CG-4602A 11-16 Oil Record Book-Full

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FORM APPROVED

OMB No. 1625-0009

______________________
OIL RECORD BOOK
FOR SHIPS
CHECK ONE: This book is for Machinery Space Operations (Part I-All Ships)

This book is for Cargo/Ballast Operations (Part II - Oil Tankers)

Name of Ship: Official Number:

Owner: IMO Number:

Gross Tonnage:

Period From: To:

THIS BOOK MUST BE MAINTAINED ABOARD THE SHIP FOR AT LEAST THREE YEARS
FOLLOWING THE “TO” DATE LISTED ABOVE.

As per 33 Code of Federal Regulations (CFR) 151.25, this record book is issued by the Secretary of Homeland
Security and is distributed by the United States Coast Guard to ships of American registry. It remains the property of
the United States Government and each owner/operator is responsible to maintain and surrender it in accordance
with the Secretary's regulations. Note that the Oil Record Book is o n e book with two parts; Machinery Space
Operations is under Part I and Cargo/Ballast Operations is under Part II.
Each oil tanker of 150 gross tons and above, every ship of 400 gross tons and above other than oil tankers, and
manned fixed or floating drilling rig or other platform shall maintain an Oil Record Book Part I (Machinery Space
Operations). An oil tanker of 150 gross tons and above or a non oil tanker that carries 200 cubic meters or more
of oil in bulk, shall also maintain an Oil Record Book Part II (Cargo/Ballast Operations).

Oil Record Books printed by the U.S. Government are available to the masters or operators of all U.S. ships
subject to 33 CFR 151.25, from any Coast Guard Sector Office, Marine Inspection Office, or Captain of the Port
Office.

An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB
control number. The Coast Guard estimates that the average burden for each response is 2.5 minutes. You may submit any comments
concerning the accuracy of this burden estimate or any suggestions for reducing the burden to: Commandant (CG-CVC-1), U.S. Coast Guard,
Stop 7501, 2703 Martin Luther King Jr. Ave, SE, Washington, DC 20593-7501 or Office of Management and Budget, Paperwork Reduction
Project (1625-0009), Washington, DC 20503.

DEPT. OF HOMELAND SECURITY, USCG, CG-4602A (Rev. 11-16) SN 7530-01-GF3-0660


Privacy Act Statement

Authority: 33 U.S.C. §1321, §1903; 46 U.S.C. §6101; and 33 CFR 151.25.

Purpose: The Coast Guard will use this information to inspect ships and enforce compliance with
MARPOL 73/78 and 33 CFR 151 Subpart A.

Routine Uses: The information will be used by and disclosed to authorized Coast Guard personnel to
determine that evidence of compliance is on board, the condition of the ship and its equipment
corresponds substantially with the vessel’s particulars, whether a vessel has discharged any oil or oily
mixtures in violation of MARPOL 73/78 and 33 CFR 151 Subpart A. Any external disclosures of data
within this record will be made in accordance with the DHS/USCG-013, Marine Information for Safety
and Law Enforcement (MISLE) System of Records Notice, 74 Federal Register 30305, (June 25, 2009).

Disclosure: Furnishing this information is mandatory; failure to furnish the requested information may
result in appropriate enforcement measures by the agency conducting the inspection, and possible
restriction on the operation of the vessel.
Table of Contents

Extract of 33 CFR 151.25 - Oil Record Book…………………………………………….……..1


Extracts of Selected MARPOL 73/78 Annex I Regulations (Consolidated Edition 2011)….……….2
Chapter 3, Regulation 15 – Control of discharge of oil……………………………………..2
Chapter 3, Regulation 17 – Oil Record Book, Part I – Machinery space operations………..3
Chapter 4, Regulation 34 – Control of discharge of oil……………………………………..4
Chapter 4, Regulation 36 – Oil Record Book, Part II - Cargo/ballast operations…………...6
Oil Record Book Part I – Instructions for All Ships…………………………………………….8
List of Items to be Recorded – Part I…………………………………………………………...10
Examples of List of Items to be Recorded – Part I……………………………………………..12
Plan View of Engine Room Holding Tanks…………………………………………………….18
Oil Record Book Part II – Instructions for Oil Tankers……………………………….………..19
List of Items to be Recorded – Part II……………………………………………….………….20
Plan View of Cargo and Slop Tanks…………………………….……………………….……..24
Examples of List of Items to be Recorded – Part II……………………………………………..25
Supplementary Information…………………………………………………………….……….30
Start of Record Keeping Pages………………………………………………………………….31

Disclaimer:
Selected excerpts of MARPOL 73/78 and 33 CFR 151 regulations pertaining to oil discharge and oil record book standards
are provided in the following pages. These selected excerpts reflect the regulations at the time of this book’s publication.
While the excerpts are provided to give vessel owners and operators readily available reference to certain oil discharge and
Oil Record Book regulations, they do not stand in place of the actual regulations. Vessel owners and operators shall consult
the actual regulations as these references may have been updated after the publication date of this Oil Record Book.

The Code of Federal Regulations (CFR’s) may be viewed on the web at http://www.ecfr.gov.

A copy of MARPOL Consolidated Edition 2011 is available from the International Maritime Organization, 4 Albert
Embankment, London, SE1, SR7, England. (www.imo.org)
Extract of 33 CFR 151.25 - Oil Record Book
(a) Each oil tanker of 150 gross tons and above, every ship of 400 gross tons and above other than an
oil tankers, and manned fixed or floating drilling rig or other platform shall maintain an Oil Record
Book Part I (Machinery Space Operations). An oil tanker of 150 gross tons and above or a non oil
tanker that carries 200 cubic meters or more of oil in bulk, shall also maintain an Oil Record Book
Part II (Cargo/Ballast Operations).

(b) An Oil Record Book printed by the U.S. Government is available to the masters or operators of all
U.S. ships subject to this section, from any Coast Guard Sector Office, Marine Inspection Office, or
Captain of the Port Office.

(c) The ownership of the Oil Record Book of all U.S. ships remains with the U.S. Government.

(d) Entries shall be made in the Oil Record Book on each occasion, on a tank to tank basis if
appropriate, whenever any of the following machinery space operations take place on any ship to
which this section applies--
(1) Ballasting or cleaning of fuel oil tanks;
(2) Discharge of ballast containing an oily mixture or cleaning water from fuel oil tanks;
(3) Disposal of oil residue;
(4) Discharge overboard or disposal otherwise of bilge water that has accumulated in machinery
spaces;
(5) Bunkering of fuel or bulk lubricating oil; and
(6) Any failure, and the reasons for, of the oil filtering equipment.

(e) Entries shall be made in the Oil Record Book on each occasion, on a tank to tank basis if
appropriate, whenever any of the following cargo/ballast operations take place on any oil tanker to
which this section applies--
(1) Loading of oil cargo;
(2) Internal transfer of oil cargo during voyage;
(3) Unloading of oil cargo;
(4) Ballasting of cargo tanks and dedicated clean ballast tanks;
(5) Cleaning of cargo tanks including crude oil washing;
(6) Discharge of ballast except from segregated ballast tanks;
(7) Discharge of water from slop tanks;
(8) Closing of all applicable valves or similar devices after slop tank discharge operations;
(9) Closing of valves necessary for isolation of dedicated clean ballast tanks from cargo and
stripping lines after slop tank discharge operations;
(10) Disposal of oil residue; and
(11) Any failure, and the reasons for, of the oil discharge monitoring and control system.

(f) Entries shall be made in the Oil Record Book on each occasion, on a tank-to-tank basis if
appropriate, whenever any of the following operations take place on a fixed or floating drilling rig or
other platform to which this section applies--
(1) Discharge of ballast or cleaning water from fuel oil tanks; and
(2) Discharge overboard of platform machinery space bilge water.

(g) In the event of an emergency, accidental or other exceptional discharge of oil or oily mixture, a
statement shall be made in the Oil Record Book of the circumstances of, and the reasons for, the
discharge.

