statement (life saving equipments) checklist_and_forms.pdf · 2011. 3. 14. · lifeboat location...
TRANSCRIPT
F103/R2 Issue Date: 18 Mar. 2009
Marland Boat Service Ltd.
STATEMENT (LIFE SAVING EQUIPMENTS) This is to confirm that the following life saving equipments have been carried out period maintenance by the undersigned licensed service engineer in accordance with SOLAS Regulation III 20.3.2 and MSC/Circular 1206 and that the launching appliances have been found to be fit for purpose.
Certificate Number:
Name of ship: IMO No.:
Lifeboat
Type: Date of manufacture: Manufacturer: Date of servicing: Port of servicing:
Kind of Servicing: Annual 5 yearly
Result (Details depend on the attached check list)
Starboard Side Port Side
Note: This statement is based on an agreement in the deliberation of the 48th IMO Ship Design and Equipment (DE) subcommittee.
Service Company: Service Engineer: (signature) Name: Date:
Certificate No.
Annual Inspection 5-yearly Inspection
Remark
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Item
Hull - Inner Structure
1.3
1.2
Satisfactory
Type of Lifeboat
Service Location
Lifeboat Location
Hull No.
Manufacturer
Manufacturing Date:
Hull - Outside
Ship Owner
Flag
Satisfactory
Satisfactory
Satisfactory
Maintenance Check List
1.1
Result of Inspection and Servicing
Builder
Description
Serial Number
1.5 Embarkation Door
1.4 Canopy - Inner Structure
Satisfactory
1.6 Top Access Hatch Satisfactory
1.7 Fore Access Hatch Satisfactory
1.8 Aft Access Hatch Satisfactory
1.9 Hand Rails Satisfactory
1.10 Bottom Plug Satisfactory
1.11 Bilge Hand Pump Satisfactory
1.12 Lifeline Satisfactory
Satisfactory
1.13 Painter Release Device Satisfactory
1.16 Head Cushions Satisfactory
1.17
1 18 Rubber Fender Satisfactory
SatisfactoryRetro-reflective material
Rain Water Collector
Safety Belt Satisfactory
1. General Outfit
Canopy - Outside
1.15
1.14
Class
Type of Service
IMO Number
Name of Ship
Type of Ship
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Remark
Part Exchange Repair 5-yearly examination: condition overhual
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair renew - every 10 years
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair Annual examination: light load
Part Exchange Repair 5-yearly examination: 1.1 times load
F101/R2Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
1.20 Windows Satisfactory
1.19 Skates Satisfactory
1.18 Rubber Fender Satisfactory
Certificate Nr. :
Date of Servicing :
Owner's Representative: Service Company:Service Engineer :Name:
2.2 Central Release Unit
2. Release MechanismItem Description Result of Inspection and Servicing
2.1 Satisfactory
2.6
Interlock Unit
Satisfactory
2.5 Hydrostatic Interlock Device
2.8
Fore and Aft release cables
Satisfactory
2.7 Satisfactory
2.10
Spring for Hydro. Device
Satisfactory
2.9 Satisfactory
Satisfactory
Hook Release & reseting operation
Hook Release & reseting operation
Cable for Hydro. Device
Rubber Diaphragm
Satisfactory
2.2
Hook Device
Satisfactory
Notice:
Satisfactory
2.4
Remark
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
4. Electric Parts
3.14 Cooling water pipe
4.2
3.16 Rudder Nozzle
3.13 Fuel Oil pipe Satisfactory
Satisfactory
3.12 V-belt of Generator Satisfactory
Satisfactory
3.15 Propeller
3.11 Engine Control Panel Satisfactory
3.10 Stern Tube Satisfactory
3.9 Start/Stop Button Satisfactory
3.8 Main Switch Satisfactory
Gear oil level
3.6 Lub oil level
Satisfactory3.7
3.4 Steering Gear
Fuel oil level Satisfactory3.5
Start engine
3.3
3.2
Engine gear control
Maintenance Check List
3.1
Result of Inspection and Servicing
3. Engine Plant
