INTERNATIONAL NAVAL SURVEYS BUREAU

SURVEY UNDER ANNEX II OF THE INTERNATIONAL

CONVENTION FOR THE PREVENTION OF POLLUTION
FROM SHIPS, 1973, AS MODIFIED BY THE PROTOCOL
OF 1978 RELATING THERETO

Initial Survey Renewal Survey Intermediate Survey Annual Survey

Name of Ship : Distinctive Letters : Port of Registry:

                 

Gross Tonnage: Dead Weight (metric tons): Year of Build:

                 

Managers (or agents) :

     
Place of survey: in dry-dock on slipway afloat Survey Commenced :
     
At: Survey Completed :
           
Note: i. Fields should be filled with YES, NO or N/A as required.
ii. All negative entries (NO) should be clarified under "Surveyor's Notes" with reference by item number.
I. INITIAL SURVEY

1. Pumping system documentation available

2. Stripping system documentation available
3. Tank washing system and equipment documentation available
4. Underwater discharge arrangements documentation available
5. Residue discharge system documentation available
6. Recording devises documentation available
7. Ventilation equipment for residue removal documentation available
8. Heating system documentation available
9. Surface residue quantity assessment documentation available
10. Procedures and Arrangements Manual
11. List of Annex II substances proposed for carriage
12. Cargo Record Book
13. Certificate of Fitness
14. Water test for assessing regulation stripping quantity
15. All parts of stripping system, including portable pipes or bends, are on board
16. Tank washing machines are those described in the P & A Manual and are installed in accordance with the approved
plans and in working order
17. The wash water heating system, if required, is installed in accordance with the approved plans
18. The number and position of tank cleaning openings for portable machines are in accordance with the approved plans
19. The underwater discharge outlet(s) are in accordance with the approved plans
20. Means are provided in the common discharge piping to isolate openings provided above the waterline
21. The discharge rate of the residue discharge system pumps can be controlled as specified in the approved
Manual (actual test)

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 22. Means for restricting the discharge flow of fixed rate pumps have been fixed
23. Verification by an actual test that the flow meter has an accuracy of 15% or better
24. Satisfactory operation of the recording device
25. Ventilation equipment for residue removal is installed in accordance with the approved plan and in working order
26. The pressure in the driving medium for portable fans can be achieved to give the required fan capacity
27. Heating system for solidifying and high viscosity substances is installed in accordance with the approved plan

II. MANDATORY ANNUAL SURVEY

1. NLS Certificate or Certificate of Fitness valid

2. Other statutory / class certificates valid
3. Cargo Record Book on board
4. Sighting the records of the recording device
5. P&A Manual on board
6. External examination of pumping and piping systems (including stripping system if fitted)
7. Type, capacity, number and arrangement of the tank washing machines are as approved
8. External examination of tank washing piping
9. External examination of wash water heating system
10. External examination, as far as practicable, of the underwater discharge arrangements
11. Residue discharge rate control is as approved
12. Recording device is operable
13. Ventilation equipment for residue removal is as approved
14. External examination of the heating system for solidifying and high viscosity substances as far as accessible

III. INTERMEDIATE SURVEY

Note: Items of Paragraph 2 apply to intermediate surveys. To be completed as required.
1. Verification from the Cargo Record Book that the pumping arrangements have been emptying the tanks efficiently
and are in working order.
2. The underwater discharge outlet(s) are in good condition
3. Testing of the satisfactory operation of the recording device by a simulation test or equivalent
4. Testing for the confirmation of the satisfactory operation of ventilation equipment for residue removal

IV. PERIODICAL (RENEWAL) SURVEY

Note: Items of Paragraph 2 & 3 apply to periodical (renewal) surveys. To be completed as required.
1. Al least two selected cargo tanks and their associated pumps stripping systems water tested in accordance with Standards
2. Same as 16 to 22 inclusive of paragraph I
3. Same as 24 to 27 inclusive of paragraph I
V. SURVEYOR'S NOTES
     
     
     
     
     

Date:            

Surveyor to International Naval Surveys Bureau - I.N.S.B.

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