Port State Control Ballast Water Inspection Checklist

Vessel Information
Vessel Name:
IMO Number:
Flag State:
Port of Inspection:
Date of Inspection:
Inspector Name:
Documents Checked
No. Document Available Remarks
1 International Ballast Water Management Certificate (IBWMC)
2 Ballast Water Management Plan
3 Ballast Water Record Book
4 Type Approval Certificate (for BWMS)
On Board Checks
No. Item Compliant Remarks
1 Ballast Water Exchange / Treatment System Operable
2 Ballast Water Sampling Point Accessible
3 Records Filled as per Convention
4 Crew Familiar with BWM Procedures
Observations / Deficiencies
Observation / Deficiency Action Required
Additional Notes
Inspector Signature
Master/Officer Signature