ES

RT

IFI C

VI ATION SER

RMARI TIM TE N

SURVEY REPORT FOR:

CE

CARGO SHIP SAFETY CONSTRUCTION CERTIFICATE (CSSC)

Under the provisions of the INTERNATIONAL CONVENTION FOR THE SAFETY OF LIFE AT SEA, 1974, as modified by the Protocol of 1988 relating thereto

& INTERNATIONAL LOAD LINE CERTIFICATE (ILL)

Under the provisions of the INTERNATIONAL CONVENTION ON LOAD LINES, 1966, as modified by the Protocol of 1988 relating thereto

Initial Survey Regulation 10 (a) (i) Article 14 (1) (a)-LL Annual Survey Regulation 10 (a) (iv) Article 14 (1) (c) -LL

Renewal Survey Regulation 10 (a) (ii) Article 14 (1) (b) -LL Docking Survey Regulation 10 (a) (v)

Intermediate Survey Regulation 10 (a) (iii)

Additional Survey Regulation 10 (a) (iii)

PARTICULARS OF SHIP

Name of the Ship: Distinctive Number or Letters: Port of Registry: Gross Tonnage: IMO Number: metric tons Deadweight of ship(1) Length (L) of ship as defined in Regulation III/3.12 & Article 2 (8) in metres m Type of ship: (2) Bulk Carrier / Oil tanker / Chemical tanker / Gas carrier / Cargo ship other than any of the previous Date of build (3) (Day-Month-Year): Date of building contract: Date on which keel was laid or ship was of a similar stage of construction: Date of delivery: Date on which work for a conversion or an alteration or modification of a major character was commenced (where applicable):

______________
Company Name: Date of Survey: commenced: completed: Place of Survey: Name of Surveyor:

This vessel has been duly surveyed in accordance with the provisions of SOLAS, 1974, as modified by the Protocol of 1988 relating thereto and in accordance with the provisions of International Convention on Load Lines, 1966, as modified by the Protocol of 1988 relating thereto

__________________________________________________ (1) For Oil Tankers, Chemical Tankers and Gas Carriers only (2) Delete as appropriate (3) All applicable dates shall be completed from the Supplement to the IOPP Certificate (Form A or Form B, as applicable) or from Builders Certificate

SAFETY CONSTRUCTION & LOAD LINES SURVEY REPORT (2008/02)

1/14

Surveys of Structure, Machinery and Equipment of Cargo Ships - SOLAS Chapter I Regulation 10
(a). The structure, machinery and equipment (other than items in respect of which a Cargo Ship Safety Equipment Certificate and a Cargo Ship Safety Radio Certificate are issued) of a cargo ship as referred to in paragraph (b)(i) shall be subject to the surveys and inspections specified below: (i). an INITIAL SURVEY including an inspection of the outside of the ships bottom before the ship is put in service. Refer to the IMO Circular concerning inspection of the outside of the ships bottom (PSLS.2/Circ.5) and ICS Requirements for the Periodical Surveys of the outside of the ships bottom and related items including the requirements for In-water Surveys. (ii). a RENEWAL SURVEY at intervals specified by the Administration but not exceeding 5 years, except where regulation 14(b),(e),(f) and (g) is applicable; (iii). an INTERMEDIATE SURVEY within three months before or after the second anniversary date or within three months before or after the third anniversary date of the full term Cargo Ship Safety Construction Certificate, which shall take the place of one of the annual surveys specified in paragraph (a)(iv); (iv). an ANNUAL SURVEY within 3 months before or after each anniversary date of the full term Cargo Ship Safety Construction Certificate (CSSC); (v). a MINIMUM OF TWO (2) INSPECTIONS OF THE OUTSIDE OF THE SHIPS BOTTOM DURING ANY FIVE (5) YEAR PERIOD OF THE VALIDITY OF THE CARGO SHIP SAFETY CONSTRUCTION CERTIFICATE (CSSC) , except where regulation 14(e) or (f) is applicable. Where regulation 14(e) or (f) is applicable, this five year period may be extended to coincide with the extended period of validity of the certificate. In all cases the interval between any two such inspections shall not exceed 36 months (3 years). Refer to the ICS Requirements for the Periodical Surveys of the outside of the ships bottom and related items including the requirements for Inwater Surveys. (vi). an ADDITIONAL SURVEY as prescribed for passenger ships in regulation 7(b)(iii). (b). The surveys and inspections referred to in paragraph (a) shall be carried out as follows: (i). the INITIAL SURVEY shall include a complete inspection of the structure, machinery and equipment. This survey shall be such as to ensure that the arrangements, materials, scantlings and workmanship of the structure, boilers and other pressure vessels, their appurtenances, main and auxiliary machinery including steering gear and associated control systems, electrical installation and other equipment comply with the requirements of the present regulations, are in satisfactory condition and are fit for the service for which the ship is intended and that the required stability information is provided. In the case of tankers such a survey shall also include an inspection of the pumprooms, cargo, bunker and ventilation piping systems and associated safety devices; (ii). the RENEWAL SURVEY shall include an inspection of the structure, machinery and equipment as referred to in paragraph (b)(i) to ensure that they comply with the requirements of the present regulations, are in satisfactory condition and are fit for the service for which the ship is intended; (iii). the INTERMEDIATE SURVEY shall include an inspection of the structure, boilers and other pressure vessels, machinery and equipment, the steering gear and the associated control systems and electrical installations to ensure that they remain satisfactory for the service for which the ship is intended. In the case of tankers, the survey shall also include an inspection of the pump-rooms, cargo, bunker and ventilation piping systems and associated safety devices and the testing of insulation resistance of electrical installations in dangerous zones; (iv). the ANNUAL SURVEY shall include a general inspection of the structure, machinery and equipment referred to in paragraph (b)(i), to ensure that they have been maintained in accordance with regulation 11(a) (Maintenance of conditions after survey) and that they remain satisfactory for the service for which the ship is intended; (v). the INSPECTION OF THE OUTSIDE OF THE SHIPS BOTTOM and the survey of related items inspected at the same time shall be such as to ensure that they remain satisfactory for the service for which the ship is intended. (c). The INTERMEDIATE and ANNUAL SURVEY and the INSPECTIONS OF THE OUTSIDE OF THE SHIPS BOTTOM referred to in paragraphs (a)(iii), (a)(iv) and (a)(v) shall be endorsed on the full term Cargo Ship Safety Construction Certificate (CSSC).

