Name of Vessel:
Port and Country of Inspection:
Date of Inspection (dd/mm/yy)
Date of last Inspection (dd/mm/yy)
Time of Inspection	Start:
Type of Inspection:	First

NAME OF INSPECTOR:		ID NUMBER:
INSPECTION REPORTS: This inspection form is to be signed by the Inspector and the Master of the vessel. The original shall remain on-board kept by the Master as one of the vessels official documents.

PART A: - GENERAL
1.Official No.
5a. Gross Tonnage
8. Vessel Type
8. Recognised Organisation:
9. Recognised Security Organisation:
10. Classification Society (+class notation):
11. ETA/Next Port:
12. NAME OF LOCAL PORT AGENT
Agents Name
13. NAME AND ADDRESS OF MANAGER & DPA (ISM)& CSO (ISPS)
Company Name
Address 1
Address 2
Address 3
DPA Name
CSO Name
14. Name of Maritime Resident Agent

PART B: - SHIPS OFFICIAL DOCUMENTS (all dates to be recorded dd/mm/yy)
Statutory certificates and exemptions
International Tonnage Certificate
International Load Line Certificate
Cargo Ship Safety Construction Certificate
Cargo Ship Safety Equipment Certificate
Cargo Ship Safety Radio Certificate
Exemption Certificate (from Reg.)
International Oil Pollution Prevention Cert.
IOPP Supplement
International Air Pollution Prevention Cert.
IAPP Supplement
International Sewage Pollution Prevention Cert.
Garbage Pollution Prevention Cert. / Certificate of Compliance
Anti-Fouling System Certificate / Statement of Compliance
Copy of Document of Compliance
Safety Management Certificate
International Ship Security Certificate
Copy of last special survey and outstanding requirements
Other Certificates
Certificate of Class
Civil Liability Certificate (for Tankers)
Classification Society Survey Status Report
Conditions of Class – Outstanding / Recommendations
Others (List)
Certificates issues by Flag
Certificate of Registry
Minimum Safe Manning Certificate
Ship Radio Station Licence (No.      )
Continuous Synopsis Record
Crew’s Articles of Agreement if applicable
LastPortState Control Inspection Reports (last 3 or those in last 12 months, whichever is the greater number)
Remarks:
Remarks:
Remarks:
Remarks:

PART C: - Plans and Manuals
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.

PART D: - Records
Records
1
2
3
4
5
6
7
8
9
10
11
PART E:
Publications and Charts
1
2
3
4
5
6
7
8
9
10
11
12
13
27
28
29
30

PART F:
Bridge Logbooks
1
2
3
4
5
6
7
Remarks:

PART G: Aids to Navigation and Communications
Vessel Equipped for GMDSS
Type of Maintenance
Duplicated System
VHF MF/HF INMARSAT SES
Installed or Onboard = I Operational = 0
1
2
3
4
5
6
7
8
9
10.
11.
12.
13.
14.
15
16
17.
18.

Part I: Life-saving appliances and arrangements
1
2
3
4
5
Personal LSA
6
7
8
9
10
11
12
13

	Part J: Fire Fighting Equipment	Number	Visible conditions
1	Fire pumps
2	Fire main
3	Fire hoses
4	Dual Fire nozzles with shutoff (spray/jet type)
5	Portable Fire extinguishers		Last date of inspection
6	Fixed fire-extinguishing systems in machinery spaces	Type	Last date of inspection
	Visible conditions
7	Fire-extinguishing arrangements in cargo spaces	Type	Last date of inspection
	Visible conditions
8	Fixed fire detection and fire alarm systems	Operation Y/N
9	Watertight doors	Satisfactory condition Y/N
10	Escape openings (hatches) unobstructed?	Y/N

Part K: General conditions
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29

