THIS IS TO CERTIFY that at a survey required by regulation 5 of Annex VI of the Convention the ship was found to comply with the relevant provisions of the Convention:
Annual Survey
Place:_______________________ Date:___________________
Seal MARITIME
ADMINISTRATION: ___________________
(Signature of authorized official)
___________________________________________________________________________________________________________________
Annual /Intermediate Survey*
Place:_______________________ Date:___________________
Seal MARITIME
ADMINISTRATION: ___________________
(Signature of authorized official)
____________________________________________________________________________________________________________________
Annual /Intermediate Survey*
Place:_______________________ Date:___________________
Seal MARITIME
ADMINISTRATION: ___________________
(Signature of authorized official)
____________________________________________________________________________________________________________________
Annual Survey
Place:_______________________ Date:___________________
Seal MARITIME
ADMINISTRATION: ___________________
(Signature of authorized official)
* Delete as appropriate
REGULATION 9(8)(C)
THIS IS TO CERTIFY that at an annual/intermediate survey in accordance with regulation 9(8)(c) of Annex VI of the Convention, the ship was found to comply with the relevant provisions of the Convention:
Place:_______________________ Date:___________________
Seal MARITIME
ADMINISTRATION: ___________________
(Signature of authorized official)
ENDORSEMENT TO EXTEND THE CERTIFICATE IF VALID FOR LESS THAN 5 YEARS WHERE REGULATION 9(3) APPLIES
The ship complies with the relevant provisions of the Convention, and this certificate shall, in accordance with regulation 9(3) of Annex VI of the Convention, be accepted as valid until ______________________
Place:_______________________ Date:___________________
Seal MARITIME
ADMINISTRATION: ___________________
(Signature of authorized official)
ENDORSEMENT WHERE THE RENEWAL SURVEY HAS BEEN COMPLETED AND REGULATION 9(4) APPLIES
The ship complies with the relevant provisions of the Convention, and this certificate shall, in accordance with regulation 9(3) of Annex VI of the Convention, be accepted as valid until ______________________
Place:_______________________ Date:___________________
Seal MARITIME
ADMINISTRATION: ___________________
(Signature of authorized official)
ENDORSEMENT TO EXTEND THE VALIDITY OF THE CERTIFICATE UNTIL REACHING THE PROT OF SURVEY OR FOR A PERIOD OF GRACE WHERE REGULATION 9(5) OR 9(6) APPLIES
This certificate shall, in accordance with regulation 9(5) or 9(6) of Annex VI of the Convention be accepted as valid until ______________________________
Place:_______________________ Date:___________________
Seal MARITIME
ADMINISTRATION: ___________________
(Signature of authorized official)
ENDORSEMENT FOR ADVANCEMENT OF ANNIVERSARY DATE WHERE REGULATION 9(8) APPLIES
In accordance with regulation 9(8) of Annex VI of the Convention, the new anniversary date is ________________
Place:_______________________ Date:___________________
Seal MARITIME
ADMINISTRATION: ___________________
(Signature of authorized official)
In accordance with regulation 9(8) of Annex VI of the Convention, the new anniversary date is ________________
Place:_______________________ Date:___________________
Seal MARITIME
ADMINISTRATION: ___________________
(Signature of authorized official)
Приложение №4
Supplement to the International Air Pollution
Prevention Certificate (IAPP Certificate)
RECORD OF CONSTRUCTION AND EQUIPMENT
In respect of the provisions of Annex VI of the International Convention for the Prevention of Pollution from Ships, 1973, as modified by the Protocol of 1978 relating thereto (hereinafter referred to as “the Convention”).
Notes:
1.
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This Record shall be permanently attached to the IAPP Certificate. The IAPP Certificate shall be available on board the ship at all times.
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2.
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If the language of the original Record is not English, French or Spanish, the text shall include a translation into one of these languages.
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3.
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Entries in boxes shall be made by inserting either a cross (x) for the answer “yes” and applicable or a dash (-) for the answers “no” and “not applicable” as appropriate.
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4.
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Unless otherwise stated, regulations mentioned in this Record refer to regulations of Annex VI of the Convention