DescriptioRev 02: ARev 03: CRev 04: MRev 05: RRev 06: CRev 07: ARev 08: SRev 09: NRev 10: CFO D06 I

I

Name o

IMO Nu

Date of

Place o

Name o

Inspecto Date: ..

on of RevisionAddress on forChange of logoMajor RevisionRedesigned foClarify SectionAdd bookmarkSections 1.1,2New questionsCoding erors nspection & A

InspeFo

of Ship:

umber:

f Inspection

of Inspectio

of Lead Ins

ors signatu

..................

ns rm amended o and new addns to content ormat n 7 (ISM Impleks and amend .2, 3.2,3.6, 4.1s 2.1.2, 2.5.3,

Assessment R

ectionr Dry

n:

on:

spector:

ure: ............

.................

dress

ementation) questions to r

1,4.3, 4.4, 5.25.4.14, 7.1.2,

eport for Dry C

n andy Carg

..................

..................

read yes for p, 6.2, 6.3, 8.18.1.3. Corrn

Cargo Ships

d Assgo Sh

..................

..................

positive respon

to wording 6.2

Rev: 10

essmhips (

..................

..................

nse

2.10, 6.2.19

0 Date: 18-Ju

ment R(FOD0

..................

..................

l-12 ............ Pa

Repo06) 10

..................

..................

age: 1 of 15

ort

.............

...

FO D06 I

SECTIO1.11.21.31.41.5

SECTIO2.12.22.32.42.52.6

SECTIO3.13.23.33.43.53.6

SECTIO4.14.24.34.44.54.6

SECTIO5.15.25.35.45.5

SECTIO6.16.26.36.46.5

SECTIO7.17.27.3

SECTIO8.1

SECTIO9.1

SECTIO10.110.210.310.4

nspection & A

ON 1: VEGENERAL INPRINCIPAL DREGISTRATISHIP CONSTADDITIONA

ON 2: DOSTATUTORYTECHNICALINSPECTIONOPERATIONMANNINGADDITIONA

ON 3: EFFINSPECTIONFEEDBACKSAFETY MASAFE CARRISAFETY EQUSAFETY CUL

ON 4: SAFCERTIFICATSAFETY DOSAFETY PUBSAFETY PLASECURITY MENVIRONME

ON 5: STRHOLDSHATCH COVBALLAST TASHELL AND ADDITIONA

ON 6: MARECORDS ANOBSERVATISAFETY ANDBALLAST SYADDITIONA

ON 7: BRBRIDGE EQUNAVIGATIONADDITIONA

ON 8: HOEQUIPMENT

ON 9: COADDITIONA

ON 10: INSGENERALPHYSICAL INMANAGEMEADDITIONA

Assessment R

ESSEL PARTNFORMATIONDIMENSIONSION, CLASS &

TRUCTIONL COMMENTS

OCUMENTATY AND CLASS S

NSNAL

L COMMENTS FECTIVENE

N & REVIEWANAGEMENTIAGE OF COALUIPMENT TESTLTUREFETY, SECU

TIONCUMENTATIONBLICATIONS [IANS, DRAWINGMATTERSENTAL PLANS RUCTURAL

VERS AND ASSANKSDECK PLATINL COMMENTS

ACHINERY MND MANUALSON OF CONDID ENVIRONMEYSTEMSL COMMENTS

RIDGE MANAUIPMENTNAL PRACTICEL COMMENTS

OLDS - VENTTONDITION O

L COMMENTS SPECTION S

NSPECTION SUENT SUMMARYL COMMENTS

Report for Dry C

TICULARS

INSURERSOR OBSERVATIONSTATUS AND R

OR OBSERVAESS OF ISM

LTSURITY & EN

NIN ADDITION TGS & EQUIPME

AND RECORDL CONDITIO

SOCIATED ARE

NG, FITTINGS &OR OBSERVAMANAGEM

STIONS IN MAC

ENTOR OBSERVA

AGEMENT

ESOR OBSERVA

TILATION, L

OF CRANESOR OBSERVA

SUMMARY

UMMARYYOR OBSERVA

Cargo Ships

TIONS ON VES

RECORDS

TIONS ON THE

SYSTEM

NVIRONMEN

TO STATUTORYENTS

ONEAS& EQUIPMENTTIONS ON THE

MENTCHINERY SPAC

TIONS ON THE

TIONS ON THE

LIGHTING S

TIONS ON THE

TIONS ON THE

Rev: 10

SSEL PARTICUL

E DOCUMENTA

NTAL MANA

Y REQUIREMEN

TE STRUCTURAL

CES

E MACHINERY

E BRIDGE MANSECURING

E CARGO CRAN

E SUMMARY SE

0 Date: 18-Ju

LARS SECTION

ATION SECTION

AGEMENT

NTS]

L CONDITION S

MANAGEMEN

NAGEMENT SE

NES SECTION

ECTION.

l-12 ............ Pa

N.

N.

SECTION.

NT SECTION.

ECTION.

ge: 2 of 15

FO D06 I

SECT

1.1 G1.

1.

1.

1.

1.

1.2 Pr1.

1.

1.3 R1.

1.

1.

1.4 Sh1.

1.

1.

1.

1.

1.

1.5 A

SECT

2.1 St2.

2.

2.2 Te2.

2.

