TECHNICAL DEPARTMENT

CAPTAIN’S FILE V1.1

CERTIFICATE OF SLOPS/BILGE DIRTY WATER DISPOSAL

YACHT: _______________________ DATE: ____/____/____

Our Ref: PMSY/Env/101 Palumbo Malta Superyachts Ltd.

The vessel ______________________ in Palumbo Malta Superyachts Ltd. from ____/____/____

to ____/____/____ has discharged the following slops/dirty bilge water.

Garbage Categories EWC Code Volume in m3

Waste Oil
Bilge Oil/Water
Wash Water
Fuel Oil
Sludge
Other

_____________________________ ___________________________

Yacht’s Representative Yard’s Representative

PMS Form 028 Page of

Revision Number: January 2019 1 1