Subject in relation to coming into force of AFS Convention ... · / Certificate of Installations LL Certificate . SC Certificate . SE Certificate SR Certificate / Exemption Certificate

Subject

Amendment to application formｓ in relation to coming into force of AFS Convention

Technical Information

No. TEC-0746 Date 18 September 2008

To whom it may concern

In relation to ClassNK Technical Information, No.TEC-0745 “Surveys and Certification for AFS Convention”, the following application forms have been amended:- Form 2A: Application for Surveys and Issue of Certificates Form 3A: Application for Classification and Statutory Services for an Existing Ship ClassNK shall be very grateful if you will use these new forms in future. The forms may also be down-loaded from the following URL:- http://www.classnk.or.jp/hp/download/dl_appli.asp For your information, Form 1A: Application for Classification and Statutory Services During Construction was amended on 26 June 2008 in conjunction with ClassNK Technical Information No. TEC-0739 and is also available on the said web site. For any questions about the above, please contact: NIPPON KAIJI KYOKAI (ClassNK) Classification Department, Information Center, Head Office Address: 1-8-5 Ohnodai, Midori-ku, Chiba 267-0056, Japan Tel.: +81-43-294-5797 Fax: +81-43-294-5660 E-mail: [email protected]

Attachment:

1. APPLICATION FOR SURVEYS AND ISSUE OF CERTIFICATES [Form 2A, Form 2A (J)] 2. APPLICATION FOR CLASSIFICATION AND STATUTORY SERVICES FOR AFTER

CONSTRUCTION [Form 3A, Form 3A (J)]

NOTES: ClassNK Technical Information is provided only for the purpose of supplying current information to its readers. ClassNK, its officers, employees and agents or sub-contractors do not warrant the accuracy of the information contained

herein and are not liable for any loss, damage or expense sustained whatsoever by any person caused by use of or reliance on this information.

Back numbers are available on ClassNK Internet Homepage (URL: www.classnk.or.jp).

Application for Surveys and issue of Certificates Form 2A (Rev. September 2008)

APPLICATION FOR SURVEYS AND ISSUE OF CERTIFICATES

To: NIPPON KAIJI KYOKAI Application

Document No.: Application Date:

APPLICANT *Delete as appropriate Signature and Official Stamp of Applicant:

Name: Address:

Name in Block Capitals:

Tel: Fax: Position in Company:

We hereby request you to carry out survey(s) and/or to issue certificate(s) described below. This request is made on the basis that we accept the provisions of REGULATIONS FOR THE CLASSIFICATION AND REGISTRY OF SHIPS, CONDITIONS OF SERVICE FOR CLASSIFICATION OF SHIPS AND REGISTRATION OF INSTALLATIONS and REGULATIONS FOR THE ISSUE OF STATUTORY CERTIFICATES (as well as the provisions of REGULATIONS FOR TECHNICAL SERVICES when requesting technical services) of NIPPON KAIJI KYOKAI. Regardless of whether surveys are completed or not, we agree to pay all survey fees and expenses incurred as a result of the above-mentioned survey(s) and/or issuance of relevant certificate(s) within the payment term designated in your invoice.

Please send this application directly to a local NK office for prompt arrangement for a surveyor.

Ship’s Name Class No. Ship-owner G.T. Flag Official No. Call Sign Type of Ship Service Area Other Class 1. Survey to be carried out (tick in the boxes) IMO No. (1) Survey for Maintenance of Class Special No. (Commence) Special No. (Incomplete) Special No. (Complete) Intermediate(Commence / Incomplete / Complete) Annual Docking Boiler Propeller Shaft Prolongation for Propeller Shaft Continuous Hull Continuous Machinery Planned Maintenance Occasional Hull Occasional Machinery (2) Survey for Maintenance of Installation Registration Cargo Refrigerating Installations : Special (Commence / Incomplete / Complete) Annual Continuous Survey Occasional Cargo Handling Appliances : Registration Annual Thorough Occasional Load Test Marine Pollution Prevention Installations [ MARPOL ANNEX * I/II/IV/VI ] : * Initial / Renewal Intermediate Annual Occasional Safety Equipment [ non-HSSC] : * Initial / Renewal Intermediate Annual Occasional [ HSSC ] : * Initial / Renewal Periodical Annual Occasional Safety Radio [ non-HSSC] : * Initial / Renewal Occasional [ HSSC ] : * Initial / Renewal Periodical Occasional Automatic and Remote Control System [* MC / MO / MOA / MOB / MOC/ MOD ] Special Annual Occasional Anti-Fouling Systems : [*AFS / AFS･C] Registration Periodical Occasional Diving Systems : Special (Commence) Special(complete) Annual Occasional Preventive Machinery Maintenance Systems : Special Annual Occasional (3) Other Survey ; Chemical / Gas : * Initial / Renewal Intermediate Annual Occasional Others ( )

(4) Contents of Occasional Survey 2. Date and Place of Survey ; from to at Name of Agent Tel ( )

Fax ( ) 3. Certificate(s) to be issued (tick in boxes in left) and certificate(s) to be endorsed (tick in boxes in right). Certificate of Classification / Certificate of Installations LL Certificate SC Certificate SE Certificate SR Certificate / Exemption Certificate OPP Certificate NLS Certificate SPP Certificate APP Certificate Chemical Certificate

Gas Certificate / Cargo Gear Certificate Cargo Gear Book Pakistan/Canada AFS Certificate Others ( )

Billing Contact (Please fill in if the billing contact is different from the above applicant.)

We ensure payment of all survey fees and expenses incurred in the above-mentioned survey(s) and/or issuance of relevant certificate(s).

Name: Address:

Signature and Official Stamp:

Tel: Fax: Name in Block Capitals: Note) Abbreviations: (

L ……………Load Line SR …………Cargo Ship Safety Radio SPP……….Sewage Pollution Prevention L

C ……………Cargo Ship Safety Construction OPP ……….Oil Pollution Prevention APP…..…..Air Polution Prevention S

SE ……………Cargo Ship Safety Equipment NLS ……….Noxious Liquid Substances AFS……….Anti-Fouling Systems

船級･設備維持検査等申込書 Form 2A(J) (Rev. September 2008)

船級及び設備の維持検査並びに証書等発行申込書

財団法人日本海事協会御中申込文書番号申込日年月日

日本海事協会の「登録規則」、「船級登録及び設備登録に関する業務提供の条件」及び「国際条約による証書に関する規則」（技術サービス

を申込む場合は「技術サービス規則」を含む。）を了承の上、下記に記載の船級及び設備の維持検査並びに証書の発行を申込みます。なお、

検査手数料等は検査の成否に関わらず支払うことに同意します。

申込者連絡先

氏名名称

住所印

所属 Tel Fax e-mail address

船名船級番号

所有者総トン数

国籍船舶番号信号符字

船舶の種類航行区域他船級

１．検査の種類（下表中×印を付したもの）

１－１船級維持のための検査

定期 (Commence/Incomplete/Complete)

中間/Intermediate 年次/Annual 船底ボイラ

船体継続機関計画 (CMS/PMS/PMMS) プロペラ軸抜き出し又は延期臨時＊

１－２設備維持のための検査

冷蔵設備 RMC 定期年次臨時＊

揚貨設備荷重試験登録年次詳細臨時＊

海洋汚染防止設備 MARPOL ANNEX I/II/IV/VI 初回 /定期中間年次臨時＊

SE (non-HSSC) 初回 /定期中間年次臨時＊

安全設備 SE (HSSC) 初回 /定期定期的年次臨時＊

SR/SRP/GMDSS (non-HSSC) 初回 /定期臨時＊

通信設備 SR/SRP/GMDSS (HSSC) 初回 /定期定期的臨時＊

自動化設備 MC/M0/M0A/M0B/M0C/M0D 定期年次臨時＊

居住衛生設備 CAA 初回/定期中間年次臨時＊

船橋設備 /総合火災制御設備 /潜水装置定期年次臨時＊

船体防汚システム AFS/AFS･C 登録定期的臨時＊

１－３その他の検査

ケミカル/ガス/その他( ) 初回/定期中間年次臨時＊

１－４臨時検査の受検内容（上記中＊を付したもの）

３．検査

日時月日

入港/入渠出港/出渠

月日

月日

２．検査

場所

４．証書の発行・裏書きの申込み（下記該当欄に×印を付して下さい。）

証書・書類名証書

発行証書

裏書証書・書類名証書

発行

証書

裏書証書・書類名証書

発行

証書

裏書

船級証書設備証書満載喫水線証書

安全構造証書安全設備証書安全無線証書

免除証書油汚染防止証書有害液体汚染防止証書

汚水汚染防止証書大気汚染防止証書ケミカル適合証書

ガス適合証書荷重試験証明書荷役設備検査記録簿

Pakistan/Canada 防汚方法証書その他（）

検査手数料等請求先（検査手数料の支払い者が申込者と異なる場合に記入下さい）連絡先

所属･氏名 TEL

名称

住所

印

FAX

(注)本申込書は日本以外の国籍の船舶にも使用可

Application for Classification and Statutory Services Form 3A (Rev. September 2008)

APPLICATION FOR CLASSIFICATION AND STATUTORY SERVICES

FOR AFTER CONSTRUCTION

To: NIPPON KAIJI KYOKAI Application Document No.: Application Date:

APPLICANT Signature and Official Stamp of Applicant:

Name: Address:

Name in Block Capitals:

TEL: FAX: Position in Company:

We hereby request you to carry out the survey for registration and to issue the certificates described in the attached Form 3A-ATT1. This request is made on the basis that we accept the provisions of REGULATIONS FOR THE CLASSIFICATION AND REGISTRY OF SHIPS, CONDITIONS OF SERVICE FOR CLASSIFICATION OF SHIPS AND REGISTRATION OF INSTALLATIONS and REGULATIONS FOR THE ISSUE OF STATUTORY CERTIFICATES (as well as the provisions of REGULATIONS FOR TECHNICAL SERVICES when requesting technical services) of NIPPON KAIJI KYOKAI. We agree to pay all survey fees and expenses incurred as a result of the above-mentioned survey and issuance of relevant certificate(s), regardless of whether class and/or installations are registered or not.

SHIP INFORMATION Main particulars of hull and machinery are to be filled in using separate Form 3A-ATT2.

Name of Ship IMO No.

Shipbuilder: Name Address

Yard/Hull Number:

Date of Contract: Date of Keel Laying: Date of Launch: Date of Completion:

Flag: Port of registry:

Type of ship: Gross tonnage:

Survey Schedule From: To: At:

Intended area of navigation:

International / Non-international Ocean going / Not ocean going (Please enter specified navigation area)

REGISTRATION Classification Characters and Notations for which applying: NS

Character of Main Propulsion Machinery: MNS

Descriptive Note(s)

Classification not built under the Society’s survey

Other Descriptive Note(s): n.s. n.f. CoC IWS Other:

Registration of Installations not built under the Society’s survey

Safety Equipment Radio Installations Cargo Handling Appliances Crew Accommodation Arrangements Marine Pollution Prevention Installations Preventive Machinery Maintenance Systems Automatic and Remote Control Systems ( MC, M0, M0-A, M0-B, M0-C, M0-D) Navigation Bridge Systems ( BRS, BRS1, BRS1A) Integrated Fire Control Systems ( IFC-M, IFC-A, IFC-AM) Cargo Refrigerating Installations ( RMC, RMC-CA) Anti-Fouling Systems ( AFS, AFS･C ) Other:

Billing Contact (Please fill in if the billing contact is different from the above applicant.) Name: Address:

Signature and Official Stamp:

TEL: FAX: Name in Block Capitals: Attachments: Form 3A-ATT1 Form 3A-ATT2 Form 3A-ATT3 Form 3A-ATT4-1 Form 3A-ATT4-2 Remarks: 1. Please send this form to the nearest ClassNK branch office. 2. Please attach the plans and documents stipulated in the ClassNK Guidance for the Survey and Construction of Ships. 3. If the items filled in this form have been changed or if undecided items have been determined, please inform the nearest ClassNK branch office of them.

For NK internal use. Date received Receipt No.