2.

nspection & A

TION 1: V

eneral Info.1.1 Year

.1.2 Place

.1.3 Name

.1.4 Name

.1.5 Name

rincipal Dim.2.1 Summ

.2.2 Summ

egistration.3.1 Flag:

.3.2 Class

.3.3 P&I C

hip Constr.4.1 Ship

.4.2 Doub

.4.3 Hatch

.4.4 Suita

.4.5 Is the

.4.6 Are c

[If Ye

dditional C

TION 2: D

tatutory an.1.1 The v

comp

.1.2 Is a M2.1.2.1

echnical .2.1 Was

[If No

.2.2 Are th

2.3 Have

Assessment R

VESSEL

ormation of build [mm

e built: .......

e of yard: ..

e of Owner

e of Compa

mensions mer Deadw

mer Draft [m

n, Class & I.................

s & Notation

Club: ..........

ruction Type: ........

ble/Single sk

h cover type

ble for heav

e vessel res

cargo holds

es]: At Sea

Comments

DOCUME

nd Class Stvessel's cerplete and va

Maritime La1 Is a Dec

the vessel f

o, provide de

he CSM sur

records of

Report for Dry C

PARTICU

m/yy]: ........

..................

..................

from Certifi

any on ISM

eight [tonne

metres]:

Insurers ..................

n: ...............

..................

..................

kin: ............

e: ...............

vy cargoes

stricted by S

used for ba

Nos:

or Observa

ENTATIO

tatus and Rrtification asalid: ............

bour Certificlaration of M

free of Cond

etails and d

rvey items u

ultrasonic t

Cargo Ships

ULARS

..................

..................

..................

icate of Reg

Document o

es]: .............

..................

..................

..................

..................

..................

..................

of 1.780 t/m

SOLAS XII/1

allast? ........

In Port N

ations on V

ON

Records s required u..................

cate on boaMaritime La

ditions of C

due date] : ..

up to date?

tests been m

Rev: 10

..................

..................

..................

gistry: ........

of Complian

..................

..................

..................

..................

..................

..................

..................

m3 and abo

14: .............

..................

Nos:

Vessel Part

nder statuto..................

ard? ...........abour Comp

Class at the

..................

.................

maintained

0 Date: 18-Ju

..................

..................

..................

..................

nce: ...........

..................

..................

..................

..................

..................

..................

..................

ve: .............

..................

..................

ticulars se

ory and clas..................

..................pliance on b

time of insp

..................

..................

on board? .

l-12 ............ Pa

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

ction.

ss requirem..................

..................board? .......

pection? .....

..................

..................

..................

ge: 3 of 15

...

...

...

...

...

...

...

...

...

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

ments is ........... ?

........... ?

........... ?

........... ?

...

........... ?

........... ?

FO D06 I

2.

2.

2.

2.

2.

2.

2.3 In2.

2.

2.

2.

2.4 O2.

2.

2.

2.5 M2.

2.

2.

2.6 A

nspection & A

[If yes

.2.4 Are th

.2.5 Does

[If No

.2.6 Is ves

[If No

.2.7 Is the

[If No

.2.8 Date

.2.9 Date

nspections .3.1 Is the

.3.2 Have

[If No

.3.3 Is the

.3.4 Have

[If No

perational .4.1 Are c

[If No

.4.2 Are th

[If No

.4.3 Is a B

Manning .5.1 The n

[Spec

.5.2 The w

.5.3 Are a

dditional C

Assessment R

s, period fo

he results o

s the vessel

o, reasons fo

ssel history

o, reasons fo

e vessel free

o, reasons fo

of last Spec

of last dry-d

e vessel free

all findings

o, provide de

e vessel free

all findings

o, provide de

cargo opera

o, provide de

he Loading

o, provide de

Ballast Oper

number of n

cify nationa

working lang

all Officers a

Comments

Report for Dry C

r which reco

of the ultraso

have an En

or same] : ..

free of maj

or same] :

e of any ext

or same] : ..

cial Survey

dock: .........

e of PSCI d

s been clear

etails] :

e of Flag St

s been clear

etails] :

tions planne

etails] :

Instrument

etails] :

rations Log

nationalities

lities] :

guage(s) un

and Enginee

or Observa

Cargo Ships

ords are av

onic tests c

nhanced Su

..................

or repairs?

tensive stee

..................

: .................

..................

eficiencies

red .............

tate inspect

red: ............

ed and reco

operationa

maintained

represente

nderstood o

ers able to c

ations on t

Rev: 10

ailable] : ....

onsidered s

urvey Progr

..................

.................

el renewal [

..................

..................

..................

in the last 6

..................

ion deficien

..................

orded in acc

al and test re

d ................

ed on board

on board is .

communica

the Docum

0 Date: 18-Ju

..................

satisfactory

ramme [ESP

..................

..................

>25 tons]? .

..................

..................

..................

6 months....

..................

ncies in the

..................

cordance w

ecords avai

..................

are: ..........

..................

ate effective

entation S

l-12 ............ Pa

..................

.................

P] report file

..................

..................

..................

..................

..................

..................

..................

..................

last 6 mont

..................

with the BLU

ilable .........

..................

..................

..................

ely in Englis

ection.

ge: 4 of 15

...

........... ?

e? ....... ?

...

........... ?

........... ?

...

...

...

