| No. | Item | Yes | No | Remarks |
|---|---|---|---|---|
| 1 | Are all relevant authorities notified? | |||
| 2 | Are waste reception arrangements agreed and documented? | |||
| 3 | Is appropriate PPE being used by all personnel? | |||
| 4 | Is communication between ship and shore established and tested? | |||
| 5 | Are emergency procedures agreed and understood? | |||
| 6 | Is reception equipment in good working order? | |||
| 7 | Spill response equipment available and accessible? | |||
| 8 | Is ship securely moored? |
| Ship's Representative | Shore Representative |
|---|---|
|
Name: Signature: Date: |
Name: Signature: Date: |