-
.
船
/
岸安全检查表
SHIP/SHORE
SAFETY CHECK LIST
Ship
’
s Name
船名
………………………………………
.
Berth
泊位
………………………………………
Date of Arrival
抵达日期
……………………………………
..
Port
港口
………………………………………
.
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 questions 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
applicable,
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
< br>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 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
–
(
‘
Agreeme
nt
’
).
This
indicates
that
the
referenced
consideration
should
be
addressed
by
an
agreement
or
procedure
that
should
be
identified
in
the
‘
Remarks
’
< br>
column
of
the
Check
List,
or
communicated in some other mutually
acceptable 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 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
A
部分
－散装普通液货
－
现场核实
Bulk Liquid
–
General
散装液体
－
普通
1.
There is safe access between the ship
and shore.
船岸之间有安全通道
.
2.
The ship is
securely moored.
船舶已安全系泊
.
3.
The agreed
ship/shore communication system is
operative.
商定的船
/
岸通信系统可用
.
4.
Emergency
towing-off pennants are correctly
rigged and positioned.
应急拖缆已带好并处于正确位置
.
5.
The
ship
’
s 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
.
6.
The
terminal
’
s 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
.
7.
The
ship
’
s 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
terminal
’
s cargo and bunker
hoses/arms are
in good condition,
properly rigged and
appropriate for the
service intended.
岸方的货物、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.
.
Ship
船舶
Terminal
Code
码头
代码
Remarks
备注
R
R
System
系统
.......
A
R
Back
up
system
备
用系统
...
…………
.
R
R
R
. <
/p>
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，
空的集液盘放置
到位。
R
Bulk Liquid
–
General
散装液体
－
普通
11.
Temporarily
removed scupper plugs will be
constantly monitored.
临时移开流水孔塞需保持监控。
12.
Shore spill
containment and sumps are correctly
managed.
岸方的溢油围堰和积油槽正确管理
13.
The
ship
’
s unused cargo and
bunker connections
are properly secured
with 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 terminal
’
s
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 valves, 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.
<
/p>
居住舱室、储物间和机器处所的所有外部门
,
开口和
.
Ship
船舶
Terminal
Code
码头
代码
Remarks
备注
R
R
R
.
窗户已关闭
.
机舱的通风可以打开
.
18.
The
ship
’
s emergency fire
control plans are
located 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
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
20.
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
)
Ship
船舶
Terminal
Code
码头
代码
Remarks
备注
R
P
R
PART
‘
B
’
–
BULK LIQUID GENERAL
–
VERBAL VERIFICATION
B
部分－散装普通液货
－
口头确认
Bulk Liquid
–
General
散装液体
－
普通
21.
The ship is ready to move under its own
power.
船舶能够随时靠自航移位
.
22.
There is an
effective deck watch in attendance on
board and adequate supervision of
operations on
the ship and in the
terminal.
船上安排了有效的甲板值班
,
码头和船上有足够
的监督人员
.
23.
There are
sufficient personnel on board and
ashore to deal with an emergency.
船上和岸上有足够人员应付紧急情况
.
24.
The
procedures for cargo, bunker and ballast
handling have been agreed
货物、燃油和压载的装卸程序已议定
.
25.
The emergency
signal and shutdown procedure to
be used by the ship and shore have been
explained and understood
解释并
理解船岸之间使用的应急信号和应急关闭
程序
.
Ship
船舶
Terminal
Code
码头
代码
Remarks
备注
P
R
R
R
A
R
A
.
26.
Material
S
afety
D
ata
S
heets (MSDS) for the cargo
transfer have been exchanged where
requested.
作业货物的物质安全数据单已按要求进行交换
P
R
27.
The hazards associated with toxic
substances in
the cargo
being handled have been identified and
understood.
作业货物中所含有毒物质的相关危害
已辨识并清
楚。
28.
An
International Shore Fire Connection has been
provided.
已提供国际通岸接头
29.
The agreed
tank venting system will be used.
将使用协议的货舱透气系统
H
2
S
Content
..........
…
硫化氢含量：
Benzene
Content
苯含量：
.
……
A
R
法
…
.......
Method
方
Bulk
Liquid
–
General
散装液体
－
普通
30.
