ESP Survey Programme Fillable PDF.0 R5.0.1

SURVEY QUESTIONNAIRE - PROGRAMME
FOR ALL ESP SHIPS
1. Particulars
Name of ship:
IMO (LR) number:
Type of ship:
Flag State:
-
Port of registry:
Gross tonnage:
Deadweight (metric tonnes):
Length between perpendiculars (m):
Shipbuilder:
Hull number:
Recognized organization (RO):

Lloyd's Register
RO ship identity:
Date of delivery of the ship:
Owner:
Intermediate / Special Survey:
Due date of Intermediate / Special Survey:
Due date of Docking Survey:
Type of cargoes carried:
Document no; ESP_R13.0 2014

FOR ALL ESP SHIPS
2. General Plan:
Please identify the location and dates that the Intermediate / Special Survey be held?
Please identify the location and dates that the docking survey be held?
Please identify the location and dates that thickness measurements be carried out?
Which company will perform the thickness measurements?
Please identify and list the ship Tanks / Holds for tank testing purposes:

FOR ALL ESP SHIPS
Or attach an image file of the proposed tank testing plan: Clear image

FOR ALL ESP SHIPS
3. Assessment of Corrosion Risk
The information below may assist in the assessment of corrosion risk and determination of areas
subject to close-up examination and thickness measurement.
History of cargo of a corrosive nature: cargo with high sulphur (H2S) content or heated cargo for the last 3
years:
4. Owner’s inspections
The owner should provide details of the results of their inspections over the last 3 (three) years for
the tanks/spaces that are subject to Survey with reference to structural deterioration in general,
leakages in tank boundaries and piping and condition of the coating and corrosion protection
system (including anodes) if any.
Note: Indicate tanks which are used for oil/ballast
(1) HC = hard coating; SC = soft coating; A = anodes; NP = no protection

(2) U = upper part; M = middle part; L = lower part; C = complete
(3) G = good; F = fair; P = poor; RC = recoated (during the last 3 years)
(4) N = no findings recorded; Y = findings recorded, description of findings
(5) DR = Damage & Repair; L = Leakages; CV = Conversion Description
Hold/Tank No. Corrosion Coating Coating Structural Hold and tank history
protection extent condition deterioration
(1) (2) (3) (4) (5)
Water Ballast Tanks

FOR ALL ESP SHIPS
Aft Peak Tank
Fore Peak Tank
Cargo centre tanks / Cargo holds
Cargo wing tanks

FOR ALL ESP SHIPS
Slop tanks
Topside tanks
Hopper / double bottom tanks
Double skin side tanks

FOR ALL ESP SHIPS
Upper stools
Lower stools
Miscellaneous other spaces

FOR ALL ESP SHIPS
5. Reports of Port State Control inspections
List the reports of Port State Control inspections containing hull structural related deficiencies, relevant
information on rectification of the deficiencies:
Deficiency Corrective action
6. Safety Management System
List non-conformities related to hull maintenance, including the associated corrective actions:
Non-conformity Corrective action

FOR ALL ESP SHIPS
7. Scope for close-up survey:
Close-up survey requirements Locations subject to close up survey
FOR SHIPS CARRYING OIL WITH LENGTH ≥ 130 m AND OVER 10 YEARS OF AGE (i.e. NORMALLY AT SSIII), THE
LONGITUDINAL STRENGTH IS TO BE EVALUATED.
IN SUCH CASES, A MINIMUM OF THREE TRANSVERSE SECTIONS ARE TO BE MEASURED WITHIN 0,5L
AMIDSHIPS.
IS THIS SHIP REQUIRED TO COMPLY WITH LONGITUDINAL STRENGTH REQUIREMENTS DURING THE
FORTHCOMING SURVEY (PLEASE TICK AS APPROPRIATE)?

