MARPOL Port Reception Facility Feedback Form
Name of Ship
IMO Number
Ship's Nationality
Port
Date of Use
Shipping Company
Type(s) of Waste Discharged
Annex I (Oily Waste)
Annex II (Noxious Liquid Substances)
Annex III (Harmful Substances in Packaged Form)
Annex IV (Sewage)
Annex V (Garbage)
Annex VI (Air Pollution Related Waste)
Quality of Reception Facility Services
Excellent
Good
Average
Poor
Very Poor
Was there any delay experienced? If yes, please specify.
Were there any problems encountered?
Suggestions for Improvement
Contact Person
Email (Optional)