Materials and

Qualification
Procedures for
Ships

Book P

Procedure 19-3

Approval procedure for water ballast tank coating systems in

accordance with IMO MSC.215(82) and IACS UI SC223 (PSPC-WBT)

Revision 2, December 2013

   
Material and Qualification Procedures for Ships Book P
Procedure 19-3

Lloyd’s Register Group Limited, its subsidiaries and affiliates and their respective
officers, employees or agents are, individually and collectively, referred to in this
clause as ‘Lloyd’s Register’. Lloyd’s Register assumes no responsibility and shall not be
liable to any person for any loss, damage or expense caused by reliance on the
information or advice in this document or howsoever provided, unless that person
has signed a contract with the relevant Lloyd’s Register entity for the provision of this
information or advice and in that case any responsibility or liability is exclusively on
the terms and conditions set out in that contract.

© Lloyd's Register Group Limited 2013. All rights reserved.

Except as permitted under current legislation no part of this work may be

photocopied, stored in a retrieval system, published, performed in public, adapted,
broadcast, transmitted, recorded or reproduced in any form or by any means, without
the prior permission of the copyright owner. Enquiries should be addressed to Lloyd's
Register Group Limited, 71 Fenchurch Street, London, EC3M 4BS.

   

    Page 2 of 14 
Material and Qualification Procedures for Ships Book P
Procedure 19-3
Approval procedure for water ballast tank coating systems in
accordance with IMO MSC.215(82) and IACS UI SC223 (PSPC-WBT)

1 General Information

1.1 Scope of The Approval

1.1.1 It is a requirement of MSC.215(82) that the coating system(s) used in the

corrosion protection of dedicated seawater ballast tanks in all types of ships
and double-side skin spaces of bulk carriers of 150 metres in length and
upwards be pre-qualified in accordance with the test procedure in annex 1 of
that resolution.

1.1.2 The coating systems submitted for type approval may consist of epoxy-based,
multi-coat product(s) applied either over specified pre-fabrication primer(s),
or over bare steel. This information will be included on the type approval
certificate and will allow the product to be used in either way.

1.1.3 Coating systems which are not epoxy-based, are not multi-coat or are applied
in a manner different from that specified in the test procedures of annex 1 of
MSC.215(82) will be considered under the provisions of the Alternative
Systems section of that resolution.

1.1.4 This document describes the requirements of Lloyd's Register for such type
approvals, and details the documents necessary for submission by the coating
system manufacturer.

1.1.5 The details of the type approved PSPC coating system will appear in Lloyd’s
Register’s List of PSPC-compliant water ballast tank coatings systems, which is
published on Lloyd’s Register’s Class Direct web site.

1.2 Related Documents

1.2.1 IMO Performance Standard for Protective Coatings for Dedicated Seawater
Ballast Tanks in All Types of Ships and Double-side Skin Spaces of Bulk
Carriers, adopted by Resolution MSC.215(82) on 8 December 2006.

1.2.2 IACS UI SC223, For Application of SOLAS Regulation II-1/3-2 Performance

Standard for Protective Coatings (PSPC) for Dedicated Seawater Ballast Tanks
in All Types of Ships and Double-side Skin Spaces of Bulk Carriers, adopted by
Resolution MSC.215(82), September 2013.

    Page 3 of 14 
Material and Qualification Procedures for Ships Book P
Procedure 19-3
2 Application for Approval

2.1 This section sets out the five stages involved in the granting of Lloyd’s
Register type approval as follows.

1. Application for approval Form-PSPC to be completed and submitted

to Lloyd’s Register.
2. The documents referred to in Section 3 of this procedure are to be
prepared and submitted for review.
3. Audits of the manufacturing site(s) and technical centre by Lloyd’s
Register Surveyors are to be performed in accordance with section
3.5, and the results reported.
4. A review of the submitted documents and the completed audit
report will be conducted by the Materials and NDE department
(MNDE).
5. A type approval certificate, valid for 5 years, will be issued by MNDE
if all the submitted evidence is found to meet the requirements
detailed in this procedure.

3 Form-PSPC

3.1 Form-PSPC shall be completed, indicating the required area of application

for the coating system (water ballast tanks, double-skin spaces or both),
locations of manufacturing sites, compatible primers (if required). The
following documents shall be provided together with the completed form:

3.1.1 The product technical data sheets (PTDS) for each of the components of the
coating system to be approved shall be submitted for review. The technical
content of PTDSs will be considered by MNDE and, if necessary, amendments
requested in order to make these documents compliant with the
requirements of the IMO resolution.