FOR ALL ESP SHIPS
8. Scope for Thickness Measurements:
Thickness measurement requirements Locations subject to thickness measurement
10
11

FOR ALL ESP SHIPS
9. Maximum Permissible Diminution of Individual Plates and Stiffeners for non-CSR Ships – To be
used to determine the minimum allowable thickness for non-CSR ships with the as-built thickness from
hull structural plans. For CSR ships the hull structural plans should be used to determine the minimum
thickness permitted for structure subject to thickness measurements.
Structural item Category 1 Category 2 & 3 TM Report Form

ships ships
See Note 5 See Note 5
Hull envelope: individual plates, shell and deck

TM 1
plating recorded along the strake (deck, bottom, 20% See Note 2 30%
See Note 3
side, wind and water)
Hull envelope: transverse section, plates recorded

by frame number and strake position (deck and 20% 30% TM 2~3
sheer/bottom and side)
Longitudinal structural members (including deck

and shell longitudinal stiffeners, longitudinal
bulkhead plating and stiffeners, inner bottom plating Plating 20% Plating 30% TM 2~3
and stiffeners, hopper sloping plating and stiffeners. Stiffeners 25% Stiffeners 25% See Note 3
(See Note 4.2 for additional bulk carrier diminution
criteria)
Transverse structural members in C.O. and W.B.

tanks (including web frame plating and face plates) 20% 25% TM 4
W.T. and O.T. transverse bulkheads including Plating 25% Plating 30% TM 5, TM 5 UR S18,
deep tank bulkheads (See Note 4.1 for additional TM 5 UR S19, TM 5
bulk carrier diminution criteria) Stiffeners and Stiffeners and UR S19%
corrugated corrugated
See Note 4.1 (f), (g)
bulkhead plating bulkhead
25% plating 25%
Miscellaneous structural members (including Plating 25% Plating 30% TM 6, TM 6UR S21,
deck plating inside the line of cargo hatch openings) TM 6UR S21A
Stiffeners 25% Stiffeners 25% See Note 3 , 7
Cargo hold transverse frames and end brackets

(See Note 4 for additional bulk carrier diminution 20% 25% TM 7
criteria)

FOR ALL ESP SHIPS
NOTES
1. For ships with (cc) notation, Surveyors are to compare the measurements with the original Rule thickness
and not the reduced, as built, scantlings which were approved in association with the (cc) notation.
2. For oil tankers of Category 1 the strength deck residual buckling thickness requirement is to be complied
with in accordance with Lloyd’s Register requirements as advised by the attending Surveyor.
3. Where extensive additional measurements are taken for continuous longitudinal plating these may be
reported on Form TM6 as applicable.
4. Additional Bulk Carrier diminution criteria:

4.1 Cargo hold transverse bulkheads
(a) Corrugated parts within cargo holds designed to be fully filled with salt-water ballast (deep tank) – 25%.
(b) Corrugated parts within cargo holds designed to be partially filled with salt-water ballast – 15%.
(c) Corrugated parts of the aft transverse bulkhead of the forward cargo hold – 15%, see (f), (g) below.
(d) Corrugated parts of the remaining transverse bulkheads in cargo holds – 20%.
(e) All plain transverse bulkhead plating (including stool plating) – 25%.
(f) For the aft transverse bulkhead of the forward cargo hold on bulk carriers which have been assessed
and/or upgraded in order to comply with requirements for the notation ESN-HOLD 1 & ESN-ALL HOLDS (UR
S19), refer to the Approved Bulkhead Upgrade Plan for diminution criteria.
These measurements are to be recorded on Form TM5 UR S19. In case the Approved Bulkhead Upgrade
Plan indicates that it is required to apply Classification Rules, then TM5 UR S19% should be used instead.
(g) For the bulkheads of cargo holds on bulk carriers which are contracted for construction on or after 1 July
1998, of 150m in length and above and of single skin (have been assessed in order to comply with
requirements of the notation ESN) and double skin construction, intended to carry solid bulk cargoes having
density of 1.0t/m^3, or above, with vertically corrugated transverse bulkheads (UR S18), measurements are to
be recorded on Form TM5 UR S18.
4.2 Cargo hold inner bottom and hopper sloping plating
(a) Where the notation Strengthened For Heavy Cargoes is assigned and length L is greater than 150 metres
then the maximum diminution applicable is 25%. For all other bulk carriers refer to longitudinal structural
FOR ALL ESP SHIPS
members above.
4.3 Cargo hold transverse frames (shell frames)
For single skin bulk carriers contracted for construction prior to 1 July 1998 undergoing a re-assessment of
their cargo hold shell frames in accordance with the Provisional Rules for Existing Ships (UR S31),
measurements are to be compared against the minimum thickness values shown in the evaluation records.
These measurements are to be recorded on TM7UR S31. For all other bulk carriers refer to ’Cargo hold
transverse frames and end brackets’ above.
5. For thickness measurement evaluation purposes, ship categories are defined as follows:
Category 1: Non CSR Oil tankers, chemical tankers, dry bulk cargo ships, combination carriers and liquefied
gas ships having a length L equal to or greater than 90 metres.
Category 2: All remaining ship types not included in Category 1 and having a length L equal to or greater
than 90 metres.
Category 3: All ship types having a length L less than 90 metres.
(L is the Rule length defined in Part 3, Chapter 1.6.1 of the Rules for Ships.)
6. The maximum diminutions are for the average thickness measured over the plate area or over the length
between supports.
7. Bulk Carriers which are contracted for construction on or after 1 July 1998 (not including CSR ships), are
required to comply with the evaluation of scantlings of hatch covers of cargo holds (UR S21). In addition to
the above, Bulk Carriers, Ore Carriers and Combination Carriers contracted for construction on or after 1
January 2004 are required to comply with the evaluation of scantlings of hatch coamings of cargo holds in
accordance to UR S21.6.2.
Measurements are to be recorded on Form TM6 UR S21.
8. All ships except bulk carriers, ore carriers and combination carriers contracted for construction on or after 1
July 2012 and required to comply with the evaluation of scantlings of hatch covers and coamings on exposed
decks (UR S21A). In specific, requirements should be applied in accordance to UR S21A.7.1. Measurements
are to be recorded on Form TM6 UR S21A.

FOR ALL ESP SHIPS
10. Access provision for close-up surveys and thickness measurement
The means of access to the structures subject to close-up examination and thickness measurement shall
be indicated in the table below. A close-up examination is an examination where the details of structural
components are within the close visual inspection of the Surveyor, i.e. within reach of hand. Conditions
for survey and areas subject to thickness measurement required to be identified.
Hold/ Structure Cargo / Subject to Conditions Temporary Rafting Ladders Direct Other
Tank Ballast Thickness For Survey Staging Access Means
(C/B) Measurement (please
or Close up specify)
Survey (Y/N)
Main Deck SANDBLASTING

INERTING & PURGING
BALLASTING
Plating OTHER
Side Shell CLEANING

DESCALING
LIGHTING
Primary Structural Members
Plating / GAS FREEING

VENTILATION
SANDBLASTING
Wind and INERTING & PURGING
BALLASTING
Water OTHER
Strakes
Bottom and SANDBLASTING

INERTING & PURGING
BALLASTING
Bilge Plating OTHER
Transverse CLEANING
DESCALING
LIGHTING
Webs and GAS FREEING
VENTILATION
SANDBLASTING
attached INERTING & PURGING
BALLASTING
structure OTHER
Transverse CLEANING
DESCALING
LIGHTING
Bulkhead and GAS FREEING
VENTILATION
Fore Peak
SANDBLASTING
BALLASTING
structure OTHER
Transverse CLEANING
DESCALING
LIGHTING
VENTILATION
SANDBLASTING
BALLASTING
Aft Peak
structure OTHER

FOR ALL ESP SHIPS
Transverse CLEANING
DESCALING
LIGHTING
VENTILATION
SANDBLASTING
BALLASTING
structure OTHER
Transverse CLEANING
DESCALING
LIGHTING
VENTILATION
SANDBLASTING
BALLASTING
structure OTHER
Under deck SANDBLASTING