........... ?

........... ?

ths? .... ?

........... ?

U Code ?

........... ?

........... ?

........... ?

...

h? ....... ?

FO D06 I

SECT

3.1 In3.

3.

3.2 Fe3.

3.

3.

3.

3.

3.

3.

3.

3.

3.

3.

3.

3.

3.

3.

3.

3.3 Sa3.

3.

3.

3.

3.

3.

3.

nspection & A

TION 3: E

nspection &.1.1 Has M

.1.2 Is it e

eedback .2.1 Has t

.2.2 Comm

.2.3 Are fi

.2.4 Comm

.2.5 Do cocause

.2.6 Comm

.2.7 Do threcur

.2.8 Comm

.2.9 Has emont

.2.10 Comm

.2.11 Is the

.2.12 Is it fo

.2.13 Comm

.2.14 Are Shull d

.2.15 Has a

.2.16 Doesand F

afety Mana.3.1 Is ind

.3.2 Are re

.3.3 Comm

.3.4 Are arespo

.3.5 Comm

.3.6 Is thelapse

3.3.6.13.3.6.2

.3.7 Comm

Assessment R

EFFECTIV

& Review Masters rev

effective? ...

there been f

ments:

ndings from

ments:

ompany proe analysis o

ments:

he companyrrence of de

ments:

emergency hs? ...........

ments:

ere a progra

ollowed and

ments:

Senior Officedamage and

any training

s ManagemeFlag? .........

agement duction/fami

ecords kept

ments:

all crew memonsibilities a

ments:

ere a culturees/deficienc1 At ship le2 At Comp

ments:

Report for Dry C

VENESS

view of SMS

..................

feedback fr

m RightShip

ocedures anof each defic

y procedureeficiencies. .

drill involvin..................

am for drills

d document

ers aware od possible n

been comp

ent regularl..................

liarization fo

t? ..............

mbers able and duties?

e of continuies evel ...........pany level?

Cargo Ships

S OF ISM

S been com

..................

rom the sho

p Inspection

nd practicesciency? ......

s and pract..................

ng Shore M..................

and exercis

ted? ..........

of MSC/Circneed for aba

pleted? ......

y provide ve..................

or new crew

..................

to understa..................

ous improv

..................

..................

Rev: 10

SYSTEM

mpleted in la

..................

ore manage

s correlated

s for handlin..................

tices include..................

Management..................

ses. ...........

..................

c. 1143 (Guandonment

..................

essels with ..................

w members

..................

and the lang..................

ement do

..................

..................

0 Date: 18-Ju

M

ast 12 mont

..................

ment .........

d and whole

ng of deficie..................

e measures..................

t been cond..................

..................

..................

ide lines onof bulk carr

..................

copies of C..................

conducted

..................

guage of the..................

o they learn

..................

..................

l-12 ............ Pa

ths .............

..................

..................

e Fleet infor

encies requi..................

s to prevent..................

ducted in las..................

..................

..................

n early asserier) ...........

..................

Circulars fro..................

.................

..................

eir documen..................

from past

..................

..................

ge: 5 of 15

........... ?

........... ?

........... ?

rmed? . ?

ire root ........... ?

t ........... ?

st 12 ........... ?

........... ?

........... ?

essment of ........... ?

........... ?

om Class ........... ?

........... ?

........... ?

nted ........... ?

........... ?

........... ?

FO D06 I

3.4 Sa3.

3.5 Sa

3.6 Sa3.

3.

SECT

4.1 C4.

4.

4.

4.

4.

4.

4.

4.

4.2 Sa4.

4.

4.

nspection & A

afe Carriag.4.1 The v

regulasensi

[If No

afety EquipSpec

[NB Dnote tand m

afety Cultu.6.1 What

whereclothi

.6.2 AdditSectio

TION 4: S

ertification.1.1 State

.1.2 Date

.1.3 Date

.1.4 State

.1.5 Date

.1.6 Date

.1.7 Date

.1.8 Other

afety Docu.2.1 Are S

accep

.2.2 Are m

.2.3 The f4.2.3.14.2.3.24.2.3.3

Assessment R

ge Of Coal vessel can bations. [Cheng devices

o, reasons fo

pment Testify which ite

Due to multito be taken

maintenance

ure t level of safe applicableng etc.] .....

ional Common.

SAFETY,

n e issuing Au

on which th

on which th

e issuing Au

on which th

of last inter

of last exte

r general co

umentationSafety Commptable frequ

minutes ava

following are1 Non-con2 Accident3 Hazardo

Report for Dry C

be considereck all procetc] ...........

or same] :

ts ems of safe

iple fatalitiewith regard

e of lifeboat

fety conscioe, legible dis..................

ments or Ob

SECUR

thority for th

he Docume

he Docume

thority for th

he Safety M

rnal audit. ..

ernal audit. .

omments on

mittee Meetuency? .......

ailable for la

e reported, nformities ...ts ...............

ous occurren

Cargo Ships

red suitableedures, rec..................

ty equipme

s that haved to the posts and asso

ousness ansplay of rele..................

bservations

ITY & EN

he Docume

nt of Comp

nt of Comp

he Safety M

Managemen

..................

..................

n safety cer

tings under..................

st two meet

investigate....................................nces [near-

Rev: 10

e for the carcords, condi..................

nt, if any, w

been assosting of instrociated equi

d practice isevant plans..................

on the Safe

NVIRONM

ent of Comp

liance was

liance was

Managemen

t Certificate

..................

..................

rtification:

rtaken on a ..................

tings? ........

d and analy....................................misses] .....

0 Date: 18-Ju

riage of coaition of mon..................

were tested

ciated with ructions on ipment]

s apparent s, safety not..................

ety, Security

MENTAL

pliance.

issued. ......

last endors

nt Certificate

e was issued

..................

..................

regular bas..................

..................

yzed: ......................................................

l-12 ............ Pa

al cargoes anitoring equ..................

by the insp

lifeboat drilthe safe op

onboard [intices, use o..................

y and Envir

MANAG

..................

ed. ............

e

d. ..............

..................

..................

sis and with..................

..................

..................

..................

..................

ge: 6 of 15

as per IMO ipment, ........... ?

ector:

lls, special peration

ncluding f protective........... ?

ronmental

GEMENT

...

...

...

...

...

........... ?

........... ?

........... ?

........... ?

........... ?

FO D06 I

4.

4.

4.

4.

4.3 Sa4.

4.

4.

4.

4.

4.4 Sa4.

4.

4.

4.

4.

4.

4.

4.

4.

4.

4.

4.

4.

4.

4.

4.5 Se4.

4.

4.

4.

nspection & A

.2.4 Corre

.2.5 Corre

.2.6 Corre

.2.7 Other

afety Publi.3.1 Accid

.3.2 GuideAban

.3.3 Guide

.3.4 Are M

.3.5 Other

afety Plans.4.1 Muste

.4.2 Fire C

.4.3 Conti

.4.4 Is Saf

.4.5 The Slist wa

.4.6 IMO s

.4.7 Esca

.4.8 Safet

.4.9 Safet

.4.10 Perm

.4.11 Is the

.4.12 Is atm

.4.13 Are c

.4.14 Are fi

.4.15 Other

ecurity Mat.5.1 Secu

.5.2 Appro

.5.3 Vesse

.5.4 Other

Assessment R

ective action

ective action

ective action

r general co

ications [Indent preven

elines on eadonment of

elines for th

MSDS availa

r general co

s, Drawingser lists. ......

Control Plan

ngency pla

fety Officer

SOPEP wasas up to da

signs were

pe routes w

ty plans wer

ty notices w

mits to work w

ere evidence

mosphere te

calibration re

re main iso

r general co

tters rity was at l

opriate secu

el has a val

r general co

Report for Dry C

ns recorded

ns and close

ns and close

omments on

n addition ttion on boa

arly assessmf Bulk Carrie

he mitigation

able for Car

omments on

s & Equipm..................

ns in accom

ns for emer

s identity w

s filed togette. .............

displayed. .

were marked

re displayed

were display

were issued

e that safety

esting equip

ecords avai

olation valve

omments on

level. .........

urity system

lid Continuo

omments on

Cargo Ships

d for items in

e-out record

e-out record

n safety doc

to statutoryard ship at s

ment of hulers [MSC/C

n and mana

rgo/Bunker/

n safety pub

ment ..................

mmodation a

rgency resp

well known t

ther with pip..................

..................

d. ...............

d ................

yed. ............

d. ...............

y equipmen

pment appro

lable for atm

es operation

n safety pla

..................

m was being

ous Synops

n security m

Rev: 10

n 4.2.3 ......

ded for inte

ded for exte

cumentation

y requiremsea and in p

l damage aCirc.1143] ..

agement of

/Hazardous

blications:

..................

and at gang

ponse. ........

to all onboa

ping diagram..................

..................

..................

..................

..................

..................

nt is regular

opriate and

mosphere te

nal? ...........

ns, drawing

..................

g implement

sis Record ..

matters:

0 Date: 18-Ju

..................

rnal audits?

ernal audits

n:

ents] port [ILO] (o

nd possible..................

fatigue. [MS

s Materials?

..................

gways. ........

..................

ard? ............

ms and othe..................

..................

..................

..................

..................

..................

rly checked?

fit for use?

esting equip

..................

gs and equi

..................

ted .............

..................

l-12 ............ Pa

..................

? ................

? ...............

r equivalen

e need for ..................

SC/Circ.101

? .................

..................

..................

..................

..................

er key plans..................

..................

..................

..................

..................

..................

? ...............

.................

pment? .....

..................

pment:

..................

..................

..................

ge: 7 of 15

........... ?

........... ?

........... ?

t) ........ ?

........... ?

14] ...... ?

........... ?

........... ?

........... ?

........... ?

........... ?

s, contact ........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... 0

........... ?

........... ?

FO D06 I

4.6 En4.

4.

4.

4.

4.

SECT[Guidanand clar

5.1 H5.

5.

5.

5.

5.

5.

5.

5.

5.

5.

5.

5.

5.2 H5.

5.

5.

5.

5.

5.

5.

5.

5.

5.

5.

5.

nspection & A

nvironmen.6.1 Bunk

.6.2 Garba

.6.3 Ballas

.6.4 Oil Re

.6.5 Other

TION 5: Snce Note: Arification en

olds .1.1 Bulkh

.1.2 Shell

.1.3 Hopp

.1.4 Tank

.1.5 Tops

.1.6 Bilges

.1.7 Wate

.1.8 Air ve

.1.9 Hold

.1.10 Prote

.1.11 Hold

.1.12 Other

atch Cover.2.1 Hatch

.2.2 Hatch

.2.3 Seali

.2.4 Comp

.2.5 Secu

.2.6 Track

.2.7 Hydra

.2.8 Drain

.2.9 Hatch

.2.10 Hatch

.2.11 Hatch

.2.12 Are h

Assessment R

ntal Plans aering Plan.

age Manag

st Managem

ecord Book

r general co

STRUCTUny structura

ntered in the

heads ........

plating Fra

per and Stoo

top plating

ide tank pla

s, Suction b

r ingress se

ents, Sound

ladders - ru

ective coatin

ventilation,

r general co

rs And Assh covers top

h covers int

ng rubber, c

pression ba

ring cleats

k-ways and

aulic system

ns and non-

h coaming p

h coaming s

h coaming c

hatches con

Report for Dry C

and Record..................

ement Plan

ment Plan ..

k .................

omments on

URAL COal item fittede appropriat

..................

ames, Brack

ol sloping p

.................

ating - as se

boxes, Exte

ensors .......

ding pipes M

ungs, stanch

ngs .............

Fire dampe

omments on

sociated Arps and side

ernal stays

channels ...

ars and weig

..................

rollers .......

m jacks &

return valve

plates [fwd,

stays [vertic

connections

sidered acc

Cargo Ships

ds ..................

n .................

..................

..................

n environme

ONDITIOd with a doute comment

..................

kets, Bracke

lating .........

..................

een from ho

ended spind

..................

Manhole cov

hions, platfo

..................

ers, Access

n hold cond

reas s ................

and/or stiff

..................

ght bearing

..................

..................

pipes ........

es ...............

aft, port & s

cal and horiz

s to deck pla

ceptable for

Rev: 10

..................

..................

..................

..................

ental plans

ON ubler shouldts field.]

..................

et connectio

..................

..................

old spaces ..

les etc. .....

..................

vers ...........

orms ..........

..................

s spaces ....

ition:

..................

feners ........

..................

pads .........

..................

..................

..................

..................

starboard] .

zontal] .......

ates ...........

r carriage of

0 Date: 18-Ju

..................

..................

..................

..................

and records

d be marked

..................

ons .............

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

f water sens

l-12 ............ Pa

..................

..................

..................

..................

s:

d as unsatis

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

sitive cargo

ge: 8 of 15

........... ?

........... ?

........... ?

........... ?

sfactory

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

oes? .... ?

FO D06 I

5.

5.

5.3 B5.

5.

5.

5.

5.

5.

5.

5.

5.

5.

5.

5.

5.

5.4 Sh5.

5.

5.

5.

5.

5.

5.

5.

5.

5.

5.

nspection & A

.2.13 Is infoand d

.2.14 Otherleaka

allast Tank.3.1 Bulkh

.3.2 Side

.3.3 Fram

.3.4 Tank

.3.5 Dump

.3.6 Suctio

.3.7 Air ve

.3.8 Manh

.3.9 Prote

.3.10 Catho

.3.11 Acces

.3.12 Sludg

.3.13 Other

hell and De.4.1 Shell

.4.2 Deck

.4.3 Deck

.4.4 Deck

.4.5 Air ve

.4.6 Wate

.4.7 Venti

.4.8 Railin

.4.9 Gang

.4.10 Non-s

.4.11 Wind5.4.115.4.115.4.115.4.115.4.11

[Inspe

[If Ye

Assessment R

ormation avdynamic loa

r general coage etc.]:

ks heads in tan

shell plating

es, Bracket

sloping pla

p valves an

on and Fillin

ents, Sound

hole covers

ective Coatin

odic protect

ss spaces t

ge, scale an

r general co

eck Platingplating (P&

plating incl

plating bet

pipes and

ents and So

rtight openi

lators, Mus

ngs, bulwark

gway, accom

slip paint, if

lass, winch.1 Brake-ba.2 Clutches.3 Foundat.4 Spurling.5 Have the

ector to issu

es date of la

Report for Dry C

vailable relaads imposed

omments on

nk spaces ..

g ................

ts, Side & L

ating ...........

d filling valv

ng valves, E

ding pipes ..

..................

ngs ............

tion - anode

to tanks, lad

nd other dep

omments on

g, Fittings &&S) .............

luding forec

ween hatch

valves [fire

ounding pipe

ings, acces

hroom head

ks and ram

mmodation,

f applied .....

es: ands & linins, gears & ctions ........... pipes, covee windlass/w

ue a recom

ast test]

Cargo Ships

ating to abilid by a helico

n hatch cov

..................

..................

Longitudinal

..................

ves for tops

Extended sp

..................

..................

..................

es or others

dders etc. ...

posits .........

n ballast tan

& Equipme..................

castle and p

hes .............

main, bunk

es ..............

s hatches,

ds [includin

ps ..............

deck and p

..................

ngs .............controls ........................ers, cockspwinch brake

mendation

Rev: 10

ty of any deopter landin

er condition

..................

..................

Stiffeners .

..................

side tanks...

pindles, Ma

..................

..................

..................

s .................

..................

..................

nk condition

ent ..................

poop ..........