Item Description
Engine and gear box Satisfactory
Satisfactory
Satisfactory
Satisfactory
4.1 Batteries Satisfactory
Battery charger Satisfactory
Satisfactory
Satisfactory
4.3 Ceiling Light Satisfactory
4.4 Indication Light Satisfactory
4.5 Search Light Satisfactory
5 Ai S l S t (f T k i l )
4.6 Electric wiring Satisfactory
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
6. Water Spray System (for Tanker version only)Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
Part Exchange Repair
F101/R2Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
Date of Servicing :
Service Engineer :Name:
Notice:
Owner's Representative: Service Company:
5. Air Supply System (for Tanker version only)5.1 air bottles Satisfactory
5.2 air bottles' pressure Satisfactory
5.3 pressure hoses Satisfactory
5.4 air regulator Satisfactory
6.1 Water Spray Pump Satisfactory
6.2 Water Spray Lines Satisfactory
6.3 Spray Nozzles Satisfactory
6.4 Inlet Control Valve & Gear Satisfactory
Certificate Nr. :
F103/R2 Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
STATEMENT (LAUNCHING APPLIANCES) This is to confirm that the following life saving equipments have been carried out period maintenance by the undersigned licensed service engineer in accordance with SOLAS Regulation III 20.3.2 and MSC/Circular 1206 and that the launching appliances have been found to be fit for purpose.
Certificate Number:
Name of ship: IMO No.:
Davit Type: Date of manufacture: Manufacturer:
Winch Type: Date of manufacture: Manufacturer:
Date of servicing: Port of servicing:
Kind of Servicing: Annual 5 yearly
Result (Details depend on the attached check list)
Starboard Side Port Side
Note: This statement is based on an agreement in the deliberation of the 48th IMO Ship Design and Equipment (DE) subcommittee.
Service Company:
MARLAND BOAT SERVICE LTD.
Service Engineer: (signature) Name: Date:
Certificate No.
DAVIT AND WINCH EXAMINATION CHECK LIST This check list should be issued by the manufacturer’s representative or the person certified by the manufacturer for the work.
F101/R2 Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
BOAT DAVIT ☒No.1 □No.2 DATE: Name of vessel Type of Davit IMO number Serial number No Items Result of inspection and servicing Remarks 01 Sheave Suspension block □Good □Part exchange □Repair
02 Hinge pin Rollerpin □Good □Part exchange □Repair
03 Suspension block Link □Good □Part exchange □Repair
04 Boat fall □Good □Part exchange □Repair
05 Lashing wire rope □Good □Part exchange □Repair
06 Remote control device □Good □Part exchange □Repair
07 Frame, Davit arm □Good □Part exchange □Repair
08 Davit arm horn □Good □Part exchange □Repair
09 Trigger hook □Good □Part exchange □Repair
10 Cradle stopper □Good □Part exchange □Repair
11 Shackle, Thimble Turn buckle □Good □Part exchange □Repair
12 Slip hook □Good □Part exchange □Repair
13 Bolt, Nut, etc □Good □Part exchange □Repair
14 Welding part with deck □Good □Part exchange □Repair
15 Recovery strap □Good □Part exchange □Repair
16 Maintenance pendant □Good □Part exchange □Repair
17 Spare parts □Good □Part exchange □Repair
18 Wire adjuster □Good □Part exchange □Repair
19 Turning out Operation □Good □Part exchange □Repair
20 Turning in Operation □Good □Part exchange □Repair
Notice: *Erase an unnecessary item in the slash.
Captain signature:
Service engineer: (Signature) Name:
Service company: MARLAND BOAT SERVICE LTD.
Certificate number:
Date of servicing:
DAVIT AND WINCH EXAMINATION CHECK LIST This check list should be issued by the manufacturer’s representative or the person certified by the manufacturer for the work.
