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Liquefied Gas

APP E N DIX

Cargo Information Form

'o • compłeted befcre ioading

^rbip _ Oate_ _

Fort__Time_

terminal ty 8»nb_

1 Correct rochrocal name (Ił n*xture. give main comporKntł. and name and ccncentratiom of mo$t wiatile cuirpcnrnri ł

2 Temperaturo & pressurr

1} In shore tank_ ») Aj loaded_ liii Rethi*ed on defewry.

3 Denary.

a coemoem oł exp*n»ian.

S Loadmg mto tank numberj

Notę any itowage/wgrręyation requi»emenb Notę tank minimum deygn tempeiature ar-d relic^f valvc setting

5 UUag« to bo ^le^,t in tanki.

7 li cargo mhibited?_

Ił so. camplete inhibitor .nłorrnation (orm

8 li any watec present?

9 Arry speoai preuuliom.

(See IW Cooesl

f rhe .itwe doei not supj*y suff-cent mformat on łot «fe camage oi repu red by IMO1GC Codę. paragrap*-. 18 t 1 or the wręo n nor adeguately cwereo by an ICS Data Shoet. duppeis to jyppty the nccoisary =nfomia:<-r. befoie Oadmg

Siyned for Ship

Stgnęd Im Shprc