PT PERTAMINA (PERSERO)

SHIPPING MARKETING & TRADING DIRECTORATE

SHIPPING OPERATION DIVISION, HEAD OFFICE 19TH Floor, Jln. Merdeka Timur 1A Jakarta 10110
Phone : (62-21) 3816367, 3816314, 3816339, 3816353, 3816217. Fax : 3455430, 3816348, 3507121
E-mail: opstanker@pertaminashipping.com

ULLAGE / SOUNDING - REPORT

M/T

(Name of the Vessel)

VOYAGE

(Number Voyage)

DATE

(Date of Measurement)

PORT

(Name of the Port)

(Fore side draft)

Mtr

(Mean draft)

Mtr

(After side draft)

Mtr

ULLAGES /
SOUND*
(CM)
(Measured

Ullage or

Sounding)

DRAFT

TANK NO

PORT

CENTER

STBS

4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7

OBSERVED
DENSITY
TEMP(o C)
15 o C
(Observed
(Observed
temperatur
Density of
e
of Cargo

cargo sample

TEMP CARGO (o
GRADE
C)

REMARKS

(Temperature

(Grade

(Description

Of Cargo in

of the

Of any

Compartement
)

Cargo)

particular

Sample)

Condition
Happened
During
Inspection)

Note: If any compartement used for ballast tank or empty, must be explained in the remarks column

(Name and Sign of Chief Officer)

.
CHIEF OFFICER
* choose one of two