CHECK LIST FOR ANNUAL AND RENEWAL SURVEYS OF INTERNATIONAL LOAD LINE CERTIFICATE

This form applies for vessels holding an ILL Certificate (This form is not to be used for Load Line Surveys on Mobile Offshore Units)

NATIONAL SHIPPING ADJUSTER, INC. Name of Ship: Survey Report No. Full Term ILL Certificate No.

Date:

Place:

Name and signature of Surveyor:

Survey Items ANNUAL SURVEY: (items 1 to 9.2) 1. REVIEW OF DOCUMENTATION IN MASTERS OFFICE. Is the following documentation available on board? Stability information according to Reg. 10.2 (ICLL-1966).

Condition (1) Action (2)

Comments

1.1

Recommendations are to be given by the surveyor, if applicable documentation is not available onboard.

Approved by: Dated: Note that stability information is required to be onboard also for "existing ship" (ICLL-1930). Alterations/removals/new installations concerning equipment and fittings covered by items 3.1 to 8.1 of this check list shall be entered in record/report onboard and signed by the surveyor.

1.2

Are there changes affecting the freeboard or the closing appliances?

2. 2.1

FREEBOARD MARKS The freeboard marks have been measured and found to be in accordance with the Load Line Certificate. Dated:

Check: position of the mark - correct lettering.

3.

MECHANICALLY OPERATED STEEL HATCHCOVERS Are the following items checked and found in efficient condition?

(1) Y = Survey item considered in order; N = not in order; NA = not applicable. (2) If the item was considered not in order use: R = Recommendation given. IR = item repaired/rectified
TEC-F-33/1

(If required, use additional pages)

1/8

Survey Items 3.1 Gaskets, gasket lips, compression bars and drainage channels. Clamping devices, cleatings and retaining bars.

Condition (1) Action (2)

Comments Check: non-return valves in drainage channels, that packing material is not perished or torn. Check that retaining bars and compression bars are not affected by excessive wastage. Check that cleatings ensure compression when covers are seated (special attention to cross joints). Check maintenance.

3.2

3.3

Stoppers, guide rails, track wheels and chain or rope pulleys. Hatchcovers with respect to corrosion, cracks or deformation. Hatchcoamings with respect to corrosion, cracks or deformation to plating and supporting members connected to the deck. Repairwork on hatchcoamings. hatchcovers and

3.4

Check of residual thickness of pontoons or covers, plating and stiffening members, as deemed necessary by the surveyor. Check condition of coamings with stiffeners and connection to deck.

3.5

3.6

3.7

Tightness test of hatchcovers (if deemed necessary).

Tightness test: If the surveyor deems it necessary to check the tightness devices more thoroughly than by visual inspection. If repairs etc. have been carried out.

Hose test: Chalk test: Other test: Hold nos: 4.

_______________________ _______________________ _______________________ _______________________

OTHER CLOSING APPLIANCES Are the following items checked and found in efficient condition?

4.1

Superstructures, deckhouses and companionways with their bulkheads.

Check condition of bulkheads in superstructures, deckhouses, companionways and casings with respect to corrosion, cracks and buckles.

4.2

Closing appliances of doors and small hatches etc. in superstructures and decks.

Check condition of clamping devices, hinges, packings and sills. Hose test if deemed necessary.

4.3

Engine and/or boilercasings with their doors, sills, skylights and fastenings.

Check condition of clamping devices, hinges, packings and sills. Hose test if deemed necessary.
2/8

TEC-F-33/1

Survey Items 4.4 Ventilators with closing appliances.

Condition (1) Action (2)

Comments Check: Condition of coamings with stays/ supports especially connection to the deck. Weathertightness of closing appliances. Check condition of pipe and connection to deck. Weathertightness of closing appliances. Check weathertightness. Hinges and toggles to be easily movable.

4.5

Airpipes with closing appliances.

