《船岸安全检查表》.docVIP

PAGE 2 - 船、岸安全检查表 SHIP/SHORE SAFETY CHECK LIST 船 名 Ship，Name 船舶所属单位（人） Ship，Units（Owner） 船舶国籍 Ship，Nationality 总 吨 位 Gross Tonnage 泊 位 Berth 靠泊时间 Date and Time of Berht 货物名称 Gargo，s Name 装卸量（±） Handling capacity 船 长 Ship，Length 最大吃水 Maximum 启始泵压（kg/cm2） Initial Pump Pressure 启始泵量 Initial Pump Rate 最大泵压 Maximum Pump Pressure 最大泵量 Maximum Pump Rate 最大承受装船量（kg/ cm2） Maximum Bear shipment volume 作业开始时间 Time to start operations 填 表 须 知 INSTRUCTIONSFOR COMPLETION 本检查表所列各项必须作出肯定回答并逐项落实，并用√表示，如不能作出肯定回答，则必须提出理由，并由船/岸双方就采取适当的预防措施达成协议。 All the requirements in this form should be answered affirmatively by clearly ticking (√) the appropriate box. If an affirmative answer is not possible, the reason should be given and agreement reached upon appropriate precautions to be taken between the ship and the terminal. where any question is not applicable , then a note to that effect should be inserted in the remarks column. 2、本表由岸方提供，经双方共同填写、签署后各持一份，存档备查。 This form is provided by the party of ship and both parties finish it together and sign it; both parties hold one for file. 3、本表内容一经确定，不得擅自更改。 The form can’t be changed randomly after being filled out. 4、A—所提及的程序和达成的协议应填入检查表的备注栏中或其他双方均可接受的表中。 A—Any procedures and agreements should be in writing in the remarks column of this check list or other mutually acceptable form. In either case, the signature of both parties should be required. B—岸方必须检查确认的项目。 B—All confirmed projects must be checked by the party of ship. P—如果回答是否定的，未经主管机关批准，不准进行作业。 P—In the case of a negative answer, the operation should not be carried out without the permission of the Competent Authority. R—表示在超过声明内规定的情况下，需要再次检查的项目。 R-Indicates items to be re-checked exceeding that agreed in the declaration. 5、如有安全相关未尽事宜，由船、岸双方共同协商后确定。 In the case of any doubts concerning safety, they should be negotiated and decided together by both parties. A部分—通用 适用于所有液态危险品货船 Part AGeneral Applied to all the cargo tanks of liquid dangerous goods 代码 Code 船