2 Details of radio facilities (continued)
＜font size=+1＞
|-----------------------------------------------------------------------
| | |
| Item | Actual provision |
| | |
|-----------------------------------------|----------------------------|
| 2 Secondary means of alerting |……………………………………|
| | |
| 3 Facilities for reception | |
| of maritime safety information | |
| 3.1 NAVTEX receiver |……………………………………|
| 3.2 EGC receiver |……………………………………|
| 3.3 HF direct-printing | |
| radiotelegraph receiver |……………………………………|
| | |
| 4 Satellite EPIRB | |
| | |
| 4.1 COSPAS-SARSAT |……………………………………|
| | |
| 4.2 INMARSAT |……………………………………|
| | |
| 5 VHF EPIRB |……………………………………|
| | |
| 6 Ship''s radar transponder |……………………………………|
| | |
| 7 Radiotelephone distress frequency | |
| watch receiver on 2,182 kHz ① |……………………………………|
| | |
| 8 Device for generating the | |
| radiotelephone alarm signal | |
| on 2,182 kHz ② |……………………………………|
|-----------------------------------------------------------------------
＜/font＞
[ ① Unless another date is determined by the Maritime Safety
Committee, this item need not be reproduced on the record attached to
certificates issued after 1 February 1999.]
[ ② This item need not be reproduced on the record attached to
certificates issued after 1 February 1999.]
3 Methods used to ensure availability of radio facilities (regulations
IV/15.6 and 15.7)
3.1 Duplication of equipment -----------------------------------------
-------------------------
3.2 Shore-based maintenance ------------------------------------------
-------------------------
3.3 At-sea maintenance capability ------------------------------------
-------------------------
4 Ships constructed before 1 February 1995 which do not comply with
all the applicable requirements of chapter IV of the Convention as amended
in 1988③
[ ③ This section need not be reproduced on the record attached to
certificates issued after 1 February 1999.]
4.1 For ships required to be fitted with radiotelegraphy in accordance
with the Convention in force prior to 1 February 1992.
＜font size=+1＞
|----------------------------------------------------------------------------
| |Requirements of| Actual |
| | | |
| |regulations |provision|
|-------------------------------------------------|---------------|---------|
| Hours of listening by operator | ……………… | ……… |
| Number of operators | ……………… | ……… |
| Whether auto alarm fitted | ……………… | ……… |
| Whether main installation fitted | ……………… | ……… |
| Whether reserve installation fitted | ……………… | ……… |
| Whether main and reserve transmitters electri- | | |
| cally separated or combined | ……………… | ……… |
|----------------------------------------------------------------------------
＜/font＞
4.2 For ships required to be fitted with radiotelephony in accordance
with the Convention in force prior to 1 February 1992.
＜font size=+1＞
|-----------------------------------------------------------------------
| | Requirements of | Actual |
| | regulations | provision |
|-----------------------------------|--------------------|-------------|
| Hours of listening | ……………… | ……… |
| Number of operators | ……………… | ……… |
|-----------------------------------------------------------------------
＜/font＞
THIS IS TO CERTIFY that this Record is correct in all respects
Issued at ------------------------------------------------------------
(Place of issue of the Record)
-------------------------- ---------------------------------
(Date of Issue) (Signature of duly authorized
official issuing the Record)
(Seal or stamp of the issuing authority, as
appropriate)
Form C (Safety Certificate for Cargo Ships)
Form of Safety Certificate for Cargo Ships
CARGO SHIP SAFETY CERTIFICATE
This Certificate shall be supplemented by a Record of Equipment
(Form C)
(Official seal) (State)
Issued under the provisions of the
INTERNATIONAL CONVENTION FOR THE SAFETY OF LIFE AT SEA, 1974,
as modified by the Protocol of 1988 relating thereto
under the authority of the Government of
----------------------------------------------------------------------
(name of the State) by ------------------------
----------------------------------------------
(person or organization authorized)
Particulars of ship ①
[ ① Alternatively, the particulars of the ship may be placed
horizontally in boxes.]