3.1.2 The product safety data sheets (PSDS) shall be submitted for each of the
components of the coating system.

3.1.3 The appropriate prequalification documents as specified in sections 3.2 to

3.4 below.

3.2 Prequalification Test Method A: Laboratory Test

3.2.1 The applicant shall submit test report(s) issued PSPC-WBT test laboratory(ies)
approved by Lloyd’s Register detailing the test conditions and results
obtained when testing the coating system(s) submitted for approval in
accordance with the pre-qualification test method in Annex 1 of the IMO
resolution.

    Page 4 of 14 
Material and Qualification Procedures for Ships Book P
Procedure 19-3
3.2.2 Each PSPC-WBT product (the component(s) of the coating system that
provide corrosion protection to the vessel’s structure in service, i.e. not
including the primer) shall be tested in accordance with both Appendix 1:
Test on Simulated Ballast Tank Conditions and Appendix 2: Condensation
Chamber Test of Annex 1 (together, the “Full” PSPC-WBT test) at least once.

3.2.3 The initial “Full” PSPC-WBT test may be performed with the product applied
over either a pre-fabrication primer or over bare clean blasted steel. Any
primer forming a component part of the system subjected to the “Full”
PSPC-WBT test will be listed on the type approval certificate as a compatible
primer. If the initial test has been performed over uncoated steel this will be
stated on the certificate, unless additional test reports are supplied to
support the addition of compatible primers.

3.2.4 Additional test reports detailing the results of tests conducted in accordance
with Annex 1, Appendix 1, Section 1.7 (the “Crossover” test) may be
submitted either at the time of the initial application or at subsequent dates
to support the addition of compatible primers to the type approval
certificate for the coating system.

3.2.5 This reduced test is exclusively suitable for primer addition; only the “Full”
test is acceptable for the initial issue of type approval certificates. Any
primer added using this method must meet the requirements detailed in
section 5 of this document.

3.2.6 Test reports submitted to Lloyd’s Register shall comply with the IACS
recommended report formats Rec. 101 (“Full” test) and/or Rec. 102
(“Crossover” test), and shall contain the specific gravities and infra-red
spectra for every component of the coating system, and clear photographs
of the test pieces after testing and evaluation.

3.3 Prequalification Test Method B: 5 Years Field Exposure

3.3.1 The applicant may elect to submit service experience instead of new
laboratory testing to support the type approval of their product(s). The
requirements for this method are clearly defined in IACS UI SC223, and
include:

 Original application records

 Original coating specification
 Original pre-fabrication primer used, if any
 Original and current PTDS
 Confirmation that the current formulation(s) are identical to those
applied during new-building

    Page 5 of 14 
Material and Qualification Procedures for Ships Book P
Procedure 19-3
 Specific gravity data and infra-red spectra for both the current and
applied coating system components
 Inspection report of all ballast tanks of a vessel with over 5 years of
service with no significant maintenance or repairs by an
Administration or Class Society inspector

3.3.2 The vessel surveyed shall have:

 At least one tank of 2000 m3 or more in capacity

 At least one tank shall be adjacent to a heated tank
 At least one tank contains an underdeck exposed to the sun

If the vessel does not meet all these criteria the type approval certificate will
note the exception(s).

3.3.3 All tanks on the vessel must be in the “GOOD” condition, as defined in IACS
UI SC223 and MSC.1/Circ. 1330:

“Condition with spot rusting on less than 3% of the area under

consideration without visible failure of the coating. Rusting at edges and
welds should be on less than 20% of edges or weld lines in the area under
consideration”

3.3.4 For the purposes of the approval of a PSPC-WBT coatings system by

inspection after 5 years’ service experience the “area under consideration” is
the totality of the surfaces of all seawater ballast tanks on the vessel.

3.3.5 If the coating system under consideration was applied at a nominal dry film
thickness different to that specified in table 1 of the IMO resolution the
deviation shall be noted on the type approval certificate.

3.3.6 If the pre-fabrication primer is not specified or it cannot be confirmed that

the primer formulation is the same as was applied during new-building, the
type approval certificate shall specify that the coating system may be
applied over bare steel only.

3.4 Prequalification Test Method C: Existing Marintek B1 Approvals

3.4.1 The applicant may elect to submit test report(s) issued by Marintek before
8th December 2006 to support the type approval of their product(s). The
minimum level of B1 must have been assigned to any of the candidate
coating systems.