INERTING & PURGING
BALLASTING
longitudinals OTHER
Side shell and LIGHTING

GAS FREEING
VENTILATION
attached SANDBLASTING
INERTING & PURGING
BALLASTING
longitudinals OTHER
VENTILATION
Bottom
Cargo Wing Tanks
SANDBLASTING
INERTING & PURGING
Transverses BALLASTING
OTHER
Deck SANDBLASTING
INERTING & PURGING
BALLASTING
Transverses OTHER
Longitudinal CLEANING
DESCALING
LIGHTING
Bulkhead GAS FREEING
VENTILATION
SANDBLASTING
plating and INERTING & PURGING
BALLASTING
attached OTHER
structure
Web Frame CLEANING

DESCALING
LIGHTING
Rings and GAS FREEING
VENTILATION
SANDBLASTING
BALLASTING
structure OTHER
Under deck SANDBLASTING

INERTING & PURGING
BALLASTING
longitudinals OTHER
Bottom VENTILATION
SANDBLASTING
INERTING & PURGING
Centre Tanks
OTHER
Deck VENTILATION
SANDBLASTING
INERTING & PURGING
OTHER

FOR ALL ESP SHIPS
CLEANING
Transverse
DESCALING
LIGHTING
VENTILATION
SANDBLASTING
BALLASTING
structure OTHER
Web Frame CLEANING

DESCALING
LIGHTING
Rings and GAS FREEING
VENTILATION
SANDBLASTING
BALLASTING
structure OTHER
Hatch CLEANING
DESCALING
LIGHTING
Coamings & GAS FREEING
VENTILATION
Hatch Covers SANDBLASTING
INERTING & PURGING
BALLASTING
OTHER
Upper stool VENTILATION

SANDBLASTING
INERTING & PURGING
plating BALLASTING
OTHER
Cross decks SANDBLASTING

INERTING & PURGING
BALLASTING
OTHER
Transverse CLEANING
DESCALING
LIGHTING
VENTILATION
plating and SANDBLASTING
Cargo Holds
INERTING & PURGING

attached BALLASTING
OTHER
structure
Lower stool VENTILATION

SANDBLASTING
INERTING & PURGING
plating BALLASTING
OTHER
Transverse Side GAS FREEING

VENTILATION
SANDBLASTING
Shell Web- INERTING & PURGING
BALLASTING
frames OTHER
DESCALING
LIGHTING
VENTILATION
Plating and SANDBLASTING
INERTING & PURGING
attached BALLASTING
OTHER
structure

FOR ALL ESP SHIPS
Underdeck SANDBLASTING
INERTING & PURGING
BALLASTING
longitudinals OTHER
Side shell and GAS FREEING

VENTILATION
SANDBLASTING
BALLASTING
Longitudinals OTHER
Topside Tanks
Sloping plate GAS FREEING

VENTILATION
SANDBLASTING
and attached INERTING & PURGING
BALLASTING
Longitudinals OTHER
Transverse SANDBLASTING
INERTING & PURGING
BALLASTING
Webs OTHER
Transverse VENTILATION
SANDBLASTING
INERTING & PURGING
Bulkhead BALLASTING
OTHER
Hopper sloping CLEANING

DESCALING
LIGHTING
plate and GAS FREEING
VENTILATION
INERTING & PURGING
Hopper Tanks & Double Bottom Tanks
longitudinals BALLASTING
OTHER

VENTILATION
SANDBLASTING
BALLASTING
longitudinals OTHER
Bottom SANDBLASTING
INERTING & PURGING
BALLASTING
structure OTHER
INERTING & PURGING
BALLASTING
Webs OTHER
Transverse GAS FREEING

VENTILATION
SANDBLASTING
Bulkheads INERTING & PURGING
BALLASTING
OTHER
Upper stools GAS FREEING

VENTILATION
SANDBLASTING
internal INERTING & PURGING
BALLASTING
structure OTHER
Lower stools GAS FREEING