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(h) Each operation described in paragraphs (d), (e) and (f) of this section shall be fully recorded
without delay in the Oil Record Book so that all the entries in the book appropriate to that operation
are completed. Each completed operation shall be signed by the person or persons in charge of the
operations concerned and each completed page shall be signed by the master or other person having
charge of the ship.

(i) The Oil Record Book shall be kept in such a place as to be readily available for inspection at all
reasonable times and shall be kept on board the ship.

(j) The master or other person having charge of a ship required to keep an Oil Record Book shall be
responsible for the maintenance of such record.

(k) The Oil Record Book for a U.S. ship shall be maintained on board for not less than three years.

(l) This section does not apply to a barge or a fixed or floating drilling rig or other platform that is not
equipped to discharge overboard any oil or oily mixture.

(m) This section does not apply to a fixed or floating drilling rig or other platform that is operating in
compliance with a valid National Pollutant Discharge Elimination System (NPDES) permit.

Extracts of MARPOL 73/78 Regulations


MARPOL 73/78 Annex I: Chapter 3, Regulation 15 – Control of discharge of oil

1. Subject to the provisions of regulation 41 of this annex and paragraphs 2, 3, and 6 of this
regulation, any discharge into the sea of oil or oily mixtures from ships shall be prohibited. 1

A. Discharges outside special areas

2. Any discharge into the sea of oil or oily mixtures from ships of 400 gross tonnage and above shall
be prohibited except when all the following conditions are satisfied:
.1 the ship is proceeding en route; 2
.2 the oily mixture is processed through an oil filtering equipment meeting the requirements of
regulation 14 of this Annex; 3
.3 the oil content of the effluent without dilution does not exceed 15 parts per million;
.4 the oily mixture does not originate from cargo pump room bilges on oil tankers; and
.5 the oily mixture, in case of oil tankers, is not mixed with oil cargo residues.

B. Discharges in special areas

3. Any discharge into the sea of oil or oily mixtures from ships of 400 gross tonnage and above shall
be prohibited except when all of the following conditions are satisfied:
.1 the ship is proceeding en route; 2
.2 the oily mixture is processed through an oil filtering equipment meeting the
requirements of regulation 14.7 of this Annex;
.3 the oil content of the effluent without dilution does not exceed 15 parts per million;
.4 the oily mixture does not originate from cargo pump room bilges on oil tankers; and
.5 the oily mixture, in case of oil tankers, is not mixed with oil cargo residues.

4. In respect of the Antarctic area, any discharge into the sea of oil or oily mixtures from any ship
shall be prohibited.
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5. Nothing in this regulation shall prohibit a ship on a voyage only part of which is in a special area
from discharging outside a special area in accordance with paragraphs 2 of this regulation.

C. Requirements for ships of less than 400 gross tonnage in all areas except the Antarctic area

6. In the case of a ship of less than 400 gross tonnage, oil and all oily mixtures shall either be
retained on board for subsequent discharge to reception facilities or discharged into the sea in
accordance with the following provisions:
.1 the ship is proceeding en route; 2
.2 the ship has in operation equipment of a design approved by the Administration that ensures
that the oil content of the effluent without dilution does not exceed 15 parts per million;
.3 the oily mixture does not originate from cargo pump room bilges on oil tankers; and
.4 the oily mixture, in case of oil tankers, is not mixed with oil cargo residues.

D. General requirements

7. Whenever visible traces of oil are observed on or below the surface of the water in the immediate
vicinity of a ship or its wake, Governments of Parties to the present Convention should, to the extent
they are reasonably able to do so, promptly investigate the facts bearing on the issue of whether there
has been a violation of the provisions of this regulation. The investigation should include, in
particular, the wind and sea conditions, the track and speed of the ship, other possible sources of the
visible traces in the vicinity, and any relevant oil discharge records.

8. No discharge into the sea shall contain chemicals or other substances in quantities or
concentrations which are hazardous to the marine environment or chemicals or other substances
introduced for the purpose of circumventing the conditions of discharge specified in this regulation.

9. The oil residues which cannot be discharged into the sea in compliance with this regulation shall
be retained on board for subsequent discharge to reception facilities.
NOTES:
1
Regulation 4 is titled “Exceptions.”
2
En route means that a ship is underway at sea on a course or courses, including deviation from the shortest direct route, which, as far
as practicable for navigation purposes, will cause any discharge to be spread over as great an area of the sea as is reasonable and
practicable (MARPOL Annex I Unified Interpretation 28).
3
Regulation 14 is titled “Oil Filtering Equipment.”

MARPOL 73/78 Annex I: Chapter 3, Regulation 17 – Oil Record Book, Part I –


Machinery space operations

1. Every oil tanker of 150 gross tonnage and above and every ship of 400 gross tonnage and above
other than an oil tanker shall be provided with an Oil Record Book Part I (Machinery Space
Operations). The Oil Record Book, whether as a part of the ship’s official log-book or otherwise,
shall be in the Form specified in appendix III to this Annex.

2. The Oil Record Book Part I shall be completed on each occasion, on a tank-to-tank basis if
appropriate, whenever any of the following machinery space operations takes place in the ship:
.1 ballasting or cleaning of oil fuel tanks;
.2 discharge of dirty ballast or cleaning water from oil fuel tanks;
.3 collection and disposal of oil residues (oil residue (sludge);
.4 discharge overboard or disposal otherwise of bilge water which has accumulated

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in machinery spaces; and
.5 bunkering of fuel or bulk lubricating oil.

3. In the event of such discharge of oil or oily mixture as is referred to in regulation 4 of this Annex
or in the event of accidental or other exceptional discharge of oil not excepted by that regulation, a
statement shall be made in the Oil Record Book Part I of the circumstances of, and the reasons for,
the discharge.

4. Each operation described in paragraph 2 of this regulation shall be fully recorded without delay in
the Oil Record Book Part I, so that all entries in the book appropriate to that operation are completed.
Each completed operation shall be signed by the officer or officers in charge of the operations
concerned and each completed page shall be signed by the master of ship. The entries in the Oil
Record Book Part I, for ships holding an International Oil Pollution Prevention Certificate, shall be at
least in English, French or Spanish. Where entries in an official national language of the State whose
flag the ship is entitled to fly are also used, this shall prevail in case of a dispute or discrepancy.

5. Any failure of the oil filtering equipment shall be recorded in the Oil Record Book Part I.

6. The Oil Record Book Part I, shall be kept in such a place as to be readily available for inspection
at all reasonable times and, except in the case of unmanned ships under tow, shall be kept on board
the ship. It shall be preserved for a period of three years after the last entry has been made.

7. The competent authority of the Government of a Party to the present Convention may inspect the
Oil Record Book Part I on board any ship to which this Annex applies while the ship is in its port or
offshore terminals and may make a copy of any entry in that book and may require the master of the
ship to certify that the copy is a true copy of such entry. Any copy so made which has been certified
by the master of the ship as a true copy of an entry in the ship's Oil Record Book Part I shall be made
admissible in any judicial proceedings as evidence of the facts stated in the entry. The inspection of
an Oil Record Book Part I and the taking of a certified copy by the competent authority under this
paragraph shall be performed as expeditiously as possible without causing the ship to be unduly
delayed.

MARPOL 73/78 Annex I: Chapter 4, Regulation 34 – Control of discharge of oil

A. Discharges outside special areas

1. Subject to the provisions of regulation 4 of this Annex and paragraph 2 of this regulation, any
discharge into the sea of oil or oily mixtures from the cargo area of an oil tanker, shall be prohibited
except when all the following conditions are satisfied: 1
.1 the tanker is not within a special area;
.2 the tanker is more than 50 nautical miles from the nearest land;
.3 the tanker is proceeding en route;2
.4 the instantaneous rate of discharge of oil content does not exceed 30 liters per
nautical mile;
.5 the total quantity of oil discharged into the sea does not exceed for tankers delivered on or
before 31 December 1979, as defined in regulation 1.28.1, 1/15,000 of the total quantity of the
particular cargo of which the residue formed a part, and for tankers delivered after 31 December
1979, as defined in regulation 1.28.2, 1/30,000 of the total quantity of the particular cargo of
which the residue formed a part; and3
.6 the tanker has in operation an oil discharge monitoring and control system and a slop tank
arrangement as required by regulations 29 and 31 of this Annex.4
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2. The provisions of paragraph 1 of this regulation shall not apply to the discharge of clean or
segregated ballast.