Initial, Renewal and Annual Surveys - Load Lines, 1966 as modified by the Protocol of 1988 Article 14
(1). A ship shall be subjected to the surveys specified below: (a). An INITIAL SURVEY before the ship is put in service, which shall include a complete inspection of its structure and equipment in so far as the ship is covered by the present Convention. The survey shall be such as to ensure that the arrangements, materials and scantlings fully comply with the requirements of the present Convention. (b). A RENEWAL SURVEY at intervals specified by the Administration but not exceeding five years, except where paragraphs (2), (5), (6) and (7) of article 19 are applicable, which shall be such as to ensure that the structure, equipment, arrangements, materials and scantlings fully comply with the requirements of the present Convention. (c). An ANNUAL SURVEY within 3 months before or after each anniversary date of the full term International Load Line Certificate (ILL) to ensure that: (i). alterations have not been made to the hull or superstructures which would affect the calculations determining the position of the load line; (ii). the fittings and appliances for the protection of openings, guard rails, freeing ports and means of access to crews quarters are maintained in an effective condition; (iii). the freeboard marks are correctly and permanently indicated;

(iv). the information required by regulation 10 is provided. (Information to be supplied to the master) (2). The ANNUAL SURVEYS referred to in paragraph (1)(c) of this article shall be endorsed on the full term International Load Line Certificate or the International Load Line Exemption Certificate issued to a ship exempted under paragraph (2) of article 6 of the present Convention.

SAFETY CONSTRUCTION & LOAD LINES SURVEY REPORT (2008/02)

2/14

General Instructions Mark Yes to indicate complied with, No for not complied with or NA for Not Applicable in appropriate box All required dates should be recorded at these surveys as: Day/Month/Year (*) Delete as appropriate Annual Survey: To be held within 3 months before or after the anniversary date of the full term CSSC & ILL Certificates. Refer to SOLAS, Reg.I/10 (a)(iv) & Load Lines, Article 14 (1)(c) Anniversary date means the day and the month of each year which will correspond to the date of expired of full term CSSC & ILL Certificates. Refer to SOLAS, Reg. I/2 (n) & Load Lines, Article 2 (9) Intermediate Survey: Together with the 2nd or 3rd Annual Survey of the full term CSSC Certificate (including full requirements of the Annual Survey) Refer to SOLAS, Chapter I, Reg.10 (a) (iii) Docking Survey: To be held as required by SOLAS, Reg.I/10 (a) (v). For Docking Survey complete sections G1 to H1 as applicable. Refer to the IMO Resolution A.744 (18), as amended and ICS Requirements for the Periodical Surveys of the outside of the ships bottom and related items including the requirements for In-water Surveys. Overall Survey: Is a Survey intended to report on the overall condition of the hull structure and determine the extent of additional close-up Surveys. Refer to the IMO Resolution A.744 (18), as amended Close-up survey: Is a Survey where the details of structural components are within the close visual inspection range of the surveyor preferably within reach of hand. Refer to the IMO Resolution A.744 (18), as amended In-water Survey: The In-water Survey is to provide the information normally obtained from the Docking Survey as required by SOLAS, Reg. I/ 10 (a) (v). Only ICS Head Office under special circumstances will accept an In-water Survey in lieu of the Intermediate Docking Survey mandatory between Renewal Surveys required in a five year period. In-water Surveys is not applicable under any circumstance for Bulk Carriers & Oil Tankers exceeding 15 years of age subject to the ESP (Enhanced Survey Programme). Special consideration is to be given to other Ships of 15 years or over before being permitted to have In-water Survey instead of Intermediate Docking Survey under special authorization granted by the ICS-Head Office only. Refer to the ICS Requirements for the Periodical Surveys of the outside of the ships bottom and related items including the requirements for In-water Surveys. Renewal Survey: To be held at intervals specified by the Administration but not exceeding five (5) years. Refer to SOLAS, Reg.I/10 (a) (ii) & Load Line, Article 14 (1) (b) ESP ships means ships subject to the Enhanced Survey Programme (ESP) during the Annual, Intermediate and Renewal Surveys of Bulk Carrier & Oil Tankers mandatory under SOLAS Regulation XI-1/2. Refer to the Guidelines on the Enhanced Programme of Inspections during Surveys of Bulk Carrier and Oil Tankers adopted by the IMO by Resolution A.744 (18), as amended. Sections A1 to L1 of the Survey Report are to be completed at Annual, Intermediate, Renewal or Docking Survey, as applicable.

