigational Vocabulary 1985 International Code of Signals (1987 with 1994 5 amendments) Collision Regulations (1972) 6 + amendments Y/N Y/N Y/N Y/N Y/N Y/N

ICS/IMO Bridge Procedures 7 Guide 1998 Y/N

MARPOL 73/78 (1997 Edition 8 + 97/99 amends) Y/N

STCW 1995

Y/N

ISSUE STATUS: 3

SHIP CERTIFICATES & DOCUMENTS Detail only those items due to expire within three months or where specific comment required. Date of Expiry Issued Date & Place (inc. Annual)

ALL SHIPS 1 2 3 4 5 6 7 8 9 10 Registry: International Tonnage Certificate: International Loadline Certificate: International Oil Pollution Prevention Certificate (IOPPC): Minimum Safe Manning Document: Intact Stability Booklet Damage Stability Information Shipboard Oil Pollution Emergency Plan (SOPEP): Certificates of Ship's Personnel (validation / possession): International Ship Security Certificate

All CARGO SHIPS 11 12 13 14 15 16 Safety Construction Certificate: Safety Equipment Certificate (equipment list attached): Safety Radio Certificate: Document of Compliance for Dangerous Goods (if carrying): Dangerous Goods Manifest / Stowage Plan : Document of authorisation for carriage of grain:

ISSUE STATUS: 3

TANKERS (additional) 17 Certificate of Insurance / Financial Security for Civil Liability for Oil Pollution Damage (CLC)

Date & Place of Issue

Date of Expiry

PASSENGER SHIPS (additional) 18 Passenger Ship Safety Certificate OR (Form attached): Special Trade Passenger Ship Certificate: 19 Special Trade Passenger Ship Space Certificate:

Date & Place of Issue

Date of Expiry

CHEMICAL CARRIER (additional) Date & Place of Issue Date of Expiry Certificate of Fitness for the Carriage 20 of Dangerous Chemicals in Bulk OR (issued under BCH Code): International Certificate of Fitness for 21 the Carriage of Dangerous Chemicals in Bulk (issued under IBC Code): ANY VESSEL CARRYING NOXIOUS LIQUID CHEMICAL SUBSTANCES IN BULK: International Pollution Prevention Certificate for Carriage of Noxious 22 Liquid Substances in Bulk (INLS): ( need not possess if 19 or 20 held )

GAS CARRYING VESSEL (additional) Certificate of Fitness for Carriage of 23 Liquefied Gases in Bulk (GC Code). International Certificate of Fitness for 24 Carriage of Liquefied Gases in Bulk (IGC Code).

Date & Place of Issue

Date of Expiry

HIGH SPEED CRAFT (additional) 25 26 High Speed Craft Safety Certificate: Permit to Operate High Speed Craft:

Date & Place of Issue

Date of Expiry

ISSUE STATUS: 3

MISCELLANEOUS (additional) 27 Special Purpose Ship Safety Certificate: Certificate of Fitness for Offshore Supply Vessels when carrying Noxious Liquid Substances in Bulk or IOPP Certificate. Diving System Certificate Construction & Equipment Certificate (Dynamically Positioned Ships):

Date & Place of Issue

Date of Expiry

28

29 30

CLASSIFICATION SOCIETY

Date & Place of Survey

Date & Place of Next Survey

31a

Hull Special Survey:

31b

Hull Annual Survey:

32a

Machinery Special Survey:

32b

Machinery Annual Survey:

33

Dry Docking:

34

Other (e.g. Refrigeration): Y

35

Does vessel participate in CAP? N

If yes, give rating

ISSUE STATUS: 3

MANNING AND MANAGEMENT Total Manning Certificate Total Persons per Dominant Safety Certificate Nationality

1 2 3

Officers: Ratings: Total Number of Persons on Board: Master: Chief Engineer: Length of Sea Service as Master (Years) Length of Sea Service as Chief (Years)

4 5

Language Language of Ship: 6 Management Pilotage (Yes, Strict, Moderate, Lax, Nil) 7 8 9 10 Pre-Pilotage Conference? Masters Supervision of Pilot: Officers Supervision of Pilot: Standards of Vigilance under Pilot: Officers Mother Tongue (Same or Other) Ratings Mother Tongue (Same or Other)

P&I Involvement Current P&I Literature on Board: Yes/No Master 11 12 Date of Last Contact with a P&I Correspondent? Understand Impact of P&I Costs/Claims on Operating Cost of Ship? (Yes/No) Officer Believes he has Owners Interests at Heart (e.g. in Case of Agency Employed Officers) (Yes/No) Present Cargo: Previous Experience of this Cargo? (Yes/No) Chief Officer

13 14 15

ISSUE STATUS: 3

ORGANISATION/MANAGEMENT
Rating

Comment

1 2

Superintendent Last Visited Ship? How Does Master Communicate with Owners and Charterers? Does Master Make Regular Written Reports? Compare Stores Requests to Actual Supply: Compare Repair Lists to Work Carried Out: Documentary Control (Plans etc) Are There Sufficient Crew on Board to Handle an Emergency? Does The Company Supply The Appropriate Protective Clothing Do the Crew Wear Appropriate Protective Clothing: Y/N

5 6 7

ISSUE STATUS: 3

NAVIGATION
Rating

Comment

1 2 3 4 5 6 7 8

One-Man Bridge Operation Approval: Gyro Compass: Bearing Repeater/Azimuth Rings: Autopilot: Course Recorder: Standard (Magnetic) Compass: Date of Deviation Curve: Radars: Type: Type:

Y/N Y/N Y/N Y/N

9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

A.R.P.A.: Chronometers: Satnav (GPS, GLONASS): Loran: Depth Sounder, Recorder or Indicator? Spare Paper? Radio DF: Correction Curve (if fitted): Log/Speed Indicator: Rudder Indicator: Revolution Indicator: Navigation Lights: Signal Lights / Aldis / Whistle / ships bell & gong. Navigation shapes Chart Outfit: Date Last Corrected and by Whom: Correction System on Ship: Latest Notices to Mariners: Navtex Receiver: Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N

ISSUE STATUS: 3

L (continued) 26 27 28 29 30 31 32 33 Date Last Corrected: 34 35 RPM/Speed Data: Manoeuvring Data: Spare Paper Weather Facsimile Receiver: Spare Paper Pilot Books and Supplements: Guides to Port Entry: Nautical Almanac: For Current Year. Tide Tables: areas / volumes (For Current Year). List of Lights:

NAVIGATION Y/N Y/N Y/N

Y/N

36 37 a

Pilot card / Master-Pilot Information Exchange:

Passage Planning (Berth to Berth)

Execution: Are Positions Marked b on the Charts for Port Approaches? Y/N

Are Positions Marked on the Charts for Piloted Passages? c

Y/N

ISSUE STATUS: 3

Comments: (continued)

ISSUE STATUS: 3

COMMUNICATIONS
Rating

Comment

1a

Does the Vessel Comply with GMDSS Outfit Requirements for its Operating Area (Sea Area A1, A2, A3, A4) and Hold a Valid Safety Radio Certificate? (SOLAS Ch. IV Regs. 7 to 11). Apparent Condition of the GMDSS Communication Equipment (including within equipment test date where applicable). Battery expiry dates: SARTs EPIRB Portable VHFs emergency batteries Other Communications Equipment, Condition Are there Sufficient Radio Operators Licences on Board (GOC)? Communication Log Book Emergency Instructions/Operating Procedures List of Radio Signals (date last corrected) Does the Vessel Comply with any Other Requirements for its present Trading Area (e.g. Great Lakes Area)? If the Vessel does not Comply with the GMDSS Requirements does it Hold a Valid

Y/N

1b

2 a b c 3

4 5 6 7

Y/N

Y/N

Exemption Certificate (SOLAS Ch IV Reg 3) Expiry date of certificate: If question 8 applies, is fitted equipment apparently satisfactory and in good order? State equipment provided:

Y/N

10

Y/N

ISSUE STATUS: 3

COMMENTS

ISSUE STATUS: 3

FIRE FIGHTING EQUIPMENT AND LIFE SAVING APPLIANCES

Rating

Comment

1a

Lifeboats: Type and Number:

1b

Overall Condition:

1c

Equipment:

1d 1e

Fittings: Launching equipment, davits and wires (include date end-for-ended / renewed). Liferafts: Number and location. (Appropriate certification)

2a

2b

Hydrostatic Releases: Launching equipment (as applicable): Signage / instructions posted at point of use? Lifebuoys: Life Jackets: Overall condition and Number: Light Expiry: Type-Approved: Immersion Suits: Number Stowage Location Y/N No. Expiry: Y/N

2c

4 5a

5b 6a

6b

ISSUE STATUS: 3

7 8 9 10 11 12 13 14 15 16 17 18 19 20

Thermal Protective Aids: Number and Location: Fixed FFA, including surveys as applicable: Fixed Fire Detection: Fire Lines and Hydrants: International Shore Connection: Fire Hoses and Nozzles: Fire Extinguishers (including surveys): SCBA and ELSA (including surveys): Portable Oxygen Meters: Bridge Pyrotechnics: Line Throwing Appliance: Lifeboat Pyrotechnics: Emergency Station Bills: Fire Control Plan: Internal: External: Escape Routes and Signs: Life Saving Apparatus Training Manuals (SOLAS): Maintenance Manuals (FFA/LSA):

b 21 22 23

ISSUE STATUS: 3

ENGINE ROOM AND MACHINERY

Rating

Comment

1 2a

Overall Condition of Engineroom Securing of: Spares Deck Plates Ladders & guard Main Engine: Boiler: Auxiliary Boiler: Auxiliary Machinery:

2b

2c 3 4 5 6

Generators:

8 9 10

Purifier Room Cleanliness: Switchboard: Domestic Refrigeration Machinery: Workshops (including machinery guards and/or protective items).

11

12 13

Spares: U.M.S.: Control Room Alarms and Instrumentation:

14

ISSUE STATUS: 3

15 16a

Fire Detection System: Smothering System: Closing / Sealing Devices: Remote Stops: Oil/Water Separator: Overboard Discharge Alarm: Overboard Discharge Locked in Port? Sanitation System: Sea Valves: Bilge System: High-Level Alarms: Cleanliness: Shaft Tunnel/Stern Gland: Emergency Escape: Fire-Resisting Doors: Fire/Pollution Hazards: Steering Gear and Emergency System: Date Last Tested at Sea: Emergency Generator (Tested): Emergency Fire Pump (Tested): Emergency Air Compressor (Tested): Crane/Hoist SWL and Record of Examination: Records of Maintenance for Engine Room equipment. Planned maintenance? ( ( ( ) ) ) Y/N

