Annex 1 - Company Standard Forms Checklists Logs and Posters
Annex 1 - Company Standard Forms Checklists Logs and Posters
Annex 1 - Company Standard Forms Checklists Logs and Posters
Company's Standard
Forms, Checklists,
Logs and Posters
*For Shipboard Use
Rev. 10
01-Jan-2020
INDEX
PAGE
SECTION 1 1
SECTION 2 2
SECTION 3 3
SECTION 4 4
SECTION 5 6
SECTION 6 8
- BULK CARRIER 9
- BUNKER 10
- CHEMICAL TANKER 11
- CONTAINER 13
- GAS TANKER 14
- LNG CARRIER 16
- OIL TANKER 18
SECTION 7 20
SECTION 8 21
SECTION 9 22
SECTION 10 24
SECTION 11 27
SECTION 12 28
SECTION 13 29
Rev. 10
01-Jan-2020
SECTION 1
Rev. 10
Page 1 01-Jan-2020
SECTION 2
S-2.6 F Store List (For Custom Purpose) Rev.0 07/18 Paper / PARIS
S-2.9 F Authority sign B/L on behalf of Master Rev.0 07/18 Paper / PARIS
S-2.13 F LO and Marine pollutant storage facility plan Rev.0 07/18 Paper / PARIS
Rev. 10
Page 2 01-Jan-2020
SECTION 3
S-3.1 L Training Log for Chief Officer to Master Rev.1 01/20 Paper / PARIS
S-3.2 L Training Log for Second Officer to Chief officer Rev.1 01/20 Paper / PARIS
S-3.3 L Training Log for Third Officer to Second Officer Rev.1 01/20 Paper / PARIS
S-3.8 F Sea Service Testimonial for Engineer Officers Rev.0 07/18 Paper / PARIS
S-3.15c C New joining Deck Officers' bridge familiarisation Rev.0 07/18 Paper / PARIS
Rev. 10
Page 3 01-Jan-2020
SECTION 4
S-4.9 L Chief Engineer's Night Order book Rev.0 07/18 Log Book
S-4.12 L Daily Dry docking Safety Meeting Rev.0 07/18 Paper / PARIS
Rev. 10
Page 4 01-Jan-2020
SECTION 4
S-4.23 C Checks Prior Departure From Dry-Dock Rev.1 01/20 Paper / PARIS
Rev. 10
Page 5 01-Jan-2020
SECTION 5
S- 5.1 C Bridge Daily tests & checks Rev.0 07/18 Paper / PARIS
S- 5.7 C Preparation for Arrival/ Departure in Port Rev.1 01/20 Paper / PARIS
S- 5.15 F Master's Self Nav Audit Cover Sheet Rev.1 04/19 Paper / PARIS
Rev. 10
Page 6 01-Jan-2020
SECTION 5
S-5.31 L VHF Log (Only for NIS Flag Vessel) Rev.0 07/18 Log Book
S-5.32 L Radar Log (Only for NIS Flag Vessel) Rev.0 07/18 Log Book
Additional
Required Boarding Arrangements for Pilot Rev.0 07/18 Poster
(P)
Additional
Wheelhouse Poster Rev.0 07/18 Poster
(P)
Rev. 10
Page 7 01-Jan-2020
SECTION 6
S-6A.6 L Mooring System Management Plan (MSMP) Rev.0 01/20 Paper / PARIS
Rev. 10
Page 8 01-Jan-2020
SECTION 6 - BULK CARRIER
S - 6BC.3 F Maintenance Manual for Hatch covers Rev.0 07/18 Paper / PARIS
S - 6BC.4 C Bulk Carrier ship-shore Safety checklist Rev.0 07/18 Paper / PARIS
S - 6BC.6 F Cargo hold Gas, Bilge and ventilation records Rev.0 07/18 Excel / PARIS
Rev. 10
Page 9 01-Jan-2020
SECTION 6 - BUNKER
BOT 6D Barge / Launch to Ship - Packed Products Rev.0 05/19 Paper / PARIS
BOT 6L Gas Detection Equipments - Calibration Record Rev.0 05/19 Paper / PARIS
Rev. 10
Page 10 01-Jan-2020
SECTION 6 - CHEMICAL TANKER
No. Forms Revision Source
S-6CT.1a C Addendum to Cargo Transfer Checklist - P.O. Rev.0 07/18 Paper / PARIS
S-6CT.13 L Cargo Sample Retention & Disposal Log Rev.0 07/18 Log Book
S-6CT.17 C Checklist for Use of Portable pump Rev.0 07/18 Paper / PARIS
Rev. 10
Page 11 01-Jan-2020
SECTION 6 - CHEMICAL TANKER
No. Forms Revision Source
S-6CT.27 C Comparision Record of Compound Pressure Gauges Rev.0 07/18 Paper / PARIS
S-6CT.29b C Cargo Tank Entry Permit for Chemical Tanker Rev.0 07/18 Paper / PARIS