B. Discharges in special areas

3. Subject to the provisions of paragraph 4 of this regulation, any discharge into the sea of oil or oily
mixture from the cargo area of an oil tanker shall be prohibited while in a special area.5

4. The provisions of paragraph 3 of this regulation shall not apply to the discharge of clean or
segregated ballast.

5. Nothing in this regulation shall prohibit a ship on a voyage only part of which is in a special area
from discharging outside the special area in accordance with paragraph 1 of this regulation.

C. Requirements for oil tankers of less than 150 gross tonnage

6. The requirements of regulations 29, 31 and 32 of this Annex shall not apply to oil tankers of less
than 150 gross tonnage, for which the control of discharge of oil under this regulation shall be
effected by the retention of oil on board with subsequent discharge of all contaminated washings to
reception facilities. The total quantity of oil and water used for washing and returned to a storage tank
shall be discharged to reception facilities unless adequate arrangements are made to ensure that any
effluent which is allowed to be discharged into the sea is effectively monitored to ensure that the
provisions of this regulation are complied with.6

D. General requirements

7. Whenever visible traces of oil are observed on or below the surface of the water in the immediate
vicinity of a ship or its wake, the Governments of Parties to the present Convention should, to the
extent they are reasonably able to do so, promptly investigate the facts bearing on the issue of
whether there has been a violation of the provisions of this regulation. The investigation should
include, in particular, the wind and sea conditions, the track and speed of the ship, other possible
sources of the visible traces in the vicinity, and any relevant oil discharge records.

8. No discharge into the sea shall contain chemicals or other substances in quantities or
concentrations which are hazardous to the marine environment or chemicals or other substances
introduced for the purpose of circumventing the conditions of discharge specified in this regulation.

9. The oil residues which cannot be discharged into the sea in compliance with paragraphs 1 and 3 of
this regulation shall be retained on board for subsequent discharge to reception facilities.
NOTES:
1
Regulation 4 is titled “Exceptions.”
2
En route means that a ship is underway at sea on a course or courses, including deviation from the shortest direct route, which, as far
as practicable for navigation purposes, will cause any discharge to be spread over as great an area of the sea as is reasonable and
practicable (MARPOL Annex I Unified Interpretation 28).
3
Regulation 1 is titled “Definitions.”
4
Regulation 29 is titled “Slop tanks.”
Regulation 31 is titled “Oil discharge monitoring and control system.”
5
Refer to regulation 38.6 (Regulation 38 is titled “Reception facilities.”)
6
Regulation 32 is titled “Oil/water interface detector.”

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MARPOL 73/78 Annex I: Chapter 4, Regulation 36 – Oil Record Book, Part II -
Cargo/ballast operations

1. Every oil tanker of 150 gross tonnage and above shall be provided with an Oil Record Book Part
II (Cargo/Ballast Operations). The Oil Record Book Part II, whether as a part of the ship's official
logbook or otherwise, shall be in the Form specified in appendix III to this Annex.

2. The Oil Record Book Part II shall be completed on each occasion, on a tank-to-tank basis if
appropriate, whenever any of the following cargo/ballast operations take place in the ship:
.1 loading of oil cargo;
.2 internal transfer of oil cargo during voyage;
.3 unloading of oil cargo;
.4 ballasting of cargo tanks and dedicated clean ballast tanks;
.5 cleaning of cargo tanks including crude oil washing;
.6 discharge of ballast except from segregated ballast tanks;
.7 discharge of water from slop tanks;
.8 closing of all applicable valves or similar devices after slop tank discharge
operations;
.9 closing of valves necessary for isolation of dedicated clean ballast tanks from
cargo and stripping lines after slop tank discharge operations; and
.10 disposal of residues.

3. For oil tankers referred to in regulation 34.6 of this Annex, the total quantity of oil and water used
for washing and returned to a storage tank shall be recorded in the Oil Record Book Part II.

4. In the event of such discharge of oil or oily mixture as is referred to in regulation 4 of this Annex
or in the event of accidental or other exceptional discharge of oil not excepted by that regulation, a
statement shall be made in the Oil Record Book Part II of the circumstances of, and the reasons for,
the discharge.

5. Each operation described in paragraph 2 of this regulation shall be fully recorded without delay in
the Oil Record Book Part II so that all entries in the book appropriate to that operation are completed.
Each completed operation shall be signed by the officer or officers in charge of the operations
concerned and each completed page shall be signed by the master of ship. The entries in the Oil
Record Book Part II shall be at least in English, French or Spanish. Where entries in an official
language of the State whose flag the ship is entitled to fly are also used, this shall prevail in case of
dispute or discrepancy.

6. Any failure of the oil discharge monitoring and control system shall be noted in the Oil Record
Book Part II.

7. The Oil Record Book shall be kept in such a place as to be readily available for inspection at all
reasonable times and, except in the case of unmanned ships under tow, shall be kept on board the
ship. It shall be preserved for a period of three years after the last entry has been made.

8. The competent authority of the Government of a Party to the Convention may inspect the Oil
Record Book Part II on board any ship to which this Annex applies while the ship is in its port or
offshore terminals and may make a copy of any entry in that book and may require the master of the
ship to certify that the copy is a true copy of such entry. Any copy so made which has been certified
by the master of the ship as a true copy of an entry in the ship's Oil Record Book Part II shall be made
admissible in any judicial proceedings as evidence of the facts stated in the entry. The inspection of
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an Oil Record Book Part II and the taking of a certified copy by the competent authority under this
paragraph shall be performed as expeditiously as possible without causing the ship to be unduly
delayed.

9. For oil tankers of less than 150 gross tonnage operating in accordance with regulation 34.6 of this
Annex, an appropriate Oil Record Book should be developed by the Administration.

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OIL RECORD BOOK
PART I - Machinery Space Operations
(All Ships)

INSTRUCTIONS FOR ALL SHIPS

Each oil tanker of 150 gross tons and above, every ship of 400 gross tons and above other than oil tankers, and
manned fixed or floating drilling rig or other platform shall maintain an Oil Record Book Part I (Machinery Space
Operations). (From 33 CFR 151.25 (a))

The following pages of this section show a comprehensive list of items of machinery space operations which are,
when appropriate, to be recorded in the Oil Record Book Part I (Machinery Space Operations) in accordance with
regulation 17 of Annex I to MARPOL 73/78 and implemented in 33 CFR 151.25. The items have been grouped
into operational sections, each of which is denoted by a letter Code.

When making entries in the Oil Record Book Part I, the date, operational code, and item number shall be inserted
in the appropriate columns and the required particulars shall be recorded in chronological order as they have been
executed on board. Each operation shall be fully recorded without delay so that all the entries in the book
appropriate to that operation are completed. Each operation should be dated in the dd-MONTH-yyyy format (e.g.
20- JAN-2011). Each Completed operation shall be entered and signed by the officer/person or
officers/persons in charge of the operations concerned and each completed page shall be signed by the
master of the ship.

Incineration or landing ashore of oily garbage and used filters should be recorded in the Garbage Record Book
only.

Do not leave any full lines empty between successive entries. If a wrong entry has been recorded in the Oil Record
Book (ORB), it should immediately be struck through with a single line in such a way that the wrong entry is still
legible. The wrong entry should be signed and dated, with the new corrected entry following.

Tank nomenclature should be recorded as per the format noted within the International Oil Pollution Prevention
(IOPP) Certificate.

The Oil Record Book Part I contains many references to oil quantity. The limited accuracy of tank measurement
devices, temperature variations and c1ingage will affect the accuracy of these readings. The entries in the Oil
Record Book Part I should be considered accordingly. All quantities should be consistently recorded
throughout the Oil Record Book as cubic meters (m3), gallons (gals), or barrels (bbls).