16b 17 18a

18b 18c 19 20 21a 21b 21c 22 23 24 25 26a

26b 27a 27b 27c

28 29

Y/N

ISSUE STATUS: 3

Comments:

ISSUE STATUS: 3

CONDITION OF HULL Rating Comment

External Shell Plating:

Decks, Maindeck, Forecastle, Poop:

Superstructure:

Internal Shell Plating, Bulkheads, Frames:

Ballast Tanks, Peak Tanks, Cofferdams:

Mooring Equipment, Anchors, Cables, Mooring Ropes, Fairleads:

ISSUE STATUS: 3

Rating

Comment

WT Openings, Doors, Ports, Skylights:

Ventilators, Pipes, Sounding Pipes and Closing Devices, including identification of compartment served:

Deck Lighting:

10

Manifold, Bunker Tank Vent and Sounding Pipe Savealls, including identification of tank served:

11

Pilot Hoist /Ladders

12

Accommodation Ladders and gangways.

13

Deck Store / Focsle Store / Paint Locker / CO2 / incident (Oil Pollution etc.) spaces.

ISSUE STATUS: 3

GENERAL CONDITION OF OTHER AREAS Rating. Comment

Accommodation 1 (Internal):

Galleys and Storerooms:

Hospital:

Dispensary and Medical:

Oxygen Resuscitator:

ISSUE STATUS: 3

ST1 : GENERAL CARGO SHIPS ST1 GENERAL CARGO SHIPS Comment

Certificates, Publications and Documentation (additional to Section H) 1 2 3 4 5 6 7 8 9a International Maritime Dangerous Goods Code IMDG Consolidated Supplement Code of Safe Practice for Solid Bulk Cargoes (Unless in IMDG Code) IMO Grain Rules Code of Safe Practice for Ships Carrying Timber Deck Cargoes Cargo Stowage Plans: Stress Calculations: Stability calculations: Cargo Gear Quad. / Quintennial Survey in date: Cargo Gear Annual: Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N

9b

ISSUE STATUS: 3

ST1 : GENERAL CARGO SHIPS

STEEL HATCHCOVERS
Rating

Comment

10 11 12 13 14 15 16 17 18 OR

Type and Number: Method of Opening/Closing: Condition of Covers(Pontoons/Panels) Coaming Compression Bars: Sealing Rubbers: Cross Joint Drain Channels: Coaming Channels and Drains Securing Devices for Sea Hatchcovers Container Fitted?

Y/N

HATCHCOVERS DESIGNED FOR USE WITH TARPAULINS: Rating Comment Is vessel designed for use with 10 Y/N tarpaulins? 11 Number of Hatchcovers: Type and Number of Pontoons / 12 battens per hatch: Condition: Means of removing covers / 13 pontoons / battens: Number and condition of 14 tarpaulins per hatch: 15 Side/end batten bars: 16 Wedges: 17 Locking Bars: 18 Spares: HATCH FITTINGS
Rating

Comment

19 20 21 22 23 24 25

Hold Access Hatches Test for Watertightness: Method Used: Spares: Hold Vent Opening/Closing Hold Vent Cowlings Hatchcovers Container Fittings? Any other fittings?:

Y/N

ISSUE STATUS: 3

ST1 : GENERAL CARGO SHIPS

HOLDS INTERNAL
Rating

Comment

26a 26b 27 28 29 30 31 32 33 34 35 36 37 38 39

Number of Holds: Holds Approved for Dangerous Cargoes (specify): Coatings: Ladders: Guardrails: Spar Ceiling: Tank Tops: Manholes, Covers: Bilges and Suctions; Air Sounding Pipes: Tween Deck Hatchcovers: Lighting: Ventilation Type: Ventilation Trunking: Smothering Distribution System:

CARGO AND STORES HANDLING MACHINERY

Rating

Comment

Cranes or Derricks: Number: 40 Type: SWL: Limit Switches: 41 42a 42b 43 44 45 Cargo Running Gear: Winches: Controls: Entries Made in Register: Spares: Safety/Operation Markings: Y/N

ISSUE STATUS: 3

ST1 : GENERAL CARGO SHIPS COMMENTS:

ISSUE STATUS: 3

ST2 : DRY BULK CARRIERS ST2 DRY BULK CARRIERS

FOR DRY BULK CARRIERS AND OBO Certificates, Publications and Documentation (additional to Section H) 1 2 3 4 IMDG Consolidated Supplement (inc. BC Code) Code of Safe Practice for Solid Bulk Cargoes (Unless carried in IMDG Consolidated Supplement ) IMO Grain Rules Cargo Stowage Plans: Y/N Y/N Y/N Y/N Comment

Stress Calculations:

Y/N

Stability calculations: Cargo Gear Quad. / Quintennial Survey in date: Cargo Gear Annual:

Y/N Y/N Y/N

HATCHCOVERS
Rating

Comment

Type and Number:

Method of Opening/Closing:

10

Condition of Covers:

11

Coaming Compression Bars:

12

Sealing Rubbers:

13

Cross Joint Drain Channels:

ISSUE STATUS: 3

ST2 : DRY BULK CARRIERS

14

Coaming Channels and Drains

15

Securing Devices for Sea

16

Hold Access Hatches

17

Test for Watertightness: Method Used:

18

Spares:

19

Hold Vent Cowlings

20

Hold Vent Opening/Closing

ISSUE STATUS: 3

ST2 : DRY BULK CARRIERS HOLDS

Rating

Comment

21

Number of Holds: Last Shipboard Check for

22

Structural Strength, Including Grooving and Wastage:

23

Internal Steel Structure:

24

Coatings:

25

Ladders:

26

Guardrails:

27

Tank Tops:

28

Manholes, Covers:

29

Bilges and Suctions:

30

Air Sounding Pipes:

31

Lighting:

32

Ventilation Type:

33

Ventilation Trunking:

34

Smothering Distribution System:

35

Hold Water Level Indicators:

ISSUE STATUS: 3

ST2 : DRY BULK CARRIERS

CARGO AND STORES HANDLING MACHINERY

Rating

Comment

36

Cranes or Derricks: Number: Type: SWL: Limit Switches: Cargo Running Gear: Winches: Controls: Entries Made in Register: Spares: Safety/Operation Markings: Y/N

37 38a 38b 39 40 41

COMMENTS:

ISSUE STATUS: 3

ST3 : REEFER CARGO SHIPS

ST3

REEFER CARGO SHIPS

Certificates, Publications and Documentation (additional to Comment Section H) 1 2 3 4a Cargo Stowage Plans: Stress Calculations: Stability calculations: Cargo Gear Quad. / Quintennial Survey in date: Cargo Gear Annual: U.S.D.A. certification (e.g. fruit cargoes) Class Refrigeration Certification: Y/N Y/N Y/N Y/N Y/N Y/N Y/N

4b 5 6

ISSUE STATUS: 3

ST3 : REEFER CARGO SHIPS

GENERAL
Rating

Comment

7 8a 8b 8c 8d 9a 9b 10 11a 11b 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27

Shipment Instructions: Number of Holds: Hold Suitability: Securing Devices for Sea Hold Access Hatches Hold Vent Opening/Closing Hold Vent Cowlings Control of access to cargo spaces procedures / signage / notices: Number and Type of Hatch Covers: Condition: Coaming Compression Bars: Sealing Rubbers: Cross Joint Drain Channels: Coaming Channels and Drains Test for Watertightness: Method Used: Hatchcover Container Fitting Spares for hatch covers Side loading doors: Deck Gratings: Fan Rooms and Battery Spaces: Ducting: Lagging and Insulation (Type): Refrigerant Type and Spare Quantity: Refrigeration Plant: Air Freshening/Control Flaps: Temperature Monitoring Equipment:

Y/N

ISSUE STATUS: 3

ST3 : REEFER CARGO SHIPS

HOLDS INTERNAL
Rating

Comment

28 29 30 31 32 33 34a 34b 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50

Sensors for Air Delivery: Sensors for Air Return: Sensors for Cargo Spaces CO2 Test Equipment: Humidity Recorder: Air Flow Measurement: Number of Fresh Air Changes / hr. Maximum: Cargo Temperature / Ventilation / Gas Level Records: Does Vessel Meet Class Requirements, including spares provision? Number of Chambers: Coatings: Ladders: Guardrails: Spar Ceilings / Gratings: Tank Tops: Manholes, Covers: Bilges and Suctions; Air Sounding Pipes: Tween Deck Hatchcovers: Lighting: Ventilation Type: Ventilation Trunking: Smothering Distribution System:

Y/N

ISSUE STATUS: 3

ST3 : REEFER CARGO SHIPS

CARGO AND STORES HANDLING MACHINERY

Rating

Comment

51a 51b 51c 51d 52 53a 54b 55 56 57

Cranes or Derricks: Number: Type: SWL: Limit Switches: Cargo Running Gear: Winches: Controls: Entries Made in Register: Spares: Safety/Operation Markings: Y/N

COMMENTS:

ISSUE STATUS: 3

ST4 : CELLULAR CONTAINER SHIPS ST4 CELLULAR CONTAINER SHIPS

Certificates, Publications and Documentation (additional to Section H) 1 2 International Maritime Dangerous Goods Code IMDG Consolidated Supplement Y/N Y/N

Comment

Cargo Stowage Plans :

Y/N

Stress Calculations:

Y/N

Stability calculations:

Y/N

6a

Cargo Gear Quad. / Quintennial Survey in date:

Y/N

6b 7

Cargo Gear Annual:

Y/N

Lashing Equipment Inventory (give date):

Y/N

ISSUE STATUS: 3

ST4 : CELLULAR CONTAINER SHIPS

GENERAL
Rating

Comment

8 9 10 11 12 13 14 15 16 17 18 19 20 21

Calculation of Bending and Torsion Moments and Shear Forces: Number of Holds: Number / Type of Hatches: Type / Condition of Covers: Coaming Compression Bars: Sealing Rubbers: Cross Joint Drain Channels: Coaming Channels and Drains Hold Access Hatches: Spares for hatch fittings: Securing Devices for Sea Hold Vent Opening/Closing Hold Vent Cowlings Test for Watertightness: Method Used: Additional Requirements (as applicable, e.g. hatch cover-less ships). Provision of Lashing Equipment Maintenance of Lashing Equipment: Spares for lashing equipment: Procedure for Ensuring that NonConforming Twistlocks are not Used: Reefer Electrical Connections:

22 23 24 25 26 27

ISSUE STATUS: 3

ST4 : CELLULAR CONTAINER SHIPS HOLDS INTERNAL

Rating

Comment

28 29 30 31 32 33 34 35 36 37 38 39 40

Internal Structure: Coatings: Ladders: Guardrails: Cell Guides and Pads: Tank Tops: Manholes, Covers: Bilges and Suctions; Air Sounding Pipes: Lighting: Ventilation Type: Ventilation Trunking: Smothering Distribution System:

BALLAST / COMPENSATION SYSTEM

Rating

Comment

41

Type of System / Tanks:

42

Internal Condition:

ISSUE STATUS: 3

ST4 : CELLULAR CONTAINER SHIPS

CARGO AND STORES HANDLING MACHINERY

Rating

Comment

43 a b c d 44

Cranes or Derricks: Number: Type: SWL: Limit Switches: Cargo Running Gear: Winches:

45 Controls: 46 47 48 Entries Made in Register: Spares: Safety/Operation Markings: Y/N

COMMENTS:

ISSUE STATUS: 3

ST5 : PASSENGER SHIPS ST5 PASSENGER SHIPS Comment

Certificates, Publications and Documentation (additional to Section H) 1 2 7 8 9 10 11 12 Cargo Gear Annual: Y/N Stability calculations: (Approved) Damage Control Plan: (Approved) Security Manual: Agreed search and rescue co-operation plan High Speed Craft Code (as applicable) International Maritime Dangerous Goods Code IMDG Consolidated Supplement Cargo Gear Quad. / Quintennial Survey in date: Y/N Y/N Y/N Y/N Y/N Y/N Y/N

GENERAL Operating Area

Rating

Comment

13

Operating Area. State Present Area and Future Operating Area(s)

Emergency Command & Control

Rating

Comment

Emergency Control Organisation 14 15 Emergency Control Position (e.g. Bridge). (Sufficient Plans, Information and Means of Communication) Backup / redundancy features of electronic systems:

ISSUE STATUS: 3

ST5: PASSENGER SHIPS Fire Control

Rating

Comment

16 17 18a 18b 18c 18d 18e

Are Main Fire Zones Marked on the Fire Control Panel? State Number of Zones Are Remote Release Fire Doors Fitted? In Good Order and Free From Obstruction? Local and Remote Release Systems Planned Maintenance / Routine Testing System? Manually Operated Doors Kept Closed?

Y/N

Y/N Y/N

Y/N Y/N

Fire Detection System

Rating

Comment

19 20 21 22

Control Panel Duplicated at Remote Locations? Maintenance and Testing of the system Manual Fire Alarm Points in good order? Y/N Y/N

Damage Control Watertight Doors

Rating

Comment

23a 23b 23c 23d 23e 24 25 26 27

28

Are the Watertight Doors Operable From: Bridge (Control Position) Local Position at Door Bulkhead Deck Remote Position By back-up power, e.g. local hydraulic reservoir Maintenance and Testing Are all personnel instructed in the safe operation of watertight doors on joining the vessel? Announcements Made Prior to Testing of Watertight Doors? If Doors are Located in Passenger Areas, are Personnel and Signage/Barriers Positioned? Control Over the Opening of Watertight Doors Designated Shore Based Support System for Damage/Stability Information? (Specify e.g. In-House/Lloyds Register)

Y/N Y/N Y/N Y/N

Y/N Y/N Y/N

Y/N

29

Down Flooding or Other Flooding/Water Removal Arrangements

ISSUE STATUS: 3

ST5: PASSENGER SHIPS Ventilation

Rating

Comment

30

Inspection / Maintenance Routine (internal & external flaps). Marking/Signage

31

Ventilation *(Health & Hygiene section)

Rating

Comment

32

Monitoring and Maintenance of Ventilation/Air Conditioning Systems

Passenger Control
Rating

Comment

33 34 35 36a 36b 37

Passenger Muster Stations Identification and Signage Current List of Passengers Maintained at Y/N Each Muster Station? Information to Passengers on Actions in an Emergency? Crew Training in passenger control: Training onboard Shore based training Passenger and Crew Evacuation Plan

Miscellaneous
Rating

Comment

38 39

Emergency Lighting System Public Address System effectiveness

ISSUE STATUS: 3

ST5: PASSENGER SHIPS (Public) Spaces and Movement

Rating

Comment

40 41 42a

Overall Risk Assessment of fittings: Ship Stabilisation System Are Public Areas Closed for Periods (e.g. in Port, in Territorial Waters, at Night)? If so, is provision made for easy and quick access if required in an emergency? In the Comments Section at the end list the public spaces used as passenger muster points in an emergency Are any of these spaces affected by closure of Public Spaces (Specify). Excluding the locked spaces, are sufficient spaces and equipment available in an emergency? Ships Tenders. Gangways, ladders etc. Pontoons, accommodation. Y/N Y/N

42b

42c

42d 42e

Y/N Y/N

43 44

Health & Hygiene Organisation

Rating

Comment

45a 45b 45c

Onboard organisation for maintenance of hygiene standards: Crew Training in hygiene and sanitation standards Is shore support provided? Y/N

46

Has an outside Body (e.g. United States Public Health Authority USPH), inspected Vessel? If so List any Major Deficiencies in the Comments Section (here or below):

Y/N

ISSUE STATUS: 3

ST5: PASSENGER SHIPS Health and Hygiene Standards

Rating

Comment

47

Overall

Galleys (including): Food preparation areas Food presentation areas 48 Cool Cabinets Bakery Dairy Butchers Area 49 Store Rooms

50

Refrigerated Spaces

51

Handling Areas Dining Areas Including outside/covered areas, e.g. Lido Area or equivalent) Personnel

52

53

54a

Accommodation: Passenger areas

54b

Crew Areas

54c

Passenger Deck Pantries

55

Potable Water Standards (Checks/Records)

ISSUE STATUS: 3

ST5: PASSENGER SHIPS Medical

Rating

Comment

56

Number and type of Medical Staff Carried

57 58

Training and Certification of personnel in Advance Life Support techniques Systematic monitoring of health onboard (e.g. record of infectious cases)

Y/N Y/N

Swimming Pools / Jacuzzis / Spas etc.