The requirements for closed operations
have been
agreed.
封闭作业要求已达成协议
31.
The operation
of the P/V system has been verified.
压力
/
真空系统的操作已核验
32.
Where a
vapour return line is connected,
operating parameters have been agreed.
如果接气相回流管，操作参数已达成协议
33.
Independent
high level alarms, if fitted, are
operational and have been tested.
如果安装了独立的高液位报警，应处于工作状态并经测试
Ship
船舶
Terminal
Code
码头
代码
Remarks
备注
R
A
R
A
R
34.
Adequate
electrical insulating means are in place
in the ship/shore connection.
船
/
岸接管处有足够的电气绝缘方式
35.
Shore lines
are fitted with a non-return valve or
procedures to avoid
‘
back
filling
’
have been
discussed.
岸线装有止回阀，或已讨论如何避免“倒灌”的程序
A
R
P
R
.
.
36.
Smoking rooms have been identified and
smoking
requirements are
being observed.
指定吸烟室，遵守吸烟规则
.
37.
Naked light
regulations are being observed.
遵守明火规则
38.
Ship/shore
telephones, mobile phones and pager
requirements are being observed.
遵守船
/
岸、手机和传呼机使用规则
39.
Hand
torches (flashlights) are of an approved type.
手电筒（闪光灯）为认可型
40.
Fixed VHF/UHF
transceivers and AIS equipment
are on
the correct power mode or switched off.
固定式高频
/
甚高频和自动识别系统设备处于正确
的发射功率模式或关闭
.
41.
Portable
VHF/UHF transceivers are of an approved
type.
便携式高频
/
甚高频无线电收发机为认可型
.
Nominated
A
R
smoking rooms
指定的吸烟室
:
.................................
A
R
A
R
Bulk Liquid
–
General
散装液体
－
普通
42.
The ship
’
s main
radio transmitter aerials are
earthed
and radars are switched off.
船舶主无线电发射天线接地，雷达处关闭状态
43.
Electric
cables to portable electrical equipment
within the hazardous area are
disconnected from
power.
在危险区域便携式电气设备的电缆断开电源
44.
Window type
air conditioning units are
disconnected.
窗式空调电源断开
45.
Positive
pressure is being maintained inside the
accommodation, and air conditioning
intakes,
which may permit the entry of
cargo vapours, are
.
Ship
船舶
Terminal
Code
码头
代码
Remarks
备注
.
closed
居住舱室保持正压，可能吸入货物蒸汽的空调吸入
口应关闭
46.
Measures have been taken to ensure
sufficient
mechanical ventilation in
the pump room.
已采取措施保证泵房足够的机械通风
47.
There is
provision for an emergency escape.
预留有应急逃生通道
.
48.
The maximum
wind and swell criteria for
operations
have been agreed.
作业的最大风力和涌浪标准已经达成协议
R
Stop cargo at:
................
A
停止作业
Disconnect
at: ..............
拆管
Unberth at:
...............
离泊
49.
Security
protocols have been agreed between the
Ship Security Officer and the Port
Facility Security
Officer, if
appropriate.
如果适用，船舶保安员和港口设施保安员达成保安协议。
50.
Where
appropriate, procedures have been agreed
for receiving nitrogen
supplied from shore, either
for
inerting or purging ship
’
s
tanks, or for line
clearing into the
ship.
如果需要从岸方接收氮气用于惰化船舱、
驱气或吹
扫管线，就相关程序已达成协议
A
A
P
If the
ship is fitted, or
is
required to be fitted, with an Inert Gas System
(IGS) the
following
statements should be addressed.
如果船舶安装了，或被要求安装惰气系统
(IGS)
，
下列各条应进行实际检查：
Inert Gas System
惰气系统
51.
The IGS is
fully operational and in good working
order.
Ship
船舶
Terminal
Code
码头
代码
Remarks
备注
P
惰气系统可完整运行并
处于良好工作状态
52.
Deck seals,
or equivalent, are in good working
order.
甲板水封或类似装置处于良好工作状态
53.
Liquid levels
in pressure/vacuum breakers are
correct.
压力
/
真空破断器的液位正常
R
R
.