Application for Classification and Statutory Services

Form 3A-ATT1 (Rev. September 2008)

Attachment 1 Application Document No.

Shipbuilder Yard/Hull Number

Issuance of Certificates

International

Convention Certificates

Load Line (Please fill in the boxes of the main particulars of load lines using separate Form 1A-ATT2.)

Cargo Ship Safety Construction Cargo Ship Safety Equipment

Cargo Ship Safety Radio Passenger Ship Safety

Grain Loading Booklet Oil Pollution Prevention

Pollution Prevention Certificate for the Carriage of Noxious Liquid Substances in Bulk

Sewage Pollution Prevention

Air Pollution Prevention

Anti-Fouling Systems

Fitness for the Carriage of Dangerous Chemicals in Bulk

Fitness for the Carriage of Liquefied Gases in Bulk Fitness for Ship Carrying Dangerous Goods (Please fill in the boxes of the main particulars of

dangerous goods using separate Form 1A-ATT3.)

Exemption ( Fixed Fire-extinguishing System )

Other (Please specify):

Tonnage Certificates International Tonnage National Tonnage (Applicable rule: )

Suez Canal PC/UMC Documentation of total volume

Assignments Freeboard Incinerator* Lift for Crew, Etc.* (*: Applies to Japanese flag vessels only.)

Cargo Gear Certificate, etc.

(Please indicate main

particulars of cargo gear on

separate Form 1A-ATT4-1.)

Cargo Gear Book

Cargo Gear Certificate*

Derrick

Derrick for Union Purchase

Crane

Ramp-way, Lift for Cargo

(* Including Loose gear (except

rope) & Rope)


GN JP* PK* Other*:

GN JP PK* Other*:

GN: Form for NK classed vessels

JP: Form for Japanese Flag vessels PK: Form for Pakistani service

(* These forms are to be prepared by the applicant.)

Certificate for Fitness for BC Code

Appendix A cargoes ( with / without restrictions on moisture content of cargoes)

Appendix C cargoes

Appendix B cargoes (Please list all cargoes. If insufficient space, please continue on separate sheet.)

Certificate of fitness for national regulations of flag State (Please indicate requirements

that apply in space provided.)

Document of Compliance

for a Non-party to a Convention

Cargo Ship Safety Construction Cargo Ship Safety Equipment Cargo Ship Safety Radio

Pollution Prevention Certificate for the Carriage of Noxious Liquid Substances in Bulk

Oil Pollution Prevention Other (Please specify):

Certificate(s) for USCG Requirements

Pollution Prevention Foreign Flag Gas Carrier Vapor Emission Control


Other Certificate(s) ILO Crew Accommodation Attestation of Load Lines Attestation of Deadweight

Certificate of Keel Laying Other (Please specify):



Attachment 2 Application Document No.


Main Particulars of Ship (No.1)

MAIN PARTICULARS OF HULL

Lpp x B x D (meters): X X Deadweight: Coal Carrying

Special Rules to be

applied:

Part CS Part P Part Q Part T

Others ( )

Yard/Hull Number of

Sister ship(s) 1:

Fishing vessel 2 Type:

Restrictions:

Dual class 3:

1. Complete if classification during construction. 2. Complete if ship is Japanese-flag vessel. 3. If dual class, please specify name of other classification society.

MAIN PARTICULARS OF MACHINERY

Number-Type-Model: - -

Maximum Output 1-Revolutions per minute:

kW - PS - RPM

Main Engine

Manufacturer Workshop:

Propeller Shaft Type: 1A 1B 1C 2 PSCM

Propeller Number-Type-RPM: - - RPM

Number Maximum Working Pressure 1:

- MPa-kg/cm2 Boiler

Main

Auxiliary Manufacturer:

Generator Total Output: kVA

1. Please delete as appropriate. If ship is Japanese-flag vessel, please select SI unit. MAIN PARTICULARS OF LOAD LINES

Type of Ship: A B B+ B-60 B-100 Timber Freeboard: Yes No

Intended freeboard (meters):

Multiple Load Line System:

Yes No

PERMITTED NUMBER OF PERSONS TO BE ACCOMODATED

Maximum number of persons accommodated:

Total No.: (Passenger: Crew: Other: )

MAIN PARTICULARS OF CARGO REFRIGERATING INSTALLATIONS (Please complete when requesting to register the refrigerating installations.)