A1 A1.1

General Are all Statutory Certificates valid? Yes/No (*)

A2 A2.1 A2.2

National Administration Requirements Have any flag administration requirements been checked? Have all flag administration requirements been complied with? Yes/No/NA (*) Yes/No/NA (*)

A3 A3.1 A3.2

Manning Does the ships complement comply with the Minimum Safe Manning Certificate? Are the master, officers and ratings certificated as required by the STCW Convention? Yes/No/NA (*) Yes/No/NA (*)

A4 A4.1 A4.2 A4.3 A4.4

General (Annual , Intermediate, Renewal Surveys) Confirm no modifications have been made to the ship or equipment which would affect the CSSC & ILL Certificates (any modifications are to be reported) Confirm the CSSC & ILL Certificates now endorsed for Annual Survey Confirm the CSSC Certificate now endorsed for Intermediate Survey Safety Management System Failures The organization responsible for the issue of the SMC have been notified when deficiencies relating to a possible Safety Management System failure have been identified Yes/No (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

SAFETY CONSTRUCTION & LOAD LINES SURVEY REPORT (2008/02)

3/14

A5

Documentation (only during the Annual or Intermediate Surveys ,as applicable) Statutory Certificates Expiry date: Annual or Intermediate Survey (endorsement date) Certificate issued by:

A5.1 A5.2 A5.3 A5.4 A5.5 A5.6 A5.7 A5.8 A5.9 A5.10 A5.11 A5.12 A5.13 A5.14

Cargo Ship Safety Construction Certificate (CSSC) Cargo Ship Safety Equipment Certificate (CSSE) Cargo Ship Safety Radio Certificate (CSSR) International Load Line or Exemption Certificate (ILL) International Oil Pollution Prevention Certificate (IOPP) International Pollution Prevention Certificate for the Carriage of Noxious Liquid Substances in Bulk (NLS) International Sewage Pollution Prevention Certificate (ISPP) International Air Pollution Prevention Certificate (IAPP) Document of Compliance (DOC) International Safety Management Certificate (SMC) International Ship Security Certificate (ISSC) International Certificate of Fitness for the Carriage of Dangerous Chemicals in Bulk OR the Certificate of Fitness for the Carriage of Dangerous Chemicals in Bulk International Certificate of Fitness for the Carriage of Liquefied Gases in Bulk (Gas Carriers) The approved stability/loading information is on board Yes/No/NA (*)

A6 A6.1 A6.2 A6.3 A6.4 A6.5 A6.6 A6.7 A6.8 A6.9 A6.10 A6.11 A6.12 A6.13 A6.14 A6.15 A6.16 A6.17

The log entries record that the following have been checked or tested and found satisfactory within twelve (12) hours before departure from any port. Steering gear (The tests included, where applicable, the operation of the main steering gear, the auxiliary steering gear, remote control systems, bridge steering position, emergency power supply, rudder angle indicators, steering gear system power unit)

Yes/No (*) Yes/No (*) Yes/No (*) Yes/No (*) Yes/No (*) Yes/No (*) Yes/No (*) Yes/No (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

Communications system bridge to steering gear compartment Full movement of the rudder Visual inspection of steering linkage The log entries record that emergency steering drills have been carried out every three (3) months. The change-over procedure diagrams of steering gear are posted. All officers are reportedly familiar with steering gear change-over procedures. The approved stability/loading information is on board. For ships assigned timber load lines the approved timber deck cargo loading and lashing plan is on board. A complete file of the enhanced survey reports and the condition evaluation report is on board for ESP ships (for Bulk Carriers & Oil Tankers only) For bulk carriers the loading / unloading booklet is on board

For bulk carriers with restrictions with the respect to the carriage of cargoes with a density of 1,780 kg/cub m above Yes/No/NA (*) that a triangle is permanently marked at mid ship [SOLAS, Reg. XII/8.3] For bulk carriers of 150m in length and upwards of single skin construction designed to carry solid bulk cargoes having a density of 1,780 kg/cub m above constructed before 1-July-1999 have after the implementation date given in SOLAS, Yes/No/NA (*) Reg. XII/3 sufficient stability and strength to withstand flooding of the foremost cargo hold An approved Cargo Securing Manual (CSM) for ships carrying cargo units including containers is on board A loading booklet for carriage of cargoes in bulk is on board Confirm that Asbestos was not used on board at this survey (SOLAS, Reg. II-1/3-5) A set of as-built construction drawings and other plans showing any subsequent structural alterations are kept on board (for ships constructed on or after 1-January 2007) Yes/No/NA (*) Yes/No/NA(*) Yes/No (*) Yes/No/NA (*)

SAFETY CONSTRUCTION & LOAD LINES SURVEY REPORT (2008/02)

