Escolar Documentos
Profissional Documentos
Cultura Documentos
5. Approval Status
CSM-Cargo Securing Manual Approval Approved on 15 Jan 2015
FCP-Fire Control Plan Approval Approved on 20 Apr 2016
SOP-SOPEP Approval Approved on 15 Jan 2015
SSP-Ship Security Plan Approved on 14 Nov 2014
TSB-Trim And Stability Booklet Approval Approved on 15 Jan 2015
6. Outstanding Recommendations
Remarks Code Date Posted Due Date
The Emergency Fire Pump to be permanent connected to the Main Fire Line thru a hard pipe. 28 Oct 2017 Next Dry Dock
7. Memoranda
* Outstanding Recommendations shall be rectified before the due date. Otherwise certificates become invalid.
** Docking survey shall be twice in any five-year period and the period between subsequent surveys not exceeding 3 years. One of
the docking survey shall coincide with the special survey.
*** Survey Status provisionally assigned until all reviews of Assignment reports completed.
1. Do the Ship Security Plan and its amendments have been approved by the
Administration?
2. Does the vessel have a valid Continuous Synopsis Record issued by the Flag State
Administration?
3. Does the information of the current valid Continuous Synopsis Record is as per the
characteristics and documentation of the vessel?
4. Does the SSP and records are kept in the working language(s) of the crew?
5 Does the SSP and records are translated to English, Spanish or French language (if
applicable)?
6. Do the records kept in electronic format are protected by procedures aimed at
preventing their unauthorized deletion, destruction or amendment? (if applicable)
7. Do the records (including SSP) are protected from unauthorized access or
disclosure?
8. Does the vessel have an Automatic Identification System (AIS) installed onboard?
If Yes:
Description: RAY MARINE; AIS-950
Approval Info:
Authority/Agency: RIVERSIDE MARINE ELECTRONICS.
9. Does the vessel have a Ship Security Alert System (SSA) capable of being activated
from the navigation bridge and at least one another location?
If Yes:
Description: SAILOR; 6006.
Approval Info:
Authority/Agency: RIVERSIDE MARINE ELECTRONICS.
F-ISS-04c
10. Are only the authorized persons as per the SSP aware of the locations of the
activation points of the SSAS?
Note: - Perform oral interviews with Master, CSO, SSO and a representative part of
the crew. Results of the interview to be detailed in Narrative Report.
11. Do the security system and associated security and surveillance equipments is
located and displayed as per the approved SSP?
12. Do the security system and associated security and surveillance equipments comply
with statutory and manufacturer requirements?
13. Does a representative sample of security and surveillance equipment is operational
and is fit for the service for which it was intended?
14. Does the 24 hours contact information of the CSO is available onboard?
Name: JACOB CHEMALI Phone:
Fax: -- Mobile: (786) 597-7662
E-mail: ediaz0614@gmail.com
15. Does the SSO is identified in the ship security structure?
Name: DORE MARQUEZ Rank: CHIEF MATE
16. Is the Ship Security Officer Certificate endorsed by Administration?
Notes: - Copy of SSO Certificate endorsed by administration should be enclosed to
this report; Refer to Resolution MSC.203 (81) & STCW Ch. VI.5.2.
17. Has the Company Security Officer been recognized by Administration?
18. Do the CSO and SSO have the training and experience to perform their duties and
responsibilities (training certificate for their positions)?
Note: - Copies of CSO/SSO training certificates should be enclosed to this report.
19. Are the Master and SSO aware of their responsibilities and duties regarding the
ISPS Code and the SSP?
Note: - Perform oral interviews with Master and SSO. Results of the interview to be
detailed in Narrative Report.
20. Does the Company have ensured that the CSO, SSO and the Master are given the
necessary support to fulfill their duties and responsibilities in accordance with
SOLAS Chapter XI-2 and the ISPS Code?
Note: - Perform oral interviews with Master, CSO, SSO and a representative part of
the crew. Results of the interview to be detailed in Narrative Report.
21. Do the crew is aware of their responsibilities regarding the security management
system of the ship?
Note: - Perform oral interviews with a representative part of the crew. Results of
the interview to be detailed in Narrative Report.
B. FOR INITIAL SURVEYS (N/A)
22. Are there evidences demonstrating that the security management system has been in
operation on board for at least two months from the date the Ship Security Plan was
received on board from the CSO?
C. FOR INITIAL, INTERMEDIATE AND RENEWAL SURVEY
23. Does the ship keep records on board of training, drills and exercises, for the
minimum period specified by the Administration?
Note: - Copy of records carried out during the last year should be enclosed to this
report.
24. Do the drills and exercises have been carried out as per the requirements of ISPS
Code B/13.6? (25 percent of the ships personnel has been changed, at any one time,
F-ISS-04c
with personnel that has not previously participated in any drill on that ship,
within the last 3 months, a drill should be conducted within one week of the
change)
Note: - For Initial Verifications, at least one drill / exercise should be carried out.
Results should be enclosed to this report.
25. Does the ship have an annual schedule for the security drills and exercises?
Notes: - Copy of current valid schedule should be enclosed to this report.
- If schedule is part of SSP, verify that changes have been previously
approved by the Administration.
26. Do the security equipment (including the SSAS) have had the appropriated
maintenance, calibration and testing as per statutory and manufacturer
requirements? Do the records are kept for the minimum period specified by the
Administration?
Note: - Security equipment manufacturers manuals should be onboard as part of
ships documentation. Availability of this documentation should be
described in Narrative Report.
27. Do all Restricted Areas are clearly marked indicating that access to the area is
restricted and that unauthorized presence within the area constitutes a breach
of security?
28. Does the ship have issued any Declaration of Security (DoS) when interfacing port
facilities or other ships with higher security level or without a certified security
management system? Do all DoS were signed and accepted by Port Facility
Security Officer (PFSO)?
Note: - Copy of DoS issued during the last year should be enclosed to this report.
29. Does the company have provided to the Master the information required by
Regulation XI/2-5 and ISPS Code B/6.1? Is this information provided in English,
Spanish or French?
30. Does the ship have available the 10 last calls of Port Facilities, as per required by
SOLAS XI/2-9?
D. FOR INTERMEDIATE AND RENEWAL SURVEY
31. Does the ship keep have performed a periodic review of the ship security
assessment and ship security plan, as per the SSP requirements? Are records kept
for the minimum period specified by the Administration?
32. Do the assumptions of the SSA are valid for the structural and operational
characteristics of the vessel?
Note: A general review of the SSA should be carried out.
33. Does any amendment have been carried out to the SSP?
If so:
- Does the Administration have vessel approved the amendments before they
were implemented?
- Are records of the amendments to the SSP approved by the Flag State kept
for the minimum period specified by the Administration?
Note: A general review of the SSP should be carried out.
34. Does the ship have reported all security threats and security incidents in the time
established by the SSP?
Are records are kept for the minimum period specified by the Administration?
Note: - Copy of security threats and incidents reports should be enclosed to the
F-ISS-04c
~
Periodical survey: Signed: .....
Periodical survey:
Place: .
Date: .
2/5
A ENDORSEMENT FOR ANNUAL
THIS IS TO CERTIFY that, at a survey required by re lati n{)IO o
comply with the relevant requirements of the Conve 10 : . .
EDIATE SURVEYS
FORM F-SCC03c
Annual survey:
Place: .
Date: .
2/4
FORM F-SEC-03c
(Signa.~~mffi~~
Date: ..
Place: .
Date: .
(Seal or stamp of the authority, as appropriate)
Date: ..
(Seal or stamp of the authority, as appropriate)
2/5
A ENDORSEMENT FOR ANNUAL AND INTERMEDIATE SURVEY
0 CERTIFY that at a survey required by regulation 6 of Annex I of the C
comply with the relevant provisions of the Convention:
ention
FORM F-OPC-03c
Annual survey:
c ,)),
}, ..
.. ./
.i_, . , .....
Annual Delete as appropriate /Intermediate surveyDelete as appropriate :
Annual survey:
--------~ ~~ ~
A Endorsement for am~~al and i
THIS IS TO CERTIFY that at a survey required by tegulatio
FORM F~APC~03c
Annual survey:
2
FORM F-LLC-03c
a
< < Date: .Ao@ fzy- I~ .JuI?
Surveyor to CONARINA: _
Signature and/or Seal ofissuing authority.
The provisions of the Conyention being fully complied with bytbis shipi.th(tViilidity of this certificate is, in
accordance with Article 19 (2) of the Convention,ext1J;ded qlitil: ., ...-..,..............__,....,._ _
Date: _
Place:------------
NOTES:
1. When a ship departs from a port situated on a river or inland waters, deeper loading shall be permitted
corresponding to the weight of fuel and all other materials required for consumption between the point of
departure and the sea.
2. When a ship is in fresh water of unit density the appropriate load line may be submerged by the amount of the
fresh water allowance shown above. Where the density is other than unity, an allowance shall be made
proportional to difference between 1.025 and the actual density.
2
F-SMS-01c
Certificate No.: QQ-4427
Authorization No.: AAMQB0614
CONARINA
ISM CODE VERIFICATION CHECKLIST
Company Officers
Name Department Opening Closing
ELISEO DIAZ DPA X X
RAFAEL ACOSTA ALTERNATIVE DPA X X
No
Available/Acceptable/Satisfactory? YES
(See CAR)
1. Objectives
Objectives of the ISM Code and SMS are understood by the management and key personnel X
2. Safety and environmental protection policy
Company policy describing the companys commitment is signed by top level management
- safety at sea.
- Prevention of injury / loss of life.
X
- Avoidance of damage to environment.
- Avoidance of damage to third party property.
- Policy statement re companys expectations and personnel requirements to achieve policy goals.
Language of the policy: ENGLISH X
F-SMS-01c
Evidence of policy reviews. X
Evidence that policy goals are discussed with all new staff upon joining company/ships. X
Familiarity of shore staff with companys policy. X
Evidence that the safety and environmental pollution (S & E P) policy is distributed on board the
X
companys ships and is implemented, observed and understood by all concerned.
Remarks:
4. Designated Person
Appointment and details regarding Designated Persons qualification, training, experience, function,
X
independence, knowledgeability and familiarity with office and SMS related items.
DPA and management inter-relationship. X
Evidence of monitoring activities regarding:
SMS verification and improvement proposals.
Monitoring vessels performance (e.g. safety meeting minutes, safety inspections, drills,
defect/incident reports, new legislation and industrila guidelines).
Deficiencies, hazardous occurrences, accidents, incidents and non-conformities including records of X
these discussions and shore response.
Follow-up shipboard meetings, requests, training schedules, effectiveness of corrective actions.
Organising ship and shore audits.
Remarks:
No
Available/Acceptable/Satisfactory? YES (See CAR)
No
Available/Acceptable/Satisfactory? YES (See CAR)
8. Emergency preparedness
Identification of potential shipboard emergency situations. X
Guidelines and contingency plans for use by shore management and ships when dealing with emergency
X
situations. Approved and updated SOPEP manual available.
Language used in guidelines and plans should be readily understood by all concerned (ashore and
X
onboard).
Shore based contingency plans should cover:
the composition and duties of the persons acting within the contingency plan
procedures for the mobilisation of an appropriate company emergency response
procedures to follow in response to different types of accidents or hazardous occurrences
checklists appropriate to the type of emergency which may assist in the systematic questioning of
the ship during the response
availability of ship particulars, plans, stability information, and safety and environmental protection X
equipment carried on board
lists of contact names and telecommunication details of all relevant parties who may need to be
notified and consulted
reporting methods for both ship and shore based management
procedures for dealing with the media or other outside parties
Drill/exercise scenarios (also joint shore/ship drills) and frequency. X
Familiarity of shore emergency response team members with regard to their designated duties. X
Drill/exercise evaluation records with identification of areas of concern, corrective
X
actions/recommendations and follow-up.
F-SMS-01c
Remarks:
No
Available/Acceptable/Satisfactory? YES (See CAR)
No
Available/Acceptable/Satisfactory? YES (See CAR)
11. Documentation
Are all ISM requirements addressed in the Safety Management Manual X
Control, amendment, approval and distribution of SMS documentation in accordance with company
X
guidelines (under supervision of designated person).
Third Party documents in use, are controlled (e.g. Rules and Regulations, charts and publications, key
X
operating manuals, key ships drawings stability, SOPEP etc-.
Procedures to remove obsolete documents (on board and ashore) (and retention of same for document
X
control purposes only). Master revision page updated.
Evidence of document review, modifications and approval of revised document prior to issue (by
X
authorized person).
Adequacy of numbering/identification and revision status of documents. X
Manuals, documents and instructions requested by compulsory requirments or by the Company. X
F-SMS-01c
Evidence that changes to SMS documentation are distributed, received, incorporated in the SMS and
X
understood/acknowledged and followed by all relevant personnel.
Remarks:
Non conformities were identified and documented in Corrective Action Requests (CARs) as
follows:
CAR No. ISM clause Major Minor Restoration due date
CONARINA
INTERIM SEAWORTHINESS CERTIFICATE
TONNAGE: 999
THIS IS TO CERTIFY, that the vessel RO-RO NAIYA under the Flag of Republic of
BOLIVIA and owned by HELI SHIPPING, LLC was inspected at LAS CALDERAS,
DOMINICAN REPUBLIC on JANUARY 20th, 2016 and according to the Surveyors
Report of Mr. ARMANDO ARRASCAETA, the said inspection showed that the hull,
machinery and safety equipment were in good and efficient conditions for service
within protected waters.
....................................................................................
ARMANDO ARRASCAETA
Surveyor to CONARINA
Name of Ship: NAIYA IMO Number: 8408454 Flag: BOLIVIA Port of Registry: LA PAZ
Certificate No: SWC-4932 Port of Survey: Date Survey Commenced: Date Survey Completed:
LAS CALDERAS, D.R. JANUARY 19th, 2016 JAUARY 20th, 2016.
Date of last dry-docking survey: OCTOBER, 2015. Date of last tail shaft survey: OCTOBER, 2015
Carried out by (organization): CONARINA Carried out by (organization): CONARINA
Owner and Address: HELI SHIPPING, LLC.
2974 N.W. NORTH RIVER DRIVE, MIAMI, FLORIDA. 33142. USA.
Notes: Check boxes under Y to indicate YES, N to indicate NO and N/A to indicate NOT APPLICABLE.
A HULL SURVEYS Y N N/A
1 Hull and its closing appliances, so far as can be seen, have been generally examined
and found satisfactory. Weather decks, hatchways, vents and air pipes; casings,
skylights, flush deck scuttles, deckhouses and companionways; superstructures, side,
bow and stern doors; windows, side scuttles and dead lights; chutes and other
openings; scuppers, sanitary discharges and valves; guardrails and bulwarks; freeing
ports, gangways, walkways and lifelines
2 Flame screens on vents/air pipes at all fuel oil tanks are satisfactory as far as could be
seen.
3 Anchoring and mooring equipment has been examined as far as practicable and found
in satisfactory condition
4 All watertight doors in watertight bulkheads have been examined and tested as far as
practicable and found in satisfactory condition
5 Penetrations in watertight bulkheads have been examined as far as practicable and
found in satisfactory condition
6 The arrangement for structural fire protection has been checked and remains
unchanged
7 Manual and/or automatic fire doors, where fitted, have been examined and found in
satisfactory condition
8 Hatch covers and coamings have been examined and tested and found weather tight.
9 For ships with special arrangements (ramps, bow/stern/side doors, container securing
arrangements etc), the condition of the special arrangements is satisfactory as far as
could be seen.
10 Means of escape from all accommodation spaces and spaces in which crew are
normally employed (other than machinery spaces) have been examined and found in
satisfactory condition.
B MACHINERY AND ELECTRICAL INSTALLATION SURVEYS Y N N/A
1 A general examination of machinery and boiler spaces has been made with particular
attention to the propulsion system, auxiliary machinery and the fire and explosion
hazards and found in satisfactory condition
2 Emergency escape routes from machinery spaces have been checked and found in
satisfactory condition
3 The machinery and boiler spaces are free of all visible fire and explosion hazards
(leakage of oil, excess oil in bilges or drip trays, improper insulation for hot surfaces
etc)
4 Main and auxiliary steering arrangements including their associated equipment and
control systems have been examined under operation and found in satisfactory
condition
5 All the means of communication between the navigating bridge and the machinery
control positions as well as the bridge and the alternative steering position, if fitted,
have been tested and found in satisfactory condition
6 Bilge pumping systems and bilge wells including operation of pumps, remote reach
rods and level alarms, where fitted, have been examined, tested and found in
satisfactory condition
F-SWS-01c
7 All essential machinery (auxiliary engines, pumps, compressors etc) have been
examined and operationally tested, as far as practicable, and found satisfactory.
8 Adequate supply of air (ventilation) is provided in machinery spaces for the safety and
comfort of the personnel and the operation of the machinery
9 The Engineers alarm has been tested and found clearly audible in the engineers
accommodation area
10 Boilers and pressure vessels and their appurtenances including safety devices,
foundations, controls, relieving gear, high pressure and steam escape piping, insulation
and gauges have been examined externally and found in satisfactory condition.
11 The electrical equipment and cabling forming the main and emergency installations
have been generally examined under operating conditions as far as practicable and
found in satisfactory condition
12 Operation of all main and emergency sources of power has been checked as far as
practicable and found in satisfactory condition
C FIRE DETECTION AND EXTINGUISHING ARRANGEMENTS Y N N/A
1 All fire and/or smoke detection and alarm systems have been examined and tested as
far as practicable and found satisfactory
2 An operative test of each fire main system and each fire pump, including the
emergency fire pump, has been carried out separately and found satisfactory.
3 All fire hoses, nozzles, applicators and spanners are situated at their respective stations
and in satisfactory condition.
4 The fixed fire fighting system controls, piping, instructions and markings are properly
maintained and serviced.
5 All semi-portable and portable fire extinguishers are fully charged, in their stowed
positions and with valid service dates.
D LIFE SAVING APPLIANCES Y N N/A
1 Each lifeboat/rescue boat has been examined and found in good condition.
2 Inflatable liferafts and any associated hydrostatic release mechanisms have been
serviced during the previous 12 months.
3 All survival craft launching and recovery appliances found satisfactory when examined
as far as practicable
4 All embarkation arrangements and launching gear found satisfactory when examined
as far as practicable
5 Illumination of stowage and launching positions found in working order
6 General alarm systems, two way communication systems, radar transponders and
EPIRB examined and found satisfactory.
7 All pyrotechnics found in satisfactory conditions and with valid dates.
8 All navigation equipment including navigation lights, sounds and shapes found in
satisfactory condition.
9 All personal life-saving equipment examined (lifejackets, lifebuoys, immersion suits
and thermal protective aids) and found satisfactorily.
Signature of Surveyor
Surveyor to CONARINA ARMANDO ARRASCAETA
Port LAS CALDERAS, DOM. REP.
Date JANUARY 20th, 2016.
