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DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.1”
OIL SPILL
Ship: TIME: Local Place:
GMT
1. Exact Position
2. Location & cause of spill.
3. Extent of spill/estimated quantity
4. Reported or sighted by whom
5. Has notification been done in
accordance with SOPEP/OPA 90
6. Is spill an operational spill or
casualty related
7. Disposition of bunkers, ballast, cargo
type, quantity and distribution
8. Weather conditions
9. Movement and area of slick
10. Has vessel’s pollution team been
mobilised
11. Any immediate threat to the
shoreline
12. Is the vessel’s equipment/machinery
operational
13. Is the vessel’s safety endangered
14. Has shore assistance like tugs /
salvage been requested / required
15. Are there any casualties and have
steps been taken to safeguard crew
16. Has a sample been taken of the spilt
oil
17. Is the spilt oil on fire & have
measures been taken to prevent /
fight the fire
1/2
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.1”
OIL SPILL (Cont’d)
Ship: TIME: Local Place:
GMT
18. Have steps been taken to mitigate
the oil outflow
19. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions.
2/2
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.2”
GROUNDING
Ship: TIME: Local Place: GMT
1. Cause
2. Exact position
3. Wind and weather conditions
4. Direction of current
5. Tidal conditions High water Local Low water Local
time GMT time GMT
6. Tidal range
7. Soundings before grounding
8. Soundings after grounding
9. Soundings around the vessel
10. Bottom conditions
11. Machinery-condition
12. Steering machinery-condition
13. Other equipment-condition
14. Soundings performed
15. Possible leaks
16. Other damages
17. Risk factors for vessel and crew
18. Cargo weight-distribution
19. Bunker onboard-distribution
20. Ballast/Fresh water-distribution
21. Trimming possibilities
22. List-listing possibilities
23. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions.
24. Capt. or pilots opinion on the possibilities of re floating the vessel without assistance.
1/1
True course:
B
A
H
C
G F
D
E
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.3”
COLLISION
Ship: TIME: Local Place:
GMT
Name of other vessel: Nationality:
1. Exact position
2. Wind and weather conditions
3. Damages to own vessel
4. Damages to other vessel
5. Injury to persons
6. Machinery condition
7. Steering machinery-condition
8. Other equipment
9. Is assistance required
10. Anchoring possibilities
11. Beaching possibilities
12. Weather forecast/prospects
13. Nearest port of refuge
14. Cargo weight-distribution
15. Cargo distribution
16. Bunker onboard-distribution
17. Ballast/Fresh water-distribution
18. Oil spills/pollution
19. Has communication with the other vessel been established
20. * Has a collision notice been received by the other vessel
21. ** Has a collision notice been received from the other vessel
22. Are other vessels in the vicinity contacted.
23. Has a coastal radio station been contacted.
24. Risk factors
25. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions.
26. Soundings/leaks
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DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.3”
Other information:
* Example of-collision "We hold your vessel responsible for all damages,
consequences and losses as result of this collision."
** Example of answer:
"Signed as an acknowledgement of receipt only, and
not as an admission of liability."
For superintendent on duty:
Info. received by Telex/cable Time: Date:
telephone
Persons informed: Opr. Man. Time:
(Ref. contingency plan)
Others
______________________
Superintendent
2/2
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.4”
FIRE
Ship: TIME: Local Place:
GMT
1. Probable cause
2. Exact Position
3. Wind and weather conditions
4. Extent of the fire
5. Injury to persons
6. Damages to the vessel
7. Is assistance required?
8. Extinguishing method
9. Danger of explosion
10. Stock of CO2/Consumption of CO2
11. Smoke-diving equipment/capacity
12. Machinery-condition
13. Steering machinery-condition
14. Other equipment-condition
15. Cargo weight onboard
16. Condition of cargo
17. Distribution of cargo
18. Dangerous goods-explosives
19. Stability problems
20. Nearest port of refuge
21. Other ships in the vicinity
22. Weather forecast/prospects
23. Risk factors
24. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions
25. Continue Boundary Cooling
26. Continue monitoring of bulkhead temperatures.
27. Continuous communication with office.
28. Only relevant people for carrying out the above to be deployed.
1/2
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.4”
CAUTION - NO ACCESS TO BE OPENED & ENTRY MADE INSIDE ENGINE ROOM / CARGO HOLD / CONTAINERS (AS APPLICABLE) WITHOUT APPROVAL FROM THIS OFFICE.WITHOUT APPROVAL FROM THIS OFFICE.
POST RELEASE OF CO2 (FIXED FIRE FIGHTING MEDIUM) –
1. Continue Boundary Cooling
2. Continue monitoring of bulkhead temperatures.
3. Continuous communication with office.
4. Only relevant people for carrying out the above to be deployed. Fire Expert to be engaged and his advice to be incorporated in the final decision making
for opening the access and allowing man entry.
