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ZODIAC MARITIME AGENCIES LTD.

BUNKER CHECKLIST #6

Issue Date Approved

: 002 : 17-11-98 : MJR

As required by 33CFR 156.150 (United States Code of Federal Regulations) a Declaration of Inspection Form must be completed and available for inspection. Vessel Name _______________________ Berth or Location ___________________ Barge Name / Supplier __________________________ Date ________________________________________

DECLARATION OF INSPECTION 01 02 03 04 05 06 07 08 09 Vessels Mooring strong enough for weather / current / surge etc. Transfer hoses or arms long enough to allow vessel to move within moorings without causing strain Hoses supported to prevent kinks or other damage All bunker valves set up correctly to allow transfer All part of bunker system not used closed, shut off or blanked. Any overboard discharge or suction connected to the bunker or fuel system is sealed or lashed and locked in the closed position. Transfer hoses have no damage, loose covers, kinks, or soft spots. All scuppers or other drains are plugged or closed All connections in the transfer system are leak free

Initials

______ ______ ______ ______ ______ ______ ______ ______

Signatures Chief Engineer ___________________________ ___________________ Title Name (PRINT)____________________________ Suppliers representative

___________________________

Name (PRINT) __________________________

Date / Time ______________________________

Date / Time _____________________________

Page Complete checklist and make entry n deck log book

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