4.6

Side scuttles below the freeboard deck and in enclosed superstructures, windows/ sidescuttles in deckhouses. Deadlights.

4.7

Check weathertightness. Hinges and toggles to be easily movable. For supply vessels deadlights may be required at higher positions.

5. 5.1

SIDE/STERN/BOW PORTS Ports including gaskets and their closing appliances surveyed. Tightness test may be required if deemed necessary by the surveyor after visual inspection.

6. 6.1

PROTECTION OF CREW Bulwarks, guardrails, gangways, lifelines and the protection and access to crews quarters. Check stanchions, stays, courses and lines. If underdeck passage, check ventilation, lighting and gas-, oil- and weathertightness. Check rails, bars and shutters.

6.2

Freeing ports and shutters.

7. 7.1

SEA - AND SANITARY VALVES External inspection of valves. Check: external condition, tightness, holding down bolts. To be tested in operation.

7.2

Operation of remotely operated side valves.

8. 8.1

TIMBER FREEBOARD Supplementary fittings. Check condition of permanent arrangements/ appliances (e.g. eye plates and sockets for uprights). Lashings not required to be onboard when timber deck-cargo is not carried.

9. 9.1

ENDORSEMENT OF CERTIFICATE International Load Line Certificate, dated: _______________________________ and valid until ________________________ has been properly endorsed.
TEC-F-33/1

In case of deficiencies the surveyor should, as far as possible, request repairs and/or replacement before the vessel leaves port. The certificate should only be endorsed if minor recommendations are issued.

3/8

Survey Items

Condition (1) Action (2)

Comments

9.2

Short term Load Line Certificate has been issued. Valid until: ____________________________

RENEWAL SURVEY: (items 10 to 18.2)

(Applies to vessels holding an ILL Certificate and also for vessels surveyed according to national regulations. This form is not to be used for Load Line surveys on mobile offshore units).

10.

REVIEW OF DOCUMENTATION MASTERs OFFICE.

IN

Recommendations are not to be given by the surveyor (items 10.1 to 10.4).

Is the following documentation available onboard? 10.1 Stability information according to Reg. 10.2 (ICLL-1966). If applicable documentation is not available onboard, NASHA surveyor to take the necessary action. Note that stability information is required to be onboard also for "existing ship".

Approved by: _________________________

Dated: ______________________________

10.2 "Record of Conditions of Assignment". Dated: _______________________________ Forms completed by other recognized organizations.

10.3 Other initial Load Line survey form. Form No.: ____________________________ Dated: ______________________________

10.4 Are there changes affecting items 10.2 or 10.3 above?

For alterations influencing the freeboard, the surveyor shall fill in new form of "Record of Conditions of Assignment". Alterations/removals/new installations concerning equipment and fittings covered by items 12.1 to 17.1 of this check list shall be entered in record/report onboard and signed by the surveyor.

TEC-F-33/1

4/8

Survey Items 11. FREEBOARD MARKS

Condition (1) Action (2)

Comments

11.1 The freeboard marks have been measured and found to be in accordance with the Load Line Certificate Dated: ______________________________

Check position of the mark by measurements.

12.

MECHANICALLY OPERATED STEEL HATCHCOVERS Are the following items checked and found in efficient condition?

12.1 Gasket, gasket lips, compression bars and drainage channels. 12.2 Clamping devices, cleatings and retaining bars.

Check: Non-ret urn valvesindrainagechannels, that packing material is not perished or tor n. Check that retaining bars and compression bars are not affected by excessive wastage. Checkthatcleatingsensurecompressionwhen covers are seated (special attention to cross j o i n t s ) .

12.3 Stoppers, guide rails, track wheels and chain or rope pulleys. 12.4 Hatchcovers with respect to corrosion, cracks or deformation? 12.5 Hatchcoamings with respect to corrosion, cracks or deformation to plating and supporting members connected to the deck? 12.6 Repairwork on hatchcoamings. hatchcovers and

Check maintenance. Check of residual thickness of pontoons or covers, plating and stiffening members, as deemed necessary by the surveyor. Check condition of coam ings with stiffeners and connection to deck.

