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1、船/岸安全检查表SHIP/SHORE SAFETY CHECK LISTShips Name 船名 . Berth 泊位 Port 港口 .Date of Arrival 抵达日期 .Time of Arrival抵达时间 . 填表须知INSTRUCTIONS FOR COMPLETION:为保证安全作业，下列所有问题的答复均是肯定的,可在相应的方格内清楚地打上()标号。如果不能给予肯定回答，应说明理由，而且船舶和码头之间均达成关于应采取的适当预防措施的协议。如果认为有的问题不适用，应在备注栏里加以说明。The safety of operations requires that all qu
2、estions should be answered affirmatively by clearly ticking () in the appropriate box. If an affirmative answer is not available, the reason should be given and agreement reached upon appropriate precautions to be taken between the ship and the terminal. Where any question is considered to be not ap
3、plicable, then a note to that effect should be inserted in the remarks column.“船舶”和“码头”栏目下的方格，表示由负责方实施检查。A box in the column ship and terminal indicates that the party concerned should carry out checks. 在“代码”栏目里的A，P或R字母，分别表示如下的意义：The presence of the letters A, P or R in the column Code indicates the
4、 following:A （协议）表示该检查项应通过协议或程序来处理，并在检查表中的“备注”栏中明确或者通过其它一些双方可接受的表格来交流这些协议和程序。A (Agreement). This indicates that the referenced consideration should be addressed by an agreement or procedure that should be identified in the Remarks column of the Check List, or communicated in some other mutually acce
5、ptable form. P（批准）在否定回答的情况下，未经主管当局的书面许可，不可进行作业。P (Permission). In the case of a negative answer to the statements coded P, no operations are to be conducted without the written permission from the appropriate authority.R（复查） 表示在不超出声明同意的时间间隔须重复检查的项目。R (Re-check).This indicates items to be re-checked
6、at appropriate intervals, as agreed between both parties and stated in the declaration.仅在所有方检查和接受他们分配的职责和责任后方可签署共同声明The joint declaration should not be signed until all parties have checked and accepted their assigned responsibilities and accountabilities.PART A BULK LIQUID GENERAL - PHYSICAL CHECKS
7、A 部分 散装普通液货 现场核实Bulk Liquid General 散装液体 普通Ship船舶Terminal码头Code代码Remarks备注1. There is safe access between the ship and shore.船岸之间有安全通道.R2. The ship is securely moored. 船舶已安全系泊.R3. The agreed ship/shore communication system is operative. 商定的船/岸通信系统可用.A RSystem 系统 .Back up system 备用系统.4. Emergency tow
8、ing-off pennants are correctly rigged and positioned.应急拖缆已带好并处于正确位置.R5. The ships fire hoses and fire-fighting equipment are positioned and ready for immediate use. 船方消防水带和消防设备配置在位并立即可用.R6. The terminals fire-fighting equipment is positioned and ready for immediate use. 岸方消防设备配置在位并立即可用.R7. The ships
9、 cargo and bunker hoses, pipelines and manifolds are in good condition, properly rigged and appropriate for the service intended.船方的货物、燃油软管, 管线和集管处于良好状态，适当固定并适用于预计的货物作业.8. The terminals cargo and bunker hoses/arms are in good condition, properly rigged and appropriate for the service intended.岸方的货物、
10、燃油软管/装卸臂处于良好状态，适当固定并适用于预计的货物作业.9. The cargo transfer system is sufficiently isolated and drained to allow safe removal of blank flanges prior to connection.接管前，货物转移系统有效隔离并放残以能够安全地拆除盲板.10. Scuppers and save alls on board are effectively plugged and drip trays are in position and empty.船上的排水孔和积油槽有效塞堵，
11、空的集液盘放置到位。RBulk Liquid General 散装液体 普通Ship船舶Terminal码头Code代码Remarks备注11. Temporarily removed scupper plugs will be constantly monitored.临时移开流水孔塞需保持监控。R12. Shore spill containment and sumps are correctly managed.岸方的溢油围堰和积油槽正确管理R13. The ships unused cargo and bunker connections are properly secured wi
12、th blank flanges fully bolted.船方不用的货物、燃油管接头已装妥盲板并上紧全部螺栓.14. The terminals unused cargo and bunker connections are properly secured with blank flanges fully bolted.岸方不用的货物、燃油管接头已装妥盲板并上紧全部螺栓.15. All cargo, ballast and bunker tank lids are closed.所有货舱、压载舱和燃油舱舱盖都保持关闭。16. Sea and overboard discharge valv
13、es, when not in use, are closed and visibly secured. 海底阀和舷外排出阀在不使用时已关闭和确实关妥.17. All external doors, ports and windows in the accommodation, stores and machinery spaces are closed. Engine room vents may be open. 居住舱室、储物间和机器处所的所有外部门,开口和窗户已关闭. 机舱的通风可以打开.R18. The ships emergency fire control plans are l
14、ocated externally. 船舶紧急消防控制图放置在外部.Location 位置 . If the ship is fitted, or is required to be fitted, with an Inert Gas System (IGS) the following points should be physically checked:如船舶安装有，或要求安装惰气系统(IGS)，下列各条应进行现场核查：Inert Gas System 惰气系统Ship船舶Terminal码头Code代码Remarks备注19. Fixed IGS pressure and oxygen content recorders are working. 固定式的惰气系统压力和氧含量记录器正常工作R20. All cargo tank atmospheres are at positive pressure with oxygen content of 8% or less by volume. 所有货舱均为正压，氧气含量8% (体积)P R