VENTILATION
Void Spaces
SANDBLASTING
internal INERTING & PURGING
BALLASTING
structure OTHER
INERTING & PURGING
BALLASTING
Webs OTHER
INERTING & PURGING
BALLASTING
Bulkheads OTHER

FOR ALL ESP SHIPS
Underdeck GAS FREEING

VENTILATION
SANDBLASTING
longitudinals INERTING & PURGING
BALLASTING
OTHER

VENTILATION
SANDBLASTING
BALLASTING
longitudinals OTHER
Transverse CLEANING
DESCALING
LIGHTING
VENTILATION
Double Skin Side Tanks
INERTING & PURGING

structure BALLASTING
OTHER
DESCALING
LIGHTING
bulkhead GAS FREEING
VENTILATION
plating and SANDBLASTING
INERTING & PURGING
attached BALLASTING
OTHER
structure
Bottom plating LIGHTING

GAS FREEING
VENTILATION
and attached SANDBLASTING
INERTING & PURGING
structure BALLASTING
OTHER
Longitudinal LIGHTING
GAS FREEING
VENTILATION
stringers SANDBLASTING
INERTING & PURGING
BALLASTING
OTHER
10. Access provision for close-up surveys and thickness measurement (continued):
List the equipment that will be used to carry out the survey:

FOR ALL ESP SHIPS
11. Tank / Hold Particulars:
The ship's configuration is indicated on the attached general arrangement plan or similar
showing tank / hold arrangements:
Please attach image file:

Clear Image

FOR ALL ESP SHIPS
11. Tank / Hold Particulars (continued):

The following table should provide details of all cargo holds and tanks within the cargo length and to also
include all water ballast tanks outside the cargo length with their respective contents type, method of
corrosion protection and condition of coating, if any, in the holds/tanks.
TANK/HOLD TANK TYPE FRAME LOCATION CORROSION COATING

PROTECTION CONDITION
NOTES
Tank / hold Type: SBT = segregated ballast tank, CO = cargo oil, WBT = salt water ballast tank,
SP = slop tank, CC = chemical cargo, COM = Combined Oil and Ballast, BC = Bulk Cargo,
BC/SWB = Bulk Cargo/Salt Water Ballast, FO = Fuel Oil, Lub Oil = Lubrication Oil, DO = Diesel Oil, FWT = Fresh Water
Tank
Protection: C = recognised coating, A = anodes, NP = No protection
Coating Condition:
GOOD Condition with only minor spot rusting.
FAIR Condition with local breakdown of coating at edges of stiffeners and weld connections
and/or light rusting over 20 per cent or more of areas under consideration, but less than as defined for POOR
condition.
POOR Condition with general breakdown of coating over 20 per cent or more of areas or hard
scale at 10 per cent or more of areas under consideration.

FOR ALL ESP SHIPS
11.Tank / Hold Particulars (continued):
TANK/HOLD TANK TYPE FRAME LOCATION CORROSION COATING

PROTECTION CONDITION
Important reminders for Owners / Managers and attending Surveyors.

1. The main structural plans (scantling drawings), including information regarding the use of high tensile
steel, and tank plan are to be made available on board for the use of the attending Surveyor(s) and
thickness measurement company personnel.
2. The on board documentation required by the 2011 ESP CODE and any other supporting
documentation is to be made available on board for the use of the attending Surveyor(s).
3. The Owners / Managers are to ensure that those tanks and spaces subject to survey are in a clean and
gas free condition, with adequate ventilation, lighting and a safe means of access provided.
4. Periodical survey reports held in the ESP Hull Survey Records file shall contain details of any damage
experienced by the ship. It is the responsibility of Owners / Managers to report to LR without delay,
any damage, breakdown, or grounding, which could invalidate the conditions for which class has
been assigned. Further details can be found in The Rules & Regulations for the Classification of Ships
Part 1, Chapter 2, Section 3, 3.4.