Rating

Comment

59 60a 60b 60c

Monitoring of water quality (e.g. Chlorine and pH levels) Fittings and Equipment, Surfaces and Signage/Instructions

Gymnasium/Fitness Centres
Rating

Comment

61

Is Equipment Fitted Apparently Safe and Well Maintained? Supervision and Instruction

Y/N

62 Signage Shops, Concessions, Hair Salons

Rating

Comment

63 64

Equipment and Fittings Personnel (Safety Knowledge/Awareness)

ISSUE STATUS: 3

ST5: PASSENGER SHIPS

Miscellaneous
Rating

Comment

65a

Dedicated/Designated Safety Officer (Specify) Record of Crew and Passenger accidents and investigations: Are the results of the investigations acted upon (if applicable); Safety Announcements (e.g. Gangway Access, Boating Ports, Weather etc.) Approved Security Manual Y/N Y/N Y/N Y/N

65b

65c

65d

66a 66b 66c 66d 66e Is there a Dedicated Security Officer onboard? Security Training of Personnel Exercises Incorporating Security Aspects (e.g. Bomb Search) Gangway /access security Y/N

Helicopter Operation arrangements: 67 68 69 Are exercises / drills carried out, involving all affected departments: Onboard organisation Provision of equipment, including safety / FFA: Personnel: 70 Induction Training for new / re-joiners: (duties, ship systems, pollution awareness etc.) Onboard Training and Exercise Programme: Shore Support:

Rating

Comment

Y/N

Y/N
Rating

Comment

71 72

ISSUE STATUS: 3

ST5: PASSENGER SHIPS

COMMENTS:

ISSUE STATUS: 3

ST6 : RO/RO SHIPS

ST6

RO/RO SHIPS Comment

Certificates, Publications and Documentation (additional to Section H) 1 International Maritime Dangerous Goods Code Y/N 2 IMDG Consolidated Supplement Y/N 3 Approved Damage Stability Booklet Y/N 4 Approved Damage Control Plan Y/N Is an agreed search and rescue co-operation plan 5 Y/N carried?

GENERAL
Rating

Comment

6 7 8 9 10 11

Trading Area: Fire Detection System: Sprinkler/Drencher System Watertight Doors: Fire-Resisting Doors: Bow Visors/Shell Doors/Stern doors: Door Indicator Lights and T.V. Monitors:

12a 12b

Local Position Remote (Bridge)

13

Watertightness of Stabiliser Spaces:

ISSUE STATUS: 3

ST6 : RO/RO SHIPS

Public Rooms: 14 Overall

Rating

Comment

15

Risk Assessment of Fittings:

16

Escape:

17

Emergency Lighting:

18

Galley and Food Handling Areas:

19

Safety Instructions to Passengers:

20

Escape Routes and Signage:

21

Crew Response in an Emergency:

22

Ramps:

23

Lifts:

24

Fixed and Portable Cargo Lashing Equipment: Ventilation of Vehicle Decks, give type / capacity: Subdivision of vehicle decks (fire and stability), give type and number:

25

26

ISSUE STATUS: 3

ST6 : RO/RO SHIPS COMMENTS:

ISSUE STATUS: 3

ST7 : OBO AND ORE/OIL ST7 OBO AND ORE/OIL

Use page as applicable for cargo carried, i.e. tanker or bulk Also use page for alternative cargo but not carried at the time FOR DRY BULK CARRIERS AND OBO Certificates, Publications and Documentation (additional to Section H) 1 IMDG Consolidated Supplement Y/N 2 Code of Safe Practice for Solid Bulk Cargoes Y/N (Unless in IMDG Code) 3 IMO Grain Rules Y/N 4 Code of Safe Practice for Ships Carrying Timber Y/N Deck Cargoes 5 Cargo Stowage Plans: Y/N 6 Stress Calculations: Y/N 7 8a 8b 9 10 11 12 13 14 15 16 17 18 Stability calculations: Cargo Gear Quad. / Quintennial Survey in date: Cargo Gear Annual: Cargo Endorsement for Senior Officers: Operations and Procedures Manual: International Safety Guide for Oil Tankers and Terminals (4th edition): Annex I to MARPOL 73/78: Annex II to MARPOL 73/78 (Noxious Liquids) OCIMF Mooring Equipment Guidelines STS Transfer Manual: Clean Seas Guide: Oil Record Book - Part II- up to date and apparently correct: Cargo Record Book: Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Comment

19 20

ADDITIONAL ITEMS Cargo Pipelines in Ballast Spaces Arrangements for Heating Coils (specify type, e.g. raft, deck heat exchange, indirect etc.) Deck Manifolds of Heating Coils, as applicable: Stability Data for Loading/Discharging:

Rating

Comment

21 22

ISSUE STATUS: 3

ST7: OBO AND ORE/OIL

COMMENTS:

ISSUE STATUS: 3

ST8 : OIL TANKERS ST8 OIL TANKERS Comment

Certificates, Publications and Documentation (additional to Section H) 1 2 3 4 5 6 7 8 9 10 11 12 Cargo Stowage Plans: Stress Calculations: Stability calculations: Cargo Endorsement for Senior Officers: Operations and Procedures Manual: International Safety Guide for Oil Tankers and Terminals (4th edition): Annex I to MARPOL 73/78: OCIMF Mooring Equipment Guidelines STS Transfer Manual: Clean Seas Guide: Oil Record Book - Part II- up to date and apparently correct: Cargo Record Book: Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N

CARGO AND BALLAST TANKS

Rating

Comment

13a 13b 13c 14a 14b 14c 14d 14e 15 16a 16b 17a 17b 18

Number of Compartments: Cargo Ballast (specify type): Cargo Tank Structural Condition: Cargo Tank Coatings Heating System: Ballast Tank Coatings: Ballast Tank Structural Condition: Ladders and Access: Pipelines: Condition: Date Last Pressure Tested: Valve Operation: Auto/Manual Sediment/Sludge:

ISSUE STATUS: 3

ST8 : OIL TANKERS

CARGO CONTROL ROOM / CONTROL POSITION

Rating

Comment

19 20

Control Panel / Instrumentation Cargo & Ballast System mimic / information

21 22 23

Commodity Information: Ship / Shore check list completed : Cargo / Ballast Plan all phases of operation: Y/N

24 25

Stress / stability checks Portable atmosphere monitoring equipment :

26

Portable

Ullaging

Sampling

Equipment: 27 28 29 ODME, including printed record: Y/N Permits to work (as applicable) for Y/N current operation: Signage / Safety Notices

PUMPROOM
Rating

Comment

30 31 32 33 34 35 36 37

Automatic or Manual Operation of Valves? Warning Notices Ventilation: Lighting: Ladders: Rescue Equipment: Fire Fighting Equipment: Bilges:

A/M

ISSUE STATUS: 3

ST8 : OIL TANKERS

Rating

Comment

38a 38b 39 40 41a 41b 42 43 44

Pipelines: Condition: Date Last Pressure Tested: Oil Content Meter: Valves Pumps: Number and Type: Gauges: Safety/Pollution Hazards: Instrumentation:

INERT GAS AND ENVIRONMENTAL CONTROL

Rating

Comment

45a 45b 45c 46a 46b 46c 47 48 49 50a 50b 51a 51b

Inert Gas System Type: IG Distribution and Valves: Deck Water Seal (inc.type): O2 and Pressure Recorder in CCR: O2 Level in IG Produced: O2 Level in Tanks: Gas Pressure in IG Main/Tanks IG Pressure Alarms, Bridge/CCR: IG Alarms, CCR/ER: Oxygen Measurement, Fixed: Oxygen Measurement, Portable: Hydrocarbon Gas Measurement, Fixed: Hydrocarbon Gas Measurement, Portable:

ISSUE STATUS: 3

ST8 : OIL TANKERS

DECK EQUIPMENT
Rating

Comment

52 53a 53b 54 55 56a 56b 57 58a 58b 59a 59b 59c 59d 60a 60b 60c 61a 61b 61c 62

Tank Access Lids: Pipelines : MARPOL Line: Automatic or Manual Operation of Valves: Valve Operation: Manifold Valves/Blanks: Manifold Saveall: Insulation: Individual/Common Venting System: P/V Valves Automatic Ullaging System: High/Low Level Alarms: Manual Ullaging System Closed Ullaging and Sampling Capability: Deck Foam System: Oils Spill Equipment and availability: Crew Awareness of responsibilities and procedures: Tank Washing System: Method of Checking Pressure in Tank Washing System Tank Wash Openings: Emergency Towing Equipment: A/M

ISSUE STATUS: 3

ST8 : OIL TANKERS COMMENTS:

ISSUE STATUS: 3

ST9 : CHEMICAL TANKERS As for Oil Tankers plus: ST9 CHEMICAL TANKERS Certificates, Publications and Documentation (additional to Section H) (International) Bulk Chemicals Code: Y/N Index of Dangerous Chemicals Carried in Bulk: Y/N Tanker Safety Guide (Chemicals) Y/N Approved Procedures Manual: Y/N Cargo compatibility guide : Y/N Coating computability guide: Y/N Product Data Sheets: Y/N Comment

1 2 3 4 5 6 7

Cargo Containment and Equipment

Rating

Comment

8 9 10 11a 11b 11c 12 13 14 15

IMO Ship Type: IMO Tank Type: Tank Coatings: Cargo Pump Type: Cargo Pump Number: Cargo Pump drive arrangement: Pump Room (if fitted) ventilation: Gas detection for cargoes carried Overflow Control System: Deck Tanks:

PERSONNEL PROTECTION
Rating

Comment

16 17 18 19 20 21 22 23 24 25 26 27

Crew Aware of Specific Hazards/Precautions for Cargoes Carried: Fixed vapour detection system: Do all crew have regular medical checks and blood tests? Protective Clothing for Working: Protective Clothing for Emergency: Breathing Apparatus and Spare Cylinders: Monthly Check of Breathing Apparatus: Emergency Escape Apparatus: Suitable First Aid Equipment, Including Antidotes if Appropriate: Oxygen Resuscitation Equipment: Decontamination Showers: Eye Washes:

Y/N

Y/N

Y/N

ISSUE STATUS: 3

ST9 : CHEMICAL TANKERS COMMENTS:

ISSUE STATUS: 3

ST10 : GAS TANKERS As For Oil Tankers Plus: ST10

GAS TANKERS Comment

Certificates, Publications and Documentation (additional to Section H) 1 2 3 4 5 6 7 IGC Code ICS Tanker Safety Guide (Gas) OCIMF/ICS/SIGTTO Ship To Ship Transfer Guide (Liquefied Gases) SIGTTO (Liquefied Gas Handling Principles on Ships and Terminals) SIGTTO Guide to Pressure Relief Valve Maintenance and Testing: Product Data Sheets: Approved Procedures Manual Y/N Y/N Y/N Y/N Y/N Y/N Y/N

CARGO HANDLING AND CONTAINMENT

Rating

Comment

8 9 10 11a 11b 12 13 14 15 16 17 18 19 20 21 22

Cargo Tank Type: Minimum Cargo Temperature: Maximum Tank Working Pressure: Void Spaces Atmosphere: Type and Humidity: Cargo System Relief Valves: Cargo Tank Insulation: Pipeline Insulation: Tank Environmental Control: Cargo Conditioning/Reliquefaction System: Cargo Condensate Returns: Dew-Point Meter: Cargo Pumps: Overflow Control System: Deck Tanks: Cargo Hoses:

ISSUE STATUS: 3

ST10 : GAS TANKERS

Rating

Comment

23 24 25 26 27 28

Cargo Space Ventilation, AirChanges per Hour Air/IG Dryers: Fixed Automatic Vapour Detection System: Emergency Shut-Down System: Operating Time: Date Last Tested:

FIRE PROTECTION
Rating

Comment

29 30

Dry Powder System: Fixed Water Spray System:

PERSONNEL PROTECTION
Rating

Comment

31 32 33 34 35 36 37 38 39

Crew Aware of Specific Hazards/Precautions for Cargoes Carried: Protective Clothing for Emergency: Breathing Apparatus and Spare Cylinders: Monthly Check of Breathing Apparatus: Emergency Escape Apparatus: Suitable First Aid Equipment, Including Antidotes if Appropriate: Oxygen Resuscitation Equipment: Decontamination Showers: Eye Washes:

Y/N

ISSUE STATUS: 3

ST10 : GAS TANKERS COMMENTS:

ISSUE STATUS: 3

ST11 : OFFSHORE SUPPLY VESSELS ST11 OFFSHORE SUPPLY VESSELS Comment

Certificates, Publications and Documentation (additional to Section H) International Maritime Dangerous Goods Code Y/N IMDG Consolidated Supplement Y/N Approved Damage Stability Booklet Y/N Approved Damage Control Plan Y/N Is an agreed search and rescue co-operation plan carried? Y / N OFFSHORE SUPPLY VESSELS PLATFORM Rating SUPPLY PIPE VESSEL TYPE (Identify) CARRIER 1 2 BHP/HP Number of Bow/Stern Thrusters: Diesel or Electric: HP: 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Bollard Pull: Tow Winch Type and Capacity: Tow Wire Size and Time in Use: Spare Towing Wire: Work Wire Size and Time in Use: Spare Work Wire: Tugger Winches Number and Size: Rig Chain WCR Capacity: Catheads Number and Size Deck Type Material and Condition: Crash Bar Condition: Hydraulic Pins/Sharks Jaw: Tanks for Cement: Tanks for Drill Mud Etc: Tanks for Ballast/Drill Water: Pumping System: Workboat Type and Engine Capacity: Additional Accommodation for Workers/Surveyors:

AHTS OTHER

ISSUE STATUS: 3

ST11: OFFSHORE SUPPLY VESSELS COMMENTS:

ISSUE STATUS: 3

ST12 : DREDGERS ST12 DREDGERS Comment

Certificates, Publications and Documentation (additional to Section H) Approved Damage Stability Booklet Y/N Approved Damage Control Plan Y/N

DREDGERS
Rating

Comment Channel Dredger Aggregate Dredger

VESSEL TYPE (Identify) 1 2a 2b 2c 3 3a 3b 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 BHP / PH Number of Bow / Stern thrusters: Diesel/electric or hydraulic: HP Dredge Pipe: Port: Starboard: Condition of Slide: Spare Dredge Head: Dredge Pipe Winches: Spare Dredge Pipe Wire: Swell Compensator: Hopper: Walkway around / over Hopper: Hopper Coaming: Coaming sluices / freeing ports: Deck Crane: Deck Lighting: Method of Discharge: Hopper Closing Equipment: Discharging Equipment: Pump Room: Main prime mover for suction pump: Loading pipe in pump room:

ISSUE STATUS: 3

ST12 : DREDGERS

Rating

Comment

21 22 23 24 25 26 27 28 29 30

Loading pipe flexible connections: Auxiliary Pumps: Ships side valve: Conveyor belt and motor: De-watering pump: De-watering mats or sluices: Void Spaces: Watertight doors: Operational Depth of dredge: Weather limit of dredging:

DREDGERS BRIDGE
Rating

Comment

31 32 33 34

Dredge Console on Bridge: Dredge Pipe Load Indicator on Bridge: Draft Indicator on Bridge: Position Fixing equipment:

COMMENTS:

ISSUE STATUS: 3

COMMENTS

Dates and Place of Survey: Surveyor: Company: Signature: