Référence : CAG 07

MANUEL DES FORMES

Crée-le : 16/01/2017

SHIP / SHORE SAFETY CHECKLIST

SHIP’S NAME : M/V ............................................................................................................
PORT ......................................................... BERTH ............................................................
DATE OF ARRIVAL ........................................... TIME OF ARRIVAL .........................

SHIP SHORE
YES NO YES NO
1. Has appropriate information about the cargo to be loaded been
provided to the Master by the shipper to enable its proper stowage
and safe carriage?

2. Is the Master in possession of comprehensive information regard-

ing the ship’s stability and the distribution of cargo for the intended
loading conditions?

3. Has a contact person been designated and agreed by Ship and

Shore? Do arrangements exist to continue this conduct when shift
or watch change? NOTE: Both must be satisfied with the authority
of the other to interrupt cargo operations.

4. Is there safe access between ship and shore?

5. Has a cargo loading / discharge plan been prepared by the ship and
a copy passed to shore? If cargo is to be worked in two or more
hatches simultaneously, does the plan take this fully into account?

6. Have checkpoints been agreed by ship and shore at which the

quantity of cargo handled can be verified and compliance with the
cargo plan confirmed? Have expected drafts and hull stresses been
calculated for these checkpoints and made available for reference
while working cargo?

7. Have all ballasting and deballasting systems been checked and does
adequate pumping capacity exist to meet the requirements of the
cargo plan?

8. Has the need to trim the cargo in the holds been discussed and
agreed?

9. Has the ship received a statement of the terminal equipment to be

used, including its limitations: weight of grabs, load/disch rates etc.

10. Has an emergency procedure been agreed between ship and

terminal to stop cargo work?

FOR SHIP FOR SHORE

MASTER Name/Position

Issue par DPA A archiver : BORD Révisé le : 1/1