FORM F-AFC-02/a
CERTIFICATE No: AFC-4930
AUTHORIZATION No.: AAUSAFCBO3015
Issued under the International Convention on the Control of Harmful Anti-fouling Systems on Ships, 2001
Name of Ship
Call Sign Port of Registry Gross Tonnage IMO Number
NAIYA CPB-3019 LA PAZ 999 8408454
An anti-fouling system controlled under Annex 1 has not been applied during or after construction of this ship -
An anti-fouling system controlled under Annex 1 has been applied on this ship previously, but has been removed
by CIRAMAR INTERNATIONAL TRADING, LTD, DOMINICAN REPUBLIC (insert name of the facility) X
on NOVEMBER, 2015. (date)
An anti-fouling system controlled under Annex 1 has been applied on this ship previously, but has been covered
with a sealer coat applied by (insert name of the facility) on (date)
--
An anti-fouling system controlled under Annex 1 was applied on this ship prior to ________________ (date)1,
but must be removed or covered with a sealer Coat prior to _______________ (date)2 --
1. The ship has been surveyed in accordance with Regulation 1 of Annex 4 to the Convention; and
2. The survey shows that the anti-fouling system on the ship complies with the applicable requirements of Annex 1 to
the Convention.
Date of completion of the survey on which this Certificate is based: NOVEMBER 19th, 2015.
PROVISIONAL
ARMANDO ARRASCAETA
Surveyor No. 4001to CONARINA
1
Date of entry into force of the control measure
2
Date of expiration of any implementation period specific in article 4(2) or Annex I
RECORD OF ANTI-FOULING SYSTEM
Drawn up under the
International Convention on the Control of Harmful Anti-Fouling Systems on Ships
(This Record shall be permanently attached to the International Anti-Fouling System Certificate)
Record N AFC-4930
Active ingredient(s) and their Chemical Abstract Services Registry Number(s) (CAS
number(s)) COPPER OXIDE (CAS No. 1317-39-1).
HEMPEL A/S
hereby confirms that HEMPELS ANTIFOULING OLYMPIC HI-76600 applied on
the underwater area of the vessel
This Certificate merely confirms that the delivery of antifouling paint has taken place to the vessel
mentioned above. Being a manufacturer of HEMPELS ANTIFOULING OLYMPIC HI-76600 Hempel
keeps records of deliveries of TBT-free antifouling paints and inspections carried out in relation thereto.
The IMO Guidelines for Survey and Certification adopted October 2002 govern the issue of the Statement of
Compliance and the issue of the International Anti-fouling System Certificate. This Hempel declaration
contains the information required by the IMO Guidelines. The information will also be available from the
Material Safety Data Sheet.
HEMPEL A/S and any of its subsidiaries and/or affiliates cannot be held liable for any consequences arising
out of or in connection with the information provided in this certificate.
HEMPEL A/S
17 November 2015
F-AFS-01/c
NOTE:
Entries in boxes shall be made by inserting either a cross (X) for the answer yes or a dash (-) for the answers no and
na where is not applicable
All negative entries should be clarified under Surveyors Notes with reference by item number
*- Delete as appropriate
TYPE OF AFS
1. TBT
1.1.1. Statement from shipyard or contractor confirming removal / sealer coat* application
1/3
F-AFS-01/c
3.1.4. Statement from shipyard or contractor confirming that the application of existing AFS was
applied.
1.7. If 1.1.2. and 1.1.3. are not available the paint sampling and testing is required
This is to declare that the undersigned has examined and filled all items of this Report before signed it.
3/3
1. SKETCH OF THE SHIP
Disposition and dimensions of superstructures, trunks, deckhouses, machinery casings, extend of bulkwarks, guard rails and wood sheathing on exposed deck, to be
inserted in the diagrams and tables following; together with positions of hatchways, gangways, and other means for the protection of the crew; cargo ports, bow and
stern doors, side scuttles, scuppers, ventilators, air pipes, companionways, and other items that would affect the seaworthiness of the ship.
L = 90.25 m
Superestructure deck
0.25 L
Position 2 Position 1
F-LLS-01/c 2/12
Freeboard deck
Position 1
Note: A plan of suitable size may be attached to this Record in preference to sketches. Where appropriate, the information on subsequent pages of the record can be
supplemented with , or certain items substituted by sketches or extracts of plan of a size consistent with that of the Record, Provided such material is referred to in the
relevant space of the sketch or the plan of the ship.
2. DOORWAYS IN SUPERESTRUCTURES, EXPOSED MACHINERY CASINGS AND DECKHOUSES PROTECTING
OPENINGS IN FREEBOARD AND SUPERESTRUCTURE DECKS (Regs. 12, 17 & 18)
POSITION REF. NO. ON NUMBER AND SIZE HEIGHT OF SILLS CLOSING APPLIANCES
SKETCH OR PLAN OF OPENINGS (mm) TYPE AND MATERIAL NUMBER OF
CLIPS
--
In Forecastle bulkhead
5 @ 1100 x 400mm SEALED
In bridge forward bulkhead 1 1500
4 @ 1100 x 400 mm 1500
2 SEALED
In bridge aft bulkhead
16 @ 300 mm 1700 SEALED
3
In raised quarter deck bulkhead 1@ 1500 x 400 mm
--
In poop bulkhead
F-LLS-01/c 3/12
1 @ 2000 x 1000
In exposed machinery casing on freeboard or 4 mm
400 HINT & CLIPS; ST. 6
raised quarter decks
In exposed machinery casing on --
superstructure decks
--
In machinery casings within superstructure
or deckhouse on freeboard deck
In deckhouse in Position 1 enclosing openings --
leading below freeboard deck
In deckhouse in Position 2 enclosing openings --
leading below freeboard deck
--
In exposed pump-room casings
3. HATCHWAYS AT POSITIONS 1 AND 2 CLOSED BY PORTABLE COVERS AND SECURED WEATHERTIGHT
BY TARPAULINS AND BATTENING DEVICE (Reg. 15)
Position and reference No. on sketch or plan
Dimensions of clear opening at top of coamings, (m)
Height of coamings above deck, (mm)
F-LLS-01/c 4/12
(4) STEEL (1) STEEL
20 mm 20 mm
TRANSVERSAL TRANS.
156 m EACH 75 m
Spacing of Cleats 1m
Means of securing each section of covers (Reg. 15): CLEATS
Are wood covers fitted with galvanized end bands? NO
Note: Some authorities require that galvanized steel bands protecting the ends of wood hatch boards be efficiently secured. Indicated if fitted.
4. HATCHWAYS AT POSITIONS 1 AND 2 CLOSED BY WEATHERTIGHT COVERS OF STEEL (OR OTHER EQUIPMENT MATERIAL)
FITTED WITH GASKETS AND CLAMPING DEVICES (Reg. 16)
Position and Reference No. on sketch or
6
plan
Dimensions of clear opening at top of 6000 x
coamings 2500
Height of coamings above deck FLAT
Type of covers or patent name RAMP
Material STEEL
F-LLS-01/c 5/12
5. MACHINERY SPACE OPENINGS AND MISCELLANEOUS, OPENINGS IN FREEBOARD AND SUPERSTRUCTURE
DECKS (REG. 17 & 18)
Cover
Position and Reference Number on Sketch Dimensions Height of Coaming, Number and Spacing of
or Plan (mm) Material How attached Toggles
6. VENTILATORS ON FREEBOARD AND SUPERSTRUCTURE DECKS IN POSITION 1 AND2 (REG.19)
Coaming
Deck on which fitted Number Type (State Patent Name, Closing Appliances
fitted dimensions, (mm) height, if any)
(mm)
MAIN DECK 14 1200 x 600 1200 FORCED VENT HITCHES & CLIPS
F-LLS-01/c 6/12
7. AIR PIPES ON FREEBOARD AND SUPERSTRUCTURE DECKS (Reg. 20)
DECK ON WHICH FITTED NUMBER FITTED COAMING TYPE (STATE PATENT NAME, IF ANY) CLOSINGS APPLIANCES
DIMENSIONS HEIGHT,(mm)
MAIN DECK 8 200 mm 1500 FLAP
F-LLS-01/c 7/12
8. CARGO PORT AND OTHER SIMILAR OPENINGS (Reg. 21)
POSITION OF PORT DIMENSIONS OF OPENING, DISTANCE OF LOWER EDGE FROM SECURING DEVICES NOTES
(mm) FREEBOARD DECK, (mm)
F-LLS-01/c 8/12
9. SCUPPERS, INLETS AND DISCHARGES (REG.22)
State if Scupper, Pipe Vertical distance above top of keel Number, Type Position
or Discharge and material of
Number Diameter, Thickness, Material From Discharge uppermost Of controls
discharge
(mm) (mm) Valve vales
Outlet Inboard
in hull end
S 3 150 8 MS E/R 3.5 3.5 3.5 4; A; CS
D 4 150 8 MS E/R 3.5 3.5 3.5 6; A; CS
Recommended symbols:
S Scupper B Bronze SD Screw Down e
D Discharge V Screw-Down Valve MS Mild Steel
A Automatic Non-Return Valve CS Cast Steel GM Gun Metal
NOTE: If other materials are used, appropriate symbols adopted in each particular case are to be added.
F-LLS-01/c 9/12
10. SIDE SCUTTLES (Reg. 23)
Type Material Type of glass Standards Note
Position Number fitted Clear glass size, (mm)
(fixed or opening) and thickness, used and
Frame Deadlight
(mm) type No.
F-LLS-01/c 10/12
The vertical distance between the freeboard deck and the lower sill of the side scuttle positioned at the greatest vertical distance below the freeboard deck is: (mm)
11. FREEING PORTS (Reg. 24)
Freeing ports in ships portions where no trunks are fitted
Length of Height of Total area Required area
bulkwark bulkwark Number and size freeing ports each side each side each side
Freeboard deck after well
Forward well
Superstructure deck
12. PROTECTION OF THE CREW (REG.25 AND 26)
12.1 Bulwarks or guard rails on exposed parts of the freeboard and superstructure decks,( location, height, opening below the lowest course of the guard
rails, distance between courses)
MAIND DECK GUARD RAIL ALL AROUND; 1.3 Mts.
UPPER DECK GUARD RAILS; ALL AROUND; 1.3 Mts.
12.2 Details of lifelines, walkways, gangways or underdeck passage ways where required to be fitted.
LIFELINES; 12 UNITS; CAPROLON; 80 mm.
F-LLS-01/c 11/12
13. ADDITIONAL INFORMATION FOR SHIPS CARRYING TIMBER DECK CARGO (REG.43,44)
13.1 Construction of ship:
13.1.1 Length and height of a forecastle. If there is no poop, is there a raised quarter deck with a strong steel hood or a deckhouse fitted aft
13.1.2 Have double bottom tanks fitted within the midship half length of the ship watertight longitudinal subdivision
13.1.3 Have bulwarks a sufficient height and are they specially stiffened or are there rails of an approved construction
13.1.4 Is a deck of a sufficient strength for a cargo to be carried thereon
THE CONDITIONS OF ASSIGNMENT SHOWN ON THIS FORM ARE A RECORD OF THE ARRANGEMENTS AND FITTINGS PROVIDED ON
THE SHIP AND ARE IN ACCORDANCE WITH THE REQUIREMENTS OF THE RELEVANT REGULATIONS OF THE INTERNATIONAL
CONVENTION ON LOAD LINES, 1966
THIS IS TO CERTIFY THAT: This Record is correct in all respects.
ARMANDO ARRASCAETA
SURVEYOR No. 4001 to CONARINA
F-LLS-01/c 12/12
FORM F-LLC-02b
CERTIFICATE No.: FF-4567
AUTHORIZATION No.: AAMFB0614
REPUBLIC OF BOLIVIA
by CONARINA
PARTICULARS OF SHIP
Allowance for Fresh Water for all freeboards other than timber 85 mm
Allowance for Fresh Water for timber freeboards N/A mm
The upper edge of the deck line from which theses freeboards are measured is 1000 mm above the top of
the freeboard (2nd) deck at side.
1
Delete as appropriate.
Page 1 of 2
FORM F-LLC-02b
CERTIFICATE No: FF-4567
AUTHORIZATION No.: AAMFB0614
C N
THIS IS TO CERTIFY:
1. That the ship has been surveyed in accordance with the requirements of Article 14 of the Convention;
2. That the survey showed that the freeboards have been assigned and load lines shown on page 1 have
been marked in accordance with the Convention.
This certificate is valid until DECEMBER 31st, 2014 subject to annual surveys in accordance with article
14(1) (c) of the Convention.
Completion date of the survey on which this certificate is based: OCTOBER 15th, 2010.
ARMANDO ARRASCAETA
Surveyor No. 4001 to CONARINA
NOTES
1. When a ship departs from a port situated on a river or inland waters, deeper loading shall be permitted corresponding to the weight
of fuel and all other materials required for consumption between the point of departure and the sea.
2. When a ship is in fresh water of unit density the appropriate load line may be submerged by the amount of fresh water allowance
shown above. Where the density is other than unity, the allowance shall be made proportional to the difference between 1.025 and
the actual density.
Page 2 of 2
RECORD OF CONDITIONS OF ASSIGNMENT
UNDER THE PROVISIONS OF THE INTERNATIONAL CONVENTION ON LOAD LINES, 1966.
Distinctive Number or
Name of Ship Port of Registry Nationality IMO number
Letters
Date of Construction/
Classification Society Freeboard assigned as a ship of Type
Conversion (1)
(1)
Delete as Appropriate
1/12
F-LLS-01/c
Load Line Survey Report
Survey under the provisions of the International Load Line Convention 1966*
1. General
1.1 Owner: HELLI SHIPPING, LLC.
1.2 Character of Class: --
1.3 Range of service: UNLIMITTED CARIBBEAN Running as from: 15th OCTOBER, 2010.
1.4 Type of ship (Reg. 27): a) Type A b) Type B with reduced / increased / timber freeboard
2. Extend of Survey
2.1. Annual inspection of load line appliances (Art. 14(1) c)) N
2.2 Renewal survey of Load Line Certificate (Art. 14(1)b)) N
2.3 Survey on account of change of flag (to the scope of a renewal survey) Y
3. Initial Report, Alternations / Conventions
3.1 Is the initial freeboard survey report available on board? Y
3.2 Were alterations made to the structure, equipment, arrangement, material of N
Scantling which affects the calculations determining the position of the load line.
3.3 Alterations and/or conversions are listed in 10 N
4. Previous Load Line Certificate available on board
4.1 Issued by: PMDS Issue date: NOVEMBER 19, 2012 Expiry date: OCT. 31, 2015
4.2 Date of previous annual inspection: NOVEMBER 9,2013.
4.3 The next inspection / survey is due on: AUGUST, 2015.
4.4 Was the present annual inspection certified on the Load Line Certificate? N
4.5 Validity of existing certificate now extended to: N/A
4.6 Interim Certificate now issued valid until: 1 DECEMBER, 2014.
Remarks:
If the validity of the Load Line Certificate has expired, a survey for renewal of same has to be carried out
In this case, a new Load Line Certificate has to be applied for at Head Office, Panama and an Interim Certificate has to
be issued
If the certificate has not expired it may be extended directly after survey (LLC 1966, Art.19).
F-LLS-01a 1/4
5. Conclusion
5.1 THIS IS TO CERTIFY that the undersigned has examined the ship as reported herein
5.2 All parts surveyed were found to be well maintained and in an efficient and good working conditions
5.3 The undersigned hereby recommends:
.1 The issue of a Load Line Certificate valid for a period of five years in accordance with the provisions
of the Convention Regulations Y
.2 No Load Line Certificate is to be issued before the survey is complete
5.4 After renewal, where (full address) has the Load Line Certificate to be sent, and by what date?
6. Survey Checklist
6.1 Are the freeboard in accordance with the statement in the Load Line Certificate? (Reg.9) Y
6.2 Are the closing appliances of the superstructures in accordance with the regulations of the convention?
Y
(Reg. 11)
6.3 Are the closing appliances of the following openings effective and in good weather tight conditions
.1 Hatch coverings (wooden covers, bearing surface of hatch covers, tarpaulins, battening down devices) Y
Securing bars, steel covers, gaskets and securing devices) (Reg. 14, 15 and 16)**) SEE REMARKS
.2 Has weather tightness of flush deck hatch covers been proved by hose testing? N/
A
.3 Has weather tightness of cargo hatch covers with coamings been proved by hose testing? Y
(if deemed necessary by the surveyor, but at least at renewal surveyors for load line) SEE REMARKS
.5 Access openings to superstructures, deck houses and houses on superstructures and deck house, from
which Companionways are leading down (Reg. 12 and 18)
Y
.6 Companionways and access hatchways to spaces below the freeboard deck and the superstructure deck Y
6.4 Are exposed parts of engine and boiler casings on freeboard deck or superstructure decks in a good
Y
structural conditions? (Reg. 18 and 26)
6.5 .1 Are ventilators and air pipes in a good conditions? (Reg. 19 and 20) Y
6.6 Are the automatic non-return valves of sanitary discharges and scuppers and their positive means of
Y
closing in a good working conditions? (Reg.22)
6.7 Are the shutters of freeing ports in bulwarks and other drainage appliances of the upper deck easily
Y
working and in a good order? (Reg.24)
6.8 .1 Are side scuttles in the shell plating and superstructures and their deadlights efficiently watertight Y
and in a good condition? (Reg.23)
F-LLS-01a 2/4
.2 Are windows in deckhouses and their deadlights efficiently watertight and in a good condition Y
6.9 Are the closing appliances of shell ports (bow, side, stern) and other similar openings efficiently
Y
watertight and in a good conditions? (Reg.21)
6.10.1 .1 Are guardrails, lifelines, gangways of under deck passages available (Reg. 2) Y
.2 Are there means in a good conditions? (including their doors or access opening if any) Y
6.11 Are all appliances for subdivision (if any) in a good working condition? (e.g. cross flooding fitting, N/
controls, non return valves etc) (Reg. 27) A
(Only for ships of Type A and B minus.)
8.1 Are lashing appliances available in accordance with the Regulations or the approved lashing (chains,
wire ropes, stretch screws, sliphooks, eye plates)?
8.3 Are steering arrangements effectively protected from damage by timber cargo?
8.5 Is efficient provision made steering in the event of a breakdown of these main steering arrangement?
9. Ship changeable from open to closed Shelter Deck Vessels or vice versa
9.1 Are two Load Line Certificates available on board?
9.2 Have surveys been carried out both, for the closed and for the open shelter deck vessel?
9.3 Are closing appliances for conversions in order and is the Master informed about using these closing
appliances?
9.3 Has the Master at present on board signed a Declaration regarding the use of the closing appliances?
F-LLS-01a 3/4
10. Surveyors remarks in respect to the survey carried out / special reporting (Please state recommendations and
repairs)
Remarks:
11. Have these remarks been stated to the Master or the owner? Y
Place and
date: MIAMI, FLORIDA;
AUGUST 1, 2014.
ARMAMNDO ARRASCAETA
SURVEYOR
No.4001CONARINA
Note: Where dates are to be reported give Day, Month and Year.
*) All references to regulations relate to LLC 1966
**) Delete whatever is inapplicable
F-LLS-01a 4/4
RECORD OF CONDITIONS OF ASSIGNMENT
UNDER THE PROVISIONS OF THE INTERNATIONAL CONVENTION ON LOAD LINES, 1966.
