SURVEY REPORT ON AIR POLLUTION PREVENTION

Report Number

Classification Number

Place of Survey

Date of Survey

IMO Number

Gross Tonnage

Date of Keel laid

Flag and Port of Registry

Owner/ Operator

An Initial/ Renewal* survey - The survey was/ was not* completed.

An Annual survey.- The survey was/ was not* completed.

An Intermediate survey - The survey was/ was not* completed.

A general examination for: Change of Class/ Change of Flag/ Other (state reason)*

Previous Air Pollution Prevention Certificate full term/interim*.

Certificate No.

Issue Date

Expire Date

The undersigned has verified the equipment and arrangements in the Record of Construction and Equipment and found them to be in agreement, well maintained and in an efficient and good condition.

Issue of a full term Certificate/ Statement of Compliance* valid for a period of 5 years has/ has* not been recommended.

If no full term certificate issued state reason (e.g Survey not completed or deficient equipment etc.)

Recommendations/ notes to be listed in Form RNI.

Other relevant information to be listed in Form GR (repair, lateration, replacement ect.).

Đánh dấu X: 'Có', -: 'Không', hoặc để trống: không áp dụng, nếu thích hợp.

Mark X for 'Yes’, - for ‘No’ or leave blank for 'NA’ as applicable.

Cột bên phải chỉ ra loại hình kiểm tra: IN - Kiểm tra lần đầu; A - kiểm tra hàng năm; I - kiểm tra trung gian; R - kiểm tra định kỳ

The right hand column indicates the survey type for which item to be completed: IN - Initial; A - Annual; I - Intermediate; R - Renewal

III.1 - GENERAL

Have any changes been made or any new equipment installed which would affect the validity of the Certificate (If Yes, include details in Form GR).

Were all other Statutory Certificates and Classification Certificates valid at the time of survey.

Was the structure, equipment, systems, fittings arrangements and materials examined for compliance with the relevant requirements of MARPOL 73/78 Annex VI.

III.2 - DOCUMENTATION

Are there certificates for compliance with the NOx Technical Code onboard for each engine required to be certified (refer to section 2.2.1 of the Record of Construction and Equipment).

Is there an approved Technical file for each certified engine on board.

Is there a type approval certificate on board for each incinerator onboard.

Are there bunker delivery notes on board as required by regulation 18.

Is there an approval certificate and documents for the exhaust gas cleaning system (EGCS). (if fitted)

Confirm that there is a record book of engine parameters for each engine required to be certified in the case where the engine parameter check method is used as a mean of onboard NOx verification (NOx Technical Code, paragraph 6.2.3)

Confirm that there is a record of fuel changeover. This record should take the form of a log book as described by the Administration (Regulation 14(6) of Annex VI)

Confirm that there is a transfer procedure for the VOC collection system

Confirm that there is an instruction manual for each incinerator, if fitted

III.3 - OZONE DEPLETING SUBSTANCES (REGULATION 12)

Confirm that no new installation or equipment which used ODS (except HCFCs) have been fitted to the ship after 19 May 2005.

Confirm that no installations containing hydrochlorofluocarbons (HCFCs) have been fitted after 1 January 2020.

Examine externally any installation or equipment as far as practicable for satisfactory maintenance to ensure that there are no emission of ozone-depleting substances.

(SỬ dỤng III.4.1, III.4.2 hoặc III.4.3 phỤ thUỘC vào phương pháp đƯỢC nêu trong HỒ sơ kỸ thUẬT đƯỢC phê dUYỆT)

iii.4 - Nitrogen Oxide Emissions From Diesel Engines (Regulation 13)

(Use III.4.1, III.4.2 or III.4.3 dependant upon the method indicated in the approved Technical File)

Verification of the engine parameter check method:

Review engine documentation and the record book of engine parameters.

Has the engine undergone any modifications or adjustment since last surveyed.

Conduct survey as detailed in the on-board system in the Technical File.

If an electronic engine management system is used check against the original settings.

Verification of the simplified measurement method:

Review engine documentation.

Confirm test procedure approved.

Confirm test equipment correct type and calibrated in accordance with the NOxTechnical Code.

Confirm correct test cycle used for the on-board confirmation test measurements.

Was a fuel sample taken during the test and submitted for analysis.

Submit a copy of the test report for approval on completion.

Direct measurement and monitoring method:

Review engine documentation.

Confirm test procedure approved.

Confirm test equipment calibrated in accordance with the NOx Technical Code and operational.

Current data available reviewed on board and confirmed that weighted average NOx emissions in accordance with the NOx Technical Code.

Review and confirm the past three month's engine operating data in accordance with the Technical File.

III.5 - SULPHUR OXIDES ( REGULATION 14)

From an external examination verify the exhaust cleaning system is generally in a satisfactory condition.

Is the exhaust cleaning system is operating correctly with manufacturer's instructions.

Are there records of the changeover to and from low sulphur fuel during transit through SOx Emission Control Areas.

Where equipped with tanks for low and normal sulphur content fuel are switching arrangements provided and operational.

Review bunker notes for carriage of correct quality fuel(s).

III.6 - VOLATILE ORGANIC COMPOUNDS (REGULATION 15)

From a general examination, was the vapour collection piping in a satisfactory condition.

Is a means provided to eliminate the collection of condensate in the system, such as drains in low points of the line end, and are the drains operable.

Is the piping electrically continuous and electrically bonded to the hull, and the means of bonding intact.

Are the isolation valves at the vapour manifolds operational and do the valve position indicators operate correctly.

Are the ends of each line properly identified as vapour lines.

Are the vapour connections flanges in accordance with industry standards.

Where portable vapour hoses are provided are they in good condition, and electrically continuous.

Are the hose ends properly marked as vapour hoses.

Is the closed gauging system operational and the readouts in the cargo control area functional.

Is an overflow control system provided. (level alarms)

Are the alarms operational.

Do the audible and visual alarms operate.

Are the alarms properly labelled.

Does the power failure alarm operate.

Is there a means to check the operation of the alarms and is this means operational.

Are high and low pressure alarms provided in each main vapour line.

Do these alarms operate at the correct set points.

Are the high level and high high level (overfill) alarms independent of each other.

III.7 - INCINERATORS (REGULATION 16)

From an external examination, was each incinerator in a generally satisfactory condition and free from leaks of gases or smoke.

Are the warning and instruction plates legible and secured in a prominent location.

Is the manufacturers name, incinerator model, series number and capacity in heat units per hour permanently marked on the incinerator.

Are the incinerator casing insulation arrangements in good condition.

Are the following alarms and safety devices operational.

Flue gas high temperature alarms and shutdown.

Combustion temperature control and shutdown.

Combustion chamber negative pressure.

Flame safeguard control, alarms and shutdowns.

All alarms both visual, audible and functioning and do they indicate the cause of the failure.

Power loss alarm and auto shut down arrangements.

Charging arrangement

Low fuel oil pressure alarm/shut down.

Emergency stop switch and electrical isolating arrangements

Interlocks.

Was it verified that the O₂ content in the combustion chamber is between 6 – 12%.

Are complete instruction and maintenance manuals available on board.

Are Staff suitably trained.

Are drip trays fitted under each burner, pump, strainer and are they in good condition.

Was the combustion chamber flue gas outlet temperature verified as between 850 – 1200^oC.