M/V:..........................................

INSPECTION/MAINTENANCE REPORT

DATE: ...................................... Dept: Deck Engine No:………………

ITEM: ....................................................................................................................................................

REASON FOR INSPECTION:

PLANNED 

BREAKDOWN 

CONDITION FOUND:

CORRECTIVE ACTION TAKEN:

MATERIAL USED:

CORRECTIVE ACTION REQUIRED (OUTSTANDING):

REMARKS:

INSPECTED BY	CHIEF ENGINEER	MASTER
..................................................	..................................................	..................................................
NAME AND POSITION

* Insert as appropriate: E for Engine Department and D for Deck Department

ATLANTIC UNITED MARINE INC.

FORM / 4714

Safety Management System Manual - IMO Res. A.741 (18)
Developed by	: SMS Designated Person	Authorized by	: Managing Director
Date of Initial Issue	:	Revision No / Effective Date	: 3 / 07 - 99
Chapter	: 10	Page	: 1