Intended Notation:

Type of Refrigerant: Cooling System: Total Capacity of Cargo Chamber:



Attachment 3 Application

Document No.


Main Particulars of Ship (No.2)

MAIN PARTICULARS OF CARRIAGE OF DANGEROUS GOODS

Where loaded: Cargo Hold No.: Other (Please specify): Solid Dangerous Goods in Bulk

Class of DangerousGoods:

4.1 4.2 4.3 5.1 6.1 8 9

Loading restrictions for Specified Cargo1:

Where loaded: Weather Deck Cargo Hold No.: Other (Please specify): Other Dangerous Goods

Class of Dangerous Goods:

1.1-1.6 1.4S 2.1 2.2 2.3 3.1, 3.2 3.3

4.1 4.2 4.3 5.1 5.2

6.1 (All)

6.1 (liquid: flashpoint (C) below 23 between 23 and 61 over 61 solid

8 (All)

8 (liquid: flashpoint (C) below 23 between 23 and 61 over 61 solid

9

Loading restrictions for Specified Cargo1:

1. Please complete when restrictions apply to loading of specified cargo in order to meet relevant requirements.


Form 3A-ATT4-1 (Rev. September 2008)

Attachment 4-1 Application Document No.


Main Particulars of Cargo Gear CARGO GEAR Derrick/Crane

Intended safe working load (tons) - allowable minimum angle (degrees) or allowable maximum radius (meters)

Dual Location and description

with distinguishing number or mark, if any Load Angle/Radius

Load Angle/Radius

UNION PURCHASE Please also complete the separate Form 1A-ATT4-2 entitled “Data sheet for Union Purchase”.

Intended safe working load (tons) - allowable minimum angle (degrees) or allowable maximum radius (meters)

Swing system Location and description

with distinguishing number or mark, if any Safe working load

Maximum fall angle Load Angle/Radius

RAMPS/LIFT for Cargo

Location with distinguishing number or mark, if any Intended safe

working load (tons)Remarks


Form 3A-ATT4-2 (Rev. September 2008)

Attachment 4-2 Application Document No.


Datasheet for Union Purchase (*1), (*2)

- Location of Derricks: Fore / Aft of hatch no. ( ).

- Distance of lower guy eyes from upper deck (*3): Inboard boom ( ) meters Outboard boom ( ) meters

- Safe Working load in Union Purchase: ( ) tons

- Fall angle: ( )degrees

- Allowable lifting height from upper deck: ( ) meters

- Outside diameter and thickness of derrick boom: Inboard boom mm mm Outboard boom mm mm

Upper deck

Guy eye

Center Line

Outboard boom Inboard boom

Outboard boom

Inboard boom

Unit: meters

(Enter the length, height or distance for each item in the space between each pair of arrows.)

Guy eye

(*1) This form is to be prepared separately for each gang.(*2) Camber, sheer, trim, and heel are to be neglected. (*3) Enter the value 0 meters in cases where the guy eye is fixed to the upper deck.

船級登録検査等申込書様式 3（2008.09 改正）

製造後船級登録検査等申込書財団法人日本海事協会御中

申込文書番号申込日年月日

申込者連絡先

所属・氏名

TEL 名称

住所

印

FAX

日本海事協会の「登録規則」、「船級登録及び設備登録に関する業務提供の条件」及び「国際条約による証書に関する規

則」（技術サービスを申込む場合は「技術サービス規則」を含む。）を了承の上、下記の登録及び様式 1-1 に記載の証書

等の発行（発行に必要な検査を含む）を申込みます。※検査手数料等は検査の成否に関わらず申込者に請求してください。

対象船舶様式 3-2 の「船舶の主要目」の欄及び「機関の主要目」の欄に追加の要目をご記入ください。

船名 IMO No.

