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NORD N Dampskibsselskabet “NORDEN” A/S, 49, Amaliegade, DK-1256 Copenhagen K. Telephone + 45 33 15 04 51. Telefax + 45 33 93 15 99 Tanker. Telefax + 45 33 93 37 33 Technical. Telex 22445. E-mail: [email protected]. Comtext A53DK0 33. www.ds-norden.com Vessel Voyage no. R.O.B. - CARGO TANK INSPECTION CERTIFICATE (DRY CERTIFICATE) Prior Loading After discharging Port : Dat e: Termina l: Draft: FWD AFT : Trim: Cargoes : API Temp: Tank Ullage Innage inch/cm Trim correct inch/cm Correct ullage/ in. inch/cm Trim cor. volume BBLS/M 3 Free water BBLS/M 3 Liquid by wedge BBLS/M 3 Nonliqui d BBLS/M 3 Gross on board volume TOTAL Total on board volume : BBLS/M 3 This is to certiffy that all cargo tanks on board the above named ship has today been inspected/controlled and all tanks,lines and pumps have been found Less free water : BBLS/M 3 Gross on board volume : BBLS/M 3 Liquid by wedge : BBLS/M 3 Non liquid : BBLS/M 3 Above volume was not pumpable by vessel’s fixed pumps. Remarks: Form tk10

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NORD NDampskibsselskabet “NORDEN” A/S, 49, Amaliegade, DK-1256 Copenhagen K.

Telephone + 45 33 15 04 51. Telefax + 45 33 93 15 99 Tanker. Telefax + 45 33 93 37 33 Technical.Telex 22445. E-mail: [email protected]. Comtext A53DK0 33. www.ds-norden.com Vessel      

Voyage no.       R.O.B. - CARGO TANK INSPECTION CERTIFICATE(DRY CERTIFICATE)

Prior Loading After discharging

Port:      Date:      

Terminal:       Draft: FWD       AFT:       Trim:      

Cargoes:       API       Temp:      

TankUllageInnageinch/cm

Trimcorrectinch/cm

Correctullage/in.inch/cm

Trim cor.volume

BBLS/M3

Freewater

BBLS/M3

Liquid bywedge

BBLS/M3

NonliquidBBLS/M3

Grosson boardvolume

                                                     

                                                     

                                                     

                                                     

                                                     

                                                     

                                                     

                                                     

                                                     

                                                     

                                                     

                                                     

                                                     

                                                     

TOTAL                        

Total on board volume :       BBLS/M3 This is to certiffy that all cargo tanks on board the abovenamed ship has today been inspected/controlled and alltanks,lines and pumps have been found empty and welldrained.

Less free water :       BBLS/M3

Gross on board volume :       BBLS/M3

Liquid by wedge :       BBLS/M3

Non liquid :       BBLS/M3      Above volume was not pumpable by vessel’s fixed pumps. Remarks:

________________________ ________________________________ __________________________ Chief Officer Terminal Representative Surveyor

________________________________Master

Form tk10