4/14

B1 B1.1

B1.2

B1.3 B1.4 B1.5

Hull Survey (Annual , Intermediate, Renewal Surveys) The condition of the hull and its closing appliances is satisfactory as far as could be seen, the following items should be Yes/No (*) included as applicable (see also L1- Appendix 1for Shell Doors): Hatchways; weather decks, ship side plating above the waterline, casings, skylights, flush deck scuttles, deckhouses and companionways; superstructures; windows; side scuttles; and deadlights; chutes and other openings; scuppers; sanitary Yes/No (*) discharges and valves; guard rails and bulwarks; freeing ports; gangways and lifelines; and permanent fittings for timber deck cargoes. Closing appliances were not tied or temporarily secured open Vents and air pipes condition should be verified , including weld connection between air pipes and deck plating Yes/No (*) (Annual and Intermediate Surveys) The condition of the anchoring and mooring equipment is satisfactory, as far as could be seen. The watertight and weather tight doors have been examined, operationally tested (remotely and locally) and found satisfactory. The watertight & weather tight test of cargo and other hatchway covers in positions 1 & 2 required during the Initial, Annual & Renewal Surveys in accordance with LL-Reg.16 (4) have been carried out and found satisfactory The condition of the watertight bulkhead penetrations is satisfactory, as far as could be seen. The structural fire protection arrangements remain unchanged (Alterations are to be reported). The manual and/or automatic fire doors have been operationally tested and found satisfactory. The operation of the loading instrument has been verified. The deck line and load line mark are properly positioned, marked and painted Summer freeboard as measured:_____________ mm The freeboard marks have been verified. The mark of Intermaritime Certification Services (ICS) consisting in the letters I and C, are indicated alongside the load line ring above the horizontal line which passes through the centre of the ring Special requirements for ships permitted to sail with reduced freeboards found satisfactory [ when applicable ] Hatch covers, coamings and gaskets have been checked and mechanically operated hatch covers operationally tested and sealing arrangements found weather tight. Confirm that no unapproved changes have been made to the hatch covers, hatch coamings and their securing and sealing devices since the previous survey The collision and other watertight bulkheads have been examined as far as could be seen and found satisfactory The drainage from enclosed spaces on the freeboard deck is satisfactory The functionality of bilge well alarms to cargo holds and conveyor tunnels found satisfactory [ when applicable ] Any expansion joints in the sea water systems have been visually examined and found satisfactory Salt Water Ballast Tanks The tanks where protective coating was not applied at construction or has been reported in POOR condition and not repaired have been examined and found satisfactory. (See List Tanks Examined and Reported in Section J1) Examination and thickness measurement of structure identified as having substantial corrosion [Details to be reported] Dry Bulk Cargo Ships (Bulk Carriers) ESP ships Close-up survey of cargo holds steel hatch covers, coamings and stiffeners. Close-up survey and thickness measurement of areas of substantial corrosion identified in the Executive Hull Summary Report carried out satisfactorily (report area(s) and thicknesses) For ships less than 10 years old An overall survey of the forward cargo hold and an aft cargo hold, on single skin ships (Annual Survey only) For ships between 10 and 15 years old Overall survey of all cargo holds, on single skin ships, two selected on double skin ships (Annual and Intermediate Survey) Close-up survey of at least 25% of the cargo hold side shell frames, their lower end attachments and adjacent shell plating in a forward cargo hold, on single skin ships (Annual Survey only) For ships greater than 15 years old Overall survey of all cargo holds (Annual Survey only) Close-up survey of at least 25% of the cargo hold side shell frames, their lower end attachments and adjacent shell plating in a forward cargo hold and one other selected cargo hold, on single skin ships (Annual Survey only) The close-up survey has been extended to include all other cargo holds because of the need for remedial action (Details to be reported). Any necessary thickness measurement is to be reported. Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No (*) Yes/No (*)

B1.6 B1.7 B1.8 B1.9 B1.10 B1.11 B1.12 B1.13 B1.14 B1.15 B1.16 B1.17 B1.18 B1.19 B1.20 B1.21

Yes/No (*) Yes/No (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No (*) Yes/No (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No (*) Yes/No (*) Yes/No (*) Yes/No (*) Yes/No/NA (*)

B1.22 B2 B2.1 B2.2 B2.3 B2.4 B2.5 B2.6 B2.7 B2.8 B2.9 B2.10

Yes/No/NA (*)

B2.11

Yes/No/NA (*)

SAFETY CONSTRUCTION & LOAD LINES SURVEY REPORT (2008/02)

5/14

B3 B3.1

B3.2

B4

B4.1

B5 B5.1 B6 B6.1 B6.2 B6.3 B6.4 B6.5 B6.6 B6.7 C1 C1.1 C1.2 C1.3 C1.4 C1.5 C1.6 C1.7 C1.8 C1.9

Oil Tankers (including combination carriers) and chemical tankers - ESP ships Close-up survey and thickness measurement of areas of substantial corrosion identified in the Executive Hull Summary Report carried out satisfactorily (report area(s) and thicknesses) Salt Water Ballast Tanks to be examined: Tanks where a hard protective coating was not applied at construction, or a soft coating has been applied, or the hard protective coating has been reported to be in less than GOOD condition and not repaired. (Refer to List Tanks Examined and Reported in Section J1) Single hull oil tankers (including combination carriers) and chemical tankers Ballast tanks adjacent to [i.e. with a common plane boundary] a cargo tank with any means of heating have been examined and found satisfactory. Thickness measurement is to be carried out where considered necessary by the Surveyor Special consideration may be given by the Surveyor to those tanks or spaces where the coatings are found in GOOD condition at the previous Intermediate or Renewal Survey Container Ships with container securing arrangements. The condition of the securing arrangements is satisfactory as far as could be seen. General dry cargo ships (for the definition of General Dry Cargo Ship see Section I7) Close-up survey of cargo holds steel hatch covers, coaming and stiffeners. For ships between 10 and 15 years old (for Intermediate , Renewal Surveys see Section I1) Overall survey of one forward and one after cargo hold and their associated tween deck spaces (Annual Survey only) For ships greater that 15 years old (for Intermediate , Renewal Surveys see Section I1) Overall survey of all cargo holds and tween deck spaces (Annual Survey only). Close-up survey of at least 25% of all shell frames, including their end attachments and adjacent shell plating in a forward lower cargo hold and one other selected lower cargo hold (Annual Survey only). The close up survey has been extended to include all other cargo holds because of the need for remedial action (Details to be reported). Any necessary thickness measurement is to be reported. Machinery and Electrical Installation Survey (Annual , Intermediate, Renewal Surveys) The machinery and boiler spaces and essential machinery have been generally examined and found satisfactory. The emergency escape routes from the machinery and boiler spaces are free of obstruction. The machinery and boiler spaces are free of all visible fire and explosion hazards. Piping systems containing fuel oil, lubricating oil or other flammable oils where fitted have been examined and operated as far as practicable, special attention being paid to tightness, fire precaution arrangements, flexible hoses and sounding arrangements and found satisfactory. The main and auxiliary steering arrangements, including their associated equipment, alarms and control system, have been examined, operated and found satisfactory. All the means of communication between navigating bridge, machinery control and alternative steering positions have been tested and found satisfactory. The bilge pumping systems for each watertight compartment, including bilge wells, extended spindles, pumps and level alarms where fitted, have been examined and operated as far as practicable and all found satisfactory. Non-metallic expansion joints in piping systems which penetrate the hull and are fitted below the deepest loaded waterline have been examined and found satisfactory.

