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Confidential Data
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Proprietary data and composition will be treated as confidential by the
Government and their representatives who form the evaluating group within
IMO.
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Name of producing company:
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Name of the cleaning additive:
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as they are
to appear in annex 10 of the MEPC.2/Circular.
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Has this
cleaning additive been submitted before?
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Yes
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No
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If yes
give details of any changes.
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Component No.
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Component name (as used by GESAMP/EHS)
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Weight %
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GESAMP Hazard Profile
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A1
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A2
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B1
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D3
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1
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2
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3
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4
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5
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6
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7
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8
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Continuation sheets may be used when needed.
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Typical
rate of dilution in washwater required for proper use of the cleaning additive:
%
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(as stated
by the manufacturer in the description of use).
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ATTACH
USAGE INSTRUCTIONS FOR NLS CARGO TANK CLEANING (if this information is not
provided, this application will be rejected).
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Date:
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Signature:
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Title:
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dd/mm/yy
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