NATIONAL IRANIAN TANKER CO. S.Q.

E MANAGEMENT SYSTEM
FORM FILE ISM CODE / ISO 9001 / ISO 14001
TITLE : REPAIR SPECIFICATION FORM N: TZ 018
ISSUE DATE : DEC-2002 PAGE 1 OF 1
ISSUE STATUS : 1 AUTHORIZED BY :QAR
REPAIR SPECIFICATION
VSL MAIN SUB YEAR SERIAL Tick off which ever is applicable
H.O. CODE CODE CODE NO. ENG DECK RADIO ELECTRIC
JOB. NO. 2 2 9 8 4 7 9 Insurance Repairs
SHIP'S NAME : M.T.IRAN ASTARA DATE: Planned or Fair Wear/Tear
Breakdown/Accident
MACHINERY TECHNICAL SPECIFICATION.(PLS GIVE TYPE & SER NO.IF APPLICABLE). Design/Material Problem
Survey/SS/Annual
Guarantee
MAKERS / ADDRESS

WORK SPECIFICATIONS:Please give a detailed specification of job to be carried out indicating material,sizes,process of work
to be done, preferably, with a sketch if applicable.

SPECIAL INSTRUCTIONS:

C/E: MASTER: SUPERINTENDENT CHIEF SUPERINTENDENT TECHNICAL MANAGER

DATE SPECIFICATION QUOTATION INVITED ITEM LANDED JOB AWARDED DATE: WORK SHOP :
RECEIVED: DATE: DATE :
PORT :
THIS SECTION TO BE FILLED ON COMPLETION OF REPAIR OR RECEIPT OF EQUIPMENT ON BOARD AFTER REPAIRS.
ANY COMMENTS ON THE JOB CARRIED OUT :

JOB COMPLETED SATISFACTORY, C/E, MASTER

DISTRIBUTION:
TECH DEPT. : COPY
SHIP :ONE ORIGINAL IN FILE AND ONE COPY TO BE SIGNED AND STAMPED ON COMPLETION OF JOB AND SENT TO TECH. DEPT AND KEEP IN COMCERN FILE.
WORK SHOP :ONE COPY TO BE PUT IN PLASTIC BAG AND ATTACHED TO THE ITEM TO BE LANDED FOR REPAIRS.