Ballast Water Management Inspection Report

1. Vessel Details

Vessel Name IMO Number Flag State Port of Inspection Date of Inspection Inspector Name

2. Documents Review

Document	Available	Comments
International Ballast Water Management Certificate
Ballast Water Record Book
Ballast Water Management Plan

3. Shipboard Procedures & Equipment

Ballast Water Treatment System Type Location of System Operational Condition Comments

4. Ballast Water Operations

Tank	Capacity	BWM Method Used	Last Operation Date	Sampled

5. Deficiencies / Observations

Details

6. Inspector’s Summary

Summary

Inspector’s Signature	Date