Dear Sir/Madam,

Vessel must apply PKKA/SEACOM Permit before arrival to enter into Batam/Indonesia Port. Please be
informed C.I.Q.P CLEARANCE below;

Pre-Arrival:

1. Agent appointment letter with your company letter head (sample attached)
2. Send to agent Marine Health Declaration, below requested vessel document copies, to
input vessel entry and proceed PKKA/SEACOM (Foreign vessel notification)
3. Obtained Indonesia flag on board
4. Make sure Port Clearance is issued and stamped Batam as next port destination
5. Do not put Supernumery/Supercargo/Superintendent on Crew List
6. Crew List endorsed by Immigration at last port before sail to Batam
7. Send to agent the Port Clearance & stamped Crew List.
.

*Port Health Officer / Pilot Boarding Ground (PBG) is :

BATU AMPAR = 01-11-00 N / 103-58-36 E

Name & Position E-mail Address Telephone VHF Channel

Pilot Office batam@pelindo.co.id +62 778 4527 29 CH 16
VTS / Port Control support@vtsbatam.com +62 778 4100 028 CH 16
Batam Agent dolfin@elninasamudra.com +62 812 7666 3266

2 (two) hour before arrival please inform vessel arrival to VTS / Port Control at CH 16, Whilst vessel
proceed to Batam, please hoist November & Q Flag and also please contact PIPE LINE PROTECTOR on
the same channel VHF CH 16 for inform vessel arrival because vessel must clear at least 1 nm from Pipe
Line Gas.

Port Authority

 Maritime Health Declaration

 Ship Registry/Surat Kebangsaan Laut.
 International Tonnage Cert.
 International Load Line
 Minimum Safe Manning Cert.
 Ship Safety Certificate
 Passenger Ship Safety Certificate
 Cargo Ship Safety Construction Cert.
 Cargo Ship Safety Equipment Cert.
 Cargo Ship Safety Radio Cert.
 Safety Management Certificate
 Document of Compliance
 International Oil Pollution Prevention Cert.

PT. EL NINA SAMUDRA

Jl. Pasar No. 3D Baloi Indah Kel. Kampung Pelita Kec. Lubuk Baja 29432 Batam, Indonesia
Telp/Fax: +62778 488 6722 Email: dolfin@elninasamudra.com
1
  Noxious Liquefied Substance Cert.
 International Ship Security Cert.
 International Air Pollution Prevention Cert.
 International Sewage Pollution Prevention Cert.
 Liferaft Cert. of Inspection
 Fire Extinguisher Cert. of Inspection
 Exemption Cert.
 Class Cert.
 Port State Control (PSC)
 Last Port Clearance
 Health Book/Buku Kesehatan
 Ship Sanitation Control Exemption Cert.
 Crew List
 Voyage Memo(Last ten port has been visited list)
 Anti Fouling Cert.
 CLC BUNKER / BBC certificate
 WRECK REMOVAL certificate

CUSTOM

 Cargo Manifest
 BL
 NIL List / Ship Store Declaration
 Ship Particular.

IMMIGRATION

 Passport All Crew Member

 Crew list from last port
 Last Port Clearance
 IMO Crew list (Excel)

QUARANTINE

 Marine Health Declaration

 Last Port Clearance.
 Ship Sanitation control exemption certificate.
 Health Book.
 Crew List from Last Port.
 MEDICINE LIST

PT. EL NINA SAMUDRA

Jl. Pasar No. 3D Baloi Indah Kel. Kampung Pelita Kec. Lubuk Baja 29432 Batam, Indonesia
Telp/Fax: +62778 488 6722 Email: dolfin@elninasamudra.com
2