Vessel's Name ………………………………………….		Owner ……………………………………………
Fuel supplier .………………………………………….		Name of barge or pier ……………………………..
Bunkering port and date ...................................................... ....................................		Full name and rank of ship's representative present during sampling (in block letters) ……………………………….........................................
Grade ordered ……..............….….	Bunker receipt data: -viscosity ………………. -density @15°C …………..	continuous drip Sampling method spot automatic
Marks on seals on FO or DO samples:
supplier's …………………	vessel's ……………………	(mark with “X” as appropriate)
Please attach a copy of the bunker receipt note with bunker receipt data.
Machinery report: ∗ fuel temperature: - in settling tank °C - in daily tank °C ∗ settling tank draining: - frequency times/day - approx. quantity of drained water litres/day ∗ service tank draining: - frequency times/day - approx. quantity of drained water litres/day ∗ operation data of the centrifugal separators: - fuel inlet temperature °C - gravity disc diameter mm - actual throughput capacity % of the rated - time of operation hours/day - intervals between sludge discharging hours - intervals between manual bowl cleaning days - intervals of ME/AE fine filter cleaning hours - one separator in operation (tick off where appropriate) - two separators in operation: - parallely - in series - centrifuging from settling tank to service tank - recirculation by separator from service tank to service tank - recirculation by separator from settling tank to service tank and overflow to settling tank - the above fuel has been mixed with the previously bunkered fuel yes no ∗ observations whilst using the mentioned fuel (tick off where appropriate and describe if necessary) - problems with fuel pumps and injectors - problems with purification, filter clogging, etc. - problems with cylinder and exhaust system fouling - drop in engine power - no problems have been noted
∗ additional comments by ship's staff:
__________________________________________________ ________________________ Chief Engineer (full name in block letters and signature) Date

Note: To be completed by case and filed in both office's file and ship's file.

To retain for 2 years.

Issue date: 03.11.2003/Rev. 00 PBO-TD04-F14 Page: 1/2

FUEL QUALITY REPORT

QSMS PBO-TD04-F14 Rev. No.00

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