F101/R2 Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
BOAT WINCH ☒No.1 □No.2 DATE: Name of Vessel IMO Number Type of winch Serial number Date of manufacturer Name of manufacturer No Items Result of inspection and servicing Remarks 01 Gear case □Good □Part exchange □Repair
02 Gear □Good □Part exchange □Repair
03 Bearing □Good □Part exchange □Repair
04 Disk brake □Good □Part exchange □Repair
05 Brake lever □Good □Part exchange □Repair
06 Hand break device □Good □Part exchange □Repair
07 Centrifugal brake □Good □Part exchange □Repair
08 Cam clutch □Good □Part exchange □Repair
09 Wire dram □Good □Part exchange □Repair
10 Manual handle □Good □Part exchange □Repair
11 Dynamic winch Brake test □Good □Part exchange □Repair Annual
12 Dynamic winch Brake test □Good □Part exchange □Repair 1.1 times load(5-yearly)
13 Induction motor □Good □Part exchange □Repair
14 Push button switch □Good □Part exchange □Repair
15 Plug & receptacle □Good □Part exchange □Repair
16 Magnetic switchbox □Good □Part exchange □Repair
17 Limit switch □Good □Part exchange □Repair
18 Air motor □Good □Part exchange □Repair
19 Oiler, Filter □Good □Part exchange □Repair
20 Limit valve □Good □Part exchange □Repair
Notice: *Erase an unnecessary item in the slash.
Captain signature:
Service engineer: (Signature) Name:
Service company: MARLAND BOAT SERVICE LTD.
Certificate number:
Date of servicing:
DAVIT AND WINCH EXAMINATION CHECK LIST This check list should be issued by the manufacturer’s representative or the person certified by the manufacturer for the work.
F101/R2 Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
BOAT DAVIT □No.1 ☒No.2 DATE: Name of vessel Type of Davit IMO number Serial number No Items Result of inspection and servicing Remarks 01 Sheave Suspension block □Good □Part exchange □Repair
02 Hinge pin Rollerpin □Good □Part exchange □Repair
03 Suspension block Link □Good □Part exchange □Repair
04 Boat fall □Good □Part exchange □Repair
05 Lashing wire rope □Good □Part exchange □Repair
06 Remote control device □Good □Part exchange □Repair
07 Frame, Davit arm □Good □Part exchange □Repair
08 Davit arm horn □Good □Part exchange □Repair
09 Trigger hook □Good □Part exchange □Repair
10 Cradle stopper □Good □Part exchange □Repair
11 Shackle, Thimble Turn buckle □Good □Part exchange □Repair
12 Slip hook □Good □Part exchange □Repair
13 Bolt, Nut, etc □Good □Part exchange □Repair
14 Welding part with deck □Good □Part exchange □Repair
15 Recovery strap □Good □Part exchange □Repair
16 Maintenance pendant □Good □Part exchange □Repair
17 Spare parts □Good □Part exchange □Repair
18 Wire adjuster □Good □Part exchange □Repair
19 Turning out Operation □Good □Part exchange □Repair
20 Turning in Operation □Good □Part exchange □Repair
Notice: *Erase an unnecessary item in the slash.
Captain signature:
Service engineer: (Signature) Name:
Service company: MARLAND BOAT SERVICE LTD.
Certificate number:
Date of servicing:
DAVIT AND WINCH EXAMINATION CHECK LIST This check list should be issued by the manufacturer’s representative or the person certified by the manufacturer for the work.
F101/R2 Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
BOAT WINCH □No.1 ☒No.2 DATE: Name of Vessel IMO Number Type of winch Serial number Date of manufacturer Name of manufacturer No Items Result of inspection and servicing Remarks 01 Gear case □Good □Part exchange □Repair
02 Gear □Good □Part exchange □Repair
03 Bearing □Good □Part exchange □Repair
04 Disk brake □Good □Part exchange □Repair
05 Brake lever □Good □Part exchange □Repair
06 Hand break device □Good □Part exchange □Repair
07 Centrifugal brake □Good □Part exchange □Repair
08 Cam clutch □Good □Part exchange □Repair
09 Wire dram □Good □Part exchange □Repair
10 Manual handle □Good □Part exchange □Repair
11 Dynamic winch Brake test □Good □Part exchange □Repair Annual
12 Dynamic winch Brake test □Good □Part exchange □Repair 1.1 times load(5-yearly)
13 Induction motor □Good □Part exchange □Repair
14 Push button switch □Good □Part exchange □Repair
15 Plug & receptacle □Good □Part exchange □Repair
16 Magnetic switchbox □Good □Part exchange □Repair
17 Limit switch □Good □Part exchange □Repair
18 Air motor □Good □Part exchange □Repair
19 Oiler, Filter □Good □Part exchange □Repair
20 Limit valve □Good □Part exchange □Repair
Notice: *Erase an unnecessary item in the slash.