In the event of accidental or other exceptional discharge of oil, statement shall be made in the Oil Record Book
Part I of the circumstances of, and the reasons for, the discharge.

Any failure of the oil filtering equipment shall be noted in the Oil Record Book Part I.

The entries in the Oil Record Book Part I for ships holding an IOPP Certificate shall be in English.

Recording of quantities retained in bilge water holding tanks listed under section 3.3 of the IOPP Certificate is
voluntary and not required by the Convention. The recording of general maintenance of items pertaining to the
OWS remains voluntary and is not required to be recorded in the ORB.

The Oil Record Book Part I shall be kept in such a place as to be readily available for inspection at all reasonable
times and, except in the case of unmanned ships under tow, shall be kept on board the ship. It shall be preserved
for a period of three years after the last entry has been made.

The competent authority of the Government of a Party to the Convention may inspect the Oil Record Book Part I
on board any ship to which Annex I applies while the ship is in its port or offshore terminals and may make a copy
of any entry in that book and may require the master of the ship to certify that the copy is a true copy of such entry.
Any copy so made which has been certified by the master of the ship as a true copy of an entry in the Oil Record

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Book Part I shall be made admissible in any juridical proceedings as evidence of the facts stated in the entry. The
inspection of an Oil Record Book Part I and the taking of a certified copy by the competent authority under this
paragraph shall be performed as expeditiously as possible without causing the ship to be unduly delayed.

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LIST OF ITEMS TO BE RECORDED
PART I - Machinery Space Operations

(A) BALLASTING OR CLEANING OF OIL FUEL TANKS

1 Identity of tank(s) ballasted.


2 Whether cleaned since they last contained oil and, if not, type of oil previously carried.
3 Cleaning process:
.1 position of ship and time at the start and completion of cleaning;
.2 identify tank(s) in which one or another method has been employed (rinsing through, steaming,
cleaning with chemicals; type and quantity of chemicals used, in m3, gals., or bbls);
.3 identity of tank(s) into which cleaning water was transferred and the quantity in m3, gals., or bbls.
4 Ballasting:
.1 position of ship and time at start and end of ballasting;
.2 quantity of ballast if tanks are not cleaned, in m3, gals., or bbls.

(B) DISCHARGE OF DIRTY BALLAST OR CLEANING WATER FROM OIL FUEL TANKS
REFERRED TO UNDER SECTION (A)

5 Identity of tank(s).
6 position of ship at start of discharge.
7 Position of ship on completion of discharge.
8 Ship’s speed(s) during discharge.
9 Method of discharge:
.1 through 15 ppm equipment;
.2 to reception facilities.
10 Quantity discharged, in m3, gals., or bbls.

(C) COLLECTION, TRANSFER AND DISPOSAL OF OIL RESIDUES (SLUDGE AND OTHER OIL
RESIDUES)

11 Collection of oil residues (sludge).


Quantities of oil residues (sludge) retained on board. The quantity should be recorded
weekly1: (this means that the quantity must be recorded once a week even if the voyage
lasts more than one week):
.1 identity of tank(s)
.2 capacity of tank(s) in m3, gals., or bbls.
.3 total quantity of retention in m3, gals., or bbls.
.4 quantity of residue collected by manual operation in m3, gals., or bbls.
(Operator initiated manual collections where oil residue (sludge) is transferred
into the oil residue (sludge) holding tank(s).)

12 Methods of transfer or disposal of oil residues (sludge).


State quantity of oil residues transferred or disposed of, the tank(s) emptied and the
quantity of contents retained in m3, gals., or bbls:
.1 to reception facilities (identify port);2
.2 to another (other) tank(s) (indicate tank(s) and the total content of tank(s));
.3 incinerated (indicate total time of operation with time of start and stop);
.4 other method (state which).

NOTES:
1
Only those tanks listed in item 3.1 of Forms A and B of the Supplement to the IOPP Certificate used for oil residues
(sludge).
2
The ship’s master should obtain from the operator of the reception facilities, which includes barges and tank trucks, a
receipt or certificate detailing the quantity of tank washings, dirty ballast, residues or oily mixtures transferred, together with
the time and date of the transfer. This receipt or certificate, if attached to the Oil Record Book Part I, may aid the master of
the ship in proving that the ship was not involved in an alleged pollution incident. The receipt or certificate should be kept
together with the Oil Record Book Part I.

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(D) NON-AUTOMATIC STARTING OF DISCHARGE OVERBOARD, TRANSFER OR DISPOSAL
OTHERWISE OF BILGE WATER WHICH HAS ACCUMULATED IN MACHINERY SPACES

13 Quantity discharged, transferred or disposed of, in m3, gals., or bbls.1


14 Time of discharge, transfer or disposal (start and stop).
15 Method of discharge, transfer, or disposal:
.1 through 15 ppm equipment (state position at start and end);
.2 to reception facilities (identify port);2
.3 to slop tank or holding tank or other tank(s) (indicate tank(s); state quantity
retained in tank(s), in m3, gals., or bbl).

(E) AUTOMATIC STARTING OF DISCHARGE OVERBOARD, TRANSFER OR DISPOSAL


OTHERWISE OF BILGE WATER WHICH HAS ACCUMULATED IN MACHINERY SPACES

16 Time and position of ship at which the system has been put into automatic mode of
operation for discharge overboard, through 15 ppm equipment.
17 Time when the system has been put into automatic mode of operation for transfer of bilge
water to holding tank (identify tank).
18 Time when the system has been put into manual operation.

(F) CONDITION OF THE OIL FILTERING EQUIPMENT

19 Time of system failure.3


20 Time when system has been made operational.
21 Reasons for failure.
*(If a failure does occur then a code 'I' entry should also be made indicating that the overboard valve was sealed shut due to non
working Oil Filtering Equipment or Oil Content Meter.)
*(When operation is restored, a code 'I' entry should also be made indicating that the overboard valve was unsealed since the
operation of the Oil Filtering Equipment or Oil Content Meter has been restored.)

(G) ACCIDENTAL OR OTHER EXCEPTIONAL DISCHARGES OF OIL

22 Time of occurrence.
23 Place or position of ship at time of occurrence.
24 Approximate quantity and type of oil.
25 Circumstances of discharge or escape, the reasons there for and general remarks.

(H) BUNKERING OF FUEL OR BULK LUBRICATING OIL

26 Bunkering:
.1 Place of bunkering.
.2 Start and stop date and time of bunkering.
.3 Type and quantity of fuel oil and identity of tank(s) (state quantity added,
in tons, m3, gals., or bbls., and total content of tank(s)).
.4 Type and quantity of lubricating oil and identity of tank(s) (state quantity added,
in tons, m3, gals., or bbls., and total content of tank(s)).

(I) ADDITIONAL OPERATIONAL PROCEDURES AND GENERAL REMARKS

NOTES:
1
In case of discharge or disposal of bilge water from holding tank(s), state identity and capacity of holding tank(s) and
quantity retained in holding tank.
2
The ship’s master should obtain from the operator of the reception facilities, which includes barges and tank trucks, a
receipt or certificate detailing the quantity of tank washings, dirty ballast, residues or oily mixtures transferred, together with
the time and date of the transfer. This receipt or certificate, if attached to the Oil Record Book Part I, may aid the master of
the ship in proving that the ship was not involved in an alleged pollution incident. The receipt or certificate should be kept
together with the Oil Record Book Part I.
3
The condition of the oil filtering equipment covers also the alarm and automatic stopping devices, if applicable.
11 | P a g e
EXAMPLES

