Ballast Water Exchange Report
Vessel Information
Vessel Name
IMO Number
Flag State
Voyage Number
Date
Master's Name
Ballast Water Exchange Details
Ballast Water Tank(s)
Method of Exchange
Empty-Refill
Flow Through
Other
Volume Exchanged (m³)
Exchange Location (Lat/Long)
Start Date & Time
End Date & Time
Water Depth (m)
Distance from Nearest Land (nm)
Remarks
Officer Signature
Name
Rank
Date
Signature