Captain signature:
Service engineer: (Signature) Name:
Service company: MARLAND BOAT SERVICE LTD.
Certificate number:
Date of servicing:
F103/R2 Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
STATEMENT (LIFE SAVING EQUIPMENTS) This is to confirm that the following life saving equipments have been carried out period maintenance by the undersigned licensed service engineer in accordance with SOLAS Regulation III 20.3.2 and MSC/Circular 1206 and that the life saving equipments have been found to be fit for purpose.
Certificate Number:
Name of ship: IMO No.:
Freefall Lifeboat Type: Date of manufacture: Manufacturer:
Freefall Lifeboat Davit Type: Date of manufacture: Manufacturer:
Freefall Lifeboat Winch Type: Date of manufacture: Manufacturer:
Date of servicing: Port of servicing:
Kind of Servicing: Annual Servicing 5 yearly Servicing Repair
Result (Details depend on the attached check list)
Freefall Lifeboat Freefall Lifeboat Davit Freefall Lifeboat Winch
Note: This statement is based on an agreement in the deliberation of the 48th IMO Ship Design and Equipment (DE) subcommittee.
Service Company:
MARLAND BOAT SERVICE LTD.
Service Engineer:(signature) Name: Date:
FREE FALL LIFEBOAT EXAMINATION CHECK LIST
F101/R2 Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
FREE FALL LIFEBOAT Name of ship Manufacturer IMO number Type Ship Owner Serial Number Port of Registry Service Location Class Inspection Date
External Checklist of Free-fall Lifeboat NO Items Result of inspection and servicing Remarks 01 FRP Hull □Good □Part exchange □Repair
02 Marking □Good □Part exchange □Repair Seals □Good □Part exchange □Repair
Hatches & Doors □Good □Part exchange □Repair
Painter Release □Good □Part exchange □Repair
Sliding Rail □Good □Part exchange □Repair Handrails □Good □Part exchange □Repair Door Handle □Good □Part exchange □Repair Lifeline □Good □Part exchange □Repair Window □Good □Part exchange □Repair Lifting Eye □Good □Part exchange □Repair Retro Reflective Tape □Good □Part exchange □Repair Skate Rail □Good □Part exchange □Repair Recovering Ring □Good □Part exchange □Repair
03 Fitting
Lashing Eyes □Good □Part exchange □Repair Spray Tube □Good □Part exchange □Repair
04 Water Spray
System Under Nozzle □Good □Part exchange □Repair
05 Steering System Rudder □Good □Part exchange □Repair
06 Bilge System Drain Plug □Good □Part exchange □Repair
Canopy □Good □Part exchange □Repair 07 Electrics
Socket & Plug □Good □Part exchange □Repair
Notice:
Service company:
Certificate number:
Signature of Vessel Representative:
Service engineer:(Signature)
Name: Date of servicing:
FREE FALL LIFEBOAT EXAMINATION CHECK LIST
F101/R2 Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
FREE FALL LIFEBOAT Name of ship Manufacturer IMO number Type Ship Owner Serial Number Port of Registry Service Location Class Inspection Date
Internal Checklist of Free-fall Lifeboat NO Items Result of inspection and servicing Remarks
Stuffing Box □Good □Part exchange □Repair 01 Propulsion /
Shaft Bearings □Good □Part exchange □Repair
Rudder Bearing □Good □Part exchange □RepairEmergency Tiller □Good □Part exchange □Repair02 Steering
System Steering Cable □Good □Part exchange □Repair
Hydro-Pump □Good □Part exchange □Repair03 Release
Mechanism Emergency Pump □Good □Part exchange □Repair
Safety Belt □Good □Part exchange □RepairHead Protection □Good □Part exchange □RepairCompass □Good □Part exchange □Repair04 Fitting
Symbols □Good □Part exchange □Repair
Valves □Good □Part exchange □Repair 05 Water Spray
