COLLISION CHECK LIST

Company Forms and Check Lists

Date Rev.No Prep. App. Section Page

WRITEN REPORT

: 03.04.01 :1 : MGV : CAP : 03 : 1 of 3

DOCUMENTS

ACTION Sound emergency (internal) alarm

RADIO ADVICE

EVIDENCE

1 2 3 4 5 6 7 8 9

Stop engines

Manual steering

Switch on deck lights (at night)

Call Master

Switch on VHF - channel 16

Advise engine room

Close watertight doors

Alert vessels in vicinity

10 Alert shore stations 11 Exhibit NUC lights / shapes 12 Muster fire fighting / spill party 13 Muster lifeboat party

C:\FORMS\03_0012.PDF

MT LADON

COLLISION CHECK LIST

Company Forms and Check Lists

Date Rev.No Prep. App. Section Page

: 03.04.01 :1 : MGV : CAP : 03 : 2 of 3

14 Check for injuries and / or missing persons 15 Give to radio officer vessel's position 16 Sound all tanks, wells and bilges including engine room
Assess damage to hull, tanks peaks, engine room, pump 17 rooms and cargo Check cargo, fuel, steam, hydraulic pipelines and valves 18 for fracture / leaks

19 Check for oil spills and internal and / or overside pollution 20 Alert V.R.P. / Call Pleiades office 21 Mark course recorder 22 Note time of contact 23 Note vessel's position 24 Note all bridge times 25 Note all engine room times 26 Note course and speed at time of contact 27 Note times of all sound signals made and heard
C:\FORMS\03_0012.PDF

MT LADON

COLLISION CHECK LIST

Company Forms and Check Lists

Date Rev.No Prep. App. Section Page

: 03.04.01 :1 : MGV : CAP : 03 : 3 of 3

27 Check if other vessel requires assistance 28 Pay utmost attention when attempting refloating
Obtain from other vessel name / port of registry / type of 29 cargo / whence bound / where bound.

30 Photographs 31 Check if other vessel requires you to stand by it 32 Hold other vessel responsible by letter 33 Note protest
Obtain statements from officer of the watch and other 34 witnesses and note their names and addresses, and complete accident / incident report.
INSTRUCTIONS :
To be filled in in case of collision. Checklist to be kept in the Safety Officer's file and a copy to be forwarded to the office together with all relevant documentation.

C:\FORMS\03_0012.PDF

MT LADON