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Material and Qualification Procedures for Ships Book P
Procedure 19-3
3.4.2 Due to the differences between the Marintek and IMO test specifications,
the applicant must also:

 Confirm that the current product formulation(s) are identical to those

tested
 Provide representative specific gravity data and infra-red spectra for
both the current and tested coating system components
 Provide evidence of the presence and identity of the pre-fabrication
primer present during testing, in any
 Provide detailed evidence of the method of coating system
application before testing, such as surface preparation, pre-
fabrication primer weathering, primer treatment prior to product
application, the nominal dry film thicknesses of the system
components and environmental conditions during application

3.4.3 Significant deviations from the IMO test procedure will be identified on the
type approval certificate.

3.5 Audit of Coating Manufacturer

3.5.1 Regardless of the nature of the pre-qualification test submitted, auditing of

the coating manufacturer is mandatory. Both the technical centre (the
facility responsible for controlling the formulation(s) of the product(s) and
the manufacturing site(s) must be audited by a Lloyd’s Register surveyor
before type approval may be granted.

3.5.2 Where the technical centre and manufacturing site(s) are separate facilities
separate audits shall be performed. Each manufacturing site contributing
components to the coating system shall be audited.

3.5.3 Audits shall be performed in accordance with IACS UI SC223 and the
requirements of the Lloyd’s Register audit documents. Documents are to be
supplied as detailed in the audit procedures and checklists.

3.5.4 Any evidence of current quality assurance scheme certification, such as

ISO9001, should be provided with the form. Such certification does not
remove the need for auditing, but may reduce the scope of the audit(s).

   

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Material and Qualification Procedures for Ships Book P
Procedure 19-3
4 Form-M

4.1 Form-M shall be completed indicating which manufacturing sites are to be

certified as manufacturing the specified coating system. Where the technical
centre is separate to all requested manufacturing sites the technical centre
location shall be provided on the form.

4.2 The details given on Form-M should be identical to the details present on
the labels of each of the coating system components, and will be faithfully
transcribed to the type approval certificate(s).

4.3 Applicants who are new to Lloyd’s Register’s approval schemes should
provide a company profile and details of their experience in coatings
manufacture and the provision of services to the marine industry.

5 PSPC-Compatible Pre-Fabrication Primers

5.1 In order for a pre-fabrication primer to be acceptable for inclusion as a

component in a PSPC-WBT coating system, it must:

 Be a Lloyd’s Register approved pre-fabrication primer, as detailed in

MQPS Book P, Procedure 19-5
 Have been a component in a coating system which has passed the
“Full” PSPC -WBT test as defined in Annex 1 to the IMO Resolution
 Have a PTDS which has been reviewed for compliance with the
requirements of the IMO Resolution
 Have specific gravity and infra-red spectra from actual production
batches available for review
 Be produced at manufacturing sites which have been audited by
Lloyd’s Register in accordance with the requirements in section 3.5
above, which are controlled by an similarly audited technical centre

5.2 Pre-fabrication primers satisfactorily meeting the above requirements may

be added to existing PSPC-WBT coating system type approval certificates by
the submission of acceptable “Crossover” PSPC-WBT test reports.

5.3 Where an application is received that contains a request for the listing of a
primer that does not meet the above compatibility criteria, the applicant
shall be informed of that fact, and of with which of the criteria the primer is
non-compliant.

   

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Material and Qualification Procedures for Ships Book P
Procedure 19-3
6 Additional Approval Issues

6.1 The following situations may be encountered which differ from the normal
application for approval scenario described above.

6.2 Additional Sites of Manufacture

6.2.1 An approved PSPC-WBT system formulation may be produced at multiple

manufacturing sites. The following criteria shall be met:

 Each manufacturing site shall been audited in accordance with

section 3.5 above
 Each manufacturing site shall submit infra-red spectra and
specific gravity data for each component of the approved
system from actual production batches to prove similarity
 Each manufacturing site shall be issued a separate type
approval certificate for each PSPC-WBT system

6.2.2 Where an additional site of manufacture is a licencee or toll manufacturing

company, in addition to the above criteria the details shall be provided of
the licence agreement and the precise control mechanisms that are used by
the formulating technical centre to ensure product conformity.

6.3 “Winter Grade” Products

6.3.1 Where an applicant system exists in various formulations each formulation

shall be separately certified.

6.3.2 System variants such as “winter grade”, “low temperature”, “quick drying”
or equivalent that are sold and distributed with different system names
and/or codes shall be separately tested in accordance with section 3, unless it
can be proven that the formulation is identical by the provision of suitable
infra-red spectra and specific gravity data.