建造者名

住所

建造番号

建造契約日

起工日

進水日

完成日

年月日

年月日

年月日

年月日

船籍国船籍港

前船籍国前船級

船の種類総トン数

受検予定年月日着手年月日完了受検場所

航行区域国際航海 / 非国際航海遠洋 / 非遠洋(航行区域をご記入ください)：

登録

希望船級符号及び付記 NS

主推進機関の符号 MNS

希望の注記

製造後船級登録

登録原簿特記事項 n.s. n.f. IWS その他：

製造後設備登録安全設備通信設備居住衛生設備海洋汚染防止設備

自動化設備（ MC M0 M0・A M0・B M0・C M0・D ）

船橋設備（ BRS BRS1 BRS1A ）揚貨設備

機関予防保全設備冷蔵設備 ( RMC RMC・CA )

総合火災設備（ IFC・M IFC・A IFC・AM）

船体防汚システム( AFS / AFS･C) その他：

右の書類を添付します。：様式 3-1 様式 3-2 様式 3-3 様式 3-4-1 様式 3-4-2

※検査手数料等の支払い者が申込者と異なる場合は、請求先を下記にご記入ください。検査手数料等請求先連絡先

所属・氏名

TEL 名称

住所

印

FAX

NK 記入欄受理日年月日受理番号

注意事項 1. この申込書は弊会の支部･事務所に 1 部提出してください。 2. 弊会の鋼船規則集検査要領に規定される図面を添付してください。 3. 記載事項に変更が生じた場合及び未確定事項が確定した場合は支部・事務所に速やかにお知らせください

船級登録検査等申込書様式 3-1 (2008.09 改正)

船級登録検査等申込書様式 3-1 申込文書番号

建造者名建造番号

証書等発行申込み

国際条約証書等満載喫水線証書（様式 1-2 の「満載喫水線の要目」の欄に要目を記載してください。）旅客船安全証書貨物船安全構造証書貨物船安全設備証書貨物船安全無線証書免除証書（貨物区域固定式消火装置）危険化学品ばら積み運送適合証書液化ガスばら積み運送適合証書危険物適合証書（様式 1-3 の「危険物運送の主要目」の欄に要目を記載してください。）

穀類積載承認文書

油汚染防止証書ばら積み有害液体物質運送汚染防止証書汚水汚染防止証書大気汚染防止証書防汚方法証書その他：

トン数証書等国際トン数証書各国規則トン数証書（適用規則：）スエズ運河トン数証書 PC/UMC Documentation of total volume

指定書等満載喫水線指定書焼却炉制限温度指定書１昇降機制限荷重等指定書１

1. 日本籍船の場合のみ記入して下さい。

荷役設備検査記録簿等

(様式 1-4-1 に要目を記載して

ください。)