Other information: For example during fires in port
Agent informed
Assistance form the local fire brigade
For superintendent on duty:
Info. received
by telephone Telex/cable Time: Date:
Persons informed: Opr. Man. Time:
(Ref. contingency plan)
Others
____________________________
Superintendent
2/2
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.5”
STRUCTURAL FAILURE
Ship: TIME: Local Place:
GMT
1. Exact Position
2. Location & extent of the structural
failure
3. Probable cause
4. Is safety of the vessel endangered
5. Is there any ingress of water
6. Wind, sea, current, present weather
and forecast
7. Disposition of bunkers, ballast,
cargo type, quantity and distribution.
8. Shearing force & Bending moments
and possibility of reducing same by
redistribution of ballast / bunkers.
9. Alternation of course / speed done
to minimise hull stresses
10. Proximity of shore and port of
refuge
11. Is vessel’s equipment / machinery
operational
12. Is there any threat of oil pollution
13. Are there other ships in the area
14. Has the nearest coast station been
notified
15. The possibility of affecting
temporary repairs to control the situation
16. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions
1/1
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.6”
MAIN ENGINE / STEERING FAILURE
Ship: TIME: Local Place:
GMT
1. Exact Position
2. Nature & extent of the main engine /
steering failure
3. Probable cause
4. Estimated time to get the engines/
steering gear operational
5. Is the vessel in anchoring depths or
is there scope for anchoring on
nearing the coastline
6. Wind, sea, current, present weather
and forecast
7. Proximity of shore and nearest port
8. Disposition of bunkers, ballast,
cargo type, quantity and distribution.
9. Is safety of the vessel endangered
and evacuation of staff necessary
10. Are there other ships in the area
11. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions
1/1
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.7”
CARGO SHIFTING/JETTISONING
Ship: TIME: Local Place:
GMT
1. Exact Position
2. The compartment/compartments
affected & the possibility of further
shifting.
3. Disposition of bunkers, ballast,
cargo type, quantity and distribution.
4. Is the cargo a bulk cargo that can
liquefy & is this the case
5. Is there any ingress of water
6. Wind, sea, current, present weather
and forecast
7. Resultant list, stability criteria with
reference to the GM & GZ. Does
the vessel have zero or negative
GM & is she lying at an angle of loll.
8. Corrective action to be taken to
correct the list by taking ballast in db
tanks. If vessel has negative or zero
GM, ballast to be taken on lower
side first.
9. Proximity of shore and port of
refuge
10. Is the safety of the vessel
endangered & evacuation of staff
necessary.
11. Are there other ships in the area
12. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions
1/1
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.8”
FLOODING
Ship: TIME: Local Place:
GMT
1. Exact Position
2. Location & extent of flooding & is the
pumping arrangement for the
compartment able to cope with the
ingress of water.
3. Probable cause of flooding.
4. Resultant list/change of trim & if
adjacent compartments are affected
by the leakage.
5. The permeability of the flooded
compartment.
6. Disposition of bunkers, ballast,
cargo type, quantity and distribution.
7. The damaged stability calculations
taking into account flooded compart-
-ment & action required to counter
adverse list/trim (ballast / deballast ).
8. Wind weather & sea conditions.
9. Proximity of shore and port of refuge
& possibility of beaching.
10. Is the safety of the vessel
endangered & evacuation of staff
necessary.
11. Are there other ships in the area
12. Any threat of oil pollution.
1/2
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.8”
FLOODING (Cont’d)
Ship: TIME: Local Place:
GMT
13. Is the vessel’s equipment &
machinery operational.
14. Has the nearest coast station been
notified.
15. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions
2/2
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.9”
ABANDON SHIP
Ship: TIME: Local Place:
GMT
1. Exact Position.
2. Has distress message been sent out
3. Any ships in the vicinity & have they
been contacted.
4. Wind, sea & weather conditions
5. Boats prepared for launching.
6. Additional water & blankets
7. Proximity of shore & nearest port
8. Current log books, ship’s certificates
crew documents & ship’s cash
packed.
9. Epirb activated, Sarts & L.boat radio
stowed in the boats.
10. Any crew members remaining
onboard.
11. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions
1/1
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.10”
TERRORISM / PIRACY
Ship: TIME: Local Place:
GMT
1. Notify the office immediately.
2. Exact position
3. Inform nearest coast station.
4. Sound general alarm & switch on all
lights if after dark.
5. If the intruders are well armed, do
not offer resistance.