Part L:ENGINEERING, MACHINERY SPACES & EQUIPMENT

Ref.	Records to be sighted	Yes / No Obs / N/A	Notes
1	Maintenance records of main and auxiliary machinery
2	Engine room log book in use & signed by the Chief Engineer
3	Machinery failure alarms and safety trips tested
4	Unmanned Machinery Space alarm system test
5	Machinery space closings and fan dampers test
6	Emergency steering gear test
7	Remote pump and fan stops, remote closing valves test
8	Technical file and Record book of diesel engine parameters as required by NO, Tech Code paras 2.3.6 & 6.2.33 for each Engine (Marpol annex VI- Air pollution)
9	Record of Bunker delivery notes and associated samples(These may be incomplete depending upon whether the formal receipts are available from the suppliers)
	Procedures to be sighted
10	Bunkering procedures
11	Pollution prevention procedures in the control room
12	Chief Engineer’s emergency procedures & standing orders in the control room
13	Oily Water Separator operating procedures, in the vicinity of the OWS (see…………..
14	Emergency steering changeover procedures, in the steering flat.
15	Company instruction & procedures with regard to engine room management and safe engine watchkeeping.
	To Witness Operation wherever possible
16	Steering systems including change over and test of emergency steering gear.
17	Emergency generator starting and excitation.
18	ER closing mechanisms and fan dampers. Test sample.
19	Fire & general alarm test.
20	Remote pump and fan stops, remote closing valves. Test sample.
21	UMS alarm system. All positions.

Part L: ENGINEERING, MACHINERY SPACES & EQUIPMENT

Ref.	To be Verified	Yes / No Obs / N/A	Notation
22	Main and auxiliary machinery in good working order and well maintained.
23	Control and alarm functions in good order, including alarm in Engineer’s accommodation.
24	Fuel & Lubricating/hydraulic oil systems free from leaks and temporary repairs
25	Cooling systems free of water leaks and temporary repairs.
26	Compressed air piping system free of leaks and temporary repairs.
27	Tank tops and bilges clean and free of oil.
28	Steam lines and other high pressure pipes clean and free from leakage.
29	Bilge pumps
30	OWS – Oily Water Separator – pipework.
31	OWS – Verify that 3 way / dumping valve is operational
32	Switchboards and electrical equipment enclosed and provided with insulated floor mat. Satisfactory condition and proper securing of electrical cable and equipment.
33	Housekeeping & cleanliness of engine room, workshop and stores to a good standard.
34	Engine Room lighting complete and maintained for safe access / operation.
35	Engine room lighting power source in good condition & tested periodically.
36	Fire doors, emergency exits and watertight doors in good condition, clearly marked operational and clear of obstructions.
37	Escape routes clearly marked from all levels in the Engine room.
38	Main & auxiliary steering control systems operational; / reserve oil tank charged.
39	Accessibility of steering gear compartment and suitable arrangements to ensure working access to steering gear machinery / control under safe conditions.
40	Communications: Steering compartment & navigation bridge. Navigation bridge and machinery space. Other position from which engine is controlled.
41	Steering compass / rudder angle indicator visible at the emergency steering position.
42	Machinery space fire fighting & safety equipment in good order.
43	Welding and burning equipment in good condition / operating procedures displayed.
44	Emergency generator prepared, fuel tank fully charged and starting instructions clearly displayed.

