| Name of
ship/call sign:
|
|
| MMSI number:
|
|
| Port of registry:
|
|
| IMO Number:
|
|
| Gross tonnage:
|
|
| Date keel laid:
|
|
|
|
|
|
|
|
|
|
1 Installation details
|
|
|
Item
|
Status
|
| 1.1
|
AIS transponder type:
|
|
| 1.2
|
Type approval certificate
|
|
| 1.3
|
Initial installation configuration report on board?
|
|
| 1.4
|
Drawings provided? (Antenna-, AIS-arrangement and block diagram)
|
|
| 1.5
|
Main source of electrical power,
|
|
| 1.6
|
Emergency source of electrical power,
|
|
| 1.7
|
Capacity to be verified if the AIS is connected to a battery
|
|
| 1.8
|
Pilot plug near pilots operating position?
|
|
| 1.9
|
120 V AC provided near pilot plug? (Panama and St. Lawrence
requirement)
|
|
|
|
|
|
|
|
|
|
2 AIS programming - Static information
|
| 2.1
|
MMSI number
|
|
| 2.2
|
IMO number
|
|
| 2.3
|
Radio call sign
|
|
| 2.4
|
Name of
ship
|
|
| 2.5
|
Type of ship
|
|
| 2.6
|
Ship length and beam
|
|
| 2.7
|
Location of GPS antenna
|
|
|
|
|
|
|
|
|
|
3 AIS programming - Dynamic information
|
| 3.1
|
Ships position with accuracy and integrity status (Source: GNSS)
|
|
| 3.2
|
Time in UTC (Source: GNSS)
|
|
| 3.3
|
Course over ground (COG) (will fluctuate at dockside) (Source GNSS)
|
|
| 3.4
|
Speed over ground (SOG) (zero at dockside) (Source: GNSS)
|
|
| 3.5
|
Heading (Source: Gyro)
|
|
| 3.6
|
Navigational status
|
|
| 3.7
|
Rate of turn, where available (ROT)
|
|
| 3.8
|
Angle of heel, pitch and roll, where available
|
|
|
|
|
|
|
|
|
|
4 AIS programming - voyage related information
|
| 4.1
|
Ships draught
|
|
| 4.2
|
Type of cargo
|
|
| 4.3
|
Destination and ETA (at masters discretion)
|
|
| 4.4
|
Route plan (optional)
|
|
| 4.5
|
Short safety-related messages
|
|
|
|
|
|
|
|
|
|
5 Performance test using measuring instrument
|
| 5.1
|
Frequency measurements AIS ch. 1 and 2, GMDSS ch. 70
|
|
| 5.2
|
Transmitting output, AIS ch. 1 and 2, GMDSS ch. 70
|
|
| 5.3
|
Polling information ch. 70
|
|
| 5.4
|
Read data from AIS
|
|
| 5.5
|
Send data to AIS
|
|
| 5.6
|
Check AIS response to “virtual vessels”
|
|
|
|
|
|
|
|
|
|
6 “On air” performance test
|
| 6.1
|
Check reception performance
|
|
| 6.2
|
Confirm reception of own signal from other ship/VTS
|
|
| 6.3
|
Polling by VTS/shore installation
|
|
|
|
|
|
|
|
|
| Electromagnetic interference from AIS observed to other
installations?:
|
|
|
|
|
|
|
|
|
|
|
|
| Remarks:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| The AIS has been tested according to IMO SN/Circ.227 and resolution
MSC.74(69), annex 3
|
| Name of
Radio Inspector
|
Date and
place
|
Name of
Radio Inspector Company
|
|
|
|
|
|
|
|