6. Do best to navigate vessel to safety.
7. Muster all crew and do utmost to
ensure their well being & safety
8. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions
1/1
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.11”
POWER FAILURE
Ship: TIME: Local Place:
GMT
1. Exact position
2. Probable cause of failure
3. Estimated time to restore power
4. Is the vessel in anchoring depths or
is there scope for anchoring on
nearing the coast
5. Wind, sea and weather conditions
and forecast
6. Proximity of shore and nearest port
7. Disposition of bunkers, ballast, cargo
type, quantity & distribution
8. Is the safety of the vessel
endangered & is evacuation of staff
necessary
9. Are other ships in the vicinity &
the possibility of their assistance
10. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions
1/1
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.12”
SERIOUS INJURY / CASUALTY
Ship: TIME: Local Place:
GMT
1. Exact position
2. Name & rank of the crew member
3. Nature of the injury
4. Cause of the injury/casualty
5. Condition of the crew member
6. Has radio medical advice been taken
7. Wind, sea & weather conditions
8. Proximity of shore & nearest port
9. Any ships in the vicinity with doctor
10. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions
1/1
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.13”
HEAVY WEATHER DAMAGE
Ship: TIME: Local Place:
GMT
1. Exact position
2. Location & extent of damage
3. Is there any ingress of water
4. Disposition of bunkers, ballast, cargo
type, quantity & distribution
5. Wind, sea & weather conditions and
forecast
6. Is the safety of the vessel
endangered & evacuation of staff
necessary
7. Proximity of shore & the nearest
port of refuge
8. Is the vessel’s equipment &
machinery operational
9. Is there any threat of oil pollution
10. Course & speed has been altered
to minimize / prevent further damage
11. Are there any other ships in the
vicinity
12. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions
1/1
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.14”
MAN OVERBOARD
Ship: TIME: Local Place:
GMT
1. Exact position
2. Name & rank of the person
3. Date & time when first reported
4. If sighting was immediate was a
Williamson turn executed
5. Was a lifebuoy with marker thrown
overboard
6. Wind, weather sea and current
conditions & forecast as well as Air
and sea water temperatures
7. Was the person wearing a lifejacket
8. Was the person wearing an
immersion suit, TPA or other warm
clothing
9. Is the vessel in a shark infested
area
10. Has the coast station & other
shipping notified
11. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions
1/1
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.15”
BREAKAWAY FROM JETTY DURING CARGO TRANSFER
Ship: TIME: Local Place:
GMT
1. Exact Position
2. Location & cause of breakaway.
3. Any cargo spill if so, estimated quantity
4. Is vessel in danger or is she made fast
again to the jetty.
5. Has notification been done in
accordance with SOPEP/OPA 90
6. Any risk of fire / explosion
7. Have all operations been shut down.
8. Disposition of bunkers, ballast, cargo
type, quantity and distribution
9. Weather conditions
10. Any damage to ship / shore facility.
11. Has vessel’s pollution team been
mobilised
12. Has shore assistance like tugs /
salvage been requested / required
13. Are there any casualties and have
steps been taken to safeguard crew
14. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions
1/1
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.16”
TANK LEAKAGE IN DB TANKS, SIDE SPACES, VOIDS ETC
Ship: TIME: Local Place:
GMT
1. Exact Position
2. Tank affected and cause of leakage.
3. Is the cargo liable to cause damage to
the tank coating or structure.
4. Has all deck work or cargo transfer
operations been stopped.
5. Quantity of cargo that has entered the
Tank / space.
6. Have steps been taken to mitigate the
effects of the cargo by dilution or other
suitable means. Give details of
measures taken.
7. Any injuries to personnel
8. Is the vessel in any danger.
9. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions
1/1
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.17”
TOXIC LIQUID RELEASE AT SEA, ANCHORAGE OR AT TERMINAL
Ship: TIME: Local Place:
GMT
1/2
1. Exact Position
2. Location & cause of spill.
3. Extent of spill / estimated quantity
4. Reported or sighted by whom
5. Has notification been done in
accordance with SOPEP/OPA 90
6. Is spill an operational spill or
casualty related.
7. Has the spill been contained or is cargo
continuing to escape / leak.
8. Disposition of bunkers, ballast, cargo
type, quantity and distribution
9. Weather conditions
10. Health and environment hazards of the
cargo & is it soluble in water, heavier than
water or lighter than water.
11. Have vessel and shore pollution teams
been mobilized.
12. Is the cargo on fire
13. Is the vessel’s equipment / machinery
operational
14. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.17”
TOXIC LIQUID RELEASE AT SEA, ANCHORAGE OR
AT TERMINAL ( Cont’d)
Ship: TIME: Local Place:
GMT
15. Has the ventilation in the accommodation
been shut and all openings shut / sealed.
16. Are there any casualties and have
steps been taken to safeguard crew
17. Have measures been taken for evacuating
crew to safety.
2/2
DATE: 01.02.18 REV.: 3
APPENDIX – “8.2.18”
ECDIS FAILURE
Ship: TIME: Local Place:
GMT
1. Own ship Position: Latitude:
Longitude:
2. Main Engines on notice & speed reduced, as situation demands.
3. Steering switched over to Hand or regular / non TCS
4. Switch on all Steering Systems
5. Wind & Weather conditions, including details of rolling & pitching
Present: Forecast:
6. Has the available Paper Chart been referred to and vessels position plotted / ascertained?
7. Office requested for scanned copy of the charts, as & if required.
8. Has safety message been raised on VHF to warn other vessels in vicinity.
9. Proximity of shore & Port of Refugee?
10. Technician (as applicable) & Remote Trouble Shooting with makers arranged.
11. Has notification been done in accordance with port / local Regulations, if applicable.
12. Other relevant information
13. Save VDR/SVDR Data and CCTV Records, as per Makers Instructions
1/1