Name of Ship M/V ALL SHIPS


Official Number 413567_________________

CARGO/BALLAST OPERATIONS (Oil Tanker) / MACHINERY


MACHINERY SPACESPACE OPERATIONS
OPERATIONS

Date Code Item Record of Operations/signature of officers in charge


BALLASTING/CLEANING FUEL TANKS
07-OCT-2010 A 1 No. 5 DB Port and Stbd
2 No, Fuel oil IFO 380
3.1 49°56’ N x 30°00’W – Start 1605
50°00’ N x 29°58’W – Stop 1730
3.2 No. 5 DB Port and Stbd, Rinsing through
3.3 No. 1 Collecting tank
4.1 Start ballast 50°00’ N x 29°58’W at 1730
End ballast 50°04’ N x 29°56’W at 2357
J. Brennan
DISCHARGE FROM CLEANED OIL TANKS
10-OCT-2010 B 5 No. 1 Collecting tank
6 Jets Oil Contractors, New York, NY
7 Jets Oil Contractors, New York, NY
8 0 kts
9.2 Reception Facility
10 52.5 m 3
J. Brennan
EXAMPLE: VOYAGE/WEEKLY SLUDGE REPORT
Capacity Ret.
11-OCT-2010 C 11.1 / Sludge Tank #6 67.4m 3
21.7m 3

11.2
11.1 / Sludge Tank #12 5.0 m 3
4.4m 3

11.2
11.3 Total Retained on Board 26.1m 3
11.4 Weekly Total of Manual Transfers 0.68m3
M.A. Carroll

_John Cate_______
Signature of Master

12 | P a g e
EXAMPLES

Name of Ship M/V ALL SHIPS


Official Number 413567_________________

CARGO/BALLAST OPERATIONS (Oil Tanker) / MACHINERY


MACHINERY SPACESPACE OPERATIONS
OPERATIONS

Date Code Item Record of Operations/signature of officers in charge


EXAMPLE: RECORDING OF OIL RESIDUE
(SLUDGE) COLLECTED BY MANUAL OPERATION
& TRANSFERRED INTO AN OIL RESIDUE
(SLUDGE) TANK
11-OCT-2010 C 12 1.5 gal collected from galley deep fat
fryer
12.4 Transferred to Sludge Tank #6, Ret.
23.2m3
M.A. Carroll
11-OCT-2010 C 12 0.5 m3 collected from #2 air compressor
sump tank
12.4 Transferred to Sludge Tank #6, Ret.
23.7m3
M.A. Carroll
11-OCT-2010 C 12 0.5 m collected from turbo charger
3

sump
12.4 Transferred to Sludge Tank #6, Ret.
24.2m3
M.A. Carroll
EXAMPLE: SLUDGE TRANSFER
11-OCT-2010 C 12 0.5 m3 (3 drums) sludge from cleaning
#4 Collection Tank, Ret.: 0.00 m3
12.1 Landed, Providence, RI
M. Walter
EXAMPLE: SLUDGE TRANSFER
11-OCT-2010 C 12 2.6 m3 from HFO Sludge Tk, Ret.: 0.1 m3
12.2 To no 1 Waste Oil Tk, Ret.: 9.1m3
M. Walter

_John Cate_______
Signature of Master

13 | P a g e
EXAMPLES

Name of Ship M/V ALL SHIPS


Official Number 413567_________________

CARGO/BALLAST OPERATIONS (Oil Tanker) / MACHINERY


MACHINERY SPACESPACE OPERATIONS
OPERATIONS

Date Code Item Record of Operations/signature of officers in charge


EXAMPLE: INCINERATION OF SLUDGE
11-OCT-2010 C 12 0.8 m 3, Incinerator Sludge TK, Ret.: 0.2 m 3

12.3 Incinerated, 4 hrs: 1200hrs – 1600hrs


M. Walter
EXAMPLE: EVAPORATION OF WATER
11-OCT-2010 C 0.2 m 3 Water from Incinerator Sludge TK,
12
Ret.: 0.8 m 3
12.4 Evaporated to Atmosphere
J. Brennan
EXAMPLE: BILGE WATER DISPOSAL (OWS)
06-DEC-2010 D 13 14 m 3 oily bilge water from bilge Hldg Tk,
Capacity: 9.1m3, Ret: 1.1m3
14 Start 0000- Stop 0300
15.1 50°00’ N x 29°58’W - Start
49°56’ N x 30°00’W - Stop
K. Brennan
EXAMPLE: OILY BILGE WATER TO RECEPTION
FACILITIES
06-JAN-2011 D 13 16.3 m 3 Oily Bilge Water from bilge Hldg
Tk, Capacity: 9.1m3, Ret: 0.1m3
14 Start 1000hrs - Stop 1430hrs
15.2 To Shell Oil Refinery, Anacortes, WA
Z.L. Hughes
EXAMPLE: OILY BILGE WATER TRANSFER
06-JAN-2011 D 13 16.3 m3 Bilge Water from P/S Bilge Wells
14 Start 1000hrs – Stop 1430hrs
15.3 To Bilge Holding Tk, Ret: 10.1 m3
Z.L. Hughes

_John Cate_______
Signature of Master

14 | P a g e
EXAMPLES

Name of Ship M/V ALL SHIPS


Official Number 413567_________________

CARGO/BALLAST OPERATIONS (Oil Tanker) / MACHINERY


MACHINERY SPACESPACE OPERATIONS
OPERATIONS

Date Code Item Record of Operations/signature of officers in charge


EXAMPLE: PLACING BILGE PUMP IN AUTO
06-JAN-2011 E 17 0820 hrs to Bilge Holding Tank
K. Brennan
EXAMPLE: PLACING BILGE PUMP IN MANUAL
06-JAN-2011 E 18 1630 hrs
K. Brennan
EXAMPLE: FAILURE OF MONITORING/CONTROL
06-JAN-2010 F 19 Stop due to failure 1000
20 Item repaired, Started 1130
21 Recirculation valve opening prematurely,
Cleaned lens; all in apparent good order.
L. Kowalz
EXAMPLE: ACCIDENTAL OR OTHER
EXCEPTIONAL DISCHARGES OF OIL
24-JAN-2010 G 22 1500
23 Poland Ave Warf, New Orleans, LA
24 0.2 m3 No. 2 Diesel oil fuel
25 Ruptured bunkering hose
L. Kowalz

_John Cate_______
Signature of Master

15 | P a g e
EXAMPLES

Name of Ship M/V ALL SHIPS


Official Number 413567_________________

CARGO/BALLAST OPERATIONS (Oil Tanker) / MACHINERY


MACHINERY SPACESPACE OPERATIONS
OPERATIONS

Date Code Item Record of Operations/signature of officers in charge


EXAMPLE: BUNKERING
17-JAN-2010 H 26.1 Boston, Mass. USA
26.2 Start 17JAN2010 at 2210 - Stop 18JAN2010
at 0130
26.3 600 m 3 of IFO 380 Fuel oil 3.0% Sulfur
Bunkered in tanks:
F.O. Tank #4 Added 50m 3 ; Ret: 220m 3
F.O. Tank #5 Added 210m 3; Ret: 230 m 3
F.O. Tank #6 Added 340m 3; Ret: 402 m 3
M. Broughton
EXAMPLE: TESTING OF OIL WATER
SEPARATOR
21-JAN-2010 I Test operated OWS for USCG
Discharged processed water to bilge
From Bilge Holding Tank, Ret: 13.2 m 3
OWS overboard valves remained closed
and no water was processed overboard
Z.L. Hughes
EXAMPLE: ENTRY PERTAINING TO AN
EARLIER MISSED OPERATIONAL ENTRY
22-JAN-2011 I Entry pertaining to an earlier missed
(1) operational entry
24-JAN-2011 C 12 2.6 m3 from HFO Sludge Tk, Ret.: 0.1 m3
(2)
12.3 To no 1 Waste Oil Tk, Ret.: 9.1m3
Signed(1): M. Broughton
Signed(2): Z.L. Hughes

_John Cate_______
Signature of Master

16 | P a g e
EXAMPLES
Name of Ship M/V ALL SHIPS
Official Number 413567_________________

