VESSEL: ______________________

PORT: _____________________

DATE: ____________________

(1)

LIFE BOAT:

(Please attach with form “EQUIPMENT FOR LIFE BOAT”.)

Boat

Starboard

Port

Outside Condition

___________________________

___________________________

Inside Condition

___________________________

___________________________

Engine

___________________________

___________________________

Latest Drill Date

___________________________

___________________________

(2)

DAVIT OF LIFE BOAT:

Item

Starboard Boat

Port Boat

Frame

_________________________________

______________________________

Winch/Motor

_________________________________

______________________________

Block

_________________________________

______________________________

Wire: Date Renewal

_________________________________

______________________________

Date of End to End

_________________________________

______________________________

(3)

LIFE RAFTS:

Item

Starboard

Port

Forward

Container

____________________

____________________

_____________________

Launching Stand

____________________

____________________

_____________________

Hydrostatic Release Unit

____________________

____________________

_____________________

Date of Next Service

____________________

____________________

_____________________

(4)

LIFE-SAVING EQUIPMENT:

Item

Condition

Man. Date

Exp. Date

Life-jacket

_________________________________________________________________

Life-buoy

_________________________________________________________________

Manoverboard Signal

______________________________

________________

______________

Self-igniting Light

_________________________________________________________________

Life-line

_________________________________________________________________

Bridge Rocket

_________________________________

______________

_____________

St'd Boat Rocket

____________ ____________ Port Boat Rocket

______________

_____________

Hand Flare

____________ ____________ Hand Flare

______________

_____________

Smoke Signal

____________ ____________ Smoke Signal

______________

_____________

Line-throwing Apparatus

_________________________________

______________

_____________

Speed-line

_________________________________

______________

_____________

NOTE:

Monthly Inspection

Inspection of life-saving appliances shall be carried out monthly using this CHECK-LIST, a copy of the same shall be sent to Marine Division. Report of the inspection shall be entered in the log-book.

Weekly Inspection

The following tests and inspections shall be carried out weekly:

a)

Life boat, life boat davit and life raft shall be visually inspected.

b)

All engine in life boat shall be run ahead and astern.

c)

The general emergency alarm system shall be tested.

THIRD MATE: MASTER:

Note: To be completed in due course and filed in both office's file and ship's file.

To retain for 2 years.

Issue date: 03.11.2003/Rev. 00 I-AD14-F01 Page: 1/1

MONTHLY CHECK-LIST FOR LIFE-SAVING EQUIPMENT

QSMS I-AD14-F01 Rev. No.00

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