..................

ker and hyd

..................

manholes ..

g fire flaps]

..................

pilot ladders

..................

..................

..................

..................purs and guaes been tes

if No.]

0 Date: 18-Ju

eck surface ng on that s

n [Include a

..................

..................

..................

..................

..................

arkings........

..................

..................

..................

..................

..................

..................

n:

..................

..................

..................

raulic] ........

..................

..................

.................

..................

s ................

..................

..................

..................

..................ards ...........ted ............

l-12 ............ Pa

to withstansurface?. ....

ny evidence

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

ge: 9 of 15

nd the static........... ?

e of

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

c

FO D06 I

[

5.

5.

5.

5.

5.

5.

5.

5.5 A

SECT

6.1 R6.

6.

6.2 O6.

6.

6.

6.

6.

6.

6.

6.

6.

6.

6.

6.

6.

6.

nspection & A

5.4.11

[Inspector to

.4.12 Bolla

.4.13 Moor

.4.14 Is a s

.4.15 Bunk

.4.16 Other

.4.17 Deck

.4.18 Other

dditional C

TION 6: M

ecords and.1.1 Exam

syste

.1.2 A comengin

bservation.2.1 Clean

is goo

.2.2 Is ME

.2.3 Tank

.2.4 Are a

.2.5 Purifi

.2.6 Drip t

.2.7 Are sacces

.2.8 Engin

.2.9 Is the

.2.10 All sto

.2.11 If No

.2.12 Are sappro

.2.13 Safet

.2.14 Enginin pro

Assessment R

.6 Are brak

o issue a re

rds, rollers

ring ropes, w

ship specific

ering conne

r deck mach

lighting ....

r general co

Comments

MACHINE

d Manuals mination of m

ms are func

mplete set oneers availa

n Of Conditnliness in thod. ............

E exhaust a

tops and b

all pump and

er room fre

trays in way

steering spassible? ......

ne room floo

ere evidence

ores/spares

o provide b

spare parts aopriately? ..

ty instructio

ne control rooper bins ...

Report for Dry C

ke tests a pa

ecommenda

& fairleads

wires, ancho

c emergenc

ections, ma

hinery inc. s

..................

omments on

or Observa

ERY MAN

machinery rctional and

of all machinable on boar

tions In Mahe engine ro..................

nd boiler in

ilge spaces

d valve gla

e of leaks a

y of machine

aces clean, ..................

or plates in

e that adeq

s requisition

rief details.

and other g..................

ns appropri

oom clean w..................

Cargo Ships

art of the PM

ation if No.]

..................

ors & cable

y towing pro

nifolds, sav

storing and

..................

n plating an

ations on t

NAGEME

records [login good ord

nery manuard. ..............

achinery Spoom in way ..................

sulation in g

s in a good c

nds free fro

and accumu

ery items a

free of obst..................

place and f

uate stores

ns are filled

gear or equi..................

ate to the s

with chairs s..................

Rev: 10

MS ............

..................

es ...............

ocedure pro

ve alls ........

bunkering c

..................

d deck fittin

the Structu

ENT

books etc.]der. ............

als in a lang..................

paces of scaveng

..................

good condit

clean condi

om leaks? ..

ulation of oil

nd fuel tank

tructions an..................

free of obst

s and spares

in less than

pment firml..................

space displa

secured, no..................

0 Date: 18-Ju

..................

..................

..................

ovided? ......

..................

cranes .......

..................

ngs:

ural Condit

suggest al..................

guage unde..................

ge spaces a..................

tion? ..........

ition. ..........

..................

l. ................

ks dry .........

nd oil leaks a..................

ructions .....

s are provid

n 30 days? .

y secured a..................

ayed ...........

o loose mat..................

l-12 ......... Page

..................

..................

..................

..................

..................

..................

..................

ion Section

l machinery..................

rstood by th..................

and crank ca..................

..................

..................

..................

..................

..................

and readily ..................

..................

ded ............

..................

and stored ..................

..................

ts and garba..................

e: 10 of 15

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

n.

y items and ........... ?

he senior ........... ?

ase doors ........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

age placed ........... ?

FO D06 I

6.

6.

6.

6.

6.

6.

6.

6.

6.

6.3 Sa6.

6.

6.

6.

6.

6.

6.

6.

6.

6.4 B6.

6.

6.

6.

6.

6.5 A

nspection & A

.2.15 Mach

.2.16 Monitand s

.2.17 Are g

.2.18 Is Cra

.2.19 Switc

.2.20 Auto-

.2.21 Lube

.2.22 Oil sa

[If No

.2.23 Other

afety and E.3.1 It is e

mach

.3.2 Oily W

.3.3 Oil co

.3.4 WhatSteer

.3.5 Criticmetho

.3.6 Standsuch

.3.7 Is the

.3.8 Gantr

.3.9 Other

allast Syst.4.1 No of

.4.2 Stripp

.4.3 De-ba

.4.4 De-ba

.4.5 Other

dditional C

Assessment R

hinery guard

toring and isafe conditio

gauges and

ankcase Oi

chboard pan

-closing dev

oil samples

ample repor

o, provide de

r general co

Environmeevident that hinery space

Water sepa

ontent mete

t type of plaring Gear? .

al Equipmeods to prom

dby arrangeequipment

ere a written

ry crane in

r general co

tems f ballast pum

ping system

allasting tim

allasting tim

r general co

Comments

Report for Dry C

ds in place .

ndicating deon ..............

instruments

l Mist Detec

nels were fr

vices on sou

s are taken

rt free of ad

etails] :

omments on

nt only safe a

es [Compliarator mainte

er last calibr

anned maint..................

ent and Systmote reliabil

ements haveis conducte

n procedure

ER last test

omments on

mps & rating

m ................

me required

me required

omments on

or Observa

Cargo Ships

..................

evices fitted..................

s functional

ctor operatin

ree of earth

unding pipe

regularly ...

verse comm

n machinery

and pollutionance with Menance reco

ration date ..

tenance sys..................

tems have ity have bee

e been idened. .............

e for fuel cha

ted on ........

n safety and

g ................

