Vessel

Saf
etyEnf
orcementI
nspect
ion For
m“D”

PRE-
DEPARTUREINSPECTI
ONCHECKLI
ST
ForDOMESTI
COILTANKER
FOROFFI
CIALUSEOFPHI
LIPPI
NECOASTGUARDBOARDI
NGTEAM

NameofVessel
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tofI
nspect
ion:
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Owner
/Oper
ator
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eofI
nspect
ion:
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Vessel
Type:_
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tofCal
l
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Hul
lMat
eri
al:
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_ Ti
meI
nspect
ionSt
art
ed:
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GT:
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NT:
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meI
nspect
ionCompl
eted:
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REFTOREG I
TEMSFORI
NSPECTI
ON CODE YES NO REMARKS
COMPLETEANDVALI DSHI PSAFETYCERTI FICATESANDDOCUMENTS
MARI
NAMC 1.Certi
fi
cate ofPubl ic Conv enience (CPC)i s
161/
MC2006-
06
val
id.
 Aut hor i
zed routes( PortsofCal l)&
areasofoper ationi sobser v
ed. VS8113
 Cer ti
fiedtruecopyofCPC/Deci si
on
/Riderisav ail
ableonboar d.
(I
fNotVal id,
DETAI NABLE)
MC177 2.Certi
fi
cateofVessel Regist ryisv ali
d.
VS8115
(I
fNotVal id,
DETAI NABLE)
MC177 3.Certi
fi
cateofOwner shipisv ali
d.
VS8112
(I
fNotVal id,
DETAI NABLE)
MC110 4.Coastwise/Bay&Ri verLicensei svali
d.
VS8118
(I
fNotVal id,DETAI NABLE)
MC203 5.AppropriateShipSaf etyCer tif
icate(
s)i s/ar e
val
id.
CargoShi pSaf etyCer t
ifi
cate VS8104
Cargo Shi p Saf ety Const ructon VS8105
i
Certi
ficate
Cargo Shi p Saf et
y Equi pment VS8106
Certi
ficate
Certi
ficate of Fi tness (APPLICABLE TO VS8110
CARRI
ERS OF LIQUI
FIED GASSES I
N BULK OR
DANGEROUSCHEMICALINBULK)
ExemptionCer tifi
cate VS8128
Tonnage Measur ementCer t
if
icate/ VS8117
Admeasur ement sCer tifi
cate
Stabi
li
ty Cer t
if
icate of Ex empt i
on VS8114
Certi
fi
cate (SHOULD BE ENDORSED EVERY 5 VS8128
YRS.
)
MARINA appr oved intact st abi
l
ity VS8114
bookl
et
P & ICl ub orOilInsuranceCov er- VS8147
Appli
cabletooilt
ankerscar r
yingnon
persi
stentoi
l
 REFTOREG I
TEMSFORI
NSPECTI
ON CODE YES NO REMARKS
CLC Cer ti
ficat
e or i ts equi
valent VS8138
appli
cablet o oilt anker
s carrying
persist
entoil
ThirdPartyLiabil
i
tyCov erappl
icable VS8139
toLPGorLNGcar rier
s
MARI NA regist
ered deck log book, VS8114
enginelogbook,androll
book
(
IfNotVal
i
d,DETAI
NABLE)
HPCG MC NR 05- 6.Shipboar
d Oi l Poll
uti
on Emer gency Plan
2005
(SOPEP)f oral
lOi lTankersof150GTand
aboveandev eryshipotherthanOilTankers VS8158
of400GTandabov eisvali
d
(
IfNotVal
i
d,DETAI
NABLE)
HPCG MC NR 06- 7.I
nternati
onal Oi l Poll
uti
on Pr ev
enti
on
2005
Certi
fi
cate( I
OPPC)forPhil
i
ppineregi
ster
ed
vessel
s engaged i n inter
nat
ional and VS8135
domestictradei
sval
i
d
(
IfNotVal
i
d,DETAI
NABLE)
HPCG MC NR 07- 8.I
nternati
onalSewage Pol l
ution Preventi
on
2005
Certi
fi
cate(ISPPC)forr egi
steredvesselsof
200GTandabov e,vesselslessthan200GT
whichar ecerti
fi
edt ocar r
ymor et hanf i
ft
y VS8136
(50)personswhetherengagedi ndomest i
cor
i
nternat
ionaltr
adeisvali
d
(
IfNotVal
i
d,DETAI
NABLE)
HPCGMC01-
2005 9.OilWaterSeparat
orinst
all
edonboardv essel
of400GTandabov eandOilTanker
s150GT
andaboveshallbedulyapprov
edbyt hePCG VS81718
i
sv al
i
d
(
IfNotVal
i
d,DETAI
NABLE)
HPCGMC01-
2005 10.
Chemical Disper
sant Accr
edi
tat
ion
Cert
if
icat
eisv
ali
d VS8116
(
IfNotVal
i
d,DETAI
NABLE)
HPCGMC01-
2005 11.
OilSpi
l
lBoom Accr
edi
tat
ion Cer
ti
fi
cat
eis
val
id VS8146
(
IfNotVal
i
d,DETAI
NABLE)
HPCGMC06-
2005 12.
OilRecor
dBookPart1andPar
t2f oral
loi
l
VS8145
tanker
sof150GTandabov
eisv
ali
d
VS81716
(
IfNo,
tobeRECTI
FIED)
HPCGMC01-
2005 13.
Compl et
esetofoil
contai
nmentandr ecov
ery
equipmentfor vessels engaged i
n black
productand persi
stentoilis avai
l
able on VS81706
board
(
IfNo,
tobeRECTI
FIED)
HPCGMC01-
2005 14.
Oiltanker
sof150GT andabov eshallbe
provi
ded with sl
op tank arr
angements or
combinati
onofsloptankthathav
eacapacity
necessarytor et
aintheslop gener
ated by VS81740
tankwashings,oilr
esi
duesanddi r
tyball
ast
resi
dues.
(
IfNo,
tobeRECTI
FIED)
 REFTOREG I
TEMSFORI
NSPECTI
ON CODE YES NO REMARKS
HPCGMC01-
2005 15.
Minimum ofone( 1)drum ofdisper
santand
sprayerduly accredit
ed by PCG f orself-
propell
ed barges / t ankers and vessel
s
VS81752
towingdumbbar gecont ai
ningoiloper
ati
ng
inseawaterisavailabl
eonboar d.
(
IfNo,
DETAI
NABLE)
HPCGMC01-
2005 16.
Adequatequant
ityofrags(3kil
osmi
nimum)
andsorbentmateri
alsi
savail
abl
eonboar
d. VS81712
(
IfNo,
DETAI
NABLE)
HPCGMC01-
2005 17.
Woodenscupperpl
ugsandvar
ioussizesof
woodenpl
ugsareavai
l
abl
eonboard. VS81730
(
IfNo,
DETAI
NABLE)
HPCG MC 89,MC 18.
Mini
mum Saf
eManni
ngCer
ti
fi
cat
eisv
ali
d.
148,
MC179 VS8142
(
IfNotVal
i
d,DETAI
NABLE)
PMMRR 1997 19.
Shi
pSt
ati
onLi
censei
sval
i
d.
Chapt
erX
(
IfNotVal
i
d,DETAI
NABLE) VS8157
MC2007-
03 20.
LoadLi
neCer
ti
fi
cat
eisv
ali
d.
VS8140
(
IfNotVal
i
d,DETAI
NABLE)
MC124 21.
ClassSoci
etyCert
if
icat
eisval
id.
(for500GTandabov e)
VS8117
ClassSoci
ety:
___
______
___
____
(
IfNotVal
i
d,DETAI
NABLE)
MC143 22.
DocumentofCompl
i
ance(
DOC)i
sval
i
d.
MC159 VS8124
(
IfNotVal
i
d,DETAI
NABLE)
MC148,
MC179 23.
Saf
ety ManagementCer
ti
fi
cat
e(I
SM/
NSM
Code)i
sval
id. VS8154
(
IfNotVal
i
d,DETAI
NABLE)
MC161/
MC2006- 24.
Speci
alPermitto operat
ei n r
out
e not
06
menti
onedi
ntheCPCisvali
d. VS8161
(
IfNotVal
i
d,DETAI
NABLE)
MC2007-
05 25.
Int
actStabi
l
ityBookl
etappr
ovedbyMARI
NA
isavai
l
ableonboard. VS8114
(
IfNo,
tobeRECTI
FIED)
HPCGMC03-
96 26.
Master
’s Declar
ati
on of Safety Depar
ture
(MDSD)pr operl
y accompli
shed,submitted
wit
hthenecessaryatt
achments.
VS8144
 Of f
icers/CrewList
;
 Car go/CoastingManif
est;
(
IfNo,
tobeRECTI
FIED)
HPCGMC00-
2011 27.
Vessel
Saf
etyI
nspect
ionBookl
et VS8166
ADEQUATE/ACCESSI BLELI FEJACKETS
MC123 28.
Mast er/Pat r
on decl ares the adequacy of
li
fejacket s,li
ferafts and ot herl i
fe savi
ng
VS8642
appl i
ances.
(IfNo, DETAI NABLE)
MC123 29.
Random check r eveals av ai
l
abil
it
y of
aut horized MARI NA t ype-appr
oved l if
e
VS8652
jacket sandl i
fer
afts/l i
feboats.
(IfNo, DEATAI NABLE)
MC123 30.
Lifejacket compar tment s wer e randomly
checkedt ov er
ifyift heyar eunlockedand
VS8633
accessi bl
etocrewmember s.
(IfNo, tobeRECTI FIED)
REFTOREG I
TEMSFORI
NSPECTI
ON CODE YES NO REMARKS
TOTALNUMBEROFOFFI CERSANDCREW MEETSMI NIMUM SAFEMANNI NGREQUI
REMENT
MC 89,MC 148, 3 1.
The act ual number , composi tion and
MC179
qual if
ications of cr ew conf orm wi t
ht he
VS8422
Mi nimum Saf eManni ngCer ti
fi
cate.
(I
fNo, DEATAI NABLE)
MC151,170 32.
Ship’ sof f
icerspossessv alidli
censes.
VS8216
(I
fNo, DEATAI NABLE)
MC114 33.
Of fi
cer sandcr ewondut yar ewear ingpr oper
unif orm. VS82413
(I
fNo, tobeRECTI FIED)
GOODWEATHER/SEACONDI TIONPREVAI LI
NG
HPCG MC 01- 09, 34.
Shipal l
owedt osai lperHPCGMC01- 09or
MC03-01 VS8321
MC03- 01.
PCGMC01- 09 35.
Lat estPAGASA Weat herBul l
etin av ail
able
VS8309
andpl ottedintheweat herchar t
.
36.
Lat est Not i
ce t o Mar iner and Updat ed
Naut i
cal Chartisav ailableonboar d VS8308
(I
fNo, tobeRECTI FIED)
UPKEEPOFEQUI PMENTANDRUNNI NGLI GHTSVERIFI
ED
PMMRR 1997 3 7.
Requi red / f itted communi cat i
ons /
Chapt
erXandXI
nav igational equi pment per Shi p St ation
VS8745
LicenseorCSSCar ei noper ati
ngcondi ti
on.
(I
fNo, DETAI NABLE)
PMMRR 1997 3 8.
Runni ngl ightsareoper ating.
Chapt
erXI VS8746
(I
fNo, DETAI NABLE)
ALLENGI NESI NOPERATI NGCONDI TI
ON
PMMR1997 39.
Mast erandChi efEngi neerdecl ar et hatall
Chapt
erV,HPCG
mai n and aux i
liary engi nes including f i
re
MC04-98 VS81509
pumpsar einoper atingcondi ti
on.
(I
fNo, DETAI NABLE)
I
NSTRUCTIONS:
1. Nov esselshal lbecl earedt odepar tf orvoy ageunl essi tcomplieswi t
hal ltheappl icableconditi
ons( i
temsofi nspection)
ofthischeckl ist.
2. PDIshal lbeconduct ed“ priort oav essel’sdepar ture”.Thephr ase“ priort oav essel’sdepartur
e”shal lber eckonedf rom
thetimet heMast erhasdecl aredhi sintent i
ontodepar tapor tt hr
ut hesubmi ssionoft heMast er
’sDecl arationofSaf e
Depar tur
e( MDSD)t oaPCGSt ati
onorDet achment .
3. Fort heuseoft hischeckl ist,thet erm“ passenger ”shal lmeananyper soncar riedonboar dthev essel,whet herpay i
ngor
non-pay i
ng, exceptof f
ici
al member soft hecr ew.
4. WhenPDIi scompl eted, ensur ethatnomor epassenger (s)shal
lbeal lowedt oboar dandnocar goisloadedi nt hev essel
forthev oyage.
5. PCGi nspector (
s)shal lper sonal l
ywi t
nesst hedepar t
ureoft hev esself rom por t/poi ntoforigi
nt oensur ecompl i
ancet o
i
nstruct i
on2.
6. Inar easwher et hesamev esselmakesmul ti
pledepar turesont hesamepor tont hesameday ,i nspectionmaybe
conduct edont hefirstdepar t
ureexceptf orchecki ngt hepassengermani fest
,car riageofexcesspassenger s,loadl i
ne/
stabili
ty,cargol ashingsorr epor t
eddef i
ciencyormal functi
oningofshi p’sequi pment /machinery,ver
if
icationshal lbeona
bytripbasi s.
7. Appropr i
ateMVRorVSI ARshal lbei ssuedf orvi
olationsofr egul
at i
onsdi scov eredorobser vedduringthei nspect i
on.
8. Accompl i
shedcopi esoft hisv esseldepar turecheckl i
stshallbemai nt
ai nedbyeachCoastGuar dSt ati
onandDet achment
forreadyr eference.

I
nspect
ionconduct
edby
:

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Boardi
ngTeam OI
C/POI
C I
nspector

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Inspector Inspector

NOTE:PCGI
NSPECTORSSHOULDALWAYSENSURETHEATTACHMENTOFFORM “
B”AFTERTHEI
NSPECTI
ON