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Ship's name ___________________________

Date___________________

Call sign __________ Deadweight ___________ tonnes

Year built ______________

Draught aft _____ m/_____ ft _____ in, Forward ______ m/_____ ft _____in,

Displacement ____tonnes

SHIP'S PARTICULARS

Length overall __________ m,

Anchor chain: Port _______ shackles,

Starboard _____ shackles,

Breadth __________ m

Stern _______ shackles

Bulbous bow Yes/No

(1 shackle = __________ m/ _________ fathoms)

Type of engine _______________________ Maximum power __________ kW ( __________ HP)

Manoeuvring engine order

Rpm/pitch

Speed (knots)

Loaded

Ballast

Full ahead

Half ahead

Slow ahead

Dead slow ahead

Dead slow astern

Time limit astern

_____________ min

Slow astern

Full ahead to full astern

________________ s

Half astern

Max. no. of consec. starts

_________________

Full astern

Minimum RPM ________

____________ knots

Astern power

___________ % ahead

STEERING PARTICULARS

Type of rudder____________________

Maximum angle _________________________deg

Hard-over to hard-over ____________________ s

Rudder angle for neutral effect _______________________ deg

Thruster: Bow ___________ kW ( ___________ HP) Stern ___________ kW ( ___________ HP)

CHECKED IF ABOARD AND READY

Anchors

Indicators:

Whistle

Rudder

Radar 3 cm

10 cm

Rpm/pitch

ARPA

Rate of turn

Speed log

Doppler: Yes/No

Compass system

Water speed

Constant gyro error

_________deg

Ground speed

VHF

Dual-axis

Elec. pos. fix. system

Engine telegraphs

Type _____________________

Steering gear

Number of power

units operating

OTHER INFORMATION:

Master: ____________________

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

To retain for 2 years.

Issue date: 03.11.2003/Rev. 00 I-DD09-F01 Page: 2/2

PILOT CARD CHECK LIST

QSMS I-DD09-F01 Rev. No.00