荷役設備検査記録簿

制限荷重指定書※ デリック装置けんか巻きﾃﾞﾘｯｸ装置クレーン装置荷役用ﾗﾝﾌﾟｳｪｲ・ﾘﾌﾄ ※ 揚貨装具（ﾛｰﾌﾟ以外）及びロー

プを含む

その他：

GN JP※ PK※ その他※：

GN JP PK※ その他※：

GN：NK 船級船用ﾌｫｰﾑ JP：日本籍船用ﾌｫｰﾑ PK：ﾊﾟｷｽﾀﾝ就航船用ﾌｫｰﾑ

※ フォームは検査申込者が準備してください。

BC ｺｰﾄﾞ適合証明書付録 A 貨物（含水量制限あり含水量制限なし）付録 C 貨物

付録 B 貨物（貨物名を記載してください。多数の場合、リストを添付してください。）

条約非加盟国船籍船

条約適合証明書

貨物船安全構造貨物船安全設備貨物船安全無線

油汚染防止ばら積み有害液体物質運送汚染防止

その他：

各国国内規則適合証明

（右の欄に適用規則を記載し

て下さい。）

USCG 規則適合証明書海洋汚染防止規則液化ガス運搬船 Vapor Emission Control

その他：

その他 ILO 船員居住設備適合証明書満載喫水線鑑定書載貨重量鑑定書

起工証明書その他：




船舶等の主要目船舶の主要目

LppｘBｘD (m) ｘｘ載貨重量石炭運送

特殊編適用 CS 編 P 編 Q 編 T 編

その他（）

同型船の建造番号１

漁船２業務の種類：

従業制限：

二重船級３：

１．製造中登録の場合に記入して下さい。２．日本籍船の場合のみ記入して下さい。３．本会と他船級の二重船級の場合、その船級協会名を記入してください。

機関の主要目

数・種類・型式・・

連続最大出力 1・回転数 kW・PS ・ RPM

主機関

製造者・工場

プロペラ軸種類 1A 1B 1C 2 予防保全方式 (PSCM) 適用

プロペラ数・型式・回転数・・ RPM

数・制限圧力 1 ・ MPa・kg/cm2 ボイラー

主補助製造者

発電機定格総容量 kVA

１. 日本籍船の場合は、SI 単位で記入して下さい。

満載喫水線の主要目

船舶の型式 A B B＋ B-60 B-100 木材乾玄ありなし

希望指定喫水(m) マルチ証書発行希望

最大搭載人員

最大搭載人員名（旅客：名乗組員：名その他：名）

冷蔵設備の主要目（冷蔵設備の登録を申込む場合にご記入ください。）

希望する付記

冷媒の種類冷却方式冷蔵艙の総容積 m3




危険物運送の主要目

積載場所貨物倉番号：その他：

固体ばら積み

危険物

危険物の

クラス 4.1 4.2 4.3 5.1 6.1 8 9

特定貨物の積載制限１：

積載場所暴露甲板貨物倉番号：その他：

固体ばら積み

危険物以外

危険物の

クラス 1.1-1.6 1.4S 2.1 2.2 2.3 3.1, 3.2 3.3

4.1 4 .2 4.3 5.1 5.2

6.1（すべて）

6.1（液体：引火点（C） 23 以下 23 超 61 以下 61 超固体）

8 （すべて）

8 （液体・引火点（C） 23 以下 23 超 61 以下 61 超固体）

9

特定貨物の積載制限１：

1. 関連の要件に適合する上で特定貨物の積載を制限する場合、記載してください。

船級登録検査等申込書様式 3-4-1（2008.09 改正）

船級登録検査等申込書様式 3-4-1 申込文書番号


揚貨設備の主要目揚貨装置（デリック装置・クレーン装置）

希望制限荷重(ﾄﾝ)・制限角度(度)または制限半径(m)

二重表示の場合番号・種別・位置荷重角度/半径

荷重角度/半径

けんか巻き方式（船級登録検査等申込書様式 1-4-2 のﾃﾞｰﾀｼｰﾄに記入してください。）

希望制限荷重(ﾄﾝ)・最大ｶｰｺﾞﾌｫｰﾙ間角度・制限角度(度)

振回し方式の場合番号・種別・位置荷重

最大ｶｰｺﾞ

ﾌｫｰﾙ間角度荷重角度/半径

荷役用ランプウェイ・リフト

番号・位置希望制限荷重(ﾄﾝ) 備考

船級登録検査等申込書様式 3-4-2（2008.09 改正）

船級登録検査等申込書様式 3-4-2 申込文書番号


Datasheet for Union Purchase (*1), (*2) ・Location of Derricks: Fore / Aft of hatch no. ( ).

・Distance of lower guy eyes from upper deck (*3): Inboard boom ( ) meters

Outboard boom ( ) meters

・Safe Working load in Union Purchase: ( ) tons

・Fall angle: ( ) degrees

・Allowable lifting height from upper deck: ( ) meters

・Outside diameter and thickness of derrick boom: Inboard boom φmm mm

Outboard boom φmm mm

Center Line

Outboard boom

(*1) 各ギャング毎に作成願います。(*2) Camber, Sheer, Trim 及び Heel は無視してください。 (*3) guy eye が上甲板に固着されている場合は０ｍとしてください。

Guy eye

Inboard boom

Outboard boom

Inboard boom

Unit: meters

(Enter the length, height or distance for each item in the space between each pair of arrows.)

Guy eyeUpper deck

Documents

Subject in relation to coming into force of AFS Convention ... · / Certificate of Installations LL Certificate . SC Certificate . SE Certificate SR Certificate / Exemption Certificate