System Hose Connection □Good □Part exchange □Repair Pressure Valves □Good □Part exchange □Repair Air Cylinder □Good □Part exchange □Repair 06 Air Supply
System Pressure Gauge □Good □Part exchange □Repair
07 Bilge System Bilge Pump □Good □Part exchange □Repair
Interior Light □Good □Part exchange □Repair Search Light □Good □Part exchange □Repair Batteries □Good □Part exchange □Repair 08 Electrics
Charger □Good □Part exchange □Repair Notice:
Service company:
Certificate number:
Signature of Vessel Representative:
Service engineer:(Signature)
Name: Date of servicing:
FREE FALL LIFEBOAT DAVIT & WINCH CHECK LIST
F101/R2 Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
Name of ship Manufacturer IMO number Type Ship Owner Serial Number Port of Registry Davit Location Class Inspection Date DAVIT FOR FREE-FALL TYPE NO Items Result of inspection and servicing Remarks 01 Slide Track □Good □Part exchange □Repair
02 Davit Arms □Good □Part exchange □Repair 03 Hinge □Good □Part exchange □Repair 04 Sheave □Good □Part exchange □Repair 05 Roller □Good □Part exchange □Repair 06 Traverse □Good □Part exchange □Repair 07 Suspension □Good □Part exchange □Repair 08 Lashing Bollard □Good □Part exchange □Repair 09 Main Lashing □Good □Part exchange □Repair 10 Boat Fall □Good □Part exchange □Repair 11 Hook Lashing Line □Good □Part exchange □Repair 12 Wire for Lashing Plate □Good □Part exchange □Repair 13 Reset Wire for Lashing Plate □Good □Part exchange □Repair 14 Hydraulic Cylinder □Good □Part exchange □Repair 15 Spare Parts □Good □Part exchange □Repair 16 Others □Good □Part exchange □Repair
Notice:
Service company:
Certificate number:
Signature of Vessel Representative:
Service engineer:(Signature)
Name: Date of servicing:
FREE FALL LIFEBOAT DAVIT & WINCH CHECK LIST
F101/R2 Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
Name of ship Manufacturer IMO number Type Ship Owner Serial Number Port of Registry Winch Location Class Inspection Date WINCH FOR FREE-FALL TYPE NO Items Result of inspection and servicing Remarks 01 Gear Box □Good □Part exchange □Repair
02 Lubrication Oil □Good □Part exchange □Repair 03 Gear □Good □Part exchange □Repair 04 Bearing □Good □Part exchange □Repair 05 Oil Seal □Good □Part exchange □Repair 06 Hydraulic Brake Device □Good □Part exchange □Repair 07 Hydraulic Motor □Good □Part exchange □Repair 08 Wire Drum □Good □Part exchange □Repair 09 Power Pack □Good □Part exchange □Repair 10 Hydraulic Pump □Good □Part exchange □Repair 11 Hydraulic Control Valve □Good □Part exchange □Repair 12 Electric Motor □Good □Part exchange □Repair 13 Starter Panel □Good □Part exchange □Repair 14 Push Button Box □Good □Part exchange □Repair 15 Rubber Hose & Joint □Good □Part exchange □Repair
16 Launching Test by the Operation of Davit Arm □Good □Part exchange □Repair Empty Boat
(For Annual Inspection Only)
17 Brake Test by the Operation of Davit Arm □Good □Part exchange □Repair Full Load x 1.1times
(for 5-yearly Only) Notice:
Service company:
Certificate number:
Signature of Vessel Representative:
Service engineer:(Signature)
Name: Date of servicing:
F103/R2 Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
STATEMENT (LIFE SAVING EQUIPMENTS) This is to confirm that the following life saving equipments have been carried out period maintenance by the undersigned licensed service engineer in accordance with SOLAS Regulation III 20.3.2 and MSC/Circular 1206 and that the life saving equipments have been found to be fit for purpose.
