APPENDIX 1
|
GENERAL PARTICULARS
|
Ship's name:
|
IMO number:
|
Class administration identity number:
|
Port of registry:
|
Gross tonnage:
|
Deadweight:
|
Date of build:
|
Classification society:
|
Name of company performing thickness measurement
|
Thickness measurement company certified by:
|
Certificate number:
|
Certificate valid
from:..........................................to...................................................................
|
Place of measurement:
|
First date of measurement:
|
Last date of measurement:
|
renewal survey/intermediate survey due *:
|
Details of
measurement equipment:
|
|
Qualification of operator:
|
|
Report
number:
|
consisting
of pages
|
Name of
Operator:...........................................
|
Name of
surveyor:...........................................
|
Signature
of operator:......................................
|
Signature
of surveyor .....................................
|
Company
official stamp:...................................
|
Administration:.............................................. Official
stamp:
|
* Delete as
appropriate
|
|