CARGO/BALLAST OPERATIONS (Oil Tanker) / MACHINERY


MACHINERY SPACESPACE OPERATIONS
OPERATIONS

Date Code Item Record of Operations/signature of officers in charge


EXAMPLE: PUMPING OILY BILGE WATER
FROM A CARGO HOLD BILGE HOLDING TANK
TO A TANK LISTED UNDER ITEM 3.3 IN
THE SUPPLEMENT TO THE IOPP CERTIFICATE
24-FEB-2013 I 10 m3 oily bilge water from Cargo Hold
bilge holding tank
To STBD Wash Water Tank
Z.L. Hughes
EXAMPLE: De-bunkering of Fuel oil
25-JUN-2013 I xxxx MT of ISO-xxxxx HFO x.x % S de-
bunkered from tanks:
xxxx MT removed from [Tank Name &
Designation] now
containing xxx MT
De-bunkered to Joes Shore facility in Port
of New Orleans, LA
Start 25-JUN-2013; 13:15
Stop 25-JUN-2013; 14:00
Z.L. Hughes

_John Cate_______
Signature of Master

17 | P a g e
IDENTIFICATION OF SHIP’S TANKS
Name of Ship____________________________________________________________

Official Number _________________________________________________________

Plan View of Engine Room Holding Tanks


(to be completed on board)
Identification of
Ship’s Tanks Capacity

ENGINE ROOM

18 | P a g e
OIL RECORD BOOK
PART II – Cargo / Ballast Operations
(Oil Tankers)

ADDITIONAL INSTRUCTIONS FOR OIL TANKERS

Each oil tanker of 150 gross tons and above or a non oil tanker that carries 200 cubic meters (m3) or more of oil in
bulk, shall also maintain an Oil Record Book Part II (Cargo/Ballast Operations) in addition to an Oil Record Book
Part I. 33 CFR 151.25 (a)

The following pages of this section show a comprehensive list of items of cargo and ballast operations which are,
when appropriate, to be recorded in the Oil Record Book Part II in accordance with regulation 36 of Annex I to
MARPOL 73/78 and implemented in 33 CFR 151.25. The items have been grouped into operational sections. each
of which is denoted by a code letter.

When making entries in the Oil Record Book Part II, the date, operational code and item number shall be inserted
in the appropriate columns and the required particulars shall be recorded chronologically in the blank spaces. Each
operation shall be fully recorded without delay so that all the entries in the book appropriate to that operation are
completed. Each operation should be dated in the dd-MONTH-yyyy format (e.g. 20- JAN-2011). Each
Completed operation shall be entered and signed by the officer/person or officers/persons in charge of the
operations concerned and each completed page shall be signed by the master of the ship.

Do not leave any full lines empty between successive entries.

In respect of the oil tankers engaged in specific trades in accordance with regulation 2.5 of Annex I of MARPOL
73/78, appropriate entry in the Oil Record Book Part II shall be endorsed by the competent port State authority.
(This sentence should only be inserted for the Oil Record Book of a tanker engaged in a specific trade.)

The Oil Record Book Part II contains many references to oil quantity. The limited accuracy of tank measurement
devices, temperature variations and c1ingage will affect the accuracy of these readings. The entries in the Oil
Record Book Part II should be considered accordingly. All quantities should be consistently recorded
throughout the Oil Record Book as cubic meters (m3), gallons (gals), or barrels (bbls).

In the event of accidental or other exceptional discharge of oil, a statement shall be made in the Oil Record Book
Part II of the circumstances of, and the reasons for, the discharge.

Any failure of the oil discharge monitoring and control system shall be noted in the Oil Record Book Part II.

The entries in the Oil Record Book Part II, for ships holding an IOPP Certificate, shall be in English.

The Oil Record Book Part II shall be kept in such a place as to be readily available for inspection at all reasonable
times and, except in the case of unmanned ships under tow, shall be kept on board the ship. It shall be preserved
for a period of three years after the last entry has been made.

The competent authority of the Government of a Party to the Convention may inspect the Oil Record Book Part II
on board the ship to which Annex I applies while the ship is in its port or offshore terminals and may make a copy
of any entry in that book and may require the master of the ship to certify that the copy is a true copy of such entry.
Any copy so made which has been certified by the master of the ship as a true copy of an entry in the Oil Record
Book Part II shall be made admissible in any juridical proceedings as evidence of the facts stated in the entry. The
inspection of an Oil Record Book Part II and taking of a certified copy by the competent authority under this
paragraph shall be performed as expeditiously as possible without causing the ship to be unduly delayed.

19 | P a g e
LIST OF ITEMS TO BE RECORDED
PART II – Cargo / Ballast Operations

(A) LOADING OF OIL CARGO


1. Place of loading.
2. Type of oil loaded and identity of tank(s).
3. Total quantity of oil loaded (state quantity added, in m3, gals., or bbls. at 15°C and the total
content of tank(s) in m3, gals., or bbls.).

(B) INTERNAL TRANSFER OF OIL CARGO DURING VOYAGE


4. Identity of tank(s)
.1 From:
.2 To: (state quantity transferred and total quantity of tank(s), in m3, gals., or bbls.).
5. Was (were) tank(s) in 4.1 emptied? (If not, state the quantity retained, in m3, gals., or bbls.).

(C) UNLOADING OF OIL CARGO


6. Place of unloading.
7. Identity of tank(s) unloaded.
8. Was (were) tank(s) emptied? (If not, state quantity retained, in m3, gals., or bbls.).

(D) CRUDE OIL WASHING (COW TANKERS ONLY)


(To be completed for each tank being crude oil washed)
9. Port where crude oil washing was carried out or ship's position if carried out between two
discharge ports.
10. Identity of tank(s) washed.1
11. Number of machines in use.
12. Time of start of washing.
13. Washing pattern employed.2
14. Washing line pressure.
15. Time washing was completed or stopped.
16. State method of establishing that tank(s) was (were) dry.
17. Remarks. 3

(E) BALLASTING OF CARGO TANKS


18. Position of ship at start and end of ballasting.
19. Ballasting process:
.1 Identity of tank(s) ballasted;
.2 Time of start and end;
.3 Quantity of ballast received. Indicate total quantity of ballast for each tank involved
in the operation in m3, gals., or bbls.

NOTES:
1
When an individual tank has more machines than can be operated simultaneously, as described in the Operations and
Equipment Manual, then the section being crude oil washed should be identified, e.g. No. 2 center, forward section.
2
In accordance with the Operations and Equipment Manual, enter whether single-stage or multi-stage method of washing is
employed. If multi-stage method is used, give the vertical arc covered by the machines and the number of times that arc is
covered for that particular stage of the program.
3
If the programs given in the Operations and Equipment Manual are not followed, give the reasons under Remarks.

20 | P a g e
(F) BALLASTING OF DEDICATED CLEAN BALLAST TANKS (CBT TANKERS ONLY)
20. Identity of tank(s) ballasted.
21. Position of ship when water intended for flushing, or port ballast was taken to dedicated
clean ballast tank(s).
22. Position of ship when pump(s) and lines are flushed to slop tank.
23. Quantity of oily water which, after line flushing, is transferred to the slop tank(s) or cargo
tank(s) in which slop is preliminarily stored (identify tank(s)). State the total quantity, in m3, gals., or bbls.
24. Position of ship when additional ballast water was taken into dedicated clean ballast tank(s).
25. Time and position of ship when valves separating the dedicated clean ballast tanks from
cargo and stripping lines were closed.
26. Quantity of clean ballast taken on board in m3, gals., or bbls.

(G) CLEANING OF CARGO TANKS


27. Identity of tank(s) cleaned.
28. Port or ship's position.
29. Duration of cleaning.
30. Method of cleaning.1
31. Tank washings transferred to:
.1 Reception facilities (state port and quantity, in m3, gals., or bbls.);2 and
.2 Slop tank(s) or cargo tank(s) designated as slop tank(s) (Identify tank(s); state
quantity transferred and total quantity, in m3, gals., or bbls.).

