DAMAGE REPORT

Form Code

LF-D 033

Revision

01/2012

Page

1 of 1

DAMAGE REPORT
Vessels Name:
ARYALOKA, TB.
At:
Sei Pitung
Damage To:

Date:
29 Desember 2015
Damaged On:
Lampu penerangan kamar mesin
Cause Of Damage:
Afkir

Vessel stopped due to damage? *Yes / No

Period: From:

Repaired: * Yes / No

Repairs carried out: * Permanently / Temporarily

Repairs Required:
Port

By: * Shore / Crew

* Urgently

* Next

Spares Required:
Item
1. Kap Waterproof Lampu TL 18 Watt

hrs To:

* Within 3 months

hrs

* Next Dry-Dock

Qty
2 set

Details of Damage:
Kap waterproof 2 pcs di kamar mesin sudah
rusak dan di kapal tidak ada spare
Sketch or illustration:
<no photo available>
Probable Cause of Damage:
Remarks:(For Official Use Only)

LF-D 033 / Dec 2012

Written By : SK

Approved By : VP / DPA

Retention period: 1 year