Yes/No/NA (*)

Yes/No/NA (*)

Yes/No/NA (*)

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

C1.10

An external examination of boilers, pressure vessels, including foundations, controls, insulation, gauges and piping has Yes/No/NA (*) been carried out as far as practicable and found satisfactory. For boilers, the safety/protective devices have been tested and the safety valves have been operated using the relieving gear to the surveyors satisfaction. Yes/No/NA (*) For Exhaust Gas heated Economizers/Boilers, the safety valves are to be tested by the Chief Engineer at sea and Engine log book entries have been verified by the attending surveyors. Review of Records carried out (Records of Operation/Maintenance/Repair History and Feed Water Chemistry) Other pressure vessels, the safety devices have been examined and found satisfactory. The electrical equipment and cabling forming the main and emergency electrical installations have been generally examined under operating conditions as far as practicable. Bonding straps for the control of static electricity and earthing arrangements as fitted have also been examined. The satisfactory operation of the main and emergency sources of power, including lighting systems and electrical services essential for safety in an emergency mode have been verified. (Where the sources of power are automatically controlled they have been tested in the automatic mode.) A general examination of the following, where applicable, has been carried out and operation considered satisfactory: Automation equipment, including random testing of alarm, automatic and shutdown functions An examination of the electrical installation in areas which may contain flammable gas or vapour and/or combustible dust, it has verified that it is in good condition and has been properly maintained The machinery, boilers and other pressure vessels, associated piping systems and fittings are installed and protected as to reduce to a minimum any danger to persons on board, due regard being given to moving parts, hot surfaces and other hazards Confirm that the normal operation of the propulsion machinery can be sustained or restored even though one of the essential auxiliaries becomes inoperative Confirm that the engine room telegraph, the second means of communication between the navigation bridge and the machinery space and the means of communication with any other positions from which the engines are controlled are operating satisfactorily Examining, in general that the precautions provided against shock, fire and other hazards of electrical origin are being maintained Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

C1.11 C1.12 C1.13

C1.14 C1.15 C1.16 C1.17 C1.18 C1.19 C1.20 C1.21

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)
6/14

SAFETY CONSTRUCTION & LOAD LINES SURVEY REPORT (2008/02)

D1 D1.1 D1.2 D1.3 D1.4 D1.5

Statutory Survey Related Items (Annual, Intermediate, Renewal Surveys) The fire control plan and duplicate have been examined and are properly posted. All fire and/or smoke detection and alarm systems have been examined and tested, as far as practicable, and found satisfactory. An operative test of the fire main system and each fire pump, including the emergency fire pump, has been carried out separately, to demonstrate that the two required jets of water could be provided simultaneously from different hydrants. All fire hoses, nozzles, applicators and spanners are situated at their respective stations and in satisfactory condition. The fixed fire fighting system controls, piping, instructions and markings are properly maintained and serviced. Date of last reported system test: (Day/Month/Year) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

D1.6 D1.7 D1.8 D1.9 D1.10 D2 D2.1 D2.2 D3 D3.1 D3.2 D3.3 D3.4 D3.5 D3.6 D3.7 E1 E1.1 E1.2 E1.3 E1.4 E1.5 E1.6 E1.7 E1.8 E2 E2.1 E2.2 E3 E3.1 E4 E4.1 E4.2 E4.3 E4.4

All semi-portable and portable extinguishers are fully charged, in their stowed position and with valid service dates. The remote controls for stopping fans and machinery and shutting off fuel supplies in machinery spaces and where fitted, the remote controls for stopping fans in accommodation spaces and means of cutting off power to the galley are in working order. The closing arrangements of ventilators, annular spaces, skylights, doorways and tunnel where applicable are satisfactory. Confirming as far as practical, that no changes have been made in the structural fire protection, examining any manual and automatic fire doors and proving their operation, testing the means of closing the main inlets and outlets of all ventilation systems and testing the means of stopping power ventilation systems from outside the space served The firemans outfits are complete and in satisfactory condition. For CSSC & ILL Certificates the following items is also dealt with: Manoeuvring booklet with information displayed on bridge Damage Control Plans for ships built on and after 1-February-1992 Confirmation that the following is satisfactory: Structural fire protection and fire doors including remote stopping of ventilation systems Ventilation of machinery spaces Noise protection in machinery spaces Engineers alarm is audible in the engineers accommodation area Domestic gaseous fuel arrangements First start arrangements Arrangements for escape from working spaces Oil Tankers, including Combination Carriers (Annual, Intermediate , Renewal Surveys) - ESP ships Weather deck Cargo tank openings including gaskets, covers, coamings, valves and flame screens are all satisfactory as far as could be seen. A portable instrument for measuring flammable vapour concentrations with sufficient spares and means of calibration is satisfactory. Flame screens on vents at all bunker, oily ballast and oily slop tanks and void spaces are satisfactory as far as could be seen. An examination of cargo, crude oil washing, bunker, ballast, stripping and vent piping systems including vent masts and headers has been carried out and all found in satisfactory condition. An examination of cargo tank venting arrangements and secondary means of venting or over/ under pressure alarms, if fitted, has been found operational and satisfactory. The condition of electrical equipment in dangerous zones is satisfactory as far as could be ascertained. Access to bow arrangements found satisfactory

Yes/No/NA (*) Yes/No/NA (*)