Name of ship ---------------------------------------------------------
Distinctive number or letters ----------------------------------------
Port of registry -----------------------------------------------------
Gross tonnage --------------------------------------------------------
Deadweight of ship (metric tons)② ----------------------------------
[ ② For oil tankers, chemical tankers and gas carriers only.]
Length of ship (regulation III/3.10) ---------------------------------
Sea areas in which ship is certified to operate (regulation IV/2) ----
IMO Number③ --------------------------------------------------------
[ ③ In accordance with resolution A. 600(15)-IMO Ship Identification
Number Scheme, this information may be included voluntarily.]
Type of ship④
[ ④ Delete as appropriate.]
Oil tanker
Chemical tanker
Gas carrier
Cargo ship other than any of the above
Date on which keel was laid or ship was at a similar stage of
construction or, where applicable, date on which work for an alteration or
modification of a major character was commenced -----------------------
THIS IS TO CERTIFY:
1 That the ship has been surveyed in accordance with the requirements
of regulation I/8, I/9 and I/10 of the Convention.
2 That the survey showed that:
2.1 the condition of the structure, machinery and equipment as defined
in regulation I/10 was satisfactory and the ship complied with the
relevant requirements of chapter II-1 and chapter II-2 of the Convention(other than those relating to fire safety systems and appliances and fire
control plans);
2.2 the last two inspections of the outside of the ship''s bottom took
place on
-------------------------------------- and -----------------------------
(dates)
2.3 the ship complied with the requirements of the Convention as
regards fire safety systems and appliances and fire control plans;
2.4 the life-saving appliances and the equipment of the lifeboats,
liferafts and rescue boats were provided in accordance with the
requirements of the Convention;
2.5 the ship was provided with a line-throwing appliance and radio
installations used in life-saving appliances in accordance with the
requirements of the Convention;
2.6 the ship complied with the requirements of the Convention as
regards radio installations;
2.7 the functioning of the radio installation used in life-saving
appliances complied with the requirements of the Convention;
2.8 the ship complied with the requirements of the Convention as
regards shipborne navigational equipment, means of embarkation for pilots
and nautical publications;
2.9 the ship was provided with lights, shapes, means of making sound
signals and distress signals in accordance with the requirements of the
Convention and the International Regulations for Preventing Collisions at
Sea in force;
2.10 in all other respects, the ship complied with the relevant
requirements of the Convention.
3 That the ship operates in accordance with regulation III/26.1.1.1
within the limits of the trade area --------------------------------------
---------------------
4 That an Exemption Certificate has/has not ① been issued.
[ ① Delete as appropriate.]
This certificate is valid until ----------------------- ② subject to
the annual, intermediate and periodical surveys and inspections of the
outside of the ship''s bottom in accordance with regulations I/8, I/9 andI/10 of the Convention.
[ ② 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/14(h).]
Issued at ------------------------------------------------------------
-----------------
(Place of issue of certificate)
-------------------------- ---------------------------------
(Date of issue) (Signature of authorized official
issuing the certificate)
(Seal or stamp of the issuing authority, as
appropriate) Endorsement for annual and intermediate surveys relating to
structure, machinery and equipment referred to in paragraph 2.1 of this
certificate
THIS IS TO CERTIFY that, at a survey required by regulation I/10 of
the Convention, the ship was found to comply with the relevant
requirements of the Convention.
Annual survey; Signed: --------------------------------------------
(Signature of authorized official)
Place: ---------------------------------------------
Date: ----------------------------------------------
(Seal or stamp of the authority, as appropriate)
Annual/Intermediate
①survey: signed: ------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate)
[ ① Delete as appropriate.]
Annual/Intermediate
①survey: Signed: ------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate)
[ ① Delete as appropriate.]
Annual survey:
Signed: -------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate)
Annual/intermediate survey in accordance with regulation I/14(h)(iii)
THIS IS TO CERTIFY that, at an annual/intermediate② survey in
accordance with regulations I/10 and I/14 (h) (iii) of the Convention, the
ship was found to comply with the relevant requirements of the Convention.
[ ② Delete as appropriate.]
Signed: -------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate) Endorsement
for inspections of the outside of the ship''s bottom ①
[ ① Provision may be made for additional inspection.]
