Ingangsdatum: 17-11-1983
Geldig tot en met: 27-06-1996
(official seal) | | | | | | | | | | | | | | | | | (Country) |
Issued in compliance with provisions of the Code of Safety for Special Purpose Ships, and
under the authority of the Government of
| .............................................................................................................................................. |
| (full designation of the country) |
by | .............................................................................................................................................. |
| (full designation of the competent person or organization under the provisions of the Code) |
Name of ship | Distinctive number or letters | Port of registry | Gross tonnage | Maximum number of special personnel incl. passengers to be carried |
| | | | |
Ship's special purpose | ...................................................................................................................................... |
Date of build | ...................................................................................................................................... |
THIS IS TO CERTIFY:
1 That the ship has been surveyed in accordance with 1.6 of the Code.
2 That the survey showed:
2.1 the condition of the hull, machinery and equipment was in all respects satisfactory
and the ship complied with the relevant provisions of chapters 2, 3, 4 and 5 of the
Code.
2.2 the life-saving appliances provided for a total number of ...............persons and no
more. The lifeboats and liferafts were equipped in accordance with the provisions of
the Code.
2.3 the ship was provided with the a line-throwing apparatus and portable radio apparatus
for survival craft in accordance with the provisions of the Code;
2.4 the ship complied with the provisions of the Code as regards fire-detecting appliances,
fire-extinguishing appliances and fire control plans:
2.5 the ship complied with the provisions of the Code as regards shipborne navigational
equipment, pilot ladders and mechanical pilot hoists and nautical publications;
2.6 the ship was provided with lights and shapes and means of making sound signals and
distress signals in accordance with the requirements of the Code and the International
Regulations for Preventing Collisions at Sea in force;
2.7 the ship complied with the provisions of the Code as regards
radiotelegraphy/radiotelephony*:
2.8 the functioning of the radiotelegraphy installations for motor lifeboats and/or the
portable radio apparatus for survival craft, if provided, complied with the provisions
of the Code:
2.9 in all other respects the ship complied with the relevant provisions of the Code.
3 That the ship under the provision of 1.4/1.7.4* of the Code is exempted from the
provisions of ................................of the Code.
4 That the ship has/has not* been provided with Certificates issued under the 1974
SOLAS Convention, as amended by the 1978 SOLAS Protocol.
* Delete as appropriate.
This certificate is valid until.................................................................subject to the annual and
periodical surveys in accordance with...................................................................... of the Code.
Issued | ...................................................................... |
| (Place of issue of certificate) |
...................................................................... | ...................................................................... |
(Date of issue) | (Signature of authorized official issuing the certificate) |
(Seal or stamp of the Authority as appropriate)
|