Ballast Water Exchange Route Declaration Sheet
Ship Name
IMO Number
Flag State
Date
Voyage No.
Tank Name / No.
Capacity (m³)
Ballast Water On Board Before Exchange (m³)
Date & Time of Exchange
Latitude
Longitude
Ballast Water On Board After Exchange (m³)
Method Used (e.g. flow-through, dilution)
Remarks
Ballast Water Exchange Route Description
Additional Notes
Master's Name & Signature
Date