Distinctive Number or
Name of Ship Port of Registry Nationality IMO number
Letters
Date of Construction/
Classification Society Freeboard assigned as a ship of Type
Conversion (1)
(1)
Delete as Appropriate
1/12
F-LLS-01/c
REPORT OF GENERAL CONDITION SURVEY
FOR THE ISSUANCE OF A SEAWORTHINESS CERTIFICATE
IT IS HEREBY CERTIFIED THAT THE UNDERSIGNED SURVEYOR, PERFORMED A GENERAL CONDITION SURVEY
AFLOAT / DRYDOCK * ON AUGUST 1st, 2014 AT MIAMI, FLORIDA AT THE OWNERS REQUEST, AND BASED ON
THE SHIPS PLANS AND INFORMATION PROVIDED AND ON THE GENERAL CONDITIONS OBSERVED, AS FOLLOWS:
I. MAIN PARTICULARS:
A. GENERAL:
VESSEL NAME: NAIYA
CALL SIGN: CPB-3019
PORT OF REGISTRY: LA PAZ
IMO NUMBER: 8408454
VESSEL TYPE: GENERAL CARGO
MATERIAL OF HULL: STEEL
GROSS TONNAGE: 2,295 / 999
NET TONNAGE: 778
PRINCIPAL DIMENSIONS: 90.83 M X 14.10 M X 6.73 M
YEAR OF CONSTRUCTION: 1985
BUILDER: THYSSEN NORDSEEWERKE GMBH
VOLUME OF CARGO SPACES (m3): 5,002.40
B. MACHINERY:
COMMENTS:
II. SURVEY:
THE CONDITION OF THE HULL, MAIN ENGINE, CARGO SPACES, NAVIGATION INSTRUMENTS AND
OTHER SUCH APPURTANCES FOUND AS FOLLOWS:
HULL: SATISFACTORY
MACHINERY: SATISFACTORY
F-SWS-01/a 1/2
NAVIGATION EQUIPMENT: SATISFACTORY
I HEREBY RECOMMEND:
1) THE ISSUANCE OF A SEAWORTHINESS CERTIFICATE Y
* Delete as appropriate
(1) Make a short statement of the satisfactory condition
(2) Indicate state of the deficiencies found on particular items.
F-SWS-01/a 2/2
FORM F-SWC-02b
CERTIFICATE No: II-4578
AUTHORIZATION No.: AAMIB1214
CERTIFICADO DE NAVEGABILIDAD
SEAWORTHINESS CERTIFICATE
NOMBRE DE LA NAVE :
NAME OF VESSEL : NAIYA
PUERTO DE REGISTRO :
PORT OF REGISTRY : LA PAZ
NUMERO DE REGISTRO :
REGISTRY No. : 69 14 2 34 1046
LETRAS INDICATIVAS :
CALL SIGN : CPB-3019
TONELAJE :
TONNAGE : 2,295 / 999
El infrascrito declara que est debidamente autorizado por el expresado Gobierno para expedir el presente certificado.
The undersigning declares that he is duly authorized by the said Government to issue this certificate
ARMANDO ARRASCAETA
SURVEYOR No. 4001 TO CONARINA
PROVISIONAL
FORM F-ITC-02b
CERTIFICATE No: HH-4528
AUTHORIZATION No.: AAMHB0414
REPUBLIC OF BOLIVIA
para el cual el convenio entr en vigor el 18 de julio de 1982
for which the Convention came into force on the 18th of July, 1982
Por/by:
COMPAIA NACIONAL DE REGISTRO E INSPECCION DE NAVES (CONARINA)
Nombre del Buque Seal distintiva Puerto de Matrcula *Fecha
Name of Ship Distinctive Number or letters Port of Registry Date
NAIYA CPB-3019 LA PAZ 1985
* Fecha en la que se puso la quilla o en la que el buque estaba en un estado equivalente de adelanto en su construccin (Artculo 2
(6)); o fecha en la que el buque sufri transformaciones o modificaciones importantes (Artculo 3 (2) (b)), segn proceda.
Date on which the keel was laid or the ship was at a similar stage of construction (Article 2 (6)), or date on which the ship underwent alterations or modifications of a
major character (Article 3 (2) (b)), as appropriate.
DIMENSIONES PRINCIPALES
MAIN DIMENSIONS
Eslora (Artculo 2 (8)) Manga (Regla 2 (3)) Puntal de trazado hasta la cubierta superior
Length (Article 2 (8)) Breadth (Regulation 2 (3)) en el centro del buque (Regla 2 (2))
Molded Depth amidships in Upper Deck(Regulation 2
(2))
90.83 M 14.10 M 6.73 M
SE CERTIFICA que los arqueos de este buque han sido determinados de acuerdo con las disposiciones del Convenio Internacional
sobre Arqueo de Buques, 1969.
THIS IS TO CERTIFY that the tonnages of this ship have been determined in accordance with the provisions of the International Convention of Tonnage Measurement of
Ships, 1969.
El infrascrito declara que est debidamente autorizado por dicho Gobierno para expedir este certificado.
The undersigned declares that he is duly authorized by the said Government to issue this Certificate.
ARMANDO ARRASCAETA
SURVEYOR No. 4001 to CONARINA
PROVISIONAL
1/2
FORM F-ITC-02b
CERTIFICATE No: HH-4528
AUTHORIZATION No.: AAMHB0414
ARQUEO BRUTO
GROSS TONNAGE
Nombre del espacio Ubicacin Eslora
Name of the space Location (Fr) Length (Mts)
UNDERDECK -- --
FORECASTLE 133 - FE 6.56
ROUNDHOUSE 1st TIER 119 - 133 8.54
ROUNDHOUSE 2nd TIER 119 - 133 8.54
ROUNDHOUSE 3rd TIER 119.5 - 126 4.40
ROUNDHOUSE 1st TIER S/S 15 - AE 11.76
ROUNDHOUSE 1st TIER P/S 16 - AE 12.41
FUNNEL 8 - 12 2.50
HATCH COVER 28 - 116 57.46
ARQUEO NETO
NET TONNAGE
Nombre del espacio Ubicacin Eslora
Name of the space Location (Fr) Length (Mts)
CARGO HOLD 28 - 119 59.13
Remarks: The ship is re-measured according to article 3(2)(d) of the 1969 Tonnage Convention. The
GROSS TONNAGE according to the measurement system previously in force to the measurement system of
the International Convention on Tonnage Measurement of ships, 1969, is 999.75 RT, according to the
regulations in force before 18th July, 1994, which were acceptable to the Government of the Republic of
Bolivia.
PROVISIONAL 2 /2
TONNAGE CALCULATION REPORT
and has been know as builders THYSSEN NORDSEEWERKE GmBh, Germany. That her
EX NAME : SAME
FLAG: BOLIVIA
F-ITS-01/a
GROSS TONNAGE
The gross tonnage was calculated in accordance with the formula of the rule 3 annex I of
the International Convention on Tonnage Measurement of Ships, 1969.
GT=K1V
Where:
V=Total volumen of all enclosed spaces in cubics meters
K1V= 0.2 + 0.02 LOG10V
SPACES INCLUDED
ARQUEO BRUTO
GROSS TONNAGE
Nombre del espacio Ubicacin Eslora
Name of the space Location (Fr) Length (Mts)
UNDERDECK -- --
FORECASTLE 133 - FE 6.56
ROUNDHOUSE 1st TIER 119 - 133 8.54
ROUNDHOUSE 2nd TIER 119 - 133 8.54
ROUNDHOUSE 3rd TIER 119.5 - 126 4.40
ROUNDHOUSE 1st TIER S/S 15 - AE 11.76
ROUNDHOUSE 1st TIER P/S 16 - AE 12.41
FUNNEL 8 - 12 2.50
HATCH COVER 28 - 116 57.46
GROSS TONNAGE
The gross tonnage (GT) of a ship shall be determined by following formula
Where:
K1= 0.2 + 0.02 LOG10V
V=Total volumen of all enclosed spaces in cubics meters
NET TONNAGE
The net tonnage (NT) of a ship shall be determined by the followin formula:
F-ITS-01/a
d = Moulded Draft amidships
N1 = Number of other passengers in cabins with not more than eigth passengers
N1 = 0
N2 = Number of other passengers
N2 = 0
N1 + N2 = Total number of passengers the ship is permitted.
N1 + N2 = 0
SPACES INCLUDED
ARQUEO NETO
NET TONNAGE
Nombre del espacio Ubicacin Eslora
Name of the space Location (Fr) Length (Mts)
CARGO HOLD 28 - 119 59.13
NET TONNAGE
G.T. = 2,295
N.T. = 778
ARMANDO ARRASCAETA
INSPECTOR / SURVEYOR
Compaa Nacional de Registro e
Inspeccin de Naves, S. de R. L.
F-ITS-01/a
FORM F-SPC-02b
CERTIFICATE No: SS-4431
AUTHORIZATION No.: AAMSB0614
PARTICULARS OF SHIP1
Name of Ship : NAIYA
Distinctive Number or Letters : CPB-3019
Port Of Registry : LA PAZ
Gross Tonnage : 999
Number of persons which the ship is certified to carry : 10
IMO Number2 : 8408454
New / Existing ship
Date on which keel was laid or ship was at a similar stage of construction or, where applicable, date on which work for a
conversion or an alteration or modification of a major character was commenced: APRIL, 1985.
THIS IS TO CERTIFY:
1. That the ship is equipped with a sewage treatment plant / comminuter / holding tank* and a discharge pipeline in
compliance with regulations 9 and 10 of Annex IV of the Convention as follows:
*1.1 Description of the sewage treatment plant: N/A
Type of sewage treatment plant :
Name of the manufacturer :
The sewage treatment plant is certified by the Administration to meet the effluent standards as provided for in
resolution MEPC.2 (VI):
*1.2 Description of the comminuter: N/A
Type of comminuter:
Name of manufacturer:
Standard of sewage after disinfection:
*1.3 Description of holding tank equipment:
Total capacity of holding tank (cubic meters): 10.9 M3
Location : Fr 121 129 STBD SIDE.
1.4 A pipeline for the discharge of sewage to a reception facility, fitted with a standard shore connection.
2. That the ship has been surveyed in accordance with regulation 4 of Annex IV of the Convention.
3. That the survey shows that the structure, equipment, systems, fittings, arrangements and materials of the ship and the
condition thereof are in all respects satisfactory and that the ship complies with the applicable requirements of Annex IV of
the Convention.
This certificate will remain valid until DECEMBER 31st, 2014 subject to surveys in accordance with regulation 4 of Annex IV
of the Convention.
Completion date of survey on which this Certificate is based: OCTOBER 15th, 2015.
ARMANDO ARRASCAETA
SURVEYOR No. 4001 TO CONARINA
Delete as appropriate
F-SPS-01/a
SEA AREA IN WHICH VESSEL IS CERTIFIED TO OPERATE: UNLIMITTED GROSS TONNAGE: 999
CARIBBEAN
th st
FIRST VISIT DATE: 29 JULY, 2014. LAST VISIT DATE: 1 AUGUST, 2014.
YES NO N/A
1. Sewage system was examined and found to conform with the approved scheme?
2. The certificate of sewage treatment plant/comminution and disinfecting system has been verified?
3. Sewage piping system together with associated pumps and fitting have been checked for corrosion and wear down
and were found in satisfactory condition?
4. Dosage devise to disinfecting chamber has been tested and found satisfactory?
5. Sewage treatment plant has been examined internally (as far as possible) and found in good condition?
6. Result of laboratory testing of effluent from sewage treatment plant is satisfactory?
7. Automatic operation and manual control of sewage treatment plant / comminution and disinfecting system have been
tested and found satisfactory?
8. Operation manual for sewage treatment plant/ comminution and disinfecting system was reviewed?
9. Construction and equipment of the ship conform to the records in the SSP certificate?
ARMANDO ARRASCAETA
Surveyor No. 4001 to CONARINA
FORM F-GPC-02b
CERTIFICATE No: FFF-4342
AUTHORIZATION No.: AAMFFB0614
REPUBLICA DE BOLIVIA
Por /By
COMPAIA NACIONAL DE REGISTRO E INSPECCION DE NAVES (CONARINA)
Nombre de la Nave Senales Puerto de Registro Tonelaje bruto Numero de personas que
Name of Ship distinctivas Port of Registry Gross Tonnage el buque esta autorizado a
Distintive Number or transportar
Letters Number of persons which the
ship is certified to carry
NAIYA CPB-3019 LA PAZ 999 10
SE CERTIFICA:
THIS IS TO CERTIFY THAT:
1. El buque esta equipado con:
The ship is equipped with:
Incinerador / Incinerator (*)
Planta de tratamiento de basuras / Garbage treatment plant (*)
- Medios para la eliminacin de basuras / Garbage collection facilities (*)
(a) INCINERADOR / INCINERATOR (*)
Tipo / Type: N/A
Fabricante / Manufacturer:
Conforme al certificado emitido por / According to the Certificate issued by:
(nombre de la compaia emisora / name of the body issuing)
El incinerador garantiza la efectiva incineracion de / The incinerator ensures effective incineration of:
- Basura / Garbage (*)
- Aguas sucias / Sewage sludge (*)
- Desechos aceitosos / Oil sludge (*)
(b) PLANTA DE TRATAMIENTO DE BASURAS / GARBAGE TREATMENT PLANT (*)
Tipo / Type: N/A
Fabricante / Manufacturer:
Conforme al certificado emitodo por / According to the Certificate issued by:
(nombre de la compaia emisora / name of the supervision body issuing the certificate)
La planta de tratamiento de basuras garantiza / The garbage treatment plant ensures:
- Trituracin de la basura / Grinding of garbage (*)
- Compresin de la basura / Pressing of garbage (*)
(c) MEDIOS PARA LA ELIMINACION DE BASURAS / GARBAGE COLLECTION FACILITIES: (*)
Capacidad total / Total capacity: 1.04 m3
Ubicacin / Location: MAIN DECK BY ACCOMMODATION.
FORM F-GPC-02b
CERTIFICATE No: FFF-4342
AUTHORIZATION No.: AAMFFB0614
COMENTARIOS / REMARKS
1. El buque a sido inspeccionado de acuerdo con los requerimientos de la Parte V de la Convencin y dicha
inspeccin demostr que la condicin de los equipos y plantas es satisfactoria en todo aspecto y que el buque
cumple con las disposiciones de la Regla.
The ship has been surveyed in accordance with the requirements of Part V of the Rules for the Prevention of Pollution from Ships
and the survey showed that the condition of the equipment plants was in all respects satisfactory and that the ship complied with the
appropriate requirements of the Rules.
Este certificado es valido hasta / This certificate is valid until: DECEMBER 31st, 2014.
PROVISIONAL
FIRST VISIT DATE: JULY 28th, 2014. LAST VISIT DATE: AUGUST 1st, 2014.
YES NO N/A
7. Places where bags with particular categories are stored have been clearly marked?
8. Garbage receptacles on open deck are of a rigid construction, provided with tight covers and safely secured
to the ship structure?
10. The ship is provided with the following garbage processing devices:
a. Solid waste incinerator: (type)____________________________Capacity (kg/h)_______________
b. Comminuter: (type)____________________________Capacity (kg/h)_______________
c. Grinder: (type)____________________________Capacity (kg/h)_______________
d. Compactor: (type)____________________________Capacity (kg/h)______________
11. Garbage processing devices have been checked and found in good working condition?
REMARKS:
ARMANDO ARRASCAETA
Surveyor No. 4001 to
FORM F-APC-04b
CERTIFICATE No: EEE-4431
AUTHORIZATION No.: AAMEEB0414
1. PARTICULARS OF SHIP
1.1 Name of Ship NAIYA
1.6 Date on which keel was laid or ship was at a similar stage of construction APRIL, 1985.
Number completed only in respect of ships constructed on or after 1 January 2016, which are specially
designed, and used solely, for recreational purposes and to which, in accordance with regulation 13.5.2.1,
the NOx emission limit as given by regulation 13.5.1.1 will not apply
Page. 1/ 4
FORM F-APC-04b
CERTIFICATE No: EEE-4431
AUTHORIZATION No.: AAMEEB0614
2.1.2 The following systems containing hydro-chlorofluorocarbons (HCFCs) installed before 1 January 2020
may continue in service:
2.2.1 The following marine diesel engines installed on this ship comply with the
applicable emission limit of regulation 13 in accordance with the revised NOx technical
Code 2008:
Serial Number
Use
Rated speed(RPM)
Tier I (REG.13.3)
Tier II (REG.13.4)
Page. 2/ 4
FORM F-APC-04b
CERTIFICATE No: EEE-4431
AUTHORIZATION No.: AAMEEB0614
2.3.1 When the ship operates outside of a Emission control area specified in regulation 14.3
the ship uses:
1. Fuel oil with a sulphur content as documented by bunker delivery notes that does
not exceed the limit value of:
0.50% M/M.
2. An equivalent arrangement approved in accordance with regulation 4.1 as listed in
2.6 that is at least as effective in terms of SOX emission reductions as compared to
using a fuel oil with a sulphur content limit value of :
2.3.2 When the ship operates outside of a Emission control area specified in regulation 14.3
the ship uses:
1. Fuel oil with a sulphur content as documented by bunker delivery notes that does
not exceed the limit value of:
Page. 3/ 4
FORM F-APC-04b
CERTIFICATE No: EEE-4431
AUTHORIZATION No.: AAMEEB0614
2.4.2 For a tanker carrying crude oil, there is an approved VOC management plan
ARMANDO ARRASCAETA
SURVEYOR No. 4001 TO CONARINA
Page. 4/ 4
FORM F-APC-02b
CERTIFICATE No: EEE-4431
AUTHORIZATION No.: AAMEEB0614
By CONARINA.
PARTICULARS OF SHIP
THIS IS TO CERTIFY:
1. That the ship has been surveyed in accordance with regulation 5 of Annex VI of the Convention; and
2. That the survey shows that the structure, equipment, systems, fittings, arrangement and materials fully comply
with the applicable requirements of Annex VI of the Convention.
Completion date of survey on which this Certificate is based: OCTOBER 15th, 2010.
This certificate will remain valid until DECEMBER 31st, 2014 subject to surveys in accordance with regulation 5 of
Annex VI of the Convention.
ARMANDO ARRASCAETA
Surveyor No. 4001 to CONARINA.
1
In accordance with IMO ship identification number scheme adopted by the Organization by resolution A.600(15).
1
REPORT OF SURVEY OF AIR POLLUTION PREVENTION CERTIFICATE
To meet Regulations of Annex VI of the International Convention for the Prevention of Pollution from Ships, 1973/78, as amended,
in accordance with Resolution MEPC.128(53)
X INITIAL SURVEY
-- ANNUAL SURVEY
-- INTERMEDIATE SURVEY
-- RENEWAL SURVEY
-- ADDITIONAL SURVEY
Mark YES or NO by a circle in appropriate box for each item. If an item is not applicable mark NA in
appopriate box. All negative entries should be clarified under Surveyors Notes with reference to the item
number.
All required dates should be recorded at these surveys as dd/mm/yy.
Name of ship Distinctive number Port of Gross Dead weight(1) IMO Number
or letter Registry Tonnage
NAIYA CPB-3019 LA PAZ 999 --
8408454
Date of commenced of major engine conversion (if applicable) (Reg. 13) N/A
Type of Ship:
-- Tanker X Ship other than a Tanker
Place of Survey: -- in Dry Dock -- on slipway X afloat Survey commenced: JULY 28h, 2014.
