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1、1水上交通事故调查处理文书英文格式目 录Contents1. 水上交通事故报告书Marine Accident Report2. 水上交通事故调查询问笔录Marine Accident Investigation and Inquiry Record3. 水上交通事故现场勘查记录Marine Accident on Site Survey Record2Marine Accident ReportM/V Date: Port: To: M.S.A. of the P.R.C.I, the master of M/V which arrived this port at about (time)
2、 , hereby report that my vessel was involved in a marine accident that occurred at about (time) _in (position) ,and now submit to you this report attached with necessary papers and documents of _set(s). Please make an investigation and verification.Yours sincerely,(Master signature)( Ships stamp)Dat
3、e:3Particulars of ShipShips name Nationality Port of registryShips owner/operatorAddress Tel.Ships agent/chartererAddress Tel.Port of departurePort of destinationKind of cargo/quantityL.O.A Molded breadth Molded depth Hull materialGT NT DWT/allocation Age of shipKind of ship Summer draft F: A:Draft
4、while the accident occurring F: A: Draft when arriving at this port F: A:Min. stroke Min. turning radius Max. speedType of main engine Power Number of cargo holdsRadar type Max. range Blind area Bearing error Distance errorType of GPS Type/error of gyrocompass Type/error of magnetic compassOfficers
5、on duty NameNo. of Certificate Range Grade RankDuty officerDuty engineer4Details of navigation and collision avoidance (Collision)Ships name Port of registryNationality Kind of ship Hull materialShips ownerThe other shipPort of departure Port of destinationTime Distance Bearing of other shipCourse o
6、f other shipSpeed of other shipSpeed of own shipFirst sightingPosition of own shipCourse of own shipPosition of captainMethod of observationCommunication method between two vesselsLights/shapes of own shipLights/shapes of other shipObserver Time of first sightingRadar observingRange Distance Bearing
7、 of first sightingSituation of both ships when sightingAction to prevent collision Own ship Other shipTime/distance to make avoidance / /First action to be takenTime/type of making sound signal56Own ship Other shipAction to prevent collision afterwardTime Action Time ActionTime/course/speed of chang
8、ingOther actions and timeVHF equipped or not Auto bell recorder equipped or not Auto course recorder equipped or not VDR equipped or notTime of collision Place of collisionOwn shipPart of collisionOther shipTrue course of own ship when collidingCollision angle of both shipsOwn shipActions taken by b
9、oth ships after collisionOther shipSalvage measures and actions7Detailed Process of the Accident8Sketch of the AccidentWind direction Wind force Wave direction/forceCurrent direction Current speed TideVisibility Weather TemperatureNote: ships name, time, position and track required to be marked9Loss
10、 and DamagePersonDied: Missing: Injured:ShipCargoOther damageLossand damage of own shipSketch of damaged part of own ship:Loss and damage of other ship10Marine Accident Investigation and Inquiry RecordThe Case:Time: Place:Person Inquired: Nationality: Sex: Age: Company/Ship/Rank:Address: Phone No.:
11、Postcode:Inquirer: Recorder:The record has been read by the person inquired and is exactly correct.Signature of Inquirer: Signature of Person Inquired: Page : , Total Pages:11Marine Accident Investigation and Inquiry RecordThe record has been read by the person inquired and is exactly correct.Signat
12、ure of Inquirer: Signature of Person Inquired: Page : , Total Pages:12Marine Accident on Site Survey RecordThe caseTime of accidentPlace of accidentVessel/facility surveyed Owner Place of surveyTime of survey From toSketch and description of damaged parts of vessel, facility or wharfOther damageSignature of surveyor Name Place of workWitness of vessel/facility surveyed1
