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Ship I Shore Safety Check List
Date of Arrival :
Time of Arrival :
Instructions for Completion:
The safety of operations requires that all questions should be answered affirmatively by
clearly ticking (3) 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 considered to be not
applicable, then a note to that effect should be inserted in the remarks column.
A box in the columns ship and terminal indicates that checks could be carried out by
the party concerned.
The presence of the lettersA, P or R in the column Code indicates the following:
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.
P - In the case of a negative answer, the operation should not be carried out without
the permission of the Port Authority.
R -Indicates items to be re-checked at intervals not exceeding that agreed in the
declaration.
1 PART A Bulk Liquid General
Stop cargo at
1 Isthe ship securely moored? R ktswind vel.
Disconnect at
ktswind vel.
Unberthat kts
wind vel.
2 Are emergency towing wires correctly R
positioned?
3 Isthere safe access b
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