At: MIAMI, FLORIDA. Survey completed: AUGUST 1st, 2014.
A GENERAL Y N N/A
Have any changes been made or any new equipment installed which would affect the
1 validity of the International Air Pollution Prevention Certificate / Certificate of
Compliance? If YES, provide details under REMARKS column below)
Were all other statutory and Classification certificates valid at the time of survey (details
2
in Section B of this report)?
Was the structure, equipment, systems, fittings arrangements and materials examined for
3
compliance with the relevant requirements of MARPOL 73/78, Annex VI
B DOCUMENTATION Y N N/A
Checking the validity, including appropriate endorsement, of the following certificates and records (If not valid,
1
provide details under REMARKS column below):
Cargo Ship Safety Equipment, Cargo Ship Safety Construction, Cargo Ship Safety
1.1
Radio or the Cargo Ship Safety Certificate;
1.2 Safety Management Certificate (SMC) and Document of Compliance (DOC);
F-APS-01/a 1/6
Checking that the ships complement complies with the Minimum Safe Manning
1.7
Document (SOLAS 74/88, reg.V/13(b));
Checking that the master, officers and ratings are certificated as required by the
1.8
STCW Convention;
1.9 Checking whether any new equipment has been fitted and, if so, confirm that it has
been approved before installation and that any changes are reflected in the appropriate
certificate;
1.10 Checking whether the appropriate entries have been made in the Oil record book
(MARPOL 73/78, Annex I, Reg 17 ,chapter 3).
2
Engine International Air Pollution Prevention (EIAPP) Certificate
Date of installation before 1 Jan. 2000
2.1 #1 (Main) engines power (KW):
onboard: on or after 1 Jan. 2000
Date of installation before 1 Jan. 2000
#2 Engines power (KW):
onboard: on or after 1 Jan. 2000
Date of installation before 1 Jan. 2000
#3 Engines power (KW):
onboard: on or after 1 Jan. 2000
Date of installation before 1 Jan. 2000
#4 Engines power (KW):
onboard: on or after 1 Jan. 2000
Date of installation before 1 Jan. 2000
#5 Engines power (KW):
onboard: on or after 1 Jan. 2000
Date of installation before 1 Jan. 2000
#6 Engines power (KW):
onboard: on or after 1 Jan. 2000
(Additional)
For all engines over 130kW, other than solely emergency engine, installed or replaced on
2.2 or after 1 January 2000, are EIAPP certificates issued by IRS or recognized society If
first time survey by IRS, copy of EIAPP shall be attached to this report.
2.3 There is an approved technical file for each certified engine onboard.
Confirm that there are bunker delivery notes and fuel oil samples on board as required by
3
MARPOL 73/78 Annex VI regulation 18 .
4 Confirm that there is an approved certificate of exhaust gas cleaning (if appropriate);
Confirm that there is a type approval certificate for each incinerator onboard, if
appropriate:
5 - Required for incinerator(s) installed on or after 1 January 2000.
- If first time survey by IRS, copy of the type approval certificates shall be attached
to this report.
6 Confirm that there is a record book of engine parameters (if appropriate);
Confirm that there are written procedures covering fuel changeover and log book for
recording fuel change over as required by MARPOL 73/78 Annex VI regulation 14.6.
7
This information could be contained in the engine room log book, the deck log book, the
official log book, the oil record book or a separate log book solely for this purpose;
Confirm that there is a type approval certificate for the VOC (see C4 below) collection
8
system (if appropriate);
9 Confirm that there is an instruction manual for each type of incinerator;
F-APS-01/a 2/6
C2 NITROGEN OXIDE EMISSIONS FROM DIESEL ENGINES Continued Y N N/A
Confirm that the engine has not undergone any modifications or adjustments outside the
1.2
levels permitted in the technical file since the last survey;
1.3 Conduct survey as detailed in the on-board system in the technical file;
If an electronic management system is used check against the original settings proved by
1.4
the engine manufacturer.
2 If the simplified method is used:
2.2 Confirm that the test procedure has been approved by the Administration;
Confirm that the test equipment is of the correct type and has been calibrated in
2.3
accordance with the NOx Technical Code;
Confirm that the correct test cycle, as defined in the engines technical file, is used for the
2.4
on- board confirmation test measurements;
2.5 Ensure that a fuel sample is taken during the test and submitted for analysis;
Confirm that a copy of the test report has been submitted for approval on completion of
2.6
the test.
3 If the direct measurement and monitoring method is used:
review engine documentation and technical file and verify that the direct measurement
and monitoring method is documented in an on board monitoring manual based on the
3.1 guidelines contained in MEPC.103(49) and is approved by the Administration. The
approval reference of that manual should be entered under section 3 of the supplement to
the EIAPP Certificate;
confirm that the test procedure has been approved by the Administration. Engine
operation on board may not always be possible, but the test procedure, as approved by the
3.2
Administration, should be as close as possible to the procedure defined in the
NOx Technical Code, paragraph 3.2;
confirm that test equipment has been calibrated in accordance with the NOx Technical
3.3 Code and is operational in accordance with resolution MEPC.103(49) and that analyzing
equipment is operated in accordance with the manufacturers recommendations;
review data currently available on board and confirm that the weighted average NOx
3.4 emissions are in accordance with the NOx Technical Code and that data evaluation is
conducted in accordance with section 4 of resolution MEPC.103(49);
review and confirm that the last three months engine operating data is maintained on
board and is in accordance with the technical file. Data is required to be current that is
within the last 30 days. Data within the 30-day period may be collected as either a single
3.5 test
sequence across the required load points or may be obtained on two or more separate
occasions when the engine load corresponds to that required by section 3.1 of resolution
MEPC.103(49);
if an after-treatment device is installed verify from an external examination that the
3.6
device is in a generally satisfactory condition;
3.7 if an after-treatment device is installed verify its operation and NOx compliance;
if an after-treatment device is installed and additional substances are introduced (for
3.8 example steam, water or urea) verify consumption meter operation in accordance with
resolution MEPC.103(49);
if an after-treatment device is installed confirm any adjustments or modifications are
3.9
within the limits allowed in the technical file;
C2 NITROGEN OXIDE EMISSIONS FROM DIESEL ENGINES Continued Y N N/A
if an after-treatment device is installed and adjustments or modifications to the device are
3.10 outside the limits set in the technical file confirm that they have been verified as not to
exceed the NOx limits set down in MARPOL 73/78 Annex VI regulation 13.
For marine diesel engines of an output more than 5,000 kW and a per cylinder displacement at or above 90
4
litres/cylinder installed on ships constructied between 1st Jan 1990 and 31st December 1999, check whether;
F-APS-01/a 3/6
C3 SULPHUR OXIDES N/A Y N N/A
Verify from an external examination the exhaust gas cleaning system is in a generally
1
satisfactory condition (if fitted);
Is the exhaust gas cleaning system approved in accordance with the IMO guidelines [to
2
be developed] (if fitted);
Verify that the exhaust gas cleaning system is operating correctly in accordance with the
3
manufacturers instructions (if fitted);
Verify that there are records of the change over to and from low sulphur fuel during
4
transit though a SOx emission control area;
Confirm that where there are tanks fitted for low and normal sulphur content fuel that fuel
5
switching arrangement are provided and operational;
Review bunker notes and confirm the correct sulphur content of fuel oil for the area of
operation(MARPOL 73/78 Annex VI, Reg. 14):
(Note: Please Check Sulphur content of both the areas mentioned below)
6
a) For any area (Other than SECA), Sulphur Content shall not exceed 4.5% m/m
b) For Sulphur Emission Controlled Areas (SECA), Sulphur Content shall not exceed 1.0
% m/m after July 1st 2010
C4 VOLATILE ORGANIC COMPOUNDS (VOCs) N/A Y N N/A
Confirm from a general examination that the vapour collection piping is in a satisfactory
1
condition;
Confirm that there is a means provided to eliminate the collection of condensation in the
2 system, such as drains in low points of the line end. The drains should be checked to
ensure they function correctly.
Confirm that the piping is electrically continuous and electrically bonded to the hull and
3
that the bonding is intact;
Confirm that the isolation valves at the vapour manifolds are operational and that the
4
valve position indicators operate correctly;
5 Confirm that the ends of each line is properly identified as vapour collection lines;
Confirm that the vapour collection flanges are in accordance with the IMO guidelines and
6
industrial standards;
Confirm that where portable vapour lines are provided that they are in good condition and
7
electrically continuous;
Confirm that the closed gauging system is operational and the readouts in the cargo
8
control area are functional;
9 Confirm that there is an overflow control system provided and that it is operational;
Confirm that the alarm system is operational, both audible and visual alarms operate, the
10 alarms are properly labelled; the power failure alarm operates and that there is a means to
check the operation of the alarms and that this means is operational;
Confirm that there are high and low pressure alarms provided for each main vapour line
11
and that these alarms operate at the correct set points;
Confirm that the high level and high level (overfill) alarms act independently of each
12
other;
C4 VOLATILE ORGANIC COMPOUNDS (VOCs) Continued Y N N/A
Confirm that the vapour collect system is approved taking into account MSC/Circ 585
13
Standards for Vapour Emission Control Systems.
Confirm that there is a VOC Management Plan for ships carrying crude oil
14
(regulation 15.6 of Annex VI)
15 Confirm that there is a transfer procedure, if required, for the VOC collection system.
Confirm that the warning and instruction plates are legible and secured in prominent
2
positions on or near the incinerator;
Confirm that the manufacturers name, incinerator model number/type and capacity in
3
heat units per hour is permanently marked on the incinerator;
4 Confirm that the incinerator casing insulation arrangements are in good condition;
5 Confirm that the following alarms and safety devices are in good condition and fully operational:
F-APS-01/a 4/6
5.1 - flue gas high temperature alarms and shut downs;
5.10 - interlocks;
Confirm that drip trays are fitted under each burner, pump, and strainer and that they are
9
in good condition;
Confirm that the combustion camber flue gas outlet temperature verified as between 850
10
1200 degrees C;
Confirm that each incinerator installed on board after 1 January 2000 shall be type
11
approved and meets the operating limits in accordance with resolution MEPC.76(40);
Confirm that procedures for the safe operation of any incinerator are included in the
12
ships ISM safety documentation.
3.2 Previous IAPP certificate, if any, issued by other R.O. prior to this survey
Type approval certificate for each incinerator onboard, if appropriate (reference to B.5
3.3
above)
Type approval certificate for the VOC collection system, if appropriate (reference to B.8
3.4
above)
F-APS-01/a 5/6
Approval of the Vapour Collection System if installed on the tanker (reference to C4.13
3.5
above)
E ANNUAL / INTERMEDIATE SURVEY N/A Y N N/A
I have endorsed the FULL TERM HSSC INTERNATIONAL AIR POLLUTION PREVENTION
1
CERFIFICATE as required by Reg. vi/5. As Annual /Intermediate Survey completed satisfactorily.
HSSC CSSC FULL TERM CERTIFICATE No. ___________________________________
I have endorsed the FULL TERM HSSC INTERNATIONAL AIR POLLUTION PREVENTION
CERTIFICATE as required by Reg. VI/9(8) As the Annual / INTERMEDIATE* Survey have been
completed Satisfactory.
HSSC CSSC FULL TERM CERTIFICATE No. __________________________________
Vessel have been found with MAYOR deficiencies and the existing HSSC CSSE have to be withdrawn
Vessel is a new-building
I I RECOMMEND: Y N N/A
No FULL TERM HSSC INTERNATIONAL AIR POLLUTION PREVENTION CERTIFICATE is to be
issued before the RECTIFICATION OF THE REMARKS are completed.
The issuance of a FULL TERM HSSC INTERNATIONAL AIR POLLUTION PREVENTION
CERTIFICATE valid for a period not exceeding 5 years.
X
st
REPORT ISSUED AT: MIAMI, FLORIDA ON AUGUST 1 , 2014. (MM/DD/YYY)
ARMANDO ARRASCAETA
Surveyor No. 4001 to CONARINA
Name, Signature and Surveyor Seal
This is to declare that the undersigned has examined and filled all the items of this report before signed it.
1
Delete as appropriate
F-APS-01/a 6/6
FORM F-OPC-04b
CERTIFICATE No: GG-4459
AUTHORIZATION No.: AAMGB0514
FORM A
Supplement to the International Oil Pollution Prevention Certificate
(IOPP Certificate)
RECORD OF CONSTRUCTION AND EQUIPMENT
FOR SHIPS OTHER THAN OIL TANKERS
In respect of the provisions of Annex I of the International Convention for the Prevention of Pollution from Ships,
1973, as modified by the protocol of 1978 relating thereto (hereinafter referred to as the Convention)
Note:
1. This form is to be used for the third type of ships as categorized in the IOPP Certificate, i.e. "ships other than
any of the above". For oil tankers and ships other than oil tankers with cargo tanks coming under
Regulation 2(2) of Annex I of the Convention, FORM B shall be used.
2. This Record shall be permanently attached to the IOPP Certificate. The IOPP Certificate shall be available
on board the ship at all times.
3. If the language of the original Record is neither English nor French, the text shall include a translation into
one of these languages.
4. Entries in boxes shall be made by inserting either a cross (X) for the answers "yes" and "applicable" or a dash
(-) for the answers "no" and "not applicable" as appropriate.
5. Regulations mentioned in this Record refer to regulations of Annex I of the Convention and resolutions refer
to those adopted by the International Maritime Organization.
1 PARTICULARS OF SHIP
Page. 1/ 4
FORM F-OPC-04b
CERTIFICATE No: GG-4459
AUTHORIZATION No.: AAMGB0514
2.1.1 The ship may under normal conditions carry ballast water in oil fuel tanks
2.1.2 The ship does not under normal conditions carry ballast water in oil fuel tanks
2.2.2. Oil filtering (15 ppm) equipment with alarm and automatic stopping device
(Regulation 14 (7)) X
2.2.2.1 Manufacturer: BOSS
X
2.2.2.2. Type and model number as per certificate of type test: 2.2 T/107 X
2.3.2 The process unit has been approved in accordance with resolution A. 444(XI)
1
Refer to Recommendation on international performance and test specification of oily-water separating equipment and oil content
meters adopted by the Organization on 14 November 1977 by resolution A.393(X), which superseded resolution A.233 (VII). Further
reference is made to the Guidelines and specifications for pollution prevention equipment for machinery space bilges adopted by the
Marine Environment Protection Committee of the Organization by resolution MEPC.60(33) which, effective 6 July 1993, superseded
resolutions A.393(X) and A.444(XI) and the revised Guidelines and specifications for pollution prevention equipment for machinery
spaces of ships adopted by the Marine Environment Protection Committee of the Organization by resolution MEPC.107(49) which,
effective from 1 January 2005,superseded resolutions MEPC.60(33),A.393(X) and A.444(XI).
Page. 2/ 4
FORM F-OPC-04b
CERTIFICATE No: GG-4459
AUTHORIZATION No.: AAMGB0514
2.5.1. The requirements of regulation 14 (1) or 14 (2) are waived in respect of the ship in accordance
With regulation 14 (5)
.2 The ship is certified under the International Code of Safety for High Speed Craft and
Engaged on a scheduled service with a turn-around time not exceeding 24 hours
2.5.2 The ship is fitted with holding tank(s) for total retention on board of all
oily bilge water as follows:
Tank Location
Volume
Tank Identification Frames (m3)
Lateral Position
(from)-(to)
2A.1 The ship is required to be constructed according to regulation 12A and complies
With the requirements of:
2A.2 The ship is not required to comply with the requirements of regulation 12A
3.1 The ship is provided with oil residue (sludge) tanks for retention of oil residues (sludge) onboard as
Follows:
Tank Location
Volume
Tank Identification Frames (m3)
Lateral Position
(from)-(to)
SLUDGE TANK 13 - 16 PORT SIDE 4.3
DIRTY OIL TANK 20 22 PORT SIDE 5.3
LEAK TANK 16 - 18 PORT SIDE 2.1
Total Volume
11.7
(m3):
Page. 3/ 4
FORM F-OPC-04b
CERTIFICATE No: GG-4459
AUTHORIZATION No.: AAMGB0514
3.2 Means for the disposal of oil residues (sludge) retained in oil residue (sludge) tanks:
3.2.1 Incinerator for oil residues (sludge), maximums capacity __________ KW or kcal/h
3.3 The ship is fitted with holding tanks(s) for the retention on board of oily bilge water as follows
Tank Location
Volume
Tank Identification Frames (m3)
Lateral Position
(from)-(to)
Total Volume
3.6
(m3):
2 Bilge water holding tank(s) are not required by the convention, entries in the table under paragraph 3.3 are voluntary
6 EXEMPTION
6.1 Exemptions have been granted by the Administration from the requirements of Chapter III
Of Annex I of the Convention in accordance with regulation 3.1 on those items listed under
Paragraph (s) ________ of this Record
7 EQUIVALENTS (regulation 5)
7.1 Equivalents have been approved by the Administration for certain requirements of Annex I
of those items listed under paragraph(s) ________________ of this Record.
ARMANDO ARRASCAETA
SURVEYOR No. 4001 TO CONARINA.
Page. 4/ 4
FORM F-OPC-02b
CERTIFICATE No: GG-4459
AUTHORIZATION No.: AAMGB0514
Issued under the provisions of the International Convention for the Prevention
Of Pollution from Ships, 1973, as modified by the Protocol of 1978 relating
thereto, as amended, (hereinafter referred to as the Convention) under the
authority of the Government of :
REPUBLIC OF BOLIVIA
By CONARINA.
PARTICULARS OF SHIP1
THIS IS TO CERTIFY:
1. That the ship has been surveyed in accordance with regulation 6 of Annex I of the Convention; and
2. That the survey shows that the structure, equipment, systems, fittings, arrangements and material of the ship and the
condition thereof are in all respects satisfactory and that the ship complies with the applicable requirements of Annex I of
the Convention.
This Certificate is valid until DECEMBER 31st, 2014 subject to surveys in accordance with regulation 6 of Annex I of the
Convention.
Completion date of the survey on which this certificate is based: OCTOBER 15th, 2010.
1
REPORT OF INTERNATIONAL OIL POLLUTION PREVENTION SURVEY
FOR MACHINERY SPACE OPERATIONS (ALL SHIPS)
To meet Regulations of Annex I of the International Convention for the Prevention of Pollution from Ships, 1973 and its 1978
Protocol
X INITIAL SURVEY
-- ANNUAL SURVEY
-- INTERMEDIATE SURVEY
-- RENEWAL SURVEY
-- ADDITIONAL SURVEY
Type of ship: -- Oil tanker -- Combination carrying oil or solid cargoes in bulk.
-- Chemical tanker X Cargo ship other than any of above
-- Gas carrier
Place of survey: -- in drydock -- on slipway X afloat Survey commenced: JULY 29, 2014.
At: MIAMI, FLORIDA. Survey completed: AUGUST 1, 2014.