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

Fire Extinguishing Arrangements Examination of the fixed fire-fighting system for the cargo pump room, confirming that the installation tests have been satisfactorily completed with its means of operation clearly marked and when appropriate , checking the operation of Yes/No/NA (*) the remote means for closing the various openings, all found satisfactory The deck foam and deck sprinkler systems were found to be operable and in satisfactory condition Emergency Towing Arrangements Condition of emergency towing arrangements found satisfactory Cargo pump room Confirm that no potential sources of ignition (in or near the cargo pump room) such as loose gear, excessive product in bilges, excessive vapours, combustible materials, etc. have been observed and if found then eliminated. The access ladders are in satisfactory condition. All electrical equipment is in satisfactory condition as far as could be ascertained. The emergency lighting in all cargo pump rooms of tankers constructed after 1-July-2002 have been examined and found satisfactory Yes/No/NA (*) Yes/No/NA (*)

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

SAFETY CONSTRUCTION & LOAD LINES SURVEY REPORT (2008/02)

7/14

E4.5 E4.6 E4.7 E4.8 E4.9 E4.10 E4.11 E4.12 E4.13 E5 E5.1 E5.2 E5.3 E5.4 E5.5 E5.6 E5.7 E5.8 E5.9 E5.10 E5.11 E5.12 E5.13 E5.14 E5.15 E5.16 E5.17 E5.18 E5.19 E5.20 E5.21 G1 G1.1 G1.2 G1.3 G1.4 G1.5 G1.6

The pump room bulkheads are free of signs of oil leakage or fractures. The sealing arrangements of bulkhead penetrations are satisfactory. An external examination of piping systems has been carried out and all found in a satisfactory condition. The cargo, bilge, ballast and stripping pumps examined as far as practicable and found satisfactory for: Excessive gland seal leakage. Operation of electrical and mechanical remote operating and shutdown devices. Integrity of pump room bilge system and pump foundations. The ventilation system is operational the ducting intact, the dampers are operable and the screens are clean. As far as could be seen, the installed pressure gauges on cargo discharge lines and level indicator systems are operational. Inert gas systems (where fitted) From external examination, all components and piping found free of signs of corrosion or gas/effluent leakage. Both inert gas blowers are operational. The scrubber room ventilation system is operational. The deck water seal filling and draining system is operational and without evidence of water carry-over. The non-return valve is operational. The operation of all remotely operated or automatically controlled valves, in particular the flue gas isolating valve(s) found satisfactory. The interlocking feature of the soot blowers checked and found satisfactory. The gas pressure regulating valve automatically closes when the inert gas blowers are secured The following safety devices of the inert gas system have been checked, as far as practicable, using simulated conditions where necessary and found satisfactory: high oxygen content of gas in the inert gas main Low gas pressure in the inert gas main. low pressure in the supply to the deck water seal high temperature of gas in the inert gas main low water pressure to the scrubber accuracy of portable and fixed oxygen measuring equipment by means of calibration gas high water level in the scrubber failure of the inert gas blowers failure of the power supply to the automatic control system for the gas regulating valve and to the instrumentation continuous indication and permanent recording of pressure and oxygen content in the inert gas main high gas pressure in the inert gas main Inert Gas System operated on completion of the checks listed above and found satisfactory Docking Surveys Hull , Rudder and Anchors Particular attention should be paid to any application or renewal of high resistance paint Systems to the underwater portion of the hull. Surveyors should submit particulars of the Maker and coating material A satisfactory examination of the shell including bottom, side and bow plating, sea inlet boxes, keel, stern, sternframe and rudder(s) was carried out. The clearances of rudder bearings are satisfactory. Report clearances to be attached The sea suctions, overboard discharge valves, sea chests, strainers and their connections to the hull were generally examined and all found Satisfactory. The propeller and fastenings, sternbush fastenings, and the gratings at the sea inlets were examined and found satisfactory. The propeller shaft seal(s) were found satisfactory and tight and the propeller shaft(s) clearance(s) were satisfactory. Report clearance/poker gauge readings to be attached

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

G1.7 G1.8

The anchoring and mooring equipment was examined as far as practicable, the anchors and cables partially raised and. Lowered using the windlass and found satisfactory Note: The examination of anchors, chain cables, chain lockers and the requirements for thickness measurement are to be dealt with at Docking Surveys held in connection with the Renewal Survey.

SAFETY CONSTRUCTION & LOAD LINES SURVEY REPORT (2008/02)

8/14

G2 G2.1 G2.2 G2.3

Docking Surveys Oil tankers (including combination carriers) 5 years old and over A satisfactory general examination of the electrical equipment and cables in dangerous zones such as cargo pump room and spaces adjacent to and zones above cargo tanks for defective and non-certified safe-type electrical equipment or Yes/No/NA (*) improperly installed The insulation resistance of the circuits was satisfactorily tested or there is a recent record of insulation resistance Yes/No/NA (*) testing, that is considered acceptable. Where the Administration has implemented the Harmonized System of Survey and Certification (HSSC) and where ICS is authorised to issue the Cargo Ship Safety Construction Certificate, confirm certificate endorsed in respect to the date Yes/No/NA (*) of inspection of the ships bottom. Enter date: (Month/Year) Docking Surveys - Paint systems The condition of the paint system applied to the underwater portion of the hull is satisfactory High Resistant Paint (H.R.P.) [ If applicable ] High Resistant Paint applied to the underwater portion of the hull Manufacturer: Dry Film Thickness: microns Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

H1 H1.1 H1.2 H1.3 H1.4 H1.5 H1.6 H1.7 H1.8 H1.9 H1.10

Tin Free Anti-Fouling (TBT Free) [ If applied ] Anti-fouling system : [ i.e. TBT / non-TBT / TBT covered with sealer coat] Certificate No : Date: (Day/Month/Year): Certificate type : [i.e. Record of Anti-fouling System, Certificate of Compliance, IMO AFS Certificate]