Certificate Number:
Name of ship: IMO No.:
Type: Date of manufacture: Rescue Boat Manufacturer: Type: Date of manufacture: Rescue Boat Davit Manufacturer: Type: Date of manufacture: Rescue Boat Winch Manufacturer:
Date of servicing: Port of servicing:
Kind of Servicing: Annual Servicing 5 yearly Servicing Repair
Result (Details depend on the attached check list)
Rescue Boat Rescue Boat Davit Rescue Boat Winch
Note: This statement is based on an agreement in the deliberation of the 48th IMO Ship Design and Equipment (DE) subcommittee.
Service Company: Service Engineer:(signature) Name: Date:
RESCUEBOAT EXAMINATION CHECK LIST
F101/R2 Issue Date: 18 Mar. 2009
Marland Boat Service Ltd.
Name of ship Manufacturer IMO number Type Ship Owner Serial Number Port of Registry Service Location Class Inspection Date NO Items Result of inspection and servicing Remarks 01 FRP Hull □Good □Part exchange □Repair
02 Marking □Good □Part exchange □Repair Seals □Good □Part exchange □Repair
Symbol □Good □Part exchange □Repair
Handrails □Good □Part exchange □Repair
Lifeline □Good □Part exchange □Repair Retro Reflective Tape □Good □Part exchange □Repair Painter Release □Good □Part exchange □Repair Towing Eye □Good □Part exchange □Repair Lifting Hook □Good □Part exchange □Repair Rubber Fender □Good □Part exchange □Repair Compass □Good □Part exchange □Repair Fuel Tank □Good □Part exchange □Repair Arch □Good □Part exchange □Repair Lashing Guide □Good □Part exchange □Repair Under Foot Step □Good □Part exchange □Repair Impact Protection Rubber □Good □Part exchange □Repair Locker / Hatch □Good □Part exchange □Repair
03 Fitting
Paddle □Good □Part exchange □Repair
05 Steering System Rudder □Good □Part exchange □Repair
06 Bilge System Drain Plug □Good □Part exchange □Repair
Canopy □Good □Part exchange □Repair
Search Light □Good □Part exchange □Repair 07 Electrics
Socket & Plug □Good □Part exchange □Repair
Notice:
Service company:
Certificate number:
Signature of Vessel Representative:
Service engineer:(Signature)
Name: Date of servicing:
LIFE RAFT / RESCUE BOAT DAVIT & WINCH CHECK LIST
F101/R2 Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
Name of ship Manufacturer IMO number Type of Davit Ship Owner Serial Number Port of Registry Service Location Class Inspection Date DAVIT FOR LIFE RAFT / RESCUE BOAT NO Items Result of inspection and servicing Remarks 01 Post Stand □Good □Part exchange □Repair
02 Post □Good □Part exchange □Repair 03 Davit Arm □Good □Part exchange □Repair 04 Sheave □Good □Part exchange □Repair 05 Suspension Block □Good □Part exchange □Repair 06 Slewing Bearing □Good □Part exchange □Repair 07 Slewing Stopper □Good □Part exchange □Repair 08 Slewing Reducer □Good □Part exchange □Repair 09 Lubrication Oil □Good □Part exchange □Repair 10 Slewing Hydraulic Motor □Good □Part exchange □Repair 11 Release Hook □Good □Part exchange □Repair 12 Boat Fall □Good □Part exchange □Repair 13 Remote Control Device □Good □Part exchange □Repair 14 Deck Operation Device □Good □Part exchange □Repair 15 Recovery Trap □Good □Part exchange □Repair 16 Hanging Off Pendant □Good □Part exchange □Repair 17 Spare Part □Good □Part exchange □Repair 18 Others □Good □Part exchange □Repair
Notice:
Service company:
Certificate number:
Signature of Vessel Representative:
Service engineer:(Signature)
Name: Date of servicing:
LIFE RAFT / RESCUE BOAT DAVIT & WINCH CHECK LIST
F101/R2 Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
WINCH FOR LIFE RAFT / RESCUE BOAT NO Items Result of inspection and servicing Remarks 01 Gear Box □Good □Part exchange □Repair
