CARGO DAMAGE REPORT

(Standard Form of MITSUI O.S.K.LINES, LTD.)

Name of Vessel: MV / SS __________

Date of Report: __________

Voyage No.: __________ out home

At port: __________

Name of Master: __________

Name of Owner: __________

Name of Owners P & I Club: _________

1.

B/L No. (S/O No.):

2. Marks and Numbers:

3.

Kind and Amount of Cargo:

4. Quantity of Damaged Cargo:

5.

Port of Loading:

6. Port of Discharge:

7.

Shipper:

8. Consignee:

9.

Stowage:

10.

Kind of Damage:

11.

Exception at Loading:

12.

Exception at Discharging:

13.

Name of Chief Officer:

Name of Responsible Officer:

14.

Date of Note of Protest:

Name of Port where the above is taken:

15.

Name of Surveyor (If Appointed):

16.

Name of Witness (If Any):

17.

Extent of Damage:

18.

Cause of Damage:

19.

Disposition of Damage:

20.

Remarks (Masters Opinion):

Signed _________________
Master

Note
1.

2.
3.
4.

This Report is requested to send us when Cargo was damaged in the following cases:
a. Damage to Valuable cargo
b. Damage to Refrigerated cargo
c. Pilferage of cargo
d. Damage caused by improper stowage
e. Damage caused while cargo working
f. Large amount of shortland
g. Other important damage to cargo
For items 17, 18, 19, 20:
Please report details of damage using free form paper with Explanation drawing if needed.
Exception means Remarks on Mates Receipt or Bill of Lading
Send one Original and one copy to our cargo superintending team as soon as possible.

Created by A. CHALID PASYAH, M.Pd. Dip.Tesl.

STEVEDORE DAMAGE CERTIFICATE

M.V.: _________________

DATE:

_________________

PORT: _________________

VOY.NO.: _________________

We certify that the following damage(s) has / have been done to the vessel during
loading / discharging by the stevedores:
DATE: _________________

TIME: _________________

STEVEDORE COMPANY: ___________________________________________

FOREMAN / MAN IN CHARGE: _______________________________________
DISCHARGING METHODS: SHIPS CRANES WITH NET.
DESCRIPTIONS:

DECK HAND RAIL PIPES & STANCHION DAMAGE, HIT BY SHIPS

NO.4 CRANE DURING DISCHARGING FROM HOLD NO.5.

LOCATION, EXTENT, DETAILS OF DAMAGE, ETC.:

DECK HAND RAIL BESIDE HATCH NO.1 PORTSIDE
AA. Portside handrail stanchion in way of No.5 Hold (Pilot Access Point) was bent badly.
Stanchion is made of solid steel of about 18 mm thickness, 65 mm width and 100
cm height.
BB. Portside handrail in way of No.5 Hold (Pilot Access Point) was broken and
detached. G.I. pipe has diameter of about 35 mm and extended length of damage
is about 2.40 meters including Pilot Access Door.
CC. Portside steel handrail below G.I. pipe rail in way of No.5 Hold (Pilot Access Point)
was detached.

Secondary rails are made of round solid steel of about 20 mm

diameter, and extended length of damage is about 2.40 meters including Pilot
Access Door.

CAUSE OF DAMAGE: Carelessness of ships crane operator during discharging cargo.

REMARKS: Damage to be repaired and installed in proper position prior to the ships
leaving port.

_______________
MASTER

________________
STEVEDORES
_____________________
CHARTERERS AGENT /
REPRESENTATIVE

Created by A. CHALID PASYAH, M.Pd. Dip.Tesl.

REPORT OF DAMAGED VALVE

Dear sir,
SUBJECT: DAMAGED TO THE VALVE SEAT RING
We regret to inform you that the following deficiency and damage to the valve was
found and would like to deliver an order of the spare part attached herewith for
running repair.
The detail of damage and precautions taken are reported as follow:
(1). Date

: 15 October 2001

(2). Place

: At Bontang during Loading Operation

(3). Description

: Level of Ballast Water of the A.P.T. lowered in spite of

the valve kept closed position.

(4). Investigation

: On 17 October, the valve was checked after piping

disconnection then it was found that the seat ring got
turned up with small cut damage.

(5). Treatment

: the seat ring was restored in original position then

piping was connected without replacement due to
having

no spare part. The test of open and shut

were carried out with confirmation of airtight.

(6). Countermeasure

: To prevent air-sucking by Ballast Pump, the valve is kept

in closed position until the seat ring is received.

Your attention to the above mentioned would be highly appreciated.

Yours Sincerely,

______________
Master of MV..

Created by A. CHALID PASYAH, M.Pd. Dip.Tesl.