6.3.3 Similarly, where a system is sold under different names for purely marketing
reasons, each system name must be separately certified. Evidence must be
provided that the formulation is unchanged from that initially tested.

   

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Material and Qualification Procedures for Ships Book P
Procedure 19-3
6.4 Alternative Systems

6.4.1 IMO MSC.215(82) includes the concept of alternative systems for all systems
that are not epoxy-based, or not applied in accordance with table 1 of the
regulation. Examples of systems which may be regarded as ‘alternative’ are:

 Are epoxy based, but not applied in accordance with table 1

of the regulation
 Are non epoxy-based, but applied in accordance with table 1
of the regulation
 Are non epoxy-based, and not applied in accordance with
table 1 of the regulation

6.4.2 The scope of an alternative system therefore encompasses all non epoxy-
based coating systems, systems applied in one coat, systems applied over
non-compliant surface preparation techniques, and any other novel
technology related to either coating systems or surface preparation.

6.4.3 Alternative systems shall be approved based on appraising the results of

“Full” PSPC-WBT testing against the alternative systems acceptance criteria
detailed in Appendix 1: Test on Simulated Ballast Tank Conditions, and
Appendix 2: Condensation Chamber Test of Annex 1 of the IMO resolution.

6.4.4 Otherwise an alternative system may be considered for approval based on

the 5 years’ service route in section 3.3 above.

6.4.5 In addition to the documents required in section 3 above, manufacturers

seeking approval for alternative systems shall submit such additional
information as deemed necessary to prove equivalence with the normal
PSPC-WBT systems. The additional information required shall include, but
shall not be limited to, the items below.

6.4.5.1 Technical reports (internal and/or from Universities or suitable test

laboratories) relating to:

 Pinhole and void defect prevention

 Edge retention
 Levels of solvent entrapment in coating thicknesses greater
than 160 microns
 Atomisation and coalescence of the coating during
application, and the formation of a coherent coating layer on
the substrate

6.4.5.2 In-service experience for vessels using the coating system, including survey
reports and photographs. Ideally the in-service experience should be accrued
from several vessels after a minimum of 5 years.

    Page 10 of 14 
Material and Qualification Procedures for Ships Book P
Procedure 19-3
6.4.5.3 Where the application of the alternative system differs from table 1 of the
IMO resolution, details shall be given of any additional training that will be
given to shipyard paint applicators in order for the coating system to be
applied correctly.

6.4.6 Where an alternative system is to be used the shipyard shall be able to

demonstrate their ability to apply the system in accordance with the coating
manufacturer’s technical data sheet and application instructions. It is
recommended that such demonstrations be performed before the adoption
of an alternative system for a new-building project.

6.4.7 It should be noted that, in the absence of an IACS Unified Interpretation of

the acceptance criteria for alternative systems, it may be necessary to obtain
case-by-case acceptance from the vessel’s Flag State in order to use an
alternative system and still comply with their National Regulations.

7 Review

7.1 A review of the required documents referenced in Sections 3 and 4 will be

undertaken by MNDE. Queries arising from the review by MNDE will be
referred back to the applicant for clarification. The suitability of the coating
system for approval will be determined by reference to the criteria given
herein and the details entered on the audit documents.

8 Validity of Type Approval Certificate

8.1 Initial Approval

8.1.1 When a PSPC-WBT coating system has been deemed to satisfy Lloyd’s
Register’s requirements, a type approval certificate will be issued. Each type
approval certificate is specific to both the coating system and the
manufacturing site.

8.1.2 The type approval certificate will contain the following information as a
minimum:

 Name of Company, and address of the manufacturing site

 Name of PSPC-WBT compatible coating system, colours and
product codes, if required, of base and curing agent;
 Scope of approval granted
 Certificate number, date of issue and date of expiry
 Compatible pre-fabrication primers, if any

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Material and Qualification Procedures for Ships Book P
Procedure 19-3
 The method of testing approval was granted against, if not
the PSPC-WBT prequalification test detailed in Annex 1 of the
IMO resolution

8.1.3 Approval will normally be valid for a five-year period from the date of issue,
subject to the manufacturing site maintaining its Lloyd’s Register audit
status, and to a satisfactory intermediate audit at around two and half
years, if required. Significant changes to the manufacturing site quality
system, personnel or equipment may result in the withdrawal of the
certificate.