02 Lubrication Oil □Good □Part exchange □Repair 03 Gear □Good □Part exchange □Repair 04 Bearing □Good □Part exchange □Repair 05 Oil Seal □Good □Part exchange □Repair 06 Hand Brake Device □Good □Part exchange □Repair 07 Governor Brake Device □Good □Part exchange □Repair 08 Cam Clutch □Good □Part exchange □Repair 09 Manual Handle □Good □Part exchange □Repair 10 Wire Drum □Good □Part exchange □Repair 11 Power Pack □Good □Part exchange □Repair 12 Hydraulic Pump □Good □Part exchange □Repair 13 Hydraulic Control Valve □Good □Part exchange □Repair 14 Accumulator □Good □Part exchange □Repair 15 Electric Motor □Good □Part exchange □Repair 16 Starter Panel □Good □Part exchange □Repair 17 Limit Switch □Good □Part exchange □Repair 18 Hydraulic Hose & Joint □Good □Part exchange □Repair
19 Dynamic Winch Brake Test □Good □Part exchange □Repair Empty Boat (For Annual Inspection Only)
20 Dynamic Winch Brake Test □Good □Part exchange □Repair Full Load x 1.1times (for 5-yearly Only)
Notice:
Service company:
Certificate number:
Signature of Vessel Representative:
Service engineer:(Signature)
Name: Date of servicing:
Name of ship Manufacturer IMO number Type of Winch Ship Owner Serial Number Port of Registry Service Location Class Inspection Date
F103/R2 Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
STATEMENT (LIFE SAVING EQUIPMENTS) This is to confirm that the following life saving equipments have been carried out period maintenance by the undersigned licensed service engineer in accordance with SOLAS Regulation III 20.3.2 and MSC/Circular 1206 and that the life saving equipments have been found to be fit for purpose.
Certificate Number:
Name of ship: IMO No.:
Type: Date of manufacture: Liferaft Davit Manufacturer: Type: Date of manufacture: Liferaft Winch Manufacturer:
Date of servicing: Port of servicing:
Kind of Servicing: Annual Servicing 5 yearly Servicing Repair
Result (Details depend on the attached check list)
Liferaft Davit Liferaft Winch
Note: This statement is based on an agreement in the deliberation of the 48th IMO Ship Design and Equipment (DE) subcommittee.
Service Company:
Service Engineer:(signature) Name: Date:
LIFE RAFT / RESCUE BOAT DAVIT & WINCH CHECK LIST
F101/R2 Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
Name of ship Manufacturer IMO number Type of Davit Ship Owner Serial Number Port of Registry Service Location Class Inspection Date DAVIT FOR LIFE RAFT / RESCUE BOAT NO Items Result of inspection and servicing Remarks 01 Post Stand □Good □Part exchange □Repair
02 Post □Good □Part exchange □Repair 03 Davit Arm □Good □Part exchange □Repair 04 Sheave □Good □Part exchange □Repair 05 Suspension Block □Good □Part exchange □Repair 06 Slewing Bearing □Good □Part exchange □Repair 07 Slewing Stopper □Good □Part exchange □Repair 08 Slewing Reducer □Good □Part exchange □Repair 09 Lubrication Oil □Good □Part exchange □Repair 10 Slewing Hydraulic Motor □Good □Part exchange □Repair 11 Release Hook □Good □Part exchange □Repair 12 Boat Fall □Good □Part exchange □Repair 13 Remote Control Device □Good □Part exchange □Repair 14 Deck Operation Device □Good □Part exchange □Repair 15 Recovery Trap □Good □Part exchange □Repair 16 Hanging Off Pendant □Good □Part exchange □Repair 17 Spare Part □Good □Part exchange □Repair 18 Others □Good □Part exchange □Repair
Notice:
Service company:
Certificate number:
Signature of Vessel Representative:
Service engineer:(Signature)
Name: Date of servicing:
LIFE RAFT / RESCUE BOAT DAVIT & WINCH CHECK LIST
F101/R2 Issue Date: 18 Mar. 2009 Marland Boat Service Ltd.