I1 I1.1 I1.2 I1.3 I1.4 I1.5 I1.6 I1.7 I1.8 I2 I2.1 I2.2 I2.3 I3 I3.1 I4 I4.1 I5 I5.1 I5.2

Additional Survey Requirements (Intermediate , Renewal Surveys) All ships The electrical generating sets have been examined under working conditions and found satisfactory. Ships of 5 years to 10 years old Representative salt-water ballast tanks, including any protective coating, have been generally examined internally and found satisfactory. (See List of Tanks Examined and Reported in Section J1,as applicable) Ships of 10 years old and over All salt-water ballast tanks, including any protective coating, generally examined internally and found satisfactory. (See List of Tanks Examined and Reported in Section J1, as applicable) The anchors have been partially raised and lowered satisfactorily using the windlass Dry Cargo Ships 15 years old and over (not for General Dry Cargo Ships, refer to section I4) An Overall Survey of a forward and an after cargo hold has been carried out and found satisfactory. Oil Tankers (including Combination Carriers) and Chemical Tankers - ESP ships All tankers Cargo, crude oil washing, bunker, ballast, steam and vent piping on weather decks, also vent masts and headers examined and found satisfactory. The insulation resistance of the circuits was satisfactorily tested or there is a recent record of insulation resistance testing that is considered acceptable. (Refer to Docking Survey in Section G1) Single hull oil tankers [ including ore/oil and ore/bulk/oil ships ] of 5 years to 10 years old Examination of all salt- water ballast tanks. Where considered necessary by the surveyor, thickness measurement and testing are to be carried out to ensure the structural integrity remains effective Double hull oil tankers and chemical tankers of 5 years to 10 years old Overall Survey of representative salt-water ballast tanks as selected by the surveyor. If the survey reveals no visible defects , the examination may be limited to a verification that the hard protective coating remains in GOOD condition Oil tankers [ including ore/oil and ore/bulk/oil ships] over 10 years old Survey requirements are to be completed to the extent of the pervious Renewal Survey (applicable to ESP ships only) with testing of cargo holds and ballast tanks as deemed necessary by the attending surveyor. Requirements for longitudinal strength evaluation to be carried out as deemed necessary by the attending Surveyor Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

Yes/No/NA (*)

Yes/No/NA (*)

Yes/No/NA (*) Yes/No/NA (*)

SAFETY CONSTRUCTION & LOAD LINES SURVEY REPORT (2008/02)

9/14

I6 I6.1 I6.2 I6.3 I6.4 I6.5 I6.6 I6.7 I6.8

Dry bulk cargo ships (bulk carriers) 5 years old and over - ESP ships For ships between 5 and 10 years old Overall Survey of all cargo holds. Close-up survey to establish the condition of at least 25% of the cargo hold side shell frames including their upper and lower end attachments, adjacent shell plating and the transverse bulkheads in the forward cargo hold and one other selected cargo hold, on single skin ships The close-up survey has been extended because of the need for remedial action (details to be reported). Any necessary thickness measurements are to be reported. Thickness measurement of areas subject to close up survey (may be specially considered if no structural diminution and protective coating in good conditions) Overall survey of representative salt-water ballast tanks, as selected by the surveyor. The selected tanks are to include the fore peak tank, aft peak tank and a number of other tanks, taking into account the total number and type of ballast tanks For ships over 10 years Survey requirements are to be completed to the extent of the previous Renewal Survey (applicable to ESP ships only) with testing of cargo holds and ballast tanks and internal examination of fuel oil tanks as deemed necessary by the attending surveyor. General Dry Cargo Ships: A General Dry Cargo Ship is defined as a self propelled ship of 500 gross tonnes or above, constructed generally with a tween deck and intended to carry solid cargos. This excludes Bulk Carriers, Refrigerated Cargo Ships, Ro-Ro Ships and Ships dedicated for the carriage of containers, forest products (but not log or timber carriers), wood ships, cement, livestock carriers and docking/deck ships. For ships between 5 and 10 years Overall survey of one forward and one aft cargo hold and their associated tween deck spaces. The close-up survey has been extended because of the need for remedial action (details to be reported). Any necessary thickness measurements are to be reported. Overall survey of representative salt-water ballast tanks, as selected by the surveyor For ships between 10 and 15 years Overall survey of all cargo holds and tween deck spaces. The close-up survey has been extended because of the need for remedial action (details to be reported). Any necessary thickness measurements are to be reported. For ships over 15 years Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

I7

I7.1 I7.2 I7.3 I7.4 I7.5 I7.6 I7.7 I7.8 I7.9 I7.10

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

Survey requirements are to be completed to the extent of the previous Special Survey (applicable only to surveys of hull structure and piping systems in way of cargo holds, cofferdams, pipe tunnels and void spaces within cargo length area Yes/No/NA (*) and all salt water ballast tanks) Tank testing, survey of automatic air pipe heads and internal examination of fuel oil, lubricating oil and fresh water Yes/No/NA (*) tanks are to be carried out as deemed necessary by the attending Surveyor Dry Cargo Ships (other than Bulk Carriers and General Dry Cargo Ships) Dry Cargo Ship is defined as a Ship intended to carry solid cargoes includes Container Ships, Refrigerated Cargo, Forest Product Carriers, Ro-Ro and Cement Carriers) For ships over 15 years Overall Survey of selected cargo holds to be carried out [details to be reported] Yes/No/NA (*) Yes/No/NA (*)

I8

I8.1 I8.2

SAFETY CONSTRUCTION & LOAD LINES SURVEY REPORT (2008/02)

10/14

J1

List Tanks Examined and Reported (Annual , Intermediate, Renewal Surveys) Structural condition

Good/Fair/Poor/NA Protective coating condition

Forward and aft peak tanks

Topside tanks

Structural condition

Protective coating condition

Deep tank/side tanks/centre tanks

Structural condition

Protective coating condition

Water ballast tanks

Structural condition

Protective coating condition

Protective Coating Condition GOOD = FAIR = POOR = Condition with only minor spot rusting affecting not more than 20 % of areas under consideration, e.g. on a deck transverse, side transverse, on the total area of platings and stiffeners on the longitudinal structure between these components, etc Condition with local breakdown at edges of stiffeners and weld connections and/or light rusting over 20% or more of areas under consideration. Condition with general breakdown of coating over 20% or more of areas or hard scale at 10% or more of areas under consideration.