FOR ALL ESP SHIPS
12. Hull Damages for the last three years in way of cargo holds, cargo tanks, ballast tanks
and void spaces.
Cargo hold / Possible Description of the Location Repair Date of

tank / space cause, if damages Repair
known

FOR ALL ESP SHIPS
13. Hull Damages for Sister or similar ship (if available) in the case of design related damage
Cargo hold / Possible Description of the Location Repair Date of

tank / space cause, if damages Repair
known

FOR ALL ESP SHIPS
14. Areas identified with substantial corrosion from previous surveys
HOLD / SPACE / TANK STRUCTURAL AREA
15. List of main structural plans
Please ensure the main structural plans are available for the attending Surveyor at the time of
Survey, including the following:
A) Capacity Plan
B) Midship Section
C) Shell Expansion
D) Longitudinal Bulkheads
E) Transverse Bulkheads
F) Peak Tanks
G) Tank Top
H) Any other plans requested by the attending Surveyor
Name of Owner’s representative
Please attach electronic signature:

FOR ALL ESP SHIPS
16. List of Critical Areas for Tankers:

CARGO AREA REGION
Cargo tank structure
- Main Deck deckhead: Corrosion and fractures
- Buckling in web plate of the underdeck web frame and fractures at end of bracket toes.
- Longitudinal bulkhead transverse web frames: fractures at end bracket toe connection to inner
bottom.
- Necking effect of longitudinal web plating at longitudinal bulkhead plating.
- Pitting and grooving of inner bottom plating.
- Cross-tie junctions
- Longitudinals where passing through webs and transverses
Transverse bulkhead structure
- Transverse bulkhead horizontal stringers: fractures in way of cut-outs and at end bracket toe
connections to inner hull and longitudinal bulkhead.
- For plane transverse bulkheads, transverse bulkhead vertical stiffeners connected to inner
bottom: for vertically corrugated bulkheads, corrugation connection to lower shelf plate and
bulkhead plating connection to inner bottom: fractures caused by misalignment and excessive
fit-up gap.
- Transverse bulkheads at the forward and after boundaries of the cargo space: fractures in way
of inner bottom.
- Longitudinal connections to bulkheads
- The toes of brackets of transverse oil tight bulkhead stringers and also the stringer web plate in
way of the brackets
Water Ballast Tanks
- Main deck deckhead: corrosion and fractures.
- Inner hull plate and stiffener: coating breakdown.
- Buckling of the web plate in the upper and lower part of the web frame.
- Fractures at the side shell longitudinal connection to web frames due to fatigue.
- Corrosion and fractures at knuckle joints in inner hull at forward and after parts of ship.
- Corrosion and fractures at the juncture where the sloped inner hull is connected to the inner
bottom.
- Fractures at side and inner hull longitudinal connections to transverse bulkheads due to fatigue
and/or high relative deflections.
- Inner bottom deckhead, corrosion at inner bottom.
- Cracks at inner bottom longitudinal connection to double bottom floor web plating.
- Fractures at inner bottom and bottom longitudinal; connection to transverse watertight floor
due to high relative defections.
General
Structures adjacent to areas previously part renewed should be specially considered with respect to
reduced scantlings; typically i.w.o. part renewed main frames.
Note: consequences of reduced scantlings due to corrosion:
- Buckling of deck
- Buckling of watertight bulkheads
- Buckling of stringers, frames and girders
- Cracking

FOR ALL ESP SHIPS
16. List of Critical Areas for Bulk Carriers:

CARGO HOLD REGION
Upper Deck (incl. hatch coamings)

- Hatch corners and hatch end beam connection to topside tank transverse ring web
- Hatch coaming longitudinal end brackets
- Hatch coaming brackets
Cargo Hold (incl. underdeck, bulkheads & stools)

- Connections in way of upper boundaries of corrugated bulkheads
- Connection of side shell frames to hopper and topside tank plating
- Connections in way of lower stool shelf plate
- Welded knuckle connection of hopper tank sloping plating to inner bottom plating
- Reduced knuckle connection of hopper tank sloping plating to inner bottom plating
- Connections of lower stool to inner bottom plate
- Connections of lower stool to inner bottom in way of double bottom girders
Tanks
Double Bottom Tank (incl. hopper)