Rev. 10
Page 12 01-Jan-2020
SECTION 6 - CONTAINER
Rev. 10
Page 13 01-Jan-2020
SECTION 6 - GAS TANKER
No. Forms Revision Source
S-G-6.5 F Ship/Shore Information Exchange (Key Meeting) Rev.0 02/19 Paper / PARIS
S-G-6.11a F Ullage Sheet - Gas Calculations (before Loading) Rev.0 02/19 Excel / PARIS
S-G-6.11b F Ullage Sheet - Gas Calculations (after Loading) Rev.0 02/19 Excel / PARIS
S-G-6.13 F Calculation Sheet for Cargo & Stability Rev.0 02/19 Excel / PARIS
S-G-6.15 L LPG Log (Daily Records) Rev.0 02/19 Excel / Log Book
S-G-6.18a F Ship Specific Cargo Equipment Training for Officers Rev.0 02/19 Paper / PARIS
Rev. 10
Page 14 01-Jan-2020
SECTION 6 - GAS TANKER
No. Forms Revision Source
S-G-6.18b F Ship Specific Cargo Equipment Training for Ratings Rev.0 02/19 Paper / PARIS
S-G-6.19 F Cargo Lines - Record of Pressure testing Rev.0 02/19 Paper / PARIS
S-G-6.20 F Cargo Hoses - Record of Pressure testing Rev.0 02/19 Paper / PARIS
S-G-6.24 F Toxic Gas Detector - Record of Inspection Rev.0 02/19 Paper / PARIS
S-G-6.25 F Toxic Gas Detector Tubes - Monthly Inventory Rev.0 02/19 Paper / PARIS
S-G-6.26 F Cargo Tank Level Gauges - Record of comparison Rev.0 02/19 Paper / PARIS
S-G-6.27 F Cargo Pressure Gauges - Record of comparison Rev.0 02/19 Paper / PARIS
S-G-6.28 F Cargo Temperature Gauges - Record of comparison Rev.0 02/19 Paper / PARIS
S-G-6.29 F Emergency Shut-down system - Record of testing Rev.0 02/19 Paper / PARIS
S-G-6.30a F Cargo Tank level alarms - Record of testing Rev.0 02/19 Paper / PARIS
S-G-6.32b F Hold Space HL Alarm - Record of testing Rev.0 02/19 Paper / PARIS
S-G-6.34 F IG Line Non-return valve - Record of Inspection Rev.0 02/19 Paper / PARIS
Rev. 10
Page 15 01-Jan-2020
SECTION 6 - LNG CARRIER
No. Forms Revision Source
S-LNG-6.1 C Pre-arrival Checklist for LNG Carrier Rev.0 07/18 Paper / PARIS
S-LNG-6.2 C Ship/Shore Safety Checklist for LNG Carrier Rev.0 07/18 Paper / PARIS
S-LNG-6.4 C Ship to Ship Transfer Checklist for LNG Carrier Rev.0 07/18 Paper / PARIS
S-LNG-6.5 F Ship/Shore Information Exchange for LNG Carrier Rev.0 07/18 Excel / PARIS
S-LNG-6.6 C Pre-departure Checklist for LNG Carrier Rev.0 07/18 Paper / PARIS
S-LNG-6.7 C Cargo Watch Change-over Checklist for LNG Carrier Rev.0 07/18 Paper / PARIS
S-LNG-6.8 F Cargo Operation Plan for LNG Carrier Rev.0 07/18 Excel / PARIS
S-LNG-6.9 F Cargo Plan Bar Diagram for LNG Carrier Rev.0 07/18 Excel / PARIS
S-LNG-6.11 L Calculation Sheet - Cargo & Stability for LNG Carrier Rev.0 07/18 Excel / PARIS
S-LNG-6.15 L Daily Log for LNG Carrier Rev.0 07/18 Excel / PARIS
S-LNG-6.17 F Gas-freeing/Gassing-up Plan for LNG Carrier Rev.0 07/18 Excel / PARIS
Rev. 10
Page 16 01-Jan-2020
SECTION 6 - LNG CARRIER
No. Forms Revision Source
S-LNG-6.25 F Toxic Gas Detector Tube - Monthly Inventory Rev.0 07/18 Paper / PARIS
S-LNG-6.33 F Hold Space on LNG Carrier- Inspection Report Rev.0 07/18 Paper / PARIS
S-LNG-6.36 F IG & N2 Line Non-return Valve - Inspection Record Rev.0 07/18 Paper / PARIS
Rev. 10
Page 17 01-Jan-2020
SECTION 6 - OIL TANKER
No. Forms Revision Source
S-6OT.2 L Cargo Sample retention & Disposal log Rev.0 07/18 Log Book
S-6OT.8 F Last Cargo & Tank Cleaning Procedure Rev.0 07/18 Paper / PARIS
S-6OT.15 F Inspection Record of Portable Cargo Pump Rev.0 07/18 Paper / PARIS
S-6OT.18 F Megger Test of Tank Cleaning Hoses Rev.0 07/18 Paper / PARIS
S-6OT.20 C Calibration Record for Combustible Gas Indicator Rev.0 07/18 Paper / PARIS
S-6OT.22 C Calibration Record for Tank Scope Rev.0 07/18 Paper / PARIS
Rev. 10
Page 18 01-Jan-2020
SECTION 6 - OIL TANKER
No. Forms Revision Source
S-6OT.25 F Calibration Record for Mussasino Temp Rev.0 07/18 Paper / PARIS
S-6OT.30 C Crude oil washing checklists (Oil Tankers) Rev.0 07/18 Paper / PARIS
S-6OT.31 F Crude oil washing records (Oil Tankers) Rev.0 07/18 Paper / PARIS
Rev. 10
Page 19 01-Jan-2020
SECTION 7
S-7.5 F Chief Officer Hand Over Notes Rev.0 07/18 Paper / PARIS
S-7.6 F Second Officer Hand Over Notes Rev.1 01/20 Paper / PARIS
S-7.7 F Third Officer Hand Over Notes Rev.0 07/18 Paper / PARIS
S-7.8 F Chief Engineer Hand Over Notes Rev.0 07/18 Paper / PARIS
S-7.9 F Second Engineer Hand Over Notes Rev.0 07/18 Paper / PARIS
S-7.10 F Third Engineer Hand Over Notes Rev.0 07/18 Paper / PARIS
S-7.11 F Fourth Engineer Hand Over Notes Rev.0 07/18 Paper / PARIS
Rev. 10
Page 20 01-Jan-2020
SECTION 8
S-8.1 F Incident/ Near Miss Report form Rev.0 07/18 Paper / PARIS
Rev. 10
Page 21 01-Jan-2020
SECTION 9
S-9.1 F Safety Committee Meeting & QHSE Review Rev.3 01/20 Paper / PARIS
S-9.2 C Checklist for Entry into Enclosed Spaces Rev.1 01/20 Paper / PARIS
S-9.6 C Permit for Working Aloft or Outboard Rev.1 01/20 Paper / PARIS
S-9.9 C Checklist for Painting inside Enclosed Spaces Rev.0 07/18 Paper / PARIS
S-9.10 C Checklist for Office Permission for Hotwork Rev.0 07/18 Paper / PARIS
S-9.12 C (1-7) Housekeeping and Safety Checklist Rev.1 01/20 Paper / PARIS
S-9.16 L Control of Enclosed Space Entry Permists Rev.0 07/18 Log Book
S-9.19 C Occupational Health and Safety Inspection Rev.0 07/18 Paper / PARIS
Rev. 10
Page 22 01-Jan-2020
SECTION 9
Rev. 10
Page 23 01-Jan-2020
SECTION 10
No. Forms Revision Source
S-10.13a L Garbage Disposal Record Book - Part 1 Rev.0 07/18 Log Book
S-10.13b L Garbage Disposal Record Book - Part 2 Rev.0 07/18 Log Book
S-10.14 L Marine Fuel Sulphur Record Book Rev.1 02/19 Log Book
S-10.15 L SOx Compliance Guide in SECA area Rev.1 02/19 Log Book
Rev. 10
Page 24 01-Jan-2020
SECTION 10
No. Forms Revision Source
Rev. 10
Page 25 01-Jan-2020
SECTION 10
No. Forms Revision Source
Rev. 10
Page 26 01-Jan-2020
SECTION 11
Rev. 10
Page 27 01-Jan-2020
SECTION 12
S-12.2 C ISM Internal Audit Checklist - General Rev.0 07/18 Excel / PARIS
S-12.3 F ISM Internal Audit Report - General Rev.1 04/19 Paper / PARIS
S-12.4 C ISM Internal Audit Checklist - EMS Rev.0 07/18 Excel / PARIS
S-12.5 F ISM Internal Audit Report - EMS Rev.1 04/19 Paper / PARIS
S-12.8 C ISM Internal Audit Checklist - Navigation Rev.1 01/20 Excel / PARIS
S-12.9 F ISM Internal Audit Report - Navigation Rev.1 04/19 Paper / PARIS
Rev. 10
Page 28 01-Jan-2020
SECTION 13
No. Forms Revision Source
S-13.2 C MST Safety and Security Familiarization Rev.0 07/18 Paper / PARIS
S-13.3 C Weapon Testing Checklist & Permit Rev.0 07/18 Paper / PARIS
S-13.4 C Security Preparation and Access Control Rev.0 07/18 Paper / PARIS
Rev. 10
Page 29 01-Jan-2020
SECTION 13
No. Forms Revision Source
SCSF 02B Record of Cyber Security Familiarization Rev.0 08/18 Paper / PARIS
Rev. 10
Page 30 01-Jan-2020