(1)
An intermediate survey, but not an unscheduled inspection, may take the place of a mandatory annual survey
(2)
For oil tankers, chemical tankers and gas carriers only
(3)
Entries in boxes shall be made by inserting either a cross (X) for the answer yes or a dash (-) for the answers no and na where is not applicable
(4)
All negative entries should be clarified under Surveyors Notes with reference by item number
(5)
This survey will only be applied to a ship 400 GRT which is required to hold an International Oil Pollution Prevention (IOPP) Certificate.
F-OPS-01/a 1/8
A1 INITIAL SURVEY (ALL SHIPS) Y N N/A
1 Have plans and designs for the following been checked and found complying with applicable regulations?
Examining the arrangements, plan and design for the oil filtering equipment and 15 ppm
1.1
alarm system. (Reg. 14)
Arrangements for the segregation of oil and water ballast and the prohibition of the carriage
1.2
of oil in tanks forward of the collision bulkhead (Reg. 12)
1.3 Arrangement of the sludge tank capacity and standard discharge (Reg. 12 & 13)
1.5 Examining the oil fuel tank protection arrangement (Reg. 12A)
2 For survey during construction and after installation to check the following;
Confirm the satisfactory installation and operation of, as appropriate, (Reg. 14 & 15)
2.1 Oil Filtering Equipment Maker : BOSS
Model / Serial Number : 2.2 T/107
Oil Content meter Maker : BOSS
2.2
Model / Serial Number : 2.2 T/107
Testing, where fitted, the automatic stopping device required for discharges in Special Areas
2.3
(Reg. 15)
Confirming the segregation of oil fuel and water ballast system and the non-carriage of oil in
2.4
forepeak tanks. (Reg. 16)
Confirming the oily residue (sludge) tank and its discharge arrangement are satisfactory and,
when the size of the sludge tank is approved on the basis of such installations, confirming
2.5
the satisfactory operation of homogenizers, sludge incinerators or other recognized means
for control of sludge (Reg. 12)
2.6 Confirming the provision for Standard Discharge Connection (Reg. 13)
2 For survey during construction and after installation to check the following;
Confirming arrangement of slop tanks or cargo tanks designated as slop tanks and associated
2.1
piping systems are satisfactory (Reg. 29 and 34)
Satisfactory installation and operation of; (Reg. 31 & 34)
Oil Discharge Monitoring & Control System
Maker :
2.2
Model / Serial Number :
Oil Content meter Maker :
Model / Serial Number :
2.3 Confirming approved oil/water interface detectors are onboard and operational
Confirming arranging of pumps, pipes and valves are in accordance with requirements for
2.4 segregated ballast systems and that there are no cross-connections between cargo and
segregated ballast systems (Reg.18)
Portable spool piece is provided for emergency discharge of segregated ballast by
connecting segregated ballast system to a cargo pump, confirming that non-return valve are
2.5
fitted on the segregated ballast connections and the spool piece is in a conspicuous position
in the pump room with a permanent notice restricting its use (Reg. 18)
Testing ballast pipelines that pass through cargo tanks and those cargo pipelines that pass
2.6
through ballast tanks to ensure there is no cross contamination (Reg. 18)
Confirming Crude Oil Washing System is installed in accordance with the approved plans (Reg. 18 & 33) in
2.7
particular;
Piping, pumps, valves, deck-mounted washing machines, all anchoring devices are intact
2.7.1
and secure;
2.7.2 Carry out pressure testing of crude oil washing system to 1.5 times working pressure;
Confirming in those cases where drive units are not integral with tank washing machines,
2.7.3
that the number of operational drive units specified in the manual are onboard;
Checking that, when fitted, steam heaters for water washing can be properly isolated during
2.7.4 crude oil washing operations, either by double shut-off valves or by clearly identifiable
blanks;
Checking that the prescribed means of communication between the deck watch keeper and
2.7.5
the cargo control position is operational;
Confirming that an overpressure relief device (or other approved arrangement) is fitted to
2.7.6
the pumps supplying the crude oil washing system;
Verifying that flexible hoses for supply of oil to the washing machines on combination
2.7.7
carriers are of an approved type, are properly stored and are in good condition;
2.8 Verifying the effectiveness of Crude Oil Washing System; (Reg. 33) in particular;
Checking that the crude oil washing machines are operable and observing the proper
2.8.1 operation of the washing machines by means of the movement indicators and/or sound
patterns or other approved methods;
Checking the effectiveness of the stripping system in appropriate cargo tanks by observing
2.8.2
the monitoring equipment and by hand-dipping or other approved means;
Verifying by internal tank inspection after crude oil washing that the installation and
2.8.3
operational procedures laid down in the Operations and Equipment Manual are satisfactory;
Confirming that, where there is a crude oil washing system, an inert gas system has been
2.9
installed and tested in accordance with the requirements of SOLAS 74/88/2000;
Confirming, as appropriate, that the arrangements for the prevention of oil pollution in the
2.10
event of collision or stranding are in accordance with the approved plans (Reg. 19 to 22);
F-OPS-01/a 3/8
Confirming that the piping systems associated with the discharge of dirty ballast water or
2.11
oil-contaminated water is satisfactory (Reg. 30);
Confirming that the observation and discharge control positions for visually observing the
2.12 discharge of oil-contaminated water, including the testing of the communication system
between the two positions are satisfactory (Reg. 30);
Confirming that the means of draining cargo pumps and cargo lines, including the provision
2.13 of a stripping device and the connections for pumping to the slop or cargo tanks or ashore,
are satisfactory (Reg. 30);
Confirming that the arrangements for the part flow system, where fitted, are satisfactory
2.14
(Reg. 30);
Confirming that closing devices installed in the cargo transfer system and cargo piping, as
2.15
appropriate, are satisfactory (Reg. 23 & 26);
Confirming that the subdivision and stability arrangements, in addition to the provision of
2.16
A2.2.15, to prevent progressive flooding are satisfactory (Reg. 23 & 26);
Confirming the arrangements for cargo pump-room bottom protection (double bottom where
2.17
required) (Reg. 22).
3 Check to ensure following documents are available onboard:
confirming that, if applicable, a Dedicated Clean Ballast Tank Operation Manual has been
3.1
provided (Reg. 18);
confirming that, if applicable, a Crude Oil Washing Operations and Equipment Manual has
3.2
been provided (Reg. 35);
confirming that an operations manual for the oil discharge monitoring and control system
3.3 has been provided together with any other documentation requested by the applicable
resolution2 (Reg. 31);
confirming that certificates for type approval for the oil content meters, oil discharge
3.4 monitoring and control system and oil/water interface detectors are available
(Regs. 31 and 32);
3.5 confirming that the Oil Record Book (Part II) has been provided (Reg. 36);
confirming that the instructions for the operation of the part flow system have been provided
3.6
or included in the ships cargo and ballast handling manuals (Reg. 30.6.5);
confirming that the information and data concerning the subdivision and damage stability
3.7
has been provided (Reg. 28);
confirming that the shipboard oil pollution emergency plan or in the case of a
3.8 chemical/product tanker a shipboard marine pollution emergency plan has been provided
(Reg. 37);
confirming, for oil tankers of 5,000 deadweight and above delivered on/after 1 February
3.9
2002, that the intact stability has been approved (Reg.27);
confirming, for oil tankers of 5,000 deadweight and above, that arrangements are in place to
3.10 provide prompt access to shore-based damage stability and residual structural strength
computerized calculation programmes (Reg. 37.4).
B1 ANNUAL SURVEY (ALL SHIPS) N/A Y N N/A
F-OPS-01/a 4/8
Checking whether the appropriate entries have been made in Part I of the Oil Record Book
1.6
(Reg. 17).
Examining externally the oil filtering equipment and confirming, as far as practicable, its
satisfactory operation including, when appropriate, testing the operation of the automatic
2
means provided to stop the discharge of effluent and the alarm for the oil filtering equipment
(Reg. 14 and 15);
Testing, where fitted, the oil filtering equipment required for discharge in special areas
3
(Reg. 15);
Confirming the segregation of oil fuel and water ballast systems and that the arrangements
4 prohibit the carriage of oil in forepeak tanks or in spaces forward of the collision bulkheads
(Reg. 16);
Checking that the arrangement of oily residue (sludge) tank and its discharge arrangements
5 are satisfactory and confirming that, where applicable, homogenizers, sludge incinerators or
other recognized means for the control of sludge are satisfactory (Reg. 12);
6 Confirming that a standard discharge connection is provided. (Reg. 13).
F-OPS-01/a 5/8
Testing, as far as practicable, any audible or visual alarms fitted to the oil discharge
2.4
monitoring and control system;
3 Examining, as far as practicable, the oil/water interface detectors (Reg. 32);
Confirming that no cross-connections have been fitted between the cargo and segregated
4
ballast systems (Reg. 18);
Where a portable spool piece is provided for the emergency discharge of segregated ballast
by connecting the segregated ballast system to a cargo pump, confirming that non-return
5 valves are fitted on the segregated ballast connections and that the spool piece is mounted in
a conspicuous position in the pump room with a permanent notice restricting its use (Reg.
18);
Confirming by sighting that there has been no contamination with oil in the segregated
6
ballast tanks (Reg. 18);
Confirming, as far as practicable, that the dedicated clean ballast tank arrangement remains
7
satisfactory (Reg. 18);
Confirming by sighting that there has been no contamination with oil in the dedicated clean
8
ballast tanks (Reg. 18);
9 Confirming, as far as practicable, that the crude oil washing system remains satisfactory (Reg. 33) and, in particular:
Examining externally the crude oil washing piping, pumps, valves and deck mounted
9.1 washing machines for signs of leakage and checking that all anchoring devices for crude oil
washing piping are intact and secure;
Confirming, in those cases where drive units are not integral with the tank cleaning
9.2
machines, that the number of operational drive units as specified in the Manual are on board;
Checking that, when fitted, steam heaters for water washing can be properly isolated during
9.3
crude oil washing operations, either by double shut-off valves or clearly identifiable blanks;
Checking that the prescribed means of communications between the deck watch keeper and
9.4
the cargo control position is operational;
Confirming that an overpressure relief device (or other approved arrangement) is fitted to
9.5
the pumps supplying the crude oil washing systems;
Confirming that flexible hoses for supply of oil to the washing machines on combination
9.6
carriers, are of an approved type, are properly stored and are in good condition;
Verifying, where applicable and as far as practicable, the effectiveness of the crude-oil washing system (Reg. 33)
10
and, in particular:
Checking tanks containing departure and/or arrival ballast water, as applicable, to confirm
10.1
the effectiveness of the cleaning and stripping;
Checking, as far as practicable, that the crude oil washing machines are operable and, when
the survey is carried out during crude oil washing operations, observing the proper operation
10.2
of the washing machines by means of the movement indicators and/or sound patterns or
other approved methods;
checking, as far as practicable, the effectiveness of the stripping system in appropriate cargo
10.3
tanks by observing the monitoring equipment and by hand-dipping or other approved means;
confirming that on those existing tankers operating with special ballast arrangements, the
11
arrangements are as approved and are satisfactory (Reg. 18);
confirming, as appropriate and as practicable, that the arrangements for the prevention of oil
12 pollution in the event of collision or stranding are approved and are satisfactory (Regs. 19 to
22);
examining the piping systems associated with the discharge of dirty or oil-contaminated
13
water including the part flow system, if fitted (Reg. 30);
testing the communication system between the observation and discharge control positions
14
(Reg. 30);
examining the means of draining cargo pumps and cargo lines, including the stripping
15
device and the connections for pumping to the slop or cargo tanks or ashore (Reg. 30);
confirming for oil tankers of 5,000 deadweight and above that arrangements are in place to
16 provide prompt access to shore-based damage stability and residual structural strength
computerized calculation programmes (Reg. 37.4).
C1 INTERMEDIATE SURVEY (ALL SHIPS) N/A Y N N/A
5 Confirming the satisfactory operation of the alarm for the oil filtering system (Reg. 15);
Confirming the satisfactory operation of homogenizers, sludge incinerators or other
6 recognized means for the control of sludge when the size of oily residue (sludge) tank is
approved on the basis of such installations (Reg.12).
D2 RENEWAL SURVEY (TANKERS) N/A Y N N/A
I have endorsed the FULL TERM HSSC INTERNATIONAL OIL POLLUTION PREVENTION
1
CERFIFICATE as required by Reg. vi/5. As Annual /Intermediate Survey completed satisfactorily.
HSSC CSSC FULL TERM CERTIFICATE No. ___________________________________
I have endorsed the FULL TERM HSSC INTERNATIONAL OIL POLLUTION PREVENTION
CERTIFICATE as required by Reg. VI/9(8) As the Annual / INTERMEDIATE* Survey have been
completed Satisfactory.
HSSC CSSC FULL TERM CERTIFICATE No. __________________________________
Implementation of HSSC
Vessel have been found with MAYOR deficiencies and the existing HSSC CSSE have to be withdrawn
Vessel is a new-building
I I RECOMMEND: Y N N/A
No FULL TERM HSSC INTERNATIONAL OIL POLLUTION PREVENTION CERTIFICATE is to be issued
before the RECTIFICATION OF THE REMARKS are completed. X
The issuance of a FULL TERM HSSC INTERNATIONAL OIL POLLUTION PREVENTION CERTIFICATE
valid for a period not exceeding 5 years.
This is to declare that the undersigned has examined and filled all the items of this report before signed it.
ARMANDO ARRASCAETA
Surveyor No. 4001 to CONARINA
Name, Signature and Surveyor Seal
1
Delete as appropriate
F-OPS-01/a 8/8
FORM F-SRC-02b
CERTIFICATE No: DD-4490
AUTHORIZATION No.: AAMDB0614
PARTICULARS OF SHIP1
Date on which keel was laid or ship was at a similar stage of construction or, where applicable, date on
which work for a conversion or an alteration or modification of a major character was commenced:
APRIL, 1985.
1
Alternatively, the particulars of the ship may be placed horizontally in boxes.
2
In accordance with IMO ship identification number scheme adopted by the Organization by resolution A.600(15).
Page 1 of 2
FORM F-SRC-02b
CERTIFICATE No: DD-4490
AUTHORIZATION No.: AAMDB0614
THIS IS TO CERTIFY:
1. That the ship has been surveyed in accordance with the requirements of regulation I/9 of the
Convention.
2.1 the ship complied with the requirements of the Convention as regards radio installations;
2.2 the functioning of the radio installations used in life-saving appliances complied with the
requirements of the Convention.
This certificate is valid until: DECEMBER 31st, 2014 subject to the periodical surveys in accordance with
regulation I/9 of the Convention.
Completion date of the survey on which this certificate is based: OCTOBER 15th, 2010.
ARMANDO ARRASCAETA
Surveyor No. 4001 to CONARINA
3
Delete as appropriate.
Page 2 of 2
REPORT
of 406 MHz/121.5 MHz BEACON testing
Report date: 8/1/2014 Date of testing: 1/8/2014
BEACON IDENTIFICATION
BEACON Model: Ocean Signal
*The tests were carried out by BEACON Tester 406 02 of Musson Marine Ltd.
FORM F-SRC-04b
CERTIFICATE No: DD-4490
AUTHORIZATION No.: AAMDB0614
1 PARTICULARS OF SHIP
Name Of Ship : NAIYA
Distinctive Number of Letters : CPB-3019
Minimum Number of Persons with required
Qualifications to operate the radio installations : TWO
1 Primary Systems
1.3.3 Radiotelephony --
Page 1 of 2
FORM F-SRC-04b
CERTIFICATE No: DD-4490
AUTHORIZATION No.: AAMDB0614
4.2 INMARSAT --
5 VHF EPIRB --
ARMANDO ARRASCAETA
Surveyor No. 4001 to CONARINA
Page 2 of 2
RECORD OF SAFETY RADIO EQUIPMENT
FOR GMDSS SHIPS
CARGO SHIP / PASSENGER SHIP (1)
Under the provisions of the International Convention for the Safety of Life at Sea, 1974,
as modified by the Protocol of 1988 relating thereto,
for ships required to fully comply with the GMDSS requirements.
(This form must be kept on board and be available for inspection by a nominated Surveyor at all times)
Name of Ship Gross Date Keel
Port of Registry IMO Number
Tonnage Laid
This form has been completed by a Radio Technician belonging to a Society or approved as subcontractor by
CONARINA
The information contained in this record is a correct description of the Safety Radio Equipment on board.
CONARINA
1.1 Are all radio controls for operating the radio installation adequately X
illuminated?
1.2 Are the vessels call sign, ship station identity, and other codes, as applicable, X
for use of the Radio station posted?
1.4 Is the radio installation(s) so located that no harmful interference affects its use X
and so located to ensure the greatest possibility of operational availability
1.5 Are radio logs and the latest edition of radio regulations provided? X
1.9 Is the antenna fitted as high as possible, sufficiently separated from other X
antennas, and fitted in such a position that no obstacles significantly
degrade its performance
1.10 In the case of INMARSAT-A or other tracking antenna, is there a means for X
ensuring continuous supply of ships heading information?
Voltage Capacity
Make and Type Location
(V) (in Ah)
1 hour or YES NO NA
6 hours X YES NO NA
MF radio installation X
Battery (*)
(*) Reference is made to regulations II 1/42.3.2 and 43.3.2 if the emergency source is an accumulator battery
(Do not confuse this item with the reserve source of energy in item 3 of this record.)
5. COMPOSITION OF RADIO INSTALLATION (check all boxes that apply) (IV/8, 9,10, 11 & 15)
5.1 Primary system
X combined with VHF radio installation or separated from VHF radio installation
and Separated VHF DSC controller (encoder):
X combined with VHF radio installation and or separated from VHF radio
Separated VHF DSC watch receiver on channel installation
70:
Initiation of DSC distress alert transmission on 2187.5 kHz at normal navigation X YES NO
position
Initiation of DSC distress alert transmission from normal navigation position (IV/9.2) YES NO
6.3.1 MF/HF DSC FUNCTION
combined with MF/HF radio installation or separated from MF/HF radio
installation
and Separated MF/HF DSC terminal (encoder):
Standard
Make and type Location
(A, B, C, etc.)
1 C RADIO CONSOLE
Thrane & Thrane 3020C
2 Thrane & Thran 6110 C RADIO CONSOLE
Initiation of distress alerts transmission from normal navigation position X YES NO
beacon.
8.1 VHF EPIRB FOR DSC CHANNEL 70 AND LOCATING BY SART (IV/8.3) (IN LIEU OF THE
SATELLITE EPIRB)
X To Radar No.2
17 MAINTENANCE REQUIREMENTS
Maker: NA
17.2.3 Duplicated MF/HF Radio Installation
Type:
(IV/10.2.1)
Location:
Maker: Thrane & Thrane
17.2.4 Duplicated INMARSAT Ship Earth Station
Type: 3020C
(SES) (IV, 10.1.1)
Location: Bridge
Copy of Contract X
attached...........
17.3.5 Shore-Based Maintenance Name of RIVERSIDE MARINE
Contractor: ELECTRONIC
Date of Issue:
Name of NO
17.4 Capability at Sea Electronic Maintenance Maintainer:
Certificate No:
Date of Issue:
Issued By:
Additional technician documents, tools , test
Equipment and spare parts
19.2 Radio Log is provided and properly maintained (ITU RR App. II) X
19.3 Alphabetical List of Call signs of Coast, Coast Earth; ship and Ship Earth Station, etc X
19.7(*) Manual for Use by the Maritime Mobile and Maritime Mobile Satellite Services X
19.10 Manual for all equipment when at sea maintenance is the declared option (IV/15) X
(*) Ship engaged exclusively on voyages within Sea Area A1 may not carry 18.4, 18.5, 18.6, 18.7.
