Ship's Name__________________ Dept.__________________ Date:____________________

PART I - made on board
Item	Contents	Superintendent remarks
Chief Eng./Off………………………. Superintendent approval ………………

PART II - Superintendent orders
Item	Contents
Superintendent ………………………. Chief Eng./Off acknowledge……………

Chief of Dept. Master Superintendent

Note: To be completed every voyage and filed in both office's file and ship's file.

To retain for 2 years.

Issue date: 03.11.2003/Rev. 00 PBO-TD02-F02 Page: 1/1

VOYAGE MAINTENANCE PLAN

QSMS PBO-TD02-F02 Rev. No.00

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