..................

excluding b

including b

n ballast sys

ations on t

Rev: 10

..................

d to relevan..................

l? ...............

ng correctly

indicators?

es being use

..................

ments ........

y space con

n-free practMARPOL] .ords in orde

..................

stem is in p..................

been identifen put in pla

ntified by the..................

ange-over i

..................

d environme

..................

..................

ballast hold

ballast hold.

stems:

the Machin

0 Date: 18-Ju

..................

t machinery..................

..................

y? ...............

? .................

ed properly

..................

..................

ndition:

ices are be..................

er ...............

..................

lace for all m..................

fied by the ace. ...........

e Company..................

n the SMS?

..................

ental issues

..................

..................

..................

..................

nery Manag

l-12 ......... Page

..................

y items and..................

..................

..................

..................

.................

..................

..................

ing followed..................

..................

..................

machinery, ..................

Company a..................

y and regula..................

? ................

..................

s:

..................

..................

..................

..................

gement Sec

e: 11 of 15

........... ?

in working ........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

d in the ........... ?

........... ?

...

including .... None

and ........... ?

ar testing of........... ?

........... ?

...

...

...

...

...

ction.

f

FO D06 I

SECT

7.1 B7.

7.

7.

7.

7.

7.2 N7.

7.

7.

7.

7.

7.

7.

7.

7.

7.3 A

SECT

8.1 Eq8.

8.

8.

8.

nspection & A

TION 7: B

ridge Equi.1.1 Bridg

.1.2 Is Bri

.1.3 All Br

.1.4 Operaunde

.1.5 Other

avigationa.2.1 Navig

.2.2 Relevavaila

.2.3 Up-to

.2.4 Relevbeen

.2.5 Therelatest

.2.6 Operadispla

.2.7 Thereall brinavig

.2.8 Recoinstru

.2.9 Other

dditional C

TION 8: H

quipment .1.1 Hold

.1.2 Wher

[If No

.1.3 Wherequip

.1.4 There ........

[If No

Assessment R

BRIDGE

pment e and Radi

dge Naviga

ridge and R

ating manurstood by th

r general co

l Practicesgation recor

vant and upable. ..........

o-date [corre

vant and upprovided. .

e is a definet navigation

ating proceayed and st

e are Owneidge and en

gation of the

ords are mauments ......

r general co

Comments

HOLDS -

ventilation

re applicabl

o, describe o

re applicablpment? ......

e are arrang.................

o, describe o

Report for Dry C

MANAGE

o Equipmen

ation Watch

Radio Equipm

als for Bridghe ships sta

omments on

s rds are avai

p-to-date na..................

ected] chart

p to date ma..................

ed practice warning in

dures and itaff are awa

ers/Managerngine room e vessel, at

intained of t..................

omments on

or Observa

VENTILA

is of the for

e, containe

observation

e is there a..................

gements pro..................

observation

Cargo Ships

EMENT

nt is provide

Alarm Syst

ment is in g

ge equipmeaff. .............

n bridge equ

ilable and m

avigational p..................

ts for the int

arine notices..................

for the colleformation. ..

nstructionsare of the sa

rs policy anequipment relevant sta

testing bridg..................

n navigation

ations on t

ATION, L

rced [mecha

r shoes on

ns] :

an ongoing i..................

ovided onbo..................

ns] :

Rev: 10

ed as per re

tem (BNWA

good workin

ent are avai..................

uipment:

maintained i

publications..................

tended voya

s for the tra..................

ection, disse..................

for Bridge ame ...........

d procedureand instrum

ages of the

ge and eng..................

n practices:

the Bridge

LIGHTING

anical] type

tank tops a

nspection r..................

oard for mo..................

0 Date: 18-Ju

elevant regu

AS) fitted an

g order. .....

lable on bo..................

n a satisfac

s to aid vess..................

age(s) have

ading patter..................

emination a..................

functions a..................

es, which rements, criticvoyage. ....

gine room eq..................

Manageme

G SECUR

e. ...............

are flush and

regime for c..................

onitoring the..................

l-12 ......... Page

ulations .....

nd functioni

..................

ard in a lan..................

ctory state.

sel operatio..................

e been prep

ns for the s..................

and monitor..................

re clearly sp..................

equire the tecal to the sa..................

quipment a..................

ent Section

RING

..................

d tight. .......

container las..................

e status of h..................

e: 12 of 15

........... ?

ng? ..... ?

........... ?

guage ........... ?

........... ?

ns are ........... ?

pared. . ?

hip have ........... ?

ing of all ........... ?

pecified, ........... ?

esting of afe ........... ?

nd ........... ?

n.