ANNEX PART A: PASSENGER VESSELS		NOTES
1	IS THERE A DECISION SUPPORT SYSTEM FOR EMERGENCY MANAGEMENT ON THE NAVIGATIONAL BRIDGE AVAILABLE FOR THE MASTER (SOLAS CH.III/24-4)?
2	A DISTRESS ALARM PANEL AT THE CONING POSITION WITH INITIAL DISTRESS ALERT BUTTONS ON IT IS INSTALLED (SOLAS CH.IV/6.5-4)?
3	THE PUBLIC ADDRESS SYSTEM IS OPERATIONAL & AUDIBLE ON ALL OPEN DECKS ABOVE AMBIENT NOISE (SOLAS CH.III/6.5)?
4	THE GENERAL EMERGENCY ALARM SYSTEM IS OPERATIONAL (SOLAS CH.III/6.4)?
5	A PLAN FOR COOPERATION OF SEARCH AND RESCUE SERVICES IN THE TRADING AREA IN EVENT OF EMERGENCY APPROVED BY THE ADMINISTRATION IS ON BOARD (CHAPTER V 15[c])?
6	A TWO WAY ON SCENE RADIOCOMMUNICATIONS FOR SEARCH AND RESCUE PURPOSES USING THE AERONAUTICAL FREQUENCIES 121.5 MHz AND 123.1 MHz IS INSTALLED AND OPERATIONAL (SOLAS CH.IV/7.5)?
7	THERE IS A TWO WAY PORTABLE RADIOTELEPHONE APPARATUS FOR EACH MEMBER OF THE FIRE PATROL (SOLAS CH.II-2/40 FOR NEW PASSENGER SHIPS > 36 PASSENGERS)?
8	THERE ARE AT LEAST TWO EPIRBS ON BOARD (SOLAS CH.III/6.2.3)?
9	THERE ARE AT LEAST TWO RADIO TRANSPONDERS ON BOARD (SOLAS CH.III/6.2.2)?
10	THERE IS A CENTRAL CONTROL STATION FOR REMOTE CONTROL AND MONITORED FIRE DOORS, FIRE DETECTION ALARMS, SHUTTING DOWN FANS, REACTIVATION OF FANS, SUPPLY FROM MAIN AND EMERGENCY SOURCE OF POWER (SOLAS CH.II-2/40)?
11	SUPPLEMENTARY EMERGENCY LIGHTING IS INSTALLED AND OPERATION (SOLAS CH.II-1/42.1)?
12	A HELICOPTER LANDING AND PICKUP AREAS HAS BEEN FITTED (SOLAS CH.III/24.3)?
13	IS THE CLOSING OF WATERTIGHT DOORS DURING NAVIGATION LOGGED (SOLAS CH.II-1/15.6.5)?
14	IS THERE AN EMERGENCY MUSTER RECORD (SOLAS CH.III/24.2.3)?
15	IS THERE A DEDICATED RADIO OFFICER (SOLAS CH.IV/16.2)?
16	AUTOMATIC SPRINKLERS FOR ACCOMMODATION AND SERVICE SPACES, STAIRWAY ENCLOSURES AND CORRIDORS ARE INSTALLED (SOLAS CH.II-2/41-1.3.4: 41-2.5 & 36-1.2)?
17	IS THERE A SMOKE DETECTION AND ALARM SYSTEM FOR ACCOMMODATION AND SERVICE SPACES, STAIRWAY ENCLOSURES AND CORRIDORS (SOLAS CH.II-2/36)?
18	IS THERE A WATER FOG APPLICATOR FOR EACH PAIR OF BREATHING APPARATUS (SOLAS CH.II-2/17.3.2)?
19	IS THERE PORTABLE FOAM APPLICATORS (SOLAS CH.II-2/17.3.2)?
20	ARE THERE ENOUGH FIREMAN’S OUTFITS ON THE VESSEL (SOLAS CH.II-2/17.3.1)?
21	ARE THE ESCAPE ROUTES ON RO-RO PASSENGER SHIPS MARKED AND IN COMPLIANCE (SOLAS CH.II-2/28.1)?
22	IS EACH LIFERAFT FITTED WITH A BOARDING RAMP AND SELF RIGHTING OR REVERSIBLE (SOLAS CH.III/24-1.2.3 & .2.4)?
23	NUMBER OF FAST RESCUE BOATS ON BOARD (SOLAS CH.III/24-1.3)?
24	ARE THERE ENOUGH CREW TRAINED FOR THE FAST RESCUE BOATS (SOLAS CH.III/24-1.3)?
25	ARE THERE SUFFICIENT NUMBER OF LIFEJACKETS STOWED IN THE VICINITY OF THE ASSEMBLY STATION (SOLAS CH.III/24-1.5)?
26	DO THE DISCHARGE VALVES FOR SCUPPER HAVE POSITIVE MEANS OF CLOSING THAT IS OPERABLE FROM A POSITION ABOVE THE BULKHEAD DECK (SOLAS CH.II-2/31.2.1.2)?
27	IS THE OPERATION OF THESE VALVES RECORDED IN THE LOGBOOK?
REMARKS
SIGNATURE OF INSPECTOR	SIGNATURE OF MASTER
NAME & ID NBR (PRINT)	NAME (PRINT)
DATE	DATE