MARPOL Compliance Waste Disposal Form
Ship Name
IMO Number
Voyage Number
Port of Disposal
Date of Disposal
Time of Disposal
Waste Details
Type of Waste
Garbage
Oily Residue / Sludge
Sewage
Cargo Residue
Others
Quantity (m³ or kg)
Reception Facility Name
Reception Facility Signature
Confirmation
Ship’s Officer Name
Ship’s Officer Rank
Ship’s Officer Signature
Date
Remarks