THIS IS TO CERTIFY that, at an inspection required by regulation I/10
of the Convention, the ship was found to comply with the relevant
requirements of the Convention.
First inspection:
Signed: -------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate)
Second inspection:
Signed: -------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate) Endorsement
for annual and periodical surveys relating to life-saving appliances andother equipment referred to in paragraphs 2.3, 2.4, 2.5, 2.8 and 2.9 of
this certificate
THIS IS TO CERTIFY that, at a survey required by regulation I/8 of the
Convention, the ship was found to comply with the relevant requirements of
the Convention.
Annual survey:
Signed: -------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate)
Annual/Periodical
① survey: Signed: -------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate)
[ ① Delete as appropriate.]
Annual/Periodical
① survey: Signed: -------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate)
[ ① Delete as appropriate.]
Annual survey:
Signed: -------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate)
Annual/periodical survey in accordance with regulation I/14 (h) (iii)
THIS IS TO CERTIFY that, at an annual/periodical① survey in
accordance with regulations I/8 and I/14 (h) (iii) of the Convention, the
ship was found to comply with the relevant requirements of the Convention.
[ ① Delete as appropriate.]
Signed: -------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate) Endorsement
for periodical surveys relating to radio installations referred to in
paragraphs 2.6 and 2.7 of this certificate
THIS IS TO CERTIFY that, at a survey required by regulation I/9 of the
Convention, the ship was found to comply with the relevant requirements of
the Convention.
Periodical survey:
Signed: -------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate)
Periodical survey: Signed: ----------------------------
(Signature of authorized official)
Place: -----------------------------
Date: ------------------------------
(Seal or stamp of the authority, as appropriate)
Periodical survey: Signed: ----------------------------
(Signature of authorized official)
Place: -----------------------------
Date: ------------------------------
(Seal or stamp of the authority, as appropriate)
Periodical survey: Signed: ----------------------------
(Signature of authorized official)
Place: -----------------------------
Date: ------------------------------
(Seal or stamp of the authority, as appropriate) Periodical
survey in accordance with regulation I/14(h)(iii)
THIS IS TO CERTIFY that, at a periodical survey in accordance with
regulations I/9 and I/14 (h) (iii) of the Convention, the ship was foundto comply with the relevant requirements of the Convention.
Signed: -------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate)
Endorsement to extend the Certificate if valid for less than 5 years
where regulation I/14(c) applies
The ship complies with the relevant requirements of the Convention,
and this certificate shall, in accordance with regulation I/14(c) of theConvention, be accepted as valid until -----------------------------
Signed: -------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate)
Endorsement where the renewal survey has been completed and regulation
I/14(d) applies
The ship complies with the relevant requirements of the Convention,
and this certificate shall, in accordance with regulation I/14(d) of theConvention, be accepted as valid until -----------------------------
Signed: -------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate)
Endorsement to extend the validity of the certificate until reaching
the port of survey or for a period of grace where regulation I/14(e) or
I/14(f) applies
This certificate shall, in accordance with regulation I/14(e)/I/14(f)
① of the convention, be accepted as valid until -------------------------
-------------------------
[ ① Delete as appropriate.]
Signed: -------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate)
Endorsement for advancement of anniversary date where regulation I/14
(h) applies
In accordance with regulation I/14(h) of the Convention, the new
anniversary date is
-------------------------------------------------------------------------
Signed: -------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate)
In accordance with regulation I/14(h) of the Convention, the new
anniversary date is
-------------------------------------------------------------------------
Signed: -------------------------------------------------
(Signature of authorized official)
Place: --------------------------------------------------
Date: ---------------------------------------------------
(Seal or stamp of the authority, as appropriate)
Form C (Record of Equipment for the Cargo Ship Safety Certificate)
This Record shall be permanently attached to the Cargo Ship Safety
Certificate
RECORD OF EQUIPMENT FOR COMPLIANCE WITH THE INTERNATIONAL CONVENTION FORTHE SAFETY OF LIFE AT SEA, 1974, AS MODIFIED BY THE PROTOCOL OF 1988
RELATING THERETO
1 Particulars of ship
Name of ship ---------------------------------------------------------
Distinctive number or letters ----------------------------------------