20. SPECIAL MEASURES FOR PASSENGER SHIPS (IV/6 & IV/7)
20.3 Means for two-way on-scene radio communications for search and X
rescue purposes using the aeronautical frequencies 121.5 MHz and
123.1 MHz from
the position from which the ship is normally navigated: (IV/7.5)
ARMANDO ARRASCAETA
Name and Signature of duly authorized official issuing
the Record
CONARINA
FORM F-SRC-01b
SURVEY REPORT OF SAFETY RADIO EQUIPMENT
FOR GMDSS SHIPS
CARGO SHIP / PASSENGER SHIP (1) (2)
Under the provisions of the International Convention for the Safety of Life at Sea, 1974,
as modified by the protocol of 1988 relating thereto,
(For ships required to fully comply with the GMDSS requirements.)
Distinctive
Port of Gross
Name of Ship Number or IMO number
Registry Tonnage
Letters
This vessel has been approved to sail within the Sea Area (Reg. IV/2.1.12, 2.1.13, 2.1.14, 2.1.15)
A. DOCUMENTATION
A.4 The latest edition of the ITU Publications is provided and updated X
B.2 Two separated and independent means of ship-to-shore distress alerts YES
B.6 Clearly marked with: call sign, ship station identity and other codes as applicable YES
for use of the Radio Installation
B.7 Visual Checking of all antennas (insulation and safety) ... YES
B.9 The charger (s) are capable of recharging the reserve battery within 10 hours . YES
C.2 Checking frequency tolerance, transmission line quality and radio-frequency power YES
output
C.4 Main, emergency (if provided) and reserve sources of energy . YES
C.5 Operation of the VHF control unit (s) or portable VHF equipment provided for YES
navigational safety .
C.6 Correct operation by on-air contact with a Coast Station or other ship YES
C.7 Examining the VHF DSC controller and channel 70 DSC watch receiver YES
FORM F-SRC-01b
E.1 Correct operation on channel 16 and one other channel ... YES
E.2 Battery charging arrangements (where rechargeable batteries are used) .. YES
E.4 Where appropriate, checking any fixed installation provided in a survival craft .. NO
F.1 Correct operation by monitoring incoming messages or inspecting recent hard copy YES
G. INMARSAT EGC RECEIVER (ENHANCED GROUP CALLING) (IV 7.1.5 & 14)
G.1 Correct operation and area by monitoring incoming messages or by inspecting recent hard YES
copy
H.4 Checking that the EPIRB ID is clearly marked on the outside of the equipment . YES
FORM F-SRC-01b
H. 406 MHZ SATELLITE EPIRB (COSPAS-SARSAT) (IV/7 & 14) CONTINUATION OF ITEM H
H.8 Date of Annual Testing according IMO Guidelines MSC/Circ. 1040 and YES
SOLAS Regulation IV/15.9______________________________
(copy of test and report to be attached)
H.9 Date of periodical EPIRB maintenance should be carried out at intervals not NA
exceeding 5 years by an approved shore-based facility according IMO Guidelines
MSC 152 (78) - SOLAS Ch. IV Reg. 15.9.2 __________________________
(copy of test and report to be attached)
I.4 Checking that the EPIRB ID is clearly marked on the outside of the equipment ..
I.5 EPIRB ID No.
I.6 Expiry date of Battery:
I.7 Expiry date of hydrostatic release (if provided):
J.4 Checking that the EPIRB ID is clearly marked on the outside of the equipment
J.5 VHF EPIRB ID No.
J.6 Expiry date of Battery:
J.7 Expiry date of hydrostatic release (if provided):
FORM F-SRC-01b
K.1 Checking that the equipment operates from the main, emergency (if provided) and
reserve sources of energy .... YES
K.3 Confirming that only distress and safety DSC frequencies are being monitoring ... YES
K.4 Correct operation by means of a test call from a Coast Station or other ship or YES
inspecting recent hard copy ...
L.1 Checking that the equipment operates from the main, emergency (if provided) and
reserve sources of energy... YES
L.2 Checking the antenna tuning in all appropriate bands ..... YES
L.3 The equipment is within frequency tolerance on all appropriate bands ... YES
L.4 Correct operation by contact with a Coast Station and / or measuring transmission
line quality and radio frequency output YES
L.5 Receiver performance by monitoring known station on all appropriate bands YES
L.7 Correct Maritime Mobile Service identity is programmed in the equipment YES
L.9 Operation by means of a test call on MF and /or HF to a Coast Radio Station if the
rules of the berth permit the use of MF/HF transmissions . YES
L.11 Confirming that only distress and safety DSC frequencies are being monitored ... YES
L.12 Checking that a continuous watch is being maintained whilst keying MF/HF radio
transmitters .. YES
L.13 Correct operation by means of a test call from a coast station or other ship YES
FORM F-SRC-01b
M.1 Checking that the equipment operates from the main, emergency (if provided) and
reserve sources of energy ..... NA
M.2 Confirming that the correct selective calling number is programmed in the NA
equipment
M.3 Correct operation by inspection of recent hard copy or by a test with a Coast Radio NA
Station.
N.1 Checking that the equipment operates from the main, emergency (if provided) and
reserve sources of energy ..... YES
N.2 Checking distress function by means of an approved test procedure where possible YES
N.3 Correct operation by inspection of recent hard copy or by test call YES
P.3.2 Additional technical documents, tools, test equipment and spare parts .. NA
FORM F-SRC-01b
Q.2 Distress alarm panel installed at conning position showing visual and aural
indications of alerts received on board (IV/6.6) . NA
Q.3 Means for two-way on-scene radio communications for search and rescue purposes
using the aeronautical frequencies (121.5 MHz and 123.1 MHz) from the position from
which the ship is normally navigated (IV/ 7.5) NA
R. EXEMPTIONS
R.1 Any Radio/GMDSS exemption .... NA
It is recommended that:
U.1 A Full Term Cargo Ship Safety Radio Certificate / Passenger Ship Safety Certificate (1) (2) may be
issued valid for a period of five (5) years. .............................................................. YES
U.2 No Full Term Cargo Ship Safety Radio Certificate / Passenger Ship Safety Certificate (1) (2) to be
issued until deficiencies are closed (marked in Item T).................................
U.3 The Existing Cargo Ship Safety Radio Certificate No.: has been endorsed at:
, of of
(Place of issue of endorsement) (Day) (Month) (Year)
U.4 I have issued the Interim/Conditional (1) Cargo Ship Safety Radio Certificate/Passenger Ship Safety Certificate (1)
Valid until: 31st of DECEMBER of 2014.
(Day) (Month) (Year)
Radio
Technician: Surveyor
*Note: Support documents from Radio Technician must be attached when issuing a Survey Report.
Sent:& Thursday,&July&31,&2014&3:15&PM&
To:& info@marineelec.com&
Subject:&SSAS&ALERT&REPORT&
&&!!!!&&Test&Call&&!!!!&
OOO&SSAS&ALERT&MESSAGE&OOO&
Vessel&Name:&MV&Naiya&
MMSI:&&&&&&&&720899000&
IMN:&&&&&&&&&472089910&&&&
callsign:CPB3019&/flag:Bolivia&/IMO:8408454&
CSO&Jacob&Chemaly&Tel:&1O786O597O7662&
DP&Eliseo&Diaz&Tel&1O786O287O7925&
LAT:&&&&&&&&&&25:47.66N&
LON:&&&&&&&&&080:14.55W&
Time:&&&&&&&&07/31/2014&21:13:00(UTC)&
COURSE:&&&&&&188°&
SPEED:&&&&&&&&00&kt&
Time:&&&&&&&&07/31/2014&21:13:00(UTC)&
&
&
&
&
&
&
CERTIFICATE
of Automatic Identification System testing
Model: Saab R4 SN: None
It is hereby certified that representative of the company: RIVERSIDE MARINE ELECTRONICS
Radio engineer: MIGUEL VALLE
performed testing of Automatic Identification System Class A and defined the following:
Transmitter parameters
Frequency in channel A,
161974.307 Frequency in channel B, kHz: 162024.321
kHz:
Power in channel A,
40.84 / 12.13 Power in channel B, dBm/W: 40.69 / 11.72
dBm/W:
Name : Naiya
Destination : Miami
Longitude : 80 14.55" w
Latitude : 25 47.66 N
____
___________________________ Ship owner representative
(Position, Name)
31/07/2014 __________________________________
RIVERSIDE MARINE ELECTRONICS,
(Position, Name)
3266 NW 49 ST MIAMI FL 33142, Tel:7862876136
31/07/2014
FORM F-SEC-02b
CERTIFICATE No: CC-4434-3
AUTHORIZATION No.: AAMCB0614
REPUBLIC OF BOLIVIA
by CONARINA
PARTICULARS OF SHIP1
Type Of Ship4 : Bulk Carrier/ Oil Tanker / Chemical Tanker / Gas Carrier / Cargo Ship other than any
of the above
Date on which keel was laid or ship was at similar stage of construction or, where applicable, date on
which work for a conversion or an alteration or modification of a major character was commenced:
APRIL, 1985.
1
Alternatively, the particulars of the ship may be placed horizontally in boxes.
2
For oil tankers, chemical tankers and gas carriers only.
3
In accordance with IMO ship identification number scheme adopted by the Organization by resolution A.600(15).
4
Delete as appropriate.
Page 1 of 2
FORM F-SEC-02b
CERTIFICATE No: CC-4434-3
AUTHORIZATION No.: AAMCB0614
THIS IS TO CERTIFY:
1 That the ship has been surveyed in accordance with the requirements of regulation I/8 of the
Convention.
This certificate will remain valid until DECEMBER 31st, 2014 subject to the annual and periodical surveys
in accordance with regulations I/8 of the Convention.
Completion date of the survey on which this certificate is based: OCTOBER 15th, 2010.
ARMANDO ARRASCAETA
Surveyor No. 4001 to CONARINA
Page 2 of 2
FORM F-SES-01c
RECORD OF CARGO SHIP SAFETY EQUIPMENT
To Meet the Provisions of the
International Convention for the Safety of Life at Sea, 1974 as amended
This Record must be kept on board and be available for inspection by
a nominated surveyor or recognized organization at all times.
Gross Tonnage: 2,295.00 Net Tonnage: 778 Type of Vessel: RO- Flag:BOLIVIA
RO/GENERAL CARGO
Date keel laid: 1985 Previous name and flag:PANAMA Length of ship: 90.83
Owner and Address HELI SHIPPING, LLC. 2974 NW N, RIVER DR. MIAMI, FL. 33142
Place of survey: Port and Country of Survey: Date Survey Date Survey
dry-dock / slip afloat MIAMI, USA Commenced:AUGUST, 1 Completed:AUGUST 21, 2014
2014
PLEASE CHECK:
The surveyor has placed Recommendations to be rectified prior to the issuance of a full term certificate.
The total number of persons provided for by life-saving appliances is 10 and no more:
liferafts for which approved launching devices are required capable of accommodating persons
(excluding any liferaft forward)
2 liferafts for which approved launching devices are not required capable of accommodating 20 persons
(excluding any liferaft forward)
8 lifebuoys
14 lifejackets
1 DOCUMENTATION Y N N/A
Fire Control Plans
1.1 (To be in the national language. If the language is neither English nor French a translation into one of that language to be
included.)
Are up-to-date plans permanently exhibited?
1.1.1
In what language is it prepared? ENGLISH
Is a duplicate set of fire plans permanently stored in a prominently marked weather-tight enclosure
1.1.2
outside the deckhouse?
Muster List and Emergency Procedures
1.2
Is muster list including manning of fire parties and emergency procedures in a language
1.2.1 understood by the ships complement posted in several parts of the ship, including on the
navigation bridge, in engine room and in the crew's quarters?
1/17
FORM F-SES-01c
1.3 Nautical Publications
Are adequate and up-to date charts, sailing directions, lists of lights, notice to mariners tide tables
1.3.1 and all other nautical publications necessary for the intended voyage provided to the Master's
satisfaction?
1.4 International Code of Signals
2.1.1 Is a gyro compass fitted in addition to the magnetic compass? (All ships >= 1,600 GRT)?
2.1.2 Is an echo-sounding device fitted (All new ships >= 500 GRT)?
Are steering gear simple operating instructions with a block diagram showing the changeover
2.1.5 procedures remote steering gear control system and steering gear power units permanently
displayed on the navigation bridge and in the steering gear compartment?
2.1.8 Heading information provided by standard magnetic compass readable at main steering position
2.1.9 Means of communication between standard compass position and bridge
2/17
FORM F-SES-01c
2.1.12 Table of residual deviation available
2.1.17 Is the vessel fitted with a device to indicate speed and distance? (ships of 500 tons gross tonnage
and upwards constructed on or after 1 September 1984)
2.1.18 Is the vessel fitted with rudder, propeller, thrust, pitch and operational mode
indicator
2.1.19 Is the vessel fitted with a rate-of-turn indicator?
2.1.30 Is the vessel fitted with a Voyage Data Recorder (VDR/S-VDR), as per SOLAS - Ch. V, Reg. 20?
Cargo Ships constructed before 1 July 2002:
- 3,000<GT<20,000 at the first scheduled dry-docking after 1 July 2007 but not later than 1 July
2010;
- 20,000<GT at the first scheduled dry-docking after 1 July 2006 but not later than 1 July 2009.
2.1.31 Is the vessel fitted with an Automatic Identification System (AIS), as per SOLAS - Ch. V, Reg.
19.2.4?
2.1.32 Is the vessel fitted with Long-Range Identification System (LRIT), as per SOLAS - Ch. V, Reg.
19.1 & MSC.1/Circ.1307?
2.1.33 Has the Conformance Test carried out by the Approved Service Provider(ASP) recognized by the
Administration and the equipment found in satisfactorily working condition?
2.1.34 Has a Conformance Test Report been issued and submitted to THO along with supporting
documents?
2.1.35 Is a receiver for a global navigation satellite system fitted? Or,
2.1.37 Electronic chart display and information system (ECDIS) is used instead of paper charts
3/17
FORM F-SES-01c
-cargo ships of 150 gross tonnage and upwards but less than 500 gross tonnage constructed before 1 July 2011, not later than the first survey after 1 July 2014.
2.2.1 Application of the revised Collision Regulations 1972 (where two masthead lights are carried)
Following information may be provided from plans if available:
2.2.1.1 Horizontal distance in meters:
2.2.1.1.1 Foremast light abaft top of stem (L1) 1.50 m (L1 <= 1/4 LOA)
2.2.1.1.2 Between foremast and aftmast lights (L2) 14.25 m (L2 >= 1/2 LOA, but need not be > 100 m)
2.2.1.3.1 Sidelights 4.5 m (placed at a height above the hull not greater than three quarters of that of the forward
masthead light)
2.2.1.3.2 Foremast light (H1) 9.0 m (H1 >=; H1 >= Breadth, if breadth > 6 m; but need not be > 12 m)
2.2.1.3.2 Aftmast light 16.50 m (place at least 4.5 vertically higher than the foremast light)
2.3.12 Are side lights fitted with inboard screens painted matt black?
4/17
FORM F-SES-01c
3. LIFE-SAVING APPLIANCES
5/17
FORM F-SES-01c
3.3 Indicate superstructures and positions of lifeboats. Indicate M (motor boats) or MP (mechanical propelled) boats.
Type Boat Number Location
3.4 Lifeboats
Port side Starboard side
6/17
FORM F-SES-01c
3.5.14 Bilge pump manually operated (1)
3.5.15 Locker for small items of equipment
3.5.16 Painters, 1 secured to stern, 1 secured forward with strop and toggle
3.5.17 Light buoyant, heaving lines (2)
3.5.18 Boat hook (2 for M and MP boats) YES YES
3.5.19 Mast with galvanized wire stays and orange sails (not required for M YES YES
and MP boats)
3.5.20 Cover, highly visible for protecting occupants YES YES
3.5.21 Food ration per person of approved type in airtight receptacles stowed in YES YES
watertight containers
3.5.22 Fresh water, 3 liters or 6 pints per person in watertight receptacles YES YES
3.5.23 Parachute signals, red (4) YES YES
3.5.24 Hand flares, red (6) YES YES
3.5.25 Buoyant smoke signals, orange (2) YES YES
7/17
FORM F-SES-01c
3.6 Davits and Winches
3.6.1 Davits Maker and Type SCHAT;PINTLE TYPE
S.W.L.1.62 TONS APPROVED BY GL
3.6.2 Winches Maker and Serial No.SCHAT, HAMBURG
S.W.L.
3.6.3 Falls Rope or Wire: WIRE Breaking load:1.8 TONS
Construction:STEEL WIRE Length and Size:60.012 M
3.6.4 Where davits are recovered by action of the fall power, are safety devices fitted which will
automatically cut off power before the davits come against the stops?
3.6.5 Launching and Embarkation Arrangements
3.6.6 Means of lowering lifeboats YES
3.6.7 Means of releasing lower fall blocks from YES
lifting hooks
3.6.8 Means of preventing discharge of water YES
into lifeboats
3.6.9 Are stowage and launching positions provided with adequate lighting and also
supplied by emergency source of power?
3.6.10 Are at least two life lines fitted to each davit span?
3.6.11 Is embarkation ladder provided at each set of davits?
3.6.12 Type of warning system for abandoning ship GENERAL ALARM
3.6.13 Are liferafts stowed clear of lifeboats?
3.7 Rescue Boats (If one of the lifeboats above is rescue boat, indicate which one is, No./Side: )
3.7.1 Capacity (No. of persons)
3.7.2 Material
3.7.3 Maker
3.7.4 Serial No.
3.7.5 Approved by (attach Certificate of Approval)
3.7.6 Rigid rescue boat
3.7.8 Inflated rescue boat
3.7.9 Internal buoyancy material
3.7.10 Engine type/maker/model
3.7.11 Engine power (kw)
3.8 Liferafts excluding and liferaft stowed forward
Kind of Liferaft Location Description Marking No. of person Certificate No. and Date
(maker, approved by, approved No.) authorized
8/17
FORM F-SES-01c
3.8.4 Is forward liferaft fastened securely? Marking of Liferafts
3.8.5 Are the certified number of persons the raft to be marked in each inflatable liferaft
container?
3.8.6 Are name and proof of registry of the ship and the certified number of persons the raft
to be carried marked on each rigid liferaft?