WINCH FOR LIFE RAFT / RESCUE BOAT NO Items Result of inspection and servicing Remarks 01 Gear Box □Good □Part exchange □Repair
02 Lubrication Oil □Good □Part exchange □Repair 03 Gear □Good □Part exchange □Repair 04 Bearing □Good □Part exchange □Repair 05 Oil Seal □Good □Part exchange □Repair 06 Hand Brake Device □Good □Part exchange □Repair 07 Governor Brake Device □Good □Part exchange □Repair 08 Cam Clutch □Good □Part exchange □Repair 09 Manual Handle □Good □Part exchange □Repair 10 Wire Drum □Good □Part exchange □Repair 11 Power Pack □Good □Part exchange □Repair 12 Hydraulic Pump □Good □Part exchange □Repair 13 Hydraulic Control Valve □Good □Part exchange □Repair 14 Accumulator □Good □Part exchange □Repair 15 Electric Motor □Good □Part exchange □Repair 16 Starter Panel □Good □Part exchange □Repair 17 Limit Switch □Good □Part exchange □Repair 18 Hydraulic Hose & Joint □Good □Part exchange □Repair
19 Dynamic Winch Brake Test □Good □Part exchange □Repair Empty Boat (For Annual Inspection Only)
20 Dynamic Winch Brake Test □Good □Part exchange □Repair Full Load x 1.1times (for 5-yearly Only)
Notice:
Service company:
Certificate number:
Signature of Vessel Representative:
Service engineer:(Signature)
Name: Date of servicing:
Name of ship Manufacturer IMO number Type of Winch Ship Owner Serial Number Port of Registry Service Location Class Inspection Date
M/V _
LIFEBOAT & LAUNCHING APPLIANCE SERVICE
WORK DONE LIST
This is to confirm that “Marland Boat Service Ltd.”
has performed the Annual / 5 Yearly maintenance for
□ Lifeboat and / or Rescue Boat
□ Launching Appliance
in accordance with Solas Regulation III 20.3.2 and
MSC/Circular 1206. on __________________
certificate issued and received.
Accepted and Signed by:
________________ ________________
Vessel Representative Marland Boat Service Ltd.
___________________________________________________________________
Add: Rm 702, Fortress Tower, 250 King’s Road, Northpoint, Hong Kong SAR, China Tel: (852) 2571 9322 Fax: (852) 2806 3153 Email: [email protected]
F102/R2 Issue Date: 18 Mar 2009
Marland Boat Service Ltd.
___________________________________________________________
___________________________________________________________ Add: Rm 702, Fortress Tower, 250 King’s Road, Northpoint, Hong Kong SAR, China
Tel: (852) 2571 9322 Fax: (852) 2806 3153 Email: [email protected] F106/R2 Issue Date: 18 Mar 2009
Marland Boat Service Ltd.
Work Done & Delivery Note Vessel Name: Shipbuilder:
IMO Number: Hull No:
Date: Date of Build:
Location: Flag / Class:
Kind of Work: 5 yearly Service / Repair or Parts Renewal / General Inspection
This is to confirm the below job to the above mentioned vessel has been carried out.
Item Descriptions Qty
Accepted and Signed by Marland Boat Service Ltd.
Vessel Representative:
________________________ __________________________
___________________________________________________________
___________________________________________________________ Add: Rm 702, Fortress Tower, 250 King’s Road, Northpoint, Hong Kong SAR, China
Tel: (852) 2571 9322 Fax: (852) 2806 3153 Email: [email protected] F107/R2 Issue Date: 18 Mar 2009
Marland Boat Service Ltd.
Time Sheet Vessel Name: Shipbuilder:
IMO Number: Hull No:
Date: Date of Build:
Location: Flag / Class:
Kind of Work: 5 yearly Service / Repair or Parts Renewal / General Inspection
Traveling Time
Date: Name Traveling Time (HH:MM ~ HH:MM) Total Hours
Working Time
Date Name Working Time (HH:MM ~ HH:MM) Total Hours
Accepted and Signed by Marland Boat Service Ltd.
Vessel Representative:
________________________ __________________________