........... ?

........... ?

shing ........... ?

hold lights?........... ?

FO D06 I

8.

nspection & A

.1.5 Does

Assessment R

s the compa

Report for Dry C

any have a w

Cargo Ships

written proc

Rev: 10

cedure for C

0 Date: 18-Ju

Cargo Hold A

l-12 ......... Page

Access?. ...

e: 13 of 15

........... ?

FO D06 I

SECTEnter ob CertificBlocks Hook/sChain ShackleCrane wOil leakCrane CWindscFire extCabin hInternaEmergeExternaJib conPerformPerformPerformLimit sw Type

Weight

Capaci

9.1 A

SECT

10.1 G10

10

nspection & A

TION 9: Cbservations

cation, Mark

swivel

es wire ks Cabins creen wipertinguisher heater

al ladder ency stops al ladder

ndition mance mance recomance at inwitch setting

t (tonnes)

ty (tonnes)

dditional C

TION 10:

eneral 0.1.1 The v

........

0.1.2 The i10.1.210.1.2

Assessment R

CONDITIOs on cranes

king & Cond

s

rds n & out limgs

Comments

INSPEC

vessel was .................

nspection s2.1 Commen2.2 Commen

Report for Dry C

ON OF Cand grabs

dition

mits

or Observa

TION SU

inspected a..................

schedule wanced travel:nced inspec

Cargo Ships

CRANESin the follow

Cranes 1 ? ? ? ? ? ?

? ? ? ? ? ? ?

? ? ?

1 ?

0.0

0.0

ations on t

UMMARY

as per instru..................

as as follow: .................ction: ..........

Rev: 09

wing table:

2 ? ? ? ? ? ?

? ? ? ? ? ? ?

? ? ?

2 ?

0.0

0.0

the Cargo C

Y

uctions rece..................

ws: ....................................

9 Date: 27-Ju

3 ? ? ? ? ? ?

? ? ? ? ? ? ?

? ? ?

Grabs 3 ?

0.0

0.0

Cranes Sec

eived from R..................

............. .............

n-12 ....... Page

4 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?

4 ?

0.0

0.0

ction

RightShip b..................

@ @

e: 14 of 15

5 ? ? ? ? ? ?

? ? ? ? ? ? ?

? ? ?

5 ?

0.0

0.0

y email on:...

hrs. hrs.

FO D06 I

10

10

10

10

10

10

10

10.2 Ph10

10

10

10

10

10

10

10

10

10

10

10.3 MComme

10.4 A

nspection & A

10.1.2.10.1.2

0.1.3 Was

[If no

0.1.4 The o

[If yes

0.1.5 The M

[If NO

0.1.6 A me ........

[If Ne

0.1.7 The i

[If NO

0.1.8 A copwith M

[If NO

0.1.9 Vesse

hysical Ins0.2.1 Acco

0.2.2 Acco

0.2.3 Whee

0.2.4 Engin

0.2.5 Exter

0.2.6 Main/

0.2.7 Cargo

0.2.8 Hatch

0.2.9 Crane

0.2.10 Ballas

0.2.11 Other

Managemenent in gener

dditional C

Assessment R

3 Finished2.4 Returned

the ships g

, explain] : .

owners repr

s, who] : ....

Master had

O give reaso

mber of the.................

ever give rea

nspector dis

O give reaso

py of the InsMaster. ......

O give reaso

el status at

spection Summodation

mmodation

elhouse: ....

ne Room/M

rnal shell pla

/Weather D

o holds: .....

h Coamings

es .............

st tanks: ....

r spaces - s

nt Summaryral about the

Comments

Report for Dry C

d inspectiond to home b

gangway co

..................

resentative

..................

been appris

ons] : .........

e ships staf..................

asons] : .....

scussed ou

ons] : .........

spectors Lis..................

ons] :

time of insp

ummary structure: .

interior: ....

..................

achinery Sp

ate .............

eck & Fittin

..................

s, Trackway

..................

..................

stores etc: ..

y e apparent s

or Observa

Cargo Ships

: .................base: ..........

orrectly rigge

..................

was on boa

..................

sed of the R

..................

ff [or Superi..................

..................

utcomes wit

..................

st of Deficie..................

pection: ......

..................

..................

..................

paces: ........

..................

ngs: ............

..................

ys and Hatc

..................

..................

..................

standard an

ations on t

Rev: 10

..................

..................

ed giving sa

..................

ard during th

..................

RightShip in

..................

ntendent] a..................

..................

h the Maste

..................

encies and R..................

..................

..................

..................

..................

..................

..................

..................

..................

ch Covers...

..................

..................

..................

nd quality o

the Summa

0 Date: 18-Ju

.............

.............

afe access:

..................

he inspectio

..................

nspection. ..

..................

accompanie..................

..................

er and/or Su

..................

Recommend..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

f onboard m

ary Section

l-12 ......... Page

@ @

.................

..................

on. .............

..................

..................

..................

ed the Inspe..................

..................

uperintende

..................

dations has..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

..................

managemen

n.

e: 15 of 15

hrs. hrs.

........... ?

...

.......... ?

...

........... ?

...

ector .... ?.............

...

ent. ...... ?

...

s been left ........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

........... ?

nt.