Approved MD

Version 1.0 / 26 Mar 2017

PG SHIPMANAGEMENT PTE.LTD.
I - MLOD File No. 44 / -
Form LP-005 Ship - Shore Agreement Ref
Page 1 of 2

Vessel Name: Voyage: Port: Terminal: Date:

AA) GENERAL INFORMATION

1. Ship/Shore Safety Check List 3. Stowage Plan Arrival Draft Forward (m) Aft: (m) Trim
2. Vessel Information/Ship Particular 4. Cargo Plan Including Sequence Dep. Draft Forward (m) Aft: (m) Trim
BB) CARGO TRANSFER AGREEMENT

Permitted Maximum Agrred

Cargo to Load/Unload Permitted Max.
Cargo Line Load / Unload Rate Agreed Topping
Agreed Cargo (MT) Stowage System to Pressure (Bar) Raducer Line clearing
S/No. Cargo Grade Density @ 15 C
0 (MT/HR) Initial rate of Final Stoppage
Temp. (Deg C) (Ship tank) be used (MT/HR) rate(MT/H Size Method
R)
Ship Shore Ship Shore Ship Shore

1 PROPANE
Agreed: Agreed:
2 BUTANE
Agreed: Agreed:
3 Diameter of shore line 6 Height of Shore tanks above sea level 9 Any booster pumps ashore 12 Min Depth m
4 Distance from berth to shore tanks 7 Maximum Pressure at Manifold 10 Any manifold freeboard restriction 13 UKC allowed m
5 Any sampling requirement 8 Any additive to be added to cargo 11 Vapour recovery tanks or flare stack 14 ICCP On or Of
CC) REQUIRED LEAD TIME
Advance notice to stop: (mins), Time to reduce rate: ____________(mins), Time to stop transfer: _______________ (mins)
Quantity remaining in shore lines after being ordered to stop: ____________________(M 3 / MT)

DD) EMERGENCY SHUT DOWN SHIP SHORE

Emergency Signal STOP-STOP-STOP on VHF radio
ESD closing time Close manifold in ________ secs
Manifold (Port & Stbd), Each Tank dome, CCR, bridge, forecastle deck,
Location of Emergency Stop Buttons walkway, Accommodation & comp. rm (p&s)

FF) COMMUNICATION PROCEDURES

Contact Personnel: SHIP - CHIEF OFFICE OR DUTY OFFICER (Call sign - Pacific XXX ), SHORE - ______________________ (Call sign - )
Means of Communication:
GG) OTHER INFORMATION
Any Bunker or store supply, Reception of Garbage/Sludge Facility, fresh water etc.

Ship shore access: Ship's Gangway/ Ship's ofshore Gangway and launch boat/ Terminal Gangway/ Transfer Basket
HH) ANTICIPATE STOPPAGES/DELAYS (shore tank changes, Cargo analysis, Documentation, EDP, Shore line clearing etc.

CHIEF OFFICER: DATE & TIME OF SHIP - SHORE AGREEMENT (NAME, SIGN & STAMP) LOADING MASTER