Code: SQE/Form-P-006

SQE MANAGEMENT SYSTEM FORM Date: Oct 01, 2013

Ver/Rev: 2.00
SMALL CRAFTS PERMIT Page 1 of 1

MV/ MT: HIGH WIND Port:      

Date:       Terminal:     

Name of Small Craft:      

Reasons for Small Craft Coming Alongside Vessel:      

SECTION 1 (To be completed before craft comes alongside vessel)

YES NO N.A
Does the terminal allow small crafts to come alongside the vessel and have they
1.1
been suitable informed?
1.2 Are ship's crew standing-by with heaving lines to make fast the craft?
1.3 Are adequate fenders kept ready for use if required?
1.4 Has engine room been informed not to turn the propeller?
1.5 Are all cargo tank lids and ullage port lids closed?
1.6 Have tank cleaning / gas-freeing operations been stopped?

SECTION 2 (To be completed after craft comes alongside)

YES NO N.A
2.1 Has the craft been securely made fast and the fending is adequate?
2.2 Has the vessel been bonded with the craft?
2.3 The craft personnel comply with the requirements of ISGOTT Ch. 4 as
appropriate, with particular regard to :

- No Smoking
- No Naked Lights
- No Cooking
2.4 Is there safe access to / from the craft?
2.5 At night, is there adequate safe illumination?
2.6 Is it ensured that the craft is not in way of any overboard discharges?
2.7 Has any means of communication established between the vessel's CCR / Bridge
and the craft?

Additional Precautions (if any) :      

Remarks (if any) :      

I am satisfied that all precautions have been taken and all safety measures will be maintained for the entire duration that
this craft remains

Signature :       Rank:       Date:       Time:      

Approval by Master : I am satisfied with all safety procedures and hereby give my permission for the craft to come and
stay alongside

Signature :       Rank:       Date:       Time:      

THIS PERMIT IS MADE FOR EACH SMALL CRAFT THAT COMES ALONGSIDE THE VESSEL.
THIS PERMIT IS VALID FOR A PERIOD OF 24 HRS ONLY.
Note: Sections 1.5, 1.6 & 2.3 apply only to Tankers.
Refer to Company Procedure SAF-15)

Issued: SQE Dept. Approved: DMR