SHIP INSPECTION REPORT

PT. PELAYARAN ANDALAS BAHTERA BARUNA Form ABB-F.

Ship Name : Date of Inspection :

Call Sign : Place of inspection :
Name of Inspector :

NON-CONFORMITY CORRECTIVE ACTION CLOSING

No. DESCRIPTION CLOSING DATE EXPLANATION
EVIDENCE PLAN EVIDENCE

Page 1 of 6
 SHIP INSPECTION REPORT

PT. PELAYARAN ANDALAS BAHTERA BARUNA Form ABB-F.

NON-CONFORMITY CORRECTIVE ACTION CLOSING

No. DESCRIPTION CLOSING DATE EXPLANATION
EVIDENCE PLAN EVIDENCE

Page 2 of 6
 SHIP INSPECTION REPORT

PT. PELAYARAN ANDALAS BAHTERA BARUNA Form ABB-F.

NON-CONFORMITY CORRECTIVE ACTION CLOSING

No. DESCRIPTION CLOSING DATE EXPLANATION
EVIDENCE PLAN EVIDENCE

Page 3 of 6
 SHIP INSPECTION REPORT

PT. PELAYARAN ANDALAS BAHTERA BARUNA Form ABB-F.

NON-CONFORMITY CORRECTIVE ACTION CLOSING

No. DESCRIPTION CLOSING DATE EXPLANATION
EVIDENCE PLAN EVIDENCE

Page 4 of 6
 SHIP INSPECTION REPORT

PT. PELAYARAN ANDALAS BAHTERA BARUNA Form ABB-F.

NON-CONFORMITY CORRECTIVE ACTION CLOSING

No. DESCRIPTION CLOSING DATE EXPLANATION
EVIDENCE PLAN EVIDENCE

Page 5 of 6
 SHIP INSPECTION REPORT

PT. PELAYARAN ANDALAS BAHTERA BARUNA Form ABB-F.

NON-CONFORMITY CORRECTIVE ACTION CLOSING

No. DESCRIPTION CLOSING DATE EXPLANATION
EVIDENCE PLAN EVIDENCE

TARGET MATRIX INPUT DATA BY THE

ATTENDING INSPECTOR
1) Voyage information for last 6 months:  Europe  North America  Australia  Asia  Domestic trading  Others  N/A.
2) Trading information for last 6 months:  Liner  Tramper  Not-home port calling ship  N/A.
3) Manning (Captain):  Direct manning by the manager  By Manning Company (permanent)  By Manning Company (temporary).
4) Inspection Preparedness by Captain:  Good  Good to Fair  Fair to Poor  Poor
5) Ship's condition:  Good  Good to Fair  Fair to Poor  Poor
6) SMS implementation:  Good  Good to Fair  Fair to Poor  Poor

Acknowledged by, Inspected by,

Name Name

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