| Vessel Name | IMO Number | ||
|---|---|---|---|
| Flag State | Call Sign | ||
| Type of Vessel | Gross Tonnage | ||
| Master Name | Date of Inspection |
| Item | Available | Valid | Remarks |
|---|---|---|---|
| International Tonnage Certificate | |||
| International Load Line Certificate | |||
| Safety Management Certificate | |||
| International Oil Pollution Prevention Certificate | |||
| Minimum Safe Manning Document | |||
| Other |
| No. | Description | Action Taken |
|---|---|---|
| 1 | ||
| 2 | ||
| 3 |