12.7 Tightness test of all hatchcovers.

Normally all hatchcovers are required to be hose tested. However, equivalent testing methods may be accepted, e.g. Air test on combination carriers, or Ultrasonic test by special equipment . Recommendation is to be given by surveyor for hatches not tested. Guidance: Nozzle diamet e r :Mi n i m u m 1 2 m m . W ater pressure: Sufficient for a free height of water with stream directed upwards of m in. 10m . Distance: Max. 1.5m .

TEC-F-33/1

5/8

Survey Items 12.8 Testing of all hatch covers in operation.

Condition (1) Action (2)

Comments Check stowage, securing (open condition), proper fit, locking and efficiency of sealings (closed condition).

13.

OTHER CLOSING APPLIANCES. Are the following items checked and found in efficient condition?

13.1 Superstructures, deckhouses and companionways with their bulkheads.

Check condition of bulkheads in superstructures, deckhouses, companionways and casings with respect to corrosion cracks and buckles. Check condition of clamping devices, hinges, packings and sills. Hose test if deemed necessary.

13.2 Closing appliances of doors and small hatches, etc. in superstructures and decks.

13.3 Engine- and/or boilercasings with their doors, sills, skylights and fastenings.

Check condition of clamping devices, hinges, packings and sills. Hose test if deemed necessary.

13.4 Ventilators with closing appliances.

Check condition of coamings with stays/ supports and especially connection to the deck. Weathertightness of closing appliances. Check condition of pipe and connection to deck. Weathertightness of closing appliances. Check weathertightness. Hinges and toggles to be easily movable. Check weathertightness. Hinges and toggles to be easily movable. For supply vessels deadlights may be required at higher positions.

13.5 Airpipes with closing appliances.

13.6 Side scuttles below the freeboard deck and enclosed superstructures, windows/ sidescuttles in deckhouses. 13.7 Deadlights.

14.

SIDE/STERN/BOW PORTS Tightness test: Hose test is required.

14.1 Ports including gaskets and closing appliances.

15.

PROTECTION OF CREW Check stanchions, stays, courses and lines. If underdeck passage, check ventilation, lighting and gas-, oil- and weathertightness.
6/8

15.1 Bulwarks, guardrails, gangways, lifelines and protection and access to crew`s quarters.

TEC-F-33/1

Survey Items 15.2 Freeing ports and shutters.

Condition (1) Action (2)

Comments Check rails, bars and shutters.

16.

SEA - AND SANITARY VALVES Check: External condition, tightness.

16.1 Ext ern al inspection of valves.

16.2 Operation of remotely operated side valves.

To be tested in operation.

16.3 Scuppers and sanitary discharges.

Opening up of valves.

16.4 Sea inlets and outlets including valves.

Opening up of valves.

17.

T I MBER FREEBOARD Check condition of permanent arrangements/ appliances (e.g. eye plates and sockets for uprights). Lashings not required to be onboard when timber deck-cargo is not carried.

17.1 Suppl e ment a r yf i t t i n g s .

18.

I NTERI M ILL CERTI FI CATE

18.1 I n t e r i m Load Line Certificate. Valid until: ___________________________ All non-compliances not considered as minor recommendations should be carried out before issuing the interim certificate. New full term certificate will not be issued until all recommendtaions have been deleted and Special Periodical Survey, Hull, has been carried out and updated.

Extended until: _______________________

18.2 Has endorsement been made on "Record of Conditions of Assignment " ?

TEC-F-33/1

7/8

RECOMMENDATIONS/OBSERVATIONS

Survey Report No. ___________________________________

Surveyor: ___________________________________
NATIONAL SHIPPING ADJUSTER, INC.

Place of Survey: Date of Survey: _________________________

8/8

TEC-F-33/1