Document: 1.Quality & Safety Manual 2.Procedure, Duties and Responsibilities of Personnel Ashore and Afloat 3.Fleet Instructions 4.Shipboard Contingency Plan/Shore-based Contingency Plan 5.Records

Division / Ship ..................................................... Controlled status: _______________

Serial Number	Distribution Date	Holder	Remarks

DPA: _________________________________________

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

To retain for 3 years.

Issue date: 03.11.2003/Rev. 00 PBO-G∗04-F01 Page: 1/1

QSMS DOCUMENT DISTRIBUTION LIST

QSMS PBO-G∗04-F01 Rev. No.00

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