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    PSC PDF

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    igortfernandes

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    PSC PDF

    Uploaded by

    igortfernandes
    4 views1 page

    Original Title

    PSC.pdf

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    Copyright:

    © All Rights Reserved
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    4 views1 page

    PSC PDF

    Uploaded by

    igortfernandes

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    on Port State Control

    Memorandum
    FORMA Ragctort
    REPORT OF INSPECTION IN ACCORDANCE WTH THE RIYADH MEMORANDUM OF
    UNDERSTANDTNG ON PORT STATE CONTROLI)
    (rrportlng AuthorltylDtstict;
    (addrers) ffi'"["%""
    (telephone) -
    (tclchx) lf ship iB doteincd, ffi?
    ["i-trJ* orsenizarion, if
    \ +
    e ppt i cabt e

    {l .^
    ott Namc ot shtp. YlV..L..nn I 0/ Reporttns authortty or. . SA9. lNi..ABAB ifs.. ..

    o? Typc ol strlp.....B.V.LK... 1ll Place ol lnspcctlon........


    03I Flag of shlp....... 12/ Deaduuelght (where
    0'U IMO numbcr...... 131 Classilicatlon soclety......
    051 Gall s19n........... l4l Year of bu||d........... r
    061Gross
    0TtGompanl.(

    OE T IMO Company Nbr'


    o9l comp*y#rcc" -
    , .'.PP.:I.:...Q
    l8l Name and slgnaturc of mastcr to certlfy that the lnlomaUon under 07 ls corec A n
    Namc.......... ...{1mm.y....&e}RF.5
    I
    S[naturc............. ,{5,1

    Survevino Authoritv /
    Title Date of exoirv
    RO
    SafeCon
    SafeEqu
    SafeRad
    SafeCargo
    SafePass
    LL
    IOPP
    IAPP
    DOC
    sMc
    :::ii I$:: L_w;kirr*
    lssc,.
    csR flq

    191 expanded inspection o Eyes


    201dellclencies o Syes (see attrached FORM B)
    21t shlp detained o tryes
    22/rdo any detainable deficiencies meet the criteria for Class
    o Elyes
    23t o flye6
    21 ,

    Name
    Signature

    TDrs ,€port must Do lbr e perlod of gggggg .nd must be .vrl,,,ile fd consun don by Poft San€ ConD!, Or,rce,ls et .ll tlmes.

    rtion report has been issued sobly for the pupose of inbrmirB the master and othar port States that an inspection by the port State,
    in the heading, hes taken plrc. This inspeclirn r€port €nnot b€ construed as a soavrorthiness oertificate in exoass of the certificstes
    is rcquircd to cary.
    ship omers, operators and/o Cornpeny arc advisod ftat detailed infurmatixr m a detendon may be subiect to publication
    3 To be cornpleted in the errent of a d€tontbn.
    4 To be fified up and duly silned ody in cse d blbwed up impedim (s) by oilnr (s) Rltlbu PSCO's.

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