3.8.7 Capacity of liferafts capable of accommodating all persons on board YES (10)
3.8.8 Additional liferaft depending where the survival craft are stowed
3.9 Rigid Liferaft Equipment (Ch. III Reg. 7)
Raft Number
RIGID LIFERAFT EQUIPMENT
1 2 3 4
3.9.1 Number of persons the boat is certified to carry
3.9.2 Painter attached (1)
3.9.3 Lifeline becketed around outside of raft
3.9.4 Lifeline around inside of raft
3.9.5 Sea Anchors (1 permanently attached and one spare)
3.9.6 Buoyant Battery Light attached by lanyard (1)
3.9.7 Food Ration for each person
3.9.8 Fresh Water in watertight receptacles (1.9 liters or 3 pints per person)
3.9.9 Anti-Seasickness Tablets, 6 per person
3.9.10 Paddles (2)
3.9.11 First-Aid Outfit, approved type in waterproof case (1)
3.9.12 Parachute Signals, red (2)
3.9.13 Hand Flares, red (6)
3.9.14 Buoyant rescue Quoit with 30 m (100 ft) buoyant line attached (1)
3.9.15 Knife, 1 each for rafts carrying less than 13 persons
3.9.16 Bailer, 2 each for rafts carrying more than 12 persons
3.9.17 Sponges (2)
3.9.21 Electric Torch, waterproof, suitable for Morse Code signalling (1) with
spare set of batteries and spare bulb in waterproof case
9/17
FORM F-SES-01c
3.9.26 Life-Saving Signals, illustrated table (1)
3.10.1 Lifejackets with whistle and light attached (1 per 14 SOLAS APPROVED CABINS, BRIDGE & E/R
person)
3.10.2 Additional lifejackets for children --
10/17
FORM F-SES-01c
4.1.2 Number and Location Capacity Type of Prime Mover
Hydrants
3 -- -- Standard Bronze
11/17
FORM F-SES-01c
4.1.8 E/R 1 50kg ABC SBG 1
Non-portable
extinguishers
CO2 -- --
.3 Spaces protected
12/17
FORM F-SES-01c
4.2.6 Special Arrangements in Machinery Spaces
Means for stopping machinery & shutting off oil fuel suction pipes Can the following openings be closed from outside the
space concerned?
5.1.3 If fixed fire-extinguishing system is not installed in cargo holds, then 5.1.4, 5.1.5,
and 5.1.6 shall apply
5.1.4 Are steel hatch covers and effective means provided for closing all ventilators and
other openings leading to holds?
5.1.5 Is the ship constructed and intended solely for carrying such cargoes as ore, coal or
grain?
5.1.6 Can mechanical fans be stopped and doorways, ventilators and all other openings
to cargo spaces closed from outside the space concerned?
5.2 Tankers, Combination Carriers, Chemical Carriers and Gas Carriers
5.2.1 Deadweight (m-tons) Type of cargo Flash point
<= 60 C
> 60 C
5.2.2 Cargo Tank Protection
A fixed deck froth system and a fixed inert gas system
apply to New Tanker dwt >= 20,000 m-ton
An inert gas system
apply to any tanker operating crude oil washing
Existing tanker dwt >= 20,000 m-ton carrying crude oil
Existing tanker dwt >= 40,000 m-ton carrying oil other than crude oil
Existing tanker dwt >= 20,000 m-ton carrying oil other than crude oil fitted with tank washing
machines having an individual throughput > 60 m3/H
5.2.3 Fixed System Installed
13/17
FORM F-SES-01c
5.2.3.1 Tanks internally Inert gas Tanks externally Foam
5.2.3.2
5.2.3.3
Foam
Approved by:
Is instruction manual provided?
5.2.4.2 Is closed ullage system provided for tanker fitted with a fixed inert gas system
5.2.5 Fixed Foam system to Tanks Internally
.1 Foam characteristics Type Quantity Maker
.4
Applicators Hydrants Hoses Nozzles
6. Methods of fire protection and alarm systems in accommodation service spaces on cargo ships
6.1.1 Method IC Smoke detection and manually operated call points in all corridors, stairways and escape
routes within accommodation spaces
6.1.2 Method IIC Automatic sprinkler, fire detection and fire alarm system of an approved type in
accommodation spaces, galleys and other service spaces
Approved by/No.
6.1.3 Method IIIC Fixed fire detection and fire alarm system of an approved type in accommodation and
service spaces
Approved by/No.
14/17
FORM F-SES-01c
7.4 Additional information
8. Spaces containing flammable liquid (SOLAS 99/00 Amend / II-2 / Reg. 10.6.3)
8.1 Paint locker system manufacturer and type of system
8.2 Flammable liquid lockers
8.3 Lockers of a deck area of less than 4
Protective clothing of material to protect the skin An approved electric safety lamp (hand lantern)
from heat radiating from a fire an from burns and with a minimum burning period of 3 hours
scalding by steam the outer surface to be water
resistant
A rigid helmet providing effective protection against An approved breathing apparatus with lifeline*
impact
*a smoke mask shall be provided with an air pump and a sufficient length of air hose, if air hose exceeding 36 m in ength would be
necessary, a self-contained breathing apparatus shall be substituted or provided in addition.
2 30 LTS 4
9.1.3 Smoke helmet or smoke mask with air pump and hose
No. Maker Approved by
15/17
FORM F-SES-01c
9.1.4 Emergency escape breathing device (EEBDs) (SOLAS II-2/13.3.4, 13.4.3, MSC/Circ.849)
Total number in machinery and accommodation spaces: 7
Spare devices:
Training devices:
Location Type/Maker Approved by
DECK, BRIDGE, E/R M-20, DRAGER MCA
Are the number and position of hydrants arranged so at least 2 jets of water not emanating from
9.2.5 the same hydrant, one of which is from a single length of hose, may reach any part of the ship
normally accessible to passengers or crew while the ship is being navigated?
Are the number and position of hydrants arranged so at least 2 jets of water can reach any part of
any cargo space when empty?
9.2.6 Diameter of the Firemain is
ADDITIONAL COMMENTS:
16/17
FORM F-SES-01c
Signature of Surveyor
17/17
SAFETY EQUIPMENT - SURVEY CHECKLIST
Notes:
1. Complete relevant sections as applicable for the survey Initial (I) / Annual (A) / Periodical (P) / Renewal (R) ;
2. The RECORD OF CONSTRUCTION AND EQUIPMENT Form SE-1 should be complete and available on board. The RECORD
form is to be prepared if one is not found on board or the one on board is not in the current format.
3. Each lifeboat is required to be launched and maneuvered at least once every 3 months, except that for freefall lifeboats the maximum
interval between freefall launches should not exceed 6 months.
4. Lifeboat falls are required to be renewed when necessary due to deterioration but at intervals not exceeding 5 years.
APPLICABLE
A GENERAL Y N N/A
1 Have any changes been made or any new equipment installed which would affect the validity of
the Cargo Ship safety equipment Certificate? If YES, provide details under REMARKS, Section A, I, R, P
Z)
2 Were all other statutory and Classification certificates valid at the time of survey? A, I, R, P
3 All instructions and/or notices including the Training Manual (reg. III/35), Instructions for
onboard maintenance (reg. III/36) and Emergency Station Muster List (reg. III/37) were posted
A, I, R, P
in the appropriate language(s) as required and to the Masters satisfaction.
4 Was there a report of any fire necessitating the operation of the fixed fire extinguishing
systems or the portable fire extinguishers, since the last Safety equipment? If YES give
A, I, R, P
details under remarks column on page 12
5 Fire control plans (including duplicate set) up-to-date and properly posted A, I, R, P
6 Muster lists posted as required in appropriate language(s) in navigation bridge, engine room and
crew accommodation spaces. The person(s) in charge of survival craft (and in case of lifeboats
A, I, R, P
the second in-command also) have a list of the survival craft crew.
7 Adequate and up-to-date charts, sailing directions, lists of lights, Notices to Mariners, tide tables
and all other nautical publications necessary for the intended voyage are available A, I, R, P
9 Practice musters and drills carried out and logged as required by Regulation III/18. Date of last
abandon ship drill JULY 20, 2014, fire drill JULY 20, 2014. A, I, R, P
10 Is the vessel provided with a material safety data sheet as per Resolution MSC.282 (86) & A, I, R, P
Regulation 5-1, Chapter VI SOLAS 1974 as amended? (For all new and existing ships,
carrying MARPOL Annex I cargoes (oil) and marine fuel oils)
11 Last occasion when lifeboats launched and maneuvered A, I, R, P
F-SES-01.1/C Page 1 of 12
12 Compass deviation Record Book being kept up-to-date A, I, R, P
13 Last occasion when rescue boat was launched and maneuvered. (Required monthly where
A, I, R, P
practicable but interval should not exceed 3 months) JULY 20, 2014.
2 Echo sounder
A, I, R, P
4 Indicators for rudder angle, propeller revolutions, propeller pitch and mode, rate of turn,
speed and distance A, I, R, P
5 Means of taking bearings through 360 degrees and means of communication between
standard compass position and navigation control position A, I, R, P
10 9 GHz Radar
A, I, R, P
19 Has the Conformance Test carried out by the Approved Service Provider (ASP)
recognized by the Administration and the equipment found in satisfactorily working A, I
condition?
20 Has a Conformance Test Report been issued and submitted to THO along with supporting
A, I
documents?
21 Automatic Identification System (AIS)
A, I, R, P
F-SES-01.1/C Page 2 of 12
24 Terrestrial radio navigation system A, I, R, P
25 ECDIS, if used instead of paper charts A, I, R, P
26 Backup for ECDIS is available (can be paper charts) A, I, R, P
27 Bridge Navigational Watch Alarm System (BNWAS)
A, I, R, P
1.1 Daylight signaling lamp and source of power (mains and alternate supply)
A, I, R, P
1.3 Gong
A, I, R, P
1.4 Ships whistle (if electric both mains and emergency supply)
A, I, R, P
F-SES-01.1/C Page 3 of 12
E DISTRESS SIGNALS (BRIDGE / LIFEBOATS / RIGID LIFERAFTS)
4 Lifelines on davit spans, and bowsing tackles were found or placed in good condition (if A, I, R, P
applicable)
7 Operative test of all emergency power supplies, emergency lighting and general alarm A, I, R, P
systems satisfactorily carried out.
10 Lifeboat / rescue boat/ liferaft etc launching instructions posted as required (instructions A, I, R, P
visible under main & emergency lighting)
F-SES-01.1/C Page 4 of 12
G LIFERAFTS AND HYDROSTATIC RELEASE UNITS
MAKERS NAME & SERIAL NO OF DATE A, I, R, P
SERVICING AGENT
NUMBER PERSONS SERVICED
OCTOBER,
VIKING 10 VIKING
2013
OTOBER,
VIKING 10 VIKING
2013
A, I, R, P
The inflatable liferafts and any associated hydrostatic release mechanisms have been serviced at an
approved service station during the previous 12 months (or new) and a valid service certificate sighted
A, I, R, P
Each rigid liferaft examined and found in good condition, stowed to facilitate rapid launching, equipment
complete and fitted with retro reflective material
1.2 Lifeboats turned out, lowered and maneuvered in the water at the time of survey lifeboat A, I, R, P
nos. 1 & 2
1.3 Each motor lifeboat engine readily started and operated satisfactorily, ahead and astern A, I, R, P
1.4 Each lifeboat self contained air support system generally examined, tested and found A, I, R, P
satisfactory
1.5 Each lifeboat water spray system generally examined, tested and found satisfactory A, I, R, P
1.6 Each motor lifeboat provided with sufficient fuel for 24 hours continuous operation A, I, R, P
1.7 Air cases removed and found or placed in good condition OR built-in buoyancy found in A, I, R, P
good condition as far as can be seen
1.9 All sheaves, blocks, falls*, lifting hooks, hook foundations and securing arrangements and A, I, R, P
release arrangements and all moving parts found free and well lubricated or made good at the
time of survey
(*Note: When falls are inspected special attention shall be paid to the areas of falls passing through sheaves; renewal due to
deterioration is required when necessary but at intervals not exceeding 5 years)
1.10 Date when lifeboat falls were renewed
F-SES-01.1/C Page 5 of 12
A, I, R, P
1.11 Freefall lifeboats: Launch track, release and recovery arrangements in satisfactory condition
1.12 Freefall lifeboats: date of last launch and maneuver JULY 20, 2014. A, I, R, P
1.13 All survival craft launching and recover appliances found satisfactory when examined as far A, I, R, P
as practicable
2.4 Release hook, falls and associated moving parts (blocks, sheaves, etc) were found free and well A, I, R, P
lubricated or made good at the time of survey
A, I, R, P
2.5 Date rescue boat falls were last renewed/reversed
A, I, R, P
2.6 The rescue boat was fitted with retro reflective material
3.1 The launching appliances have been thoroughly examined and a dynamic test of the winch brake R, P
has been carried out in presence of the surveyor: Date of last test/examination (required
every 5 years, first test/examination must be before 1st July 2003)
3.2 The lifeboat on load release mechanism has been thoroughly examined by specially trained A, I, R, P
personnel (copy of certificate / statement to be forwarded to HO along with survey reports)
R, P
3.3 The lifeboat on load release mechanism has been overhauled and subsequently operationally
tested under 1.1 times total mass of fully loaded lifeboat by specially trained personnel in
presence of surveyor (copy of certificate / statement to be forwarded to HO). Date of last
test/examination (required every 5 years, first test/examination must be before 1st July
2003)
I LIFERAFTS Y N N/A
A, I, R, P
1 The embarkation arrangements of inflatable liferafts and, where provided, the launching
arrangements of davit launched liferafts found satisfactory
F-SES-01.1/C Page 6 of 12
A, I, R, P
3 Inflatable liferaft stowage will facilitate proper release including float free facility where
required.
J LIFEJACKETS Y N N/A
1 Complete number of approved lifejackets, each with whistle and light available on board A, I, R, P
2 Each lifejacket found in good condition and found fitted with retro reflective material A, I, R, P
3 Lifejackets stowed in accessible and clearly marked places (including the lifejackets for use at A, I, R, P
remote locations)
K LIFEBUOYS Y N N/A
1 Complete number of approved lifebuoys (fitted with buoyant lines, lights or lights and smoke A, I, R, P
signals as required) available on board
2 Each lifebuoy of highly visible color, fitted with beckets and readily accessible A, I, R, P
3 Marked in block letters with the name and port of registry of ship A, I, R, P
6 Lifebuoy distress signals (MOB) are valid. Date of expiry DECEMBER, 2016. A, I, R, P
2 Complete number of approved thermal protective aids available on board and found in good A, I, R, P
condition (including the Thermal Protective Aids stowed as equipment in survival craft
2 The condition of illumination of the ladder(s) and boarding position in good order A, I, R, P
3 A heaving line and one of the lifebuoys with self igniting lights was readily to hand A, I, R, P
5 Mechanical pilot hoist was rigged, examined under working conditions and found satisfactory A, I, R, P
F-SES-01.1/C Page 7 of 12
FIRE EXTINGUISHING ARRANGEMENTS
2 All pumps, fire main, hydrants, hoses, nozzles, applicators, spanners, relief valves and A, I, R, P
international shore connection were in good condition.
3 Each hose complete with couplings, nozzle and tools kept ready for use A, I, R, P
4 Spare charge was provided for each extinguisher other than for gas cylinder (or adequate number A, I, R, P
of spare extinguishers were provided)
2 Air compressor (if fitted for recharging air bottles) operating satisfactorily A, I, R, P
3 Smoke mask, air pump and hose tested and found satisfactory. A, I, R, P
4 Date of last inspection and pressure test of SCBA bottles OCTOBER, 2013. A, I, R, P
5 Number and arrangement of EEBDs comply with the Record of Approved Ship Safety A, I, R, P
Equipment
6 EEBDs clearly marked, easily accessible and protected, against extreme heat and mechanical A, I, R, P
damages
7 Locations and numbers of EEBDs indicated in the fire control plan A, I, R, P
F-SES-01.1/C Page 8 of 12
Q FIXED FIRE EXTINGUISHING AND PROTECTION SYSTEMS N/A
BOILER ROOM
PUMP ROOM
CARGO SPACES/TANKS
ACCOMMODATION SPACES
PAINT LOCKER
OTHER SPACES, IF ANY
SPECIFY
5 Instructions for the operation of the system are posted near the controls and in language(s) A, I, R, P
understood by crew
3 Instructions for the operation of the system are posted near the controls and in language(s) A, I, R, P
understood by crew
2 Visual and audible alarm was automatically activated whenever system operates (for sprinkler A, I, R, P
system)
2 An audible alarm was activated automatically if visual and audible signal at fire control station A, I, R, P
not responded to within two minutes
F-SES-01.1/C Page 9 of 12
V INERT GAS SYSTEM N/A Y N N/A
A, I, R, P
1
Is system classed? If classed last special survey date , last annual survey date
2 Operation and service manual provided A, I, R, P
4.3 Alarms A, I, R, P
5 From external examination, all components and piping found free from signs of corrosion and/or A, I, R, P
gas/effluent leakage
6 Both inert gas blowers were operational A, I, R, P
8 The deck water seal filling and draining system operational and without evidence of water carry- A, I, R, P
over
10 Operation of all remotely operated or automatically controlled valves, in particular the flue gas A, I, R, P
isolating valve, satisfactory
12 Gas pressure regulating valve automatically closed when the inert gas blowers secured. A, I, R, P
13 The following safety devices of the inert gas system checked as far as practicable (using A, I, R, P
simulated conditions where necessary) and found satisfactory:
F-SES-01.1/C Page 10 of 12
13.3 Low pressure in the supply to the deck water seal A, I, R, P
13.6 Accuracy of portable and fixed oxygen measuring equipment by means of calibration gas A, I, R, P
13.9 Failure of the power supply to the automatic control system for the gas-regulating valve and A, I, R, P
to the instruments for continuous indication and permanent recording of pressure and oxygen
content in the inert gas main.
2 Stowage arrangement for oxygen and acetylene bottles (when not in use) examined and found A, I, R, P
satisfactory
3 Remote controls, stops and quick closing valves for machinery spaces tested and found A, I, R, P
satisfactory
4 All openings for machinery spaces can be closed from outside A, I, R, P
5 All openings for protected cargo spaces can be closed from outside A, I, R, P
6 For ships with unmanned machinery spaces, the fire detection system and the required audible A, I, R, P
and visual alarms have been checked and found operable
7 Remote controls for sea inlets and discharges below the waterline or bilge injection system (if A, I, R, P
fitted) examined and found operable.
8 For Ro-Ro cargo spaces and other spaces intended for the carriage of motor vehicles with fuel in A, I, R, P
their tanks for their own propulsion, the special requirements (as applicable) found complied
with and operating efficiently.
9 For ships engaged in the carriage of dangerous goods, the special arrangements and equipment as A, I, R, P
required in the Document of Compliance (if applicable) found complied with and operating
satisfactorily.
2 Is vessel issued with an exemption certificate? If so, has copy of the exemption certificate been
forwarded to HO along with survey reports? At change of flag surveys, if an exemption certificate has
been issued by the previous flag state, has authorization been received from HO or new flag state
regarding acceptance of the exemption (certificate not to be issued unless confirmed by HO).
3 Is there evidence of approval of the fire control plan by the organization that issued the previous SE
certificate? If not, the fire control plan to be submitted for approval to HO.
4 Do the present arrangements on board comply with the applicable regulations (number and location of
lifesaving and firefighting appliances, fixed fire extinguishing system for machinery/cargo spaces
F-SES-01.1/C Page 11 of 12
etc?)?
5 Has new record of approved cargo ship safety equipment been prepared (required only if a previous
record is not available or if the previous record does not contain the necessary information as contained
in IS form SE-1)?