(H) DISCHARGE OF DIRTY BALLAST


32. Identity of tank(s).
33. Time and position of ship at start of discharge into the sea.
34. Time and position of ship on completion of discharge into the sea.
35. Quantity discharged into the sea, in m3, gals., or bbls.
36. Ship's speed(s) during discharge.
37. Was the discharge monitoring and control system in operation during the discharge?
38. Was a regular check kept on the effluent and the surface of the water in the locality of
the discharge?
39. Quantity of oily water transferred to slop tank(s) (identify slop tank(s); state total
quantity, in m3, gals., or bbls.).
40. Discharged to shore reception facilities (identify port and quantity
involved, in m3, gals., or bbls.).2

NOTES:
1
This includes hand hosing, machine washing and/or chemical cleaning. Where chemically cleaned, state the chemical
concerned and amount used.
2
Ships' masters should obtain from the operator of the reception facilities which include barges and tank trucks, a receipt
or certificate detailing the quantity of tank washings, dirty ballast, residues or oily mixtures transferred, together with the
time and date of the transfer. This receipt or certificate, if attached to the Oil Record Book Part II, may aid the master of
the ship in proving that this ship was not involved in an alleged pollution incident. The receipt or certificate should be kept
together with (I)
theDISCHARGE
Oil Record Book OFPart II.
WATER FROM SLOP TANKS INTO THE SEA
41. Identify slop tank(s).
42. Time of settling from last entry of residues, or
43. Time of settling from last discharge.
44. Time and position of ship at start of discharge.
45. Ullage of total contents at start of discharge.
46. Ullage of oil/water interface at start of discharge.
47. Bulk quantity discharged, in m3, gals., or bbls. and rate of discharge, in m3/hour, gal/hour, or bbl/hour.
48. Final quantity discharged, in m3, gals., or bbls. and rate of discharge, in m3/hour, gal/hour, or bbl/hour.
49. Time and position of ship on completion of discharge.
50. Was the discharge monitoring and control system in operation during the
discharge?
51. Ullage of oil/water interface on completion of discharge, in meters or feet.
52. Ship's speed(s) during discharge.
53. Was a regular check kept on the effluent and the surface of the water in the
21 | P a g e
locality of the discharge?
54. Confirm that all applicable valves in the ship's piping system have been closed
on completion of discharge from the slop tanks.

(J) COLLECTION, TRANSFER AND DISPOSAL OF RESIDUES AND OILY MIXTURES NOT
OTHERWISE DEALT WITH
55. Identity of tank(s).
56. Quantity transferred or disposed of from each tank. (State the quantity retained, in m3, gals., or bbls.).
57. Method of transfer or disposal:
.1 Disposal to reception facilities (identify port and quantity involved); (identify port and quantity
involved in m3, gals., or bbls.);1
.2 Mixed with cargo (Including transfer from machinery space oil residue (sludge) and oily bilge water
tanks (identify tank(s); state quantity transferred and total quantity in tank(s),) (state quantity in m3,
gals., or bbls.);
.3 Transferred to or from (an)other tank(s) including transfer from machinery space oil residue
(sludge) and oily bilge water tanks (identify tank(s); state quantity transferred and total quantity in
tank(s), in m3, gals., or bbl);
.4 Other method (state which); state quantity disposed of, in m3, gals., or bbls.

(K) DISCHARGE OF CLEAN BALLAST CONTAINED IN CARGO TANKS


58. Position of Ship at start of clean ballast.
59. Identity of tank(s) discharged.
60. Was (were) the tank(s) empty on completion?
61. Position of ship on completion if different from 58.
62. Was a regular check kept on the effluent and the surface of the water in the locality of the
discharge?

(L) DISCHARGE OF BALLAST FROM DEDICATED CLEAN BALLAST TANKS (CBT TANKERS
ONLY)

63. Identity of tank(s) discharged.


64. Time and position of ship at start of discharge of clean ballast into the sea.
65. Time and position of ship on completion of discharge into the sea.
66. Quantity discharged, in m3, gals., or bbls.:
.1 Into the sea; or
.2 To reception facility (identify port).1
67. Was there any indication of oil contamination of the ballast water before or during the discharge into
the sea?
68. Was the discharge monitored by an oil content meter?
69. Time and position of ship when valves separating dedicated clean ballast tanks from the cargo and
stripping lines were closed on completion of deballasting.

NOTES:
1
Ships' masters should obtain from the operator of the reception facilities which include barges and tank trucks, a receipt
or certificate detailing the quantity of tank washings, dirty ballast, residues or oily mixtures transferred, together with the
time and date of the transfer. This receipt or certificate, if attached to the Oil Record Book Part II, may aid the master of the
ship in proving that this ship was not involved in an alleged pollution incident. The receipt or certificate should be kept
together with the Oil Record Book Part II.

(M) CONDITION OF OIL DISCHARGE MONITORING AND CONTROL SYSTEM

70. Time of system failure.


71. Time when system has been made operational.
72. Reasons for failure.

(N) ACCIDENTAL OR OTHER EXCEPTIONAL DISCHARGES OF OIL

73. Time of occurrence.


74. Port or ship’s position at time of occurrence.

22 | P a g e
75. Approximate quantity, in m3, gals., or bbls., and type of oil.
76. Circumstances of discharge or escape, the reasons therefore and general remarks.

(O) ADDITIONAL OPERATIONAL PROCEDURES AND GENERAL REMARKS

ADDITIONAL CODES FOR TANKERS ENGAGED IN SPECIFIC TRADES

(P) LOADING OF BALLAST WATER

77. Identity of tank(s) ballasted.


78. Position of ship when ballasted.
79. Total quantity of ballast loaded in m3, gals., or bbls.
80. Remarks.

(Q) REALLOCATION OF BALLAST WATER WITHIN THE SHIP

81. Reasons for reallocation.

(R) BALLAST WATER DISCHARGE TO RECEPTION FACILITY


82. Port(s) where ballast water was discharged.
83. Name or designation of reception facility.
84. Total quantity of ballast water discharged in m3, gals., or bbls.
85. Date, signature and stamp of port authority official.

23 | P a g e
IDENTIFICATION OF SHIP’S TANKS
Name of Ship____________________________________________________________

Official Number _________________________________________________________

Plan View of Cargo and Slop Tanks


(to be completed on board)

Identification of
Ship’s Tanks Capacity

Depth of slop tank(s):

PUMP ROOM

(Give the capacity of each tank


and the depth of slop tank(s))

24 | P a g e
EXAMPLES
Name of Ship M/V OIL TANKER
Official Number 703393_________

CARGO/BALLAST
CARGO/BALLAST OPERATIONS
OPERATION (Oil Tanker) / MACHINERY SPACE OPERATIONS (All Ships)

Date Code Item Record of Operations/signature of officers in charge


EXAMPLE: LOADING CARGO
05-OCT-2009 A 1 Port Shaw, California
2 ANS Crude Oil: 1-5 C, 1-5 STBD, and 1-5 P
3 238 m 3 loaded, 1010 m 3 Total aboard.
N. Ely
EXAMPLE: INTERNAL TRANSFER OF CARGO
20-OCT-2009 B 4.1 2C
4.2 5C: 70 m 3 transferred, 127m 3 total
5 No, 158 m 3 retained in 2C
S. Williams
EXAMPLE: UNLOADING CARGO
03-NOV-2009 C 6 Port Pine ,Texas
7 1C, 3C, and 5C
8 Yes
T. Colton

Thomas Carroll________
Signature of Master

25 | P a g e
EXAMPLES
Name of Ship M/V OIL TANKER
Official Number 703393_________