SAFETY CONSTRUCTION & LOAD LINES SURVEY REPORT (2008/02)

11/14

J1

List Tanks Examined and Reported (Annual , Intermediate , Renewal Surveys) Good/Fair/Poor/NA continued Structural condition Protective coating condition

Double bottom tanks

Other tanks

Structural condition

Protective coating condition

Notes & Comments

Protective Coating Condition GOOD = FAIR = POOR = Condition with only minor spot rusting affecting not more than 20 % of areas under consideration, e.g. on a deck transverse, side transverse, on the total area of platings and stiffeners on the longitudinal structure between these components, etc Condition with local breakdown at edges of stiffeners and weld connections and/or light rusting over 20% or more of areas under consideration. Condition with general breakdown of coating over 20% or more of areas or hard scale at 10% or more of areas under consideration.

SAFETY CONSTRUCTION & LOAD LINES SURVEY REPORT (2008/02)

12/14

L1 L1.1

Appendix 1 Bow, Inner Bow, Side and Stern

Approved Operating and Maintenance Manual confirmed on board and satisfactory maintenance maintained (Passenger ro-ro ships only for bow doors). Operations and maintenance schedule confirmed on board (ro-ro ships only for side shell and stern doors) Operation of doors and power units witnessed and found satisfactory. Doors operated from closed to fully open state, with freedom of movement established Door structure and surrounding ship structure examined and found satisfactory. The door sealing arrangements including gaskets and retaining bars found to be satisfactory. The door cleating, locking and securing arrangements are complete, with no evidence of alteration, have been examined and operate satisfactorily. The door hinging arrangements have been examined and found to be satisfactory. The local and/or remote operation of securing devices/cleats found to be satisfactory. All equipment associated with the opening, closing and securing of the doors, that is wire ropes, chains, sheaves, rollers, guides, shackles etc. examined and found to be satisfactory. The tightness of the doors has been confirmed. The remote control panels and associated indicator lights, closed circuit television system, water leakage indicator lights and alarm systems have been examined and found to operate satisfactorily (*) The required notice boards are in place and the ships log entries confirmed (*) Power units The power units used for the opening, closing and securing of the doors have been found to operate satisfactorily. The hydraulic system including pipelines and fittings has been confirmed free of leaks. The hydraulic system (or other power systems) has been tested to confirm that in the. event of system failure the hydraulically operated securing devices remain locked. All associated electrical equipment examined and found satisfactory. It is confirmed that the Report C11 on board provides sufficient information regarding the door arrangements as fitted, including details of securing devices, remote control devices and associated indicator lights, CCTV system, water leakage indicators and bilge system. Confirm the bilge system for the space between the inner and outer bow doors tested satisfactorily. Confirm that the bilge system for vehicle deck(s) has been tested satisfactorily.

Bow door Yes/No/NA (*)

Inner bow door Yes/No/NA (*)

Side doors

Stern door

L1.2

Yes/No/NA (*)

Yes/No/NA (*)

L1.3

Yes/No/NA (*)

Yes/No/NA (*)

Yes/No/NA (*)

Yes/No/NA (*)

L1.4 L1.5 L1.6 L1.7 L1.8

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

L1.9

Yes/No/NA (*)

Yes/No/NA (*)

Yes/No/NA (*)

Yes/No/NA (*)

L1.10

Yes/No/NA (*)

Yes/No/NA (*)

Yes/No/NA (*)

Yes/No/NA (*)

L1.11

Yes/No/NA (*)

Yes/No/NA (*)

Yes/No/NA (*)

Yes/No/NA (*)

L1.12 L1.13 L1.14 L1.15 L1.16 L1.17

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*) Yes/No/NA (*)

L1.18

Yes/No/NA (*)

Yes/No/NA (*)

Yes/No/NA (*)

Yes/No/NA (*)

L1.19 L1.20

Yes/No/NA (*) Yes/No/NA (*)

(*) For all inward opening doors (without size restriction) and outward opening doors with a clear opening of 12m or more.

Note: The above are intended to apply to doors on roll on-roll off ships (Ro-Ro ships) but may be applied as necessary and as applicable to other Shell Doors of other type of ships

SAFETY CONSTRUCTION & LOAD LINES SURVEY REPORT (2008/02)

13/14

ALTERATIONS OR MODIFICATIONS:

Describe in detail all system and equipment or parts which have been installed or modified............

DEFICIENCIES, REQUIREMENTS, REMARKS, RECOMMENDATIONS

FINAL RECOMMENDATION: It is recommended that: A Full Term CSSC & ILL Certificates may be issued valid for a period of five (5) years......... No Full Term CSSC & ILL Certificates to be issued until the survey is completed The Existing CSSC & ILL Certificates Nos. the (Place of issue of Endorsement) I have issued the Interim CSSC & ILL Certificates Nos. at: (Place of issue of Interim CSSC & ILL) Valid until the (Day) of (Month) of (Year) The (Day) . of (Month) of (Year) (Day) of (Month) has been endorsed at: of (Year)

THIS IS TO CERTIFY THAT: This survey report is correct in all respects. Issued at : (Place of issue of the Survey Report) the (Day) of (Month) of (Year)

Name and Signature of duly authorized official issuing the Survey Report By: Intermaritime Certification Services, S.A.

SAFETY CONSTRUCTION & LOAD LINES SURVEY REPORT (2008/02)

14/14