6 Has vessel been modified or the LSA/FFA arrangements on board been modified since the last SE
certificate was issued? If yes, full details to be forwarded to HO and certificate to be issued only after
confirmation from HO (SOLAS Chapter III, Regulation 1.4.3 refers)
7 Was any service restriction (trading area limits etc) imposed by the previous society/organization? If YES, have the
same service restrictions been included/endorsed in the Interim certificate now issued?
Details: N/A
Z DEFICIENCIES
Details:
(a) A cargo ship safety equipment INITIAL survey has been carried out in accordance with the relevant regulation of the
Convention and as described above;
(c) An INTERIM /CONDITIONAL Cargo Ship Safety Equipment Certificate No.: CC-4434 has been issued on
AUGUST 1, 2014 and valid until DECEMBER 31, 2014.
(e) A full term Certificate may be issued by HO .
(f) A full term certificate should not be issued by HO until the deficiencies noted at Z above have been rectified .
(g) The full term Cargo Ship Safety Certificate / Cargo Ship Safety Equipment certificate No.: has been endorsed for
the Initial (I) / Annual (A) / Periodical (P) / Renewal (R) survey on at .
Signature of Surveyor
Name of Surveyor
ARMANDO ARRASCAETA
Port
MIAMI, FLORIDA.
Date
AUGUST 1, 2014.
F-SES-01.1/C Page 12 of 12
From:& 472089910@inmc.eik.com&
Sent:& Thursday,&July&31,&2014&3:15&PM&
To:& info@marineelec.com&
Subject:&SSAS&ALERT&REPORT&
&&!!!!&&Test&Call&&!!!!&
OOO&SSAS&ALERT&MESSAGE&OOO&
Vessel&Name:&MV&Naiya&
MMSI:&&&&&&&&720899000&
IMN:&&&&&&&&&472089910&&&&
callsign:CPB3019&/flag:Bolivia&/IMO:8408454&
CSO&Jacob&Chemaly&Tel:&1O786O597O7662&
DP&Eliseo&Diaz&Tel&1O786O287O7925&
LAT:&&&&&&&&&&25:47.66N&
LON:&&&&&&&&&080:14.55W&
Time:&&&&&&&&07/31/2014&21:13:00(UTC)&
COURSE:&&&&&&188°&
SPEED:&&&&&&&&00&kt&
Time:&&&&&&&&07/31/2014&21:13:00(UTC)&
&
&
&
&
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FORM F-SCC-02b
CERTIFICATE No: BB-4434
AUTHORIZATION No.: AAMBB0614
PARTICULARS OF SHIP1
Type of Ship4: Bulk Carrier / Oil Tanker / Chemical Tanker / Gas Carrier
/ Cargo Ship other than any of the above
Date of build.
Date on which keel was laid or ship was at similar stage of construction: APRIL 15, 1985.
1
Alternatively, the particulars of the ship may be placed horizontally in boxes.
2
For oil tankers, chemical tankers and gas carriers only.
3
In accordance with IMO ship identification number scheme adopted by the Organization by resolution A.600(15).
4
Delete as appropriate.
Page 1 of 2
FORM F-SCC-02b
CERTIFICATE No: BB-4434
AUTHORIZATION No.: AAMBB0614
THIS IS TO CERTIFY:
1. That the ship has been surveyed in accordance with the requirements of regulation I/10 of the
Convention.
2. That the survey showed that the condition of the structure, machinery and equipment as defined in
the above regulation was satisfactory and the ship complied with the relevant requirements of
chapters II-1 and II-2 of the Convention (other than those relating to fire safety systems and
appliances and fire control plans).
3. That the last two inspections of the outside of the ship's bottom took place on AUGUST, 2010 and
JULY, 2013.
5. The ship was/was not4 subjected to an alternative design and arrangements in pursuance of
regulation II- 2/17 of the Convention;
6. A document of approval of alternative design and arrangements for fire safety is/is not4 appended to
this Certificate.
This certificate will remain valid until DECEMBER 31st, 20145 subject to the annual and intermediate
surveys and inspections of the outside of the ship's bottom in accordance with regulations I/10 of the
Convention.
Completion date of the survey on which this certificate is based: OCTOBER 15th, 2010.
ARMANDO ARRASACAETA
Surveyor No. 4001 to CONARINA
5
Insert the date of expiry as specified by the Administration in accordance with regulation I/14(a) of the Convention. The day and the month of
this date correspond to the anniversary date, as defined in regulation I/2(n) of the Convention, unless amended in accordance with regulation
I/4(h).
Page 2 of 2
SAFETY CONSTRUCTION SURVEY CHECKLIST
Assignment No: Port of Survey: Date Survey Commenced: Date Survey Completed:
BB-4434 MIAMI, FLORIDA JULY 28, 2014. AUGUST 1, 2014.
Date of last dry-docking survey: AUG/10 & JULY/13 Date of last tail shaft survey: AUGUST, 2010.
Carried out by (organization): GL & PMDS. Carried out by (organization): GL.
Notes:
1. Complete relevant sections as applicable for the surveys carried out. Check boxes under Y to indicate
YES, N to indicate NO and - to indicate NOT APPLICABLE.
2. Complete Sections A, B, C and D (if applicable) for all surveys. In addition, complete section E for
renewal/periodical surveys. For first time survey by IS, complete section F in addition to the relevant
sections as applicable for the surveys being carried out.
A GENERAL Y N N/A
Have any changes been made or any new equipment installed which would affect the
1
validity of the Cargo Ship Safety Construction Certificate? If YES, provide details on page 7)
Were all other statutory and Classification certificates valid at the time of survey?
2
Are all surveys up-to-date? (Periodical surveys for boilers and pressure vessels, dry-docking
and tail shaft surveys, periodical survey of the automation and/or remote controls for the
3 main propulsion, periodical surveys for inert gas systems etc) (SAFCON certificates
should not be issued or endorsed in cases where surveys/recommendations are overdue
and postponement has not been agreed by HO)
4 Status of certificates:
F-SCS-01/c Page 1 of 7
A GENERAL Y N N/A
The log entries record that the following have been checked or tested and found
5
satisfactory within 12 hours before departure from any port:
Steering gear The tests included, where applicable, the operation of the main
5.1 steering gear, the auxiliary steering gear, remote control systems, bridge steering
position, emergency power supply, rudder angle indicators, steering gear system
power unit failure alarms, automatic isolating arrangements and other alarms
5.2
Communication system bridge to steering gear compartment
5.3
Full movement of the rudder
5.4
Visual inspection of the steering gear linkage
6 The log entries record that emergency steering drills have been carried out every three
months
7
The change over diagrams of steering gear are posted
8
All officers are reportedly familiar with steering gear change-over procedures
9
Approved loading / intact stability information is on board
11 Loading instrument is installed, approved and in working condition (for bulk carriers of
150 m in length and upwards)
12 For ships assigned timber loadlines, the approved timber deck cargo loading and
lashing plan is on board
13 The approved cargo securing manual is on board (for ships carrying cargoes other than
solid or liquid bulk cargo)
Hull and its closing appliances, so far as can be seen, have been generally examined
and found satisfactory. Weather decks, hatchways, vents and air pipes; casings,
1 skylights, flush deck scuttles, deckhouses and companionways; superstructures, side,
bow and stern doors; windows, side scuttles and dead lights; chutes and other
openings; scuppers, sanitary discharges and valves; guardrails and bulwarks; freeing
ports, gangways, walkways and lifelines.
2 Flame screens on vents/air pipes at all fuel oil tanks are satisfactory as far as could be
seen.
3 Anchoring and mooring equipment has been examined as far as practicable and found
in satisfactory condition.
F-SCS-01/c Page 2 of 7
4 All watertight doors in watertight bulkheads have been examined and tested as far as
practicable and found in satisfactory condition
6 The arrangement for structural fire protection has been checked and remains
unchanged (any alterations to be reported)
7 Manual and/or automatic fire doors, where fitted, have been examined and found in
satisfactory condition
8 The operation of the loading instrument, where fitted, has been verified. (The loading
instrument program must be approved)
Hatch covers and coamings have been examined and tested and found weather tight.
9
Satisfactory operations of mechanically operated hatch covers have been verified.
10 Cargo holds and salt-water ballast tanks have been examined internally to the extent
possible and found in satisfactory condition.
Thickness measurements have been carried out (if required by surveyor) by approved
11
firm and copies of report has been placed on board and a copy has been forwarded to
Head Office
For ships with special arrangements (ramps, bow/stern/side doors, container securing
12
arrangements etc), the condition of the special arrangements is satisfactory as far as
could be seen.
Means of escape from all accommodation spaces and spaces in which crew are
13
normally employed (other than machinery spaces) have been examined and found in
satisfactory condition.
Is the vessel provided with new installations of asbestos onboard? (From 1 January 2011,
15 for all ships, new installations of materials which contain asbestos shall be prohibited. IMO
Resolution MSC.282 (86))
Is the vessel fitted with water level detector in cargo hold? (Water level detector is required
16
for single hold cargo ships other than bulk carriers by SOLAS II-1 Reg. 25.)
Are there protective coatings in dedicated seawater ballast tanks (of all ships) and
17 double-side skin spaces of bulk carriers? (Reg. 3-2, required for all ships built on or after 1st
st
July 2008 and oil tankers and bulk carriers constructed on or after 1 July 1998)
Is there safe access to and within space in, and forward of, the cargo area of oil tankers
18 and bulk carriers? Is there approved Ship Structure Access Manual? (Reg. 3-6, oil tankers
st
of 500 GT and over and bulk carriers of 20000 GT and over, constructed on or after 1 January
2006.)
F-SCS-01/c Page 3 of 7
The machinery and boiler spaces are free of all visible fire and explosion hazards
3
(leakage of oil, excess oil in bilges or drip trays, improper insulation for hot surfaces etc)
Piping systems containing fuel oil, lubricating oil or other flammable oils where fitted
have been examined and operated as practicable, special attention being paid to
4
tightness, fire precaution arrangements, flexible hoses and sounding arrangements and
found satisfactory (IMO Resolution A.31 (63) refers).
Main and auxiliary steering arrangements including their associated equipment and
5
control systems have been examined under operation and found satisfactory
All the means of communication between the navigating bridge and the machinery
6 control positions as well as the bridge and the alternative steering position, if fitted, have
been tested and found satisfactory.
Bilge pumping systems and bilge wells including operation of pumps, remote reach rods
7
and level alarms, where fitted, have been examined, tested and found satisfactory
Non-metallic expansion joints in piping systems, which penetrate the hull and are fitted
8
below the deepest load waterline have been examined and found satisfactory.
All essential machinery (auxiliary engines, pumps, compressors etc) have been
9
examined and operationally tested, as far as practicable, and found satisfactory.
First start arrangements (means provided to ensure that machinery can be brought into
10 operation from dead ship condition without external aid) have been tested and found
satisfactory
Adequate supply of air (ventilation) is provided in machinery spaces for the safety and
11
comfort of the personnel and the operation of the machinery
The Engineers alarm has been tested and found clearly audible in the engineers
12
accommodation area
Boilers and pressure vessels and their appurtenances including safety devices,
foundations, controls, relieving gear, high pressure and steam escape piping, insulation
13
and gauges have been examined externally and found in satisfactory condition. Date of
last auxiliary boiler survey , survey carried out by
The electrical equipment and cabling forming the main and emergency installations
14 have been generally examined under operating conditions as far as practicable and
found in satisfactory condition
Operation of all main and emergency sources of power has been checked as far as
15 practicable and found in satisfactory condition (if operation of emergency sources of
power are automatic, they should be tested also in the automatic mode)
A general examination of automation equipment and control engineering systems have
16
been carried out and operation considered satisfactory (where applicable)
The electrical installation in areas, which may contain inflammable gas or vapor and/or
17 combustible dust, has been examined and found in good condition and properly
maintained.
The remote controls for stopping fans and machinery and shutting off fuel supplies in
machinery spaces and, where fitted, the remote controls for stopping fans in
18
accommodation spaces and the means of cutting off power to the galley are in working
order.
Are provisions for the drainage of closed vehicle and Ro-Ro spaces and special
19 category spaces in compliance with SOLAS Regulations II-2/20.6.1.4 and II-2/20.6.1.5?
(IMO Resolution MSC.282 (86))
Cargo tank openings including gaskets, covers, coamings, P/V valves and flame
1
screens are all satisfactory as far as could be seen
3 Flame screens on vents at all bunker, oily ballast and oily slop tanks and void spaces
are satisfactory as far as could be seen.
An examination of cargo, crude oil washing, bunker, ballast and vent piping systems
4
including vent masts and headers have been carried out and all found in satisfactory
condition
F-SCS-01/c Page 4 of 7
An examination of cargo tank venting, purging, gas freeing and ventilation
arrangements and secondary means of venting or over/under pressure alarms, if fitted,
5
has been found operational and satisfactory. (IMO resolution MSC. 57(67) refers
compliance required at first scheduled dry-docking after 1st July 1998 and in any case
not later than 1st July 2001.
Emergency towing arrangements have been fitted and approved by/or on behalf of the
7
administration (required for all tankers of 20,000 tonnes deadweight or more by 1st
January 1999)
The vessel complies with the requirements of safe access to tanker bows (IMO
8
resolution MSC. 57(67) refers compliance required at first scheduled dry-docking after
1st July 1998 and in any case not later than 1st July 2001).
9
The following items have been examined in cargo pump room:
Potential sources of ignition in or near the pump room such as loose gear,
9.1
excessive product in the bilges, excessive vapors, combustible materials etc.
have been eliminated.
9.2
The access ladders are in satisfactory condition
9.3
The electrical equipment is in satisfactory condition as far as could be seen
9.4
The pump room bulkheads are free of signs of oil leakage or fractures
9.5 The pump rooms have a bilge level monitoring device and alarms working
satisfactorily.
10
The sealing arrangement of bulkhead penetrations is satisfactory
11 An external examination of the piping system has been carried out and all found in
satisfactory condition.
The cargo, bilge, ballast and stripping pumps examined as far as practicable and found
12 satisfactory for excessive gland seal leakage; operation of electrical and mechanical
remote operating and shutdown devices and integrity of pump room bilge system and
pump foundations
13 The pump room ventilation system is operational and the ducting intact, the dampers
are operable and the screens are clean
14 As far as could be seen, the installed pressure gauges on the cargo discharge lines and
level indicator systems are operational
All isolating valves and piping of the cargo tank and cargo pump room fixed fire fighting
15
system were externally examined as far as practicable and found satisfactory
16 The deck foam and deck sprinkler systems were found to be operable and in
satisfactory condition.
Have all spaces (cargo holds/tanks, ballast tanks, stores etc) been internally examined
1
as required and the structure and structural fire protection arrangements found in
satisfactory condition.
F-SCS-01/c Page 5 of 7
2 An approved firm has carried out thickness measurements and all results found
satisfactory. TM reports to be submitted to HO and a copy to be placed on board
3 All essential machinery has been opened up and surveyed as required and all essential
shipboard engineering systems found in satisfactory condition.
4 For ships subject to Enhanced Survey procedures (tankers, bulk carriers), full
requirements of ESP have been complied with, as applicable.
Is there evidence of approval of the loading manual (for vessels over 100 meters
length) by the organization that issued the previous SAFCON certificate? If not, the
4 loading manual is to be submitted for approval to HO. If the vessel has a loading
instrument, has the loading instrument program been approved by the organization that
issued the previous SAFCON certificate? If not, the loading instrument program and
manual is to be submitted for approval to HO.
Was any service restriction (trading area limits etc) imposed by the previous
7
society/organization? If YES, have the same service restrictions been
included/endorsed in the Interim certificate now issued?
Has vessel been modified since the last SAFCON certificate was issued? If yes, full
9
details to be forwarded to HO and certificate to be issued only after confirmation from
HO.
Details:
H DEFICIENCIES / REMARKS
Details:
F-SCS-01/c Page 6 of 7
THIS IS TO CERTIFY THAT:
(a) A cargo ship safety construction INITIAL Survey has been carried out as described above;
(b)
Minor deficiencies, if any, are described in section H;
Signature of Surveyor
F-SCS-01/c Page 7 of 7
FORM F-AFC-02/a
CERTIFICATE No: HHH-4377
AUTHORIZATION No.: AAMHHB0914
3019
INTERNATIONAL ANTI-FOULING SYSTEM
(This Certificate shall be supplemented by a Record of Anti-Fouling Systems)
Issued under the International Convention on the Control of Harmful Anti-fouling Systems on Ships, 2001
Name of Ship
Call Sign Port of Registry Gross Tonnage IMO Number
NAIYA CPB-3019 LA PAZ 999 8408454
An anti-fouling system controlled under Annex 1 has not been applied during or after construction of this ship -
An anti-fouling system controlled under Annex 1 has been applied on this ship previously, but has been removed
by CIRAMAR SHIPYARD, DOMINICAN REPUBLIC (insert name of the facility) on JULY 22, 2013. (date) X
An anti-fouling system controlled under Annex 1 has been applied on this ship previously, but has been covered
with a sealer coat applied by (insert name of the facility) on (date)
--
An anti-fouling system controlled under Annex 1 was applied on this ship prior to ________________ (date)1,
but must be removed or covered with a sealer Coat prior to _______________ (date)2 --
1. The ship has been surveyed in accordance with Regulation 1 of Annex 4 to the Convention; and
2. The survey shows that the anti-fouling system on the ship complies with the applicable requirements of Annex 1 to
the Convention.
Date of completion of the survey on which this Certificate is based: JULY 22nd, 2013.
PROVISIONAL
ARMANDO ARRASCAETA
Surveyor No. 4001to CONARINA
1
Date of entry into force of the control measure
2
Date of expiration of any implementation period specific in article 4(2) or Annex I
RECORD OF ANTI-FOULING SYSTEM
Drawn up under the
International Convention on the Control of Harmful Anti-Fouling Systems on Ships
(This Record shall be permanently attached to the International Anti-Fouling System Certificate)
Record N HHH 4377
Active ingredient(s) and their Chemical Abstract Services Registry Number(s) (CAS
number(s)) COPPER OXIDE (CAS No. 1317-39-1).
x INITIAL SURVEY
- RENEWAL SURVEY
-
Rep. N HHH-4377
Name of ship Distinctive Port of Gross IMO Number
number or Registry tonnage
letter
NOTE:
Entries in boxes shall be made by inserting either a cross (X) for the answer yes or a dash (-) for the answers no and na where is not applicable
All negative entries should be clarified under Surveyors Notes with reference by item number
*- Delete as appropriate
TYPE OF AFS
1. TBT
1.1.1. Statement from shipyard or contractor confirming removal / sealer coat* application -
F-AFS-01/a 1/3
1.2.2. Materials safety data sheet. -
1.2.3. Statement from shipyard or contractor confirming removal / sealer coat *application -
3.1.4. Statement from shipyard or contractor confirming that the application of existing AFS was applied. -
1.7. If 1.1.2. and 1.1.3. are not available the paint sampling and testing is required -
This is to declare that the undersigned has examined and filled all items of this Report before signed it.
I have issued the AFS Statement of Compliance No: N/A
st
Issued at: MIAMI, FLORIDA. On the: 1 AUGUST, 2014.
ARMANDO ARRASCAETA
Surveyor No. 4001
CONARINA
F-AFS-01/a 3/3