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POLITEKNIK PELAYARAN SURABAYA PM-02-2-R04 DRILL SCHEDULE REPORT FORM MRDF | NONTHEY Cision | Mast: Designated Peon Issue Date | UApal 2018 Retention [3 Years Revision 7 | Page 1 of 7 VESSEL: KL, BUNG TOMO. Month/Year: JANUARY! 2023, ] = | | 8 5 é El lg a g) Ele zeal [el | 13) ELSIE 5 zg z Sigie|3 \5 Bl le gieis ale |ojs glelalsisle 2s /2/2) /21S/B/812 2/e l= z/8 Sle Elsie leis iz lele ale |g A g 8 2) E ai sae ale 6|3 8/5 3 MONTHS alg elz g 5 2/2) 2/£/2/5)8) 2/818 NO_[ ENTER DATEDONE >>> ESE 1 Z| Bites of crew amustered, viv oiv we [ 2] Grewia proper PPE viv iv iv it 3 | Growin ligckes ve | | Fie Pap and owes v 5 “Emergency fire pump tested Vv 4 | =a ane ¥ 7 vo a _ v ae a v vy {aa | Gomera i at) Hc Pinan sae fi yaa 73 | Line throwing equipment v ee T - ioamed é 9] eccracancas Z TH egos 38 | (ace matasiey a | ide i 6 _| First Aid and CPR Temonstaied v viv | 47 | Reltrenceto COE v viv ‘Reference to JAMSAR Manual and | q S| Soiscames bal fide Bad | rata ] |] ee __| required alarm? ca it [777] Was it ensured that the crew is aware of the onder to | abandon ship, as spocified in the muster list? B | Were the exew members suitable dressed? t 9 | Were the Hifsjackets correctly donned? To War at hast one Without lowered aller the mecesary | preparations for launching was done and found | scepiable? i | Was starting and operating the lifeboat engines) ‘carried | 7 out satisfactorily? | E # A || Wes epeaton of ti Sis a Trosing Heats | AT] | acceptable’ Tig [Wes the emerges Taking tated ia way of ars oF (28 | nmostering and abandonment? it Ta [Ate crew members familar withthe Gir sssgned 6 hom during abandon ship operation? = GE" [Mave the crew members in charge of @ sural erat [A |[—] complete knowledge of operation and equipment ofa’? | COMMENTS, ANALYSIS AND COI Ke et Master : Capt. Anak Agung Ngurah Ade D P Y / JAN 2023 Signature ‘Date POLITEKNIK PELAY ARAN SURABAYA PM-02-2-F0S | EMERGENCY DRILIS REPORT FORM RDP I MONTY Aste | Castdian | str, Designated Pas issue Date | TApal 2008 [Retention [3 Yeas e Revision O [Page 6 of 8 NO | MOB7MAN OVER BOARD DRILL NO [REMARKS 1 | Did anyone shouling the alert “MOB? Did anyone raise the dana and undlewtand Whe signal code cconectly? 3] Was instruction to allocate a sictimoriber To pot atthe (MOB in te water and tell them to Keep pointing and not to lore sight ofthe M0 4 | Did officers undersiand how to send a DSC distress alert | and a Mayday? | weighted down with a bucket ora coil of rope demonstratod? | Was practice such as by throwing @ fender overboard | el Ps a fas UF (COMMENTS, ANALYSIS AND CORRECTIVE ACTION: on

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