Document No D-03

PT. HABCO TRANS MARITIMA Tbk Issued Date 01-01-2023

DECK FORM & CHECKLIST Issued Status 1
Revision 0

CARGO HOLD INSPECTION REPORT

Vessel’s Name: Date: Tank ID:

Reason for inspection: Routine Maintenance or Inspection by 3rd Party Survey (Class, P&I, Suspected Damage
ship’s staff PSC, etc.)
Any outstanding recommendations / deficiencies or Class Conditions:

CHECK POINTS RESULT REMARKS DATE WORK DONE

1. BULKHEADS (inlc. FLOORS, GIRDERS & STRINGERS)
Check condition of plating iwo corrosion, localized pitting and
coating breakdown
2. TANK TOP
To check condition of plating iwo corrosion, cracks and coating
breakdown
3. BOTTOM
To check condition of plating especially iwo pitting (esp.
underneath bellmouth) and welding seams.
4. PIPING
To check for corrosion/pitting of piping, dressers couplings
wastage or discoloration, pipe supports and penetration pieces.
5. LADDERS
To check integrity of ladders, local cracks, deformation of steps
and rails.
6. HYDRAULIC LINE
To check condition of pipes, supports and any old repairs.
7. HATCH COVER
Check condition, packing.
8. BALLAST ABLE ARRANGEMENT
Check condition
9. EMERGENCY
Emergency operation of cargo hold using portable emergency
pump; emergency lighting and general lighting; CO2 pipe for
cargo hold; closing device; emergency suction test cargo hold;
CH locking device, cargo hold ventilation device.

1. RESULT : Give assessment of condition of the specific section/area in the following 3 categories.
2. REMARK : Specify any additional explanatory comments related to the mentioned item (if Grade is Poor)
Notes:

3. WORK DONE : Specify work carried out on the items mentioned.

4. Complete an ENCLOSED SPACE ENTRY CHECKLIST as may be necessary and keep in file.

RESULT: This column shall indicate an assessment of condition REMARK: Reference for any WORK DONE: This column is to be used for
as follows: comments. recording work carried out using the following
GOOD = Condition only with minor problems codes:
FAIR = Condition with local problems or general condition worst DATE: Use format 01 INSPECTED BY CLASS SURVEYOR
than good but better than poor. MONTH/YEAR, eg. 01/06 for 02 PARTLY RENEWED (GIVE DETAILS)
POOR = Condition with major problems in specific areas or work done. 03 RENEWED
general condition below acceptable levels. 04 CLEANED/GREASED
05 DESCALED
GENERAL REMARKS

Name of person inspected tank: Chief Officer: Master:

D-03 Cargo Hold Inspection Report Revision No. 1 Page 1 of 1