CARGO/BALLAST OPERATIONS
CARGO/BALLAST (Oil Tanker) /
OPERATIONS MACHINERY SPACE PERATIONS

Date Code Item Record of Operations/signature of officers in charge


EXAMPLE: CRUDE OIL WASHING
18-NOV-2009 D 9 Shell NW, Anacortes, WA
10 1P
11 4
12 0815
13 Multi-Stage, Top Wash -40º-150º -40º
Bottom Wash -40º-0º -40º -0º
14 9.5 Bar
15 1115
16 Hermetic Hand Tape, Suction Loss, SAAB
17 None
S. Williams
EXAMPLE: BALLASTING OF CARGO TANKS
22-NOV-2009 E 18 Start: 49°56’ N x 30°00’W
Stop: 49°54’ N x 30°00’W
19.1 No. 3 C Cargo Tank
19.2 Start: 1600 Hrs, Stop: 1830 Hrs
19.3 3957m3, 3957m3
S. Keep
EXAMPLE: BALLASTING CLEAN BALLAST TKS
24-NOV-2009 F 20 #3 Port
21 49°56’ N x 30°00’W
22 49°54’ N x 30°00’W
23 STBD Slop Tank, 77 m3
24 49°53’ N x 30°00’W
25 1730 - 49°52’ N x 29°58’W
26 200 m3
S. Keep

_Thomas Carroll__________
Signature of Master

26 | P a g e
EXAMPLES
Name of Ship M/V OIL TANKER
Official Number 703393_________

CARGO/BALLAST OPERATIONS
CARGO/BALLAST (Oil Tanker) /
OPERATIONS MACHINERY SPACE PERATIONS

Date Code Item Record of Operations/signature of officers in charge


EXAMPLE: CLEANING CARGO TANKS
26-NOV-2009 G 27 No. 5 port
28 Rodeo, California
29 3 Hours (1300-1600)
30 Machine wash
31.2 No. 1 Slop Tank, 7.9 m 3
transferred,
87 m 3 total.
S. Bliss
EXAMPLE: DISCHARGE DIRTY BALLAST TO SEA
04-DEC-2009 H 32 3P
33 Start: 1330 - 49°52’ N x 29°58’W
34 Stop: 1530 - 49°53’ N x 30°00’W
35 3,625 m 3
36 14 Kts by GPS & ODME
37 Yes
38 Yes
39 321 m 3 to Port Slop Tank, Ret.: 826 m 3
S. Keep
EXAMPLE: DISCHARGE DIRTY BALLAST TO
RECEPTION FACILITY
10-DEC-2009 H 32 4S
40 TCR Texas City, TX, 4,529 m 3

S. Williams

_Thomas Carroll__________
Signature of Master

27 | P a g e
EXAMPLES
Name of Ship M/V OIL TANKER
Official Number 703393_________

CARGO/BALLAST OPERATIONS
CARGO/BALLAST (Oil Tanker) /
OPERATIONS MACHINERY SPACE PERATIONS

Date Cod Item Record of Operations/signature of officers in charge


e
EXAMPLE: DISCHARGE OF WATER FROM SLOP
15-DEC-2009 I 41 No. 2 Slop Tank
42 36 Hours
44 1330 - 49°52’ N x 29°58’W
45 7 feet
46 15 feet
47 87 m3 discharged at 6.813 m3/hour
48 97 m3 discharged at 2.271m 3/hour
49 1530 49°53’ N x 30°00’W
50 Yes
51 3.048 meters
52 22 knots
53 Yes
54 All piping secured.
J. Leigh
EXAMPLE: RESIDUE DISPOSAL
18-DEC-2009 J 55 # 1 Slop Tank
56 65m3, Ret.: O.Om3
57.1 Dave’s Oil Company, Rodeo, California, 65 m3
B. Cooley
EXAMPLE: OILY RESIDUES MIXED WITH CARGO
02-JAN-2010 J 55 From Engine Room No.1 Waste Oil Tank
56 12.0 m 3, Ret.: 0.0 m 3
57.2 To 3P, 12.0 m3, Ret.: 4,123.0 m 3
B. Cooley

_Thomas Carroll__________
Signature of Master

28 | P a g e
EXAMPLES
Name of Ship M/V OIL TANKER
Official Number 703393_________

CARGO/BALLAST OPERATIONS
CARGO/BALLAST (Oil Tanker) /
OPERATIONS MACHINERY SPACE PERATIONS

Date Code Item Record of Operations/signature of officers in charge


EXAMPLE: OILY RESIDUES TO PORT SLOP
TANK
08-JAN-2010 J 55 From Engine Room No.1 Waste Oil Tank
56 23.6 m 3, Ret.: 0.4 m 3
57.3 To Port Slop Tank, 23.6 m3, Ret.: 263.9 m 3
S. Williams
EXAMPLE: OILY RESIDUES TO BARGE
15-JAN-2010 J 55 From Port Slop Tank
56 263.6 m 3, Ret.: 0.3m 3
57.4 To Xiang Long Barge No.2, 263.6 m3
S. Williams
EXAMPLE: FAILURE OF ODME
18-JAN-2010 M 70 0830 Hrs
71 1045 Hrs
72 Loss of Power Supply
B. Cooley
EXAMPLE: ACCIDENTAL OR OTHER
EXCEPTIONAL DISCHARGE OF OIL
20-JAN-2010 N 73 2015 Hrs
74 TCR, Port Arthur, TX
75 1.5m3 IFO 380 Bunker Fuel
76 Incorrect alignment of loading arm with
manifold valve at start-up of fueling
operation. Corrected alignment, cleaned
area, and commenced fueling.
EXAMPLE: TEST OPERATION OF ODME
22-JAN-2010 O Performed Routine Testing of ODME
S. Williams

_Thomas Carroll__________
Signature of Master

29 | P a g e
Supplementary Information
LIST OF OILS*
(Appendix I to Annex I of MARPOL 73/78)

Asphalt Solutions: Gasoline Blending Stocks:


Blending stocks Alkylates - fuel
Roofers flux Reformates
Straight run residue Polymer - fuel

Oils: Gasolines:
Clarified Casinghead (natural)
Crude oil Automotive
Mixtures containing crude oil Aviation
Diesel oil Straight run
Fuel oil No. 4 Fuel oil No. 1 (kerosene)
Fuel oil No. 5 Fuel oil No. 1-D
Fuel oil No. 6 Fuel oil No. 2
Residual Fuel oil Fuel oil No. 2-D
Road oil
Transformer oil
Aromatic oil (excluding vegetable oil) Jet Fuels:
Lubricating oils and Blending stocks JP - 1 (kerosene)
Mineral oil JP-3
Motor oil JP-4
Penetrating oil JP - 5(kerosene, heavy)
Spindle oil Turbo fuel
Turbine oil Kerosene
Mineral Spirit

Distillates: Naptha:
Straight run Solvent
Flashed feed stocks Petroleum
Heartcut Distillate oil
Gas Oil:
Cracked

*This list of oils is not meant to be comprehensive, but suggest the most common types of oil carried.

COMMON METRIC AND UNITED STATES


LIQUID MEASURE CONVERSIONS

U.S. UNIT METRIC UNIT

1 gallon = 3.7854 liters or .003785 m3


1 barrel (42 gals.) = 158.98 liters or .15898 m3
0.26417 gallon = 1 liter
1 cubic foot = 0.028317 m3
35.315 cubic feet = 1 m3
Other Conversions
1 foot = 0.3048 m
2204 pounds = 1 ton [metric]

30 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

31 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

32 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

33 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

34 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

35 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

36 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

37 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

38 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

39 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

40 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

41 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

42 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

43 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

44 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________


Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

45 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

46 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

47 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

48 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

49 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

50 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

51 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

52 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

53 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

54 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

55 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

56 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

57 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

58 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

59 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

60 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

61 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

62 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

63 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

64 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

65 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

66 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

67 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

68 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

69 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

70 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

71 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

72 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

73 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

74 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________

Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

75 | P a g e
Name of Ship___________________________________________________________

Official Number _________________________________________________________

(Circle one)
CARGO / BALLAST OPERATIONS (Oil Tankers) / MACHINERY SPACE OPERATION (All Ships)

DATE CODE ITEM Record of operations/signature of officers in charge.

Master Signature: ___________________________________________________


Whoever in any matter within the jurisdiction of executive, legislative, or judicial branch of the Government of the U.S. knowingly and willfully
falsifies, conceals or covers up by any trick scheme or device a material fact, or makes any false, fictitious or fraudulent statement or
representation or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry
shall be fined under this title or imprisoned not more than 5 years or both (18 U.S.C. 1001).

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