8.1.4 Where additional compatible primers are added at a later date the
certificate number and expiry date will remain unchanged; the certificate
will be reissued with a revision number and the date of reissue clearly
identified.

8.1.5 Approval is contingent of the formulation of all the components remaining

the identical to those tested during the approval process.

8.1.6 It is the responsibility of the manufacturer to inform Lloyd’s Register of any

change in formulation of any component of their approved PSPC-WBT
systems.

8.2 Class Direct Listing

8.2.1 The system’s details will be entered into the Lloyd’s Register database of
approved products, in the List of PSPC-compliant water ballast tank coatings
systems, which is published on Lloyd’s Register’s Class Direct web site
(www.cdlive.lr.org). This entry will include the system details, site of
manufacture, compatible pre-fabrication primers and certificate revision
number.

8.2.2 When a PSPC-WBT certificate is withdrawn or allowed to expire, the Class

Direct listing will be amended to reflect the termination date. The listing
will be retained to assist attending surveyors when confirming of the
compliance of the Coating Technical File (CTF) of vessel coated with that
PSPC-WBT coating system.

8.2.3 The presence of a selected PSPC-WBT coating system on the Lloyd’s Register
Class Direct listing does not substitute for the current type approval
certificate being viewed during the pre-job meeting, as demanded by IACS
UI SC223, or for the inclusion of a copy of the type approval certificate in the
CTF.

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Material and Qualification Procedures for Ships Book P
Procedure 19-3
8.3 Withdrawal of Certificate

8.3.1 Lloyd’s Register reserves the right to cancel or suspend a certificate if:

 It becomes known that prequalification tests have been

improperly carried out or the results of tests improperly reported
 Significant alterations to the technical centre or manufacturing
site quality systems have been made without notification to
Lloyd’s Register, or are such as to render the original approval
invalid
 The formulation of any of the system components has been
altered, including compatible primers
 Alterations have been made to the product technical data sheets
 The manufacturer no longer wishes the approved coating
system(s) to remain on the list of approved PSPC-WBT coating
systems

8.3.2 If Lloyd’s Register considers that a type approval certificate should be

withdrawn or cancelled, the manufacturer will be informed in writing and
be given the opportunity to take appropriate corrective action, or give
notice of appeal.

8.3.3 If a type approval certificate is withdrawn, suspended or has expired, the

coating system entry in the Class Direct PSPC-WBT approved systems list will
be amended to reflect the new status.

8.3.4 A manufacturer whose approval has been cancelled or suspended may apply
for reapproval provided that they demonstrate that they have made the
necessary remedial actions to satisfy Lloyd’s Register’s requirements.

8.4 Renewal of Approval

8.4.1 Renewal of type approval certificates is to be made at intervals not

exceeding five years by the manufacturer applying for reapproval.

8.4.2 Manufacturers wishing to renew their type approval certificates should

submit to their local Lloyd’s Register office the following documents:

 Form-PSPC completed for each coating system, including compatible

primers
 The current product technical and safety data sheets for each
component of the coating system
 Written confirmation that all of the formulations of the components
of the coating system have been unchanged since the initial approval

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Material and Qualification Procedures for Ships Book P
Procedure 19-3
 Form-M completed for each manufacturing site, together with the
current quality system certificate for each site. If it has been more
than 5 years since the technical centre or manufacturing site audit a
renewal audit should be requested

8.4.3 On receipt of the completed Form-PSPC and the required supporting

documents the application will be reviewed by MNDE, and any omissions or
observations will be referred back to the applicant for clarification.

8.4.4 Upon satisfactory renewal, the Lloyd’s Register type approval will be
extended for a further five year period. A certificate will be issued with a
new certificate number and expiry date, and the system’s entry in the Class
Direct approved PSPC-WBT database updated accordingly.

    Page 14 of 14 
 FORM-PSPC

Type Approval of Protective Coatings for Water

Ballast Tanks and Double-side Skin Spaces
(Please complete and sign this form for each product submitted, enclosing all required documents)

1. General information of product:

Product name*
Product trade code(s)*
Product type (e.g. epoxy)
Company*
Manufacturing plant(s) and address(es)*

2. Application: Water ballast tanks

Double-side skin spaces
3. Compatible shop-primer(s):
Shop-primer name and trade code*
Shop-primer manufacturer,
manufacturing plant(s) and
address(es), if different from above*

4. Formulation:

Proprietary owner of formulation:

Technical transfer agreement: Yes (copy of statement enclosed):

Not applicable:
5. Documents required:

Product Technical Data Sheets (including shop primer) enclosed

Material Safety Data Sheets (including shop primer) enclosed
Quality control management system accreditation (e.g. ISO 9001) enclosed
Reports of shop primer compatibility test(s) (cross-over test) enclosed

(a) Tests in accordance with PSPC Annex 1

Test report(s) enclosed
Plant inspection report (after plant inspection ) enclosed

(b) Marintek B1 test (before 8 December 2006)

Marintek B1 report with original IR spectrum record enclosed

Current IR spectra and specific gravity record (after plant inspection ) enclosed
Plant inspection report (after plant inspection ) enclosed

(c) 5 years service experience

Original coating specification, application and inspection records enclosed

IR spectra and specific gravity (after plant inspection ) enclosed
Water Ballast Tank inspection report enclosed
Plant inspection report (after plant inspection ) enclosed

Lloyd's Register Group Limited, its subsidiaries and affiliates and their respective officers, employees or agents are, individually and
collectively, referred to in this clause as 'Lloyd's Register'. Lloyd's Register assumes no responsibility and shall not be liable to any
person for any loss, damage or expense caused by reliance on the information or advice in this document or howsoever provided,
unless that person has signed a contract with the relevant Lloyd's Register entity for the provision of this information or advice and
in that case any responsibility or liability is exclusively on the terms and conditions set out in that contract. (2013/12)
 FORM-PSPC

Type Approval of Protective Coatings for Water

Ballast Tanks and Double-side Skin Spaces
(Please complete and sign this form for each product submitted, enclosing all required documents)

6. Manufacturer’s declarations:

 The manufacturer will inform LR of any changes and modification of product

formulation, manufacturing process, product quality control and accreditation status of
quality control management system.
 The information given above and in the attached documents is accurate and complete.

Signature: Date:
Name (in BLOCK CAPITALS): Position:

* The information should be consistent with details printed on product label.

Lloyd's Register Group Limited, its subsidiaries and affiliates and their respective officers, employees or agents are, individually and
collectively, referred to in this clause as 'Lloyd's Register'. Lloyd's Register assumes no responsibility and shall not be liable to any
person for any loss, damage or expense caused by reliance on the information or advice in this document or howsoever provided,
unless that person has signed a contract with the relevant Lloyd's Register entity for the provision of this information or advice and
in that case any responsibility or liability is exclusively on the terms and conditions set out in that contract. (2013/12)
 FORM–M

Application for Lloyd’s Register Recognition

of Coating Products
This form should be used in conjunction with the appropriate coating certification procedure(s) and application
forms to apply for Lloyd’s Register initial or renewal recognition/approval of coatings. Please complete and sign
a separate copy of this form for each manufacturer or plant of manufacture.

1. Manufacturer details:
Name*:
Address*:

Parent/Holding
company:
2. Nominated contact:
Name: Tel:
Position: Fax:
Email:

3. Manufacturing plant (if different from above):

Address:

Tel:
Fax:
4. Type of application:
New application / Renewal / Add manufacturing plant (Delete as applicable)
5. Product type:
No. of No. of
products: products:
Anti-fouling paints: Abrasion resistant ice coatings
Corrosion control coatings: Maintenance coatings
Prefabrication primers: PSPC-compliant coatings
6. Documents required:
Company profile (for new manufacturer only) Document enclosed
ISO 9001:2000 certified Document enclosed
Other quality control accreditation Document enclosed
If the manufacturer does not hold any quality control management accreditation, an audit of the in-house quality
control system by a LR surveyor or an independent inspector acceptable to Lloyd’s Register is required and an audit
report should be submitted for review.
Report enclosed Request an inspection

7. Manufacturer’s declaration:
 We declare that the information given in this form and in attached documents is
accurate and complete.
 For renewals, we declare that the specification and formulation have not been changed
or modified since last approval/renewal.

Signature Date:
Name (in BLOCK CAPITALS): Position in company:
* The information should be consistent with details printed on product label.

Lloyd's Register Group Limited, its subsidiaries and affiliates and their respective officers, employees or agents are, individually and
collectively, referred to in this clause as 'Lloyd's Register'. Lloyd's Register assumes no responsibility and shall not be liable to any
person for any loss, damage or expense caused by reliance on the information or advice in this document or howsoever provided,
unless that person has signed a contract with the relevant Lloyd's Register entity for the provision of this information or advice and
in that case any responsibility or liability is exclusively on the terms and conditions set out in that contract. (2013/12)