LOAD LINE CONDITIONS OF

ASSIGNMENT REPORT
Marine Safety (Domestic Commercial Vessel) National Law act 2012
Marine Orders 503 (Certificates of survey – national law) 2013
Marine Orders 507 (Load line certificates – national law) 2013
International Convention on Load Lines, 1966. As amended in 1988 and 2003

This form is for use by attested / accredited marine surveyors whilst surveying conditions of assignment in accordance with
the requirements of the Marine Safety (Domestic Commercial Vessel) National Law Act 2012.

Vessel details
Vessel name Unique identifier

Ship builder Load line length Freeboard assigned as ship type

Survey details
Survey location Date of survey

Owner Date of construction

Name of attested / accredited surveyor Accredited surveyor number

Surveyor’s Signature Date

Doorways in superstructures, exposed machinery casings and deckhouses

protecting openings in freeboard and superstructure decks (International Convention
on Load Lines (ICLL) Reg. 6)
Number Closing Appliances
Ref No. on
and size Heights of
Location Sketch / Type and No. of
of Sills
Plan Material Dogs
openings
In deckhouses in position 1 enclosing
openings leading below freeboard deck
In deckhouses in position 2 leading within
enclosed superstructures or below freeboard
deck
In forecastle bulkhead

In bridge forward bulkhead

In bridge after bulkhead

In raised quarter deck bulkhead

In poop bulkhead
In exposed machinery casings on freeboard
deck
In exposed machinery casings on
superstructure decks
In machinery casings within superstructures
or deckhouses on freeboard deck
In exposed pump room casings

AMSA555 (06/15) Page 1 of 5

Hatchways at position 1 and 2 closed by portable covers and secured weathertight by
tarpaulins and battening devices (ICLL Reg. 9, 10, 11, 12)
Hatchway 1 Hatchway 2 Hatchway 3 Hatchway 4 Hatchway 5

Position and reference No. on sketch/plan

Dimensions of clear opening at top of
coaming
Height of coaming above deck

Number
Portable Beams Spacing

B1 X tt

D X tw

B2 X tf
Bearing
Surface
Means of
securing
Material

Thickness
Potable covers Direction
Fitted
Bearing
Surface
Spacing cleats

No. of Layers
Tarpaulins
Material

Means of securing each section of covers?

Are wood covers fitted with galvanised end
bands?
Hatchways at position 1 and 2 closed by weathertight covers of steel (or other
equivalent material) fitted with gaskets and clamping devices (ICLL Reg. 13)
Position and Dimensions of clear Potable covers
Height of coaming
reference No. on opening at top of
above deck Name Material
Sketch/Plan coaming

Machinery Space openings and miscellaneous openings in freeboard and

superstructure decks (ICLL Reg. 15 and 16)
Position and Cover Number and
Height of
reference No. Dimensions spacing of
coaming Material Method of attachment
on Sketch/Plan dogs

AMSA555 (06/15) Page 2 of 5

Ventilators on freeboard and superstructure decks in position 1 and 2. (ICLL Reg. 17)
Deck on Reference No. Coaming Closing
Number fitted Type
which fitted on Sketch Dimensions Height appliances

Air pipes above freeboard or superstructure decks (ICLL Reg. 18)

Number Coaming
Deck on which fitted Describe closing appliances
fitted Dimensions Height

Cargo port and other similar openings (ICLL Reg. 19)

Dimensions of Distance of lower edge Securing
Position of port Remarks
opening from freeboard deck devices

Scuppers, Inlets and Discharges (ICLL Reg. 20)

Item 1 Item 2 Item 3 Item 4 Item 5
Scupper or Discharge
Number
Diameter
Pipe
Thickness
Dimensions
Material
Discharge From
Vertical Outlet in hull
distance
above top of Inboard end
keel Upper most
(Discharge) NR Valve
Number
Discharge
Type
Valve
Material

Side Scuttles (ICLL Reg. 21)

Number Clear Material Type of glass Fixed or Standards used
Position
fitted glass size Frame Deadlight and thickness open and type No.

Note: Indicate the vertical distance between the freeboard deck and the lower sill of the scuttle positioned at
the greatest vertical distance below the freeboard deck.

AMSA555 (06/15) Page 3 of 5

Freeing Ports (ICLL Reg. 22)
No. and size of Required
Length of Height of Total area
freeing ports area each
Bulwark Bulwark each side
each side side
After Well
Freeboard
Forward Well
Superstructure Deck
State fore and aft position of each freeing
port in relation to superstructure end
bulkheads
Particulars of shutters, bars or rails fitted
to freeing ports
Height of lower edge of freeing port
above decks
Protection of the crew (ICLL Reg. 23)
Bulwarks Open Rails
Location Location
Height Height
Clearance below lowest
Thickness
course
Opening between
Top Rail
Courses
Courses
Scantlings
Stanchions
Distance between
stanchions

AMSA555 (06/15) Page 4 of 5

 Vessel Plan
On the diagram below, sketch any items that would affect the seaworthiness of the vessel.
Note: A plan of suitable size may be attached to this report in preference to sketches on this page.

AMSA555 (06/15) Page 5 of 5