Port State Control Inspection Checklist

Vessel Information

Vessel Name IMO Number
Flag State Call Sign
Type of Vessel Gross Tonnage
Master Name Date of Inspection

Certificates and Documents

Item Available Valid Remarks
International Tonnage Certificate
International Load Line Certificate
Safety Management Certificate
International Oil Pollution Prevention Certificate
Minimum Safe Manning Document
Other

Safety Areas

Pollution Prevention

Crew and Operational

Deficiencies Observed

No. Description Action Taken
1
2
3
Master's Signature
Inspector's Signature