Have the following actions been carried out?

1. Engine room informed and alternative/emergency steering

engaged

1. Master informed

1. “Not under command” shapes or lights exhibited

1. Appropriate sound signal made

1. If necessary, way taken off ship

1. Warning broadcasted

Duty Officer

Master

Date

Position of vessel

Note: To be completed every time and filed in ship's file.

To retain for 5 years.

Issue date: 03.11.2003/Rev. 00 PBO-G∗03-C05 Page: 1/1

EMERGENCY RESPONSE CHECK LIST - COLLISION IN INNER WATER WAYS (PILOTAGE WATERS) AND WITHIN PORT AREA

QSMS PBO-G∗03-C05 Rev. No.00

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