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AD NO.

: 04-00

Initial Issue Date: 09-08-2017


Revision Date: 00 REPUBLIC OF THE PHILIPPINES
DEPARTMENT OF TRANSPORTATION

MARITIME INDUSTRY AUTHORITY


STCW OFFICE

FORM 4: INVENTORY OF TRAINING EQUIPMENT


Course: SHIPS SECURITY AWARENESS TRAINING AND SEAFARERS WITH DESIGNATED
SECURITY DUTIES
Name of Maritime Training Institution: SAINT JOSEPH INSTITUTE OF TECHNOLOGY
MARITIME TRAINING CENTER
Self- Pre-assessment Inspection
assessment

To be To be accomplished by To be accomplished by
Accomplish STCWO Doc. Evaluator STCWO Inspector
ed by MTI

Items Quantity Number At Complied Not Complied Not


Complied Hand Complied complied

Equipment
Handheld metal detector

Step board

Table
Gloves
Round stick (15 inches)
Handbag/Luggage for inspection,
containing the following items:
book, dummy incendiary device,
suspicious looking electronic
equipment, other personal items.
Two-way radio sets
EPIRB Dummy
SART Dummy
SSAS Simulator
Hand Cuff
Padlock
Security Seals
Accomplished by: Date:
Name and Signature of
MTI’s Authorized Representative

Document Evaluator’s Comments:

Date of Evaluation ___________


Document Evaluator’s Name & Signature

Inspector’s Comments:

Date of Evaluation ___________


Inspector’s Name & Signature

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