- Floor vertical flat bar stiffener connection to bottom and inner bottom longitudinals
- Welded knuckle connection of hopper tank sloping plating to inner bottom plating
- Reduced knuckle connection of hopper tank sloping plating to inner bottom plating
- Transverse ring web, flat bar stiffener and tripping bracket connection to longitudinal
on hopper sloping plate, bottom shell and side shell and side shell plating
- Upper intermediate brackets below hold side shell frame lower brackets connections of
bottom and inner bottom longitudinals below lower stool
Topside Tank
- Deck transverses, stiffener connection and tripping bracket connection to longitudinals
on upper deck
- Transverse ring web, stiffener connection and tripping bracket connection to
longitudinals on topside tank sloping plate
- Lower intermediate brackets above hold side shell frame upper bracket
- Hatch corners and hatch end beam connection to topside tank transverse ring web
- Connections in way of upper boundaries of corrugated bulkheads
Side Tank Structure (Double Skin Bulk Carriers only)

- Connections of side shell longitudinals to horizontal stiffeners and horizontal tripping
brackets on transverse webs
General
Structures adjacent to areas previously part renewed should be specially considered with respect
to reduced scantlings; typically i.w.o. part renewed main frames.
Note: consequences of reduced scantlings due to corrosion:
- Buckling of deck
- Buckling of watertight bulkheads
- Buckling of stringers, frames and girders
- Cracking
Special attention to be paid to possible corrosion and mechanical damages of top wing tank
drop lines in holds.

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SURVEY QUESTIONNAIRE - PROGRAMME

FOR ALL ESP SHIPS

IMO (LR) number:

Deadweight (metric tonnes):

Length between perpendiculars (m):

Recognized organization (RO):

Date of delivery of the ship:

Intermediate / Special Survey:

Due date of Intermediate / Special Survey:

Due date of Docking Survey:

Type of cargoes carried:

Document no; ESP_R13.0 2014

Which company will perform the thickness measurements?

Document no; ESP_R13.0 2014

Document no; ESP_R13.0 2014

3. Assessment of Corrosion Risk

Note: Indicate tanks which are used for oil/ballast

(1) HC = hard coating; SC = soft coating; A = anodes; NP = no protection

protection extent condition deterioration

(1) (2) (3) (4) (5)

Water Ballast Tanks

Document no; ESP_R13.0 2014

Aft Peak Tank

Fore Peak Tank

Cargo centre tanks / Cargo holds

Cargo wing tanks

Document no; ESP_R13.0 2014

Hopper / double bottom tanks

Double skin side tanks

Document no; ESP_R13.0 2014

Miscellaneous other spaces

Document no; ESP_R13.0 2014

5. Reports of Port State Control inspections

information on rectification of the deficiencies:

Deficiency Corrective action

6. Safety Management System

Non-conformity Corrective action

Document no; ESP_R13.0 2014

7. Scope for close-up survey:

Close-up survey requirements Locations subject to close up survey

Document no; ESP_R13.0 2014

8. Scope for Thickness Measurements:

Thickness measurement requirements Locations subject to thickness measurement

Document no; ESP_R13.0 2014

Structural item Category 1 Category 2 & 3 TM Report Form

Hull envelope: individual plates, shell and deck

Hull envelope: transverse section, plates recorded

Longitudinal structural members (including deck

Transverse structural members in C.O. and W.B.

Stiffeners 25% Stiffeners 25% See Note 3 , 7

Cargo hold transverse frames and end brackets

Document no; ESP_R13.0 2014

4. Additional Bulk Carrier diminution criteria:

Document no; ESP_R13.0 2014

10. Access provision for close-up surveys and thickness measurement

Tank Ballast Thickness For Survey Staging Access Means

(C/B) Measurement (please

Main Deck SANDBLASTING

Side Shell CLEANING

Plating / GAS FREEING

Bottom and SANDBLASTING

Document no; ESP_R13.0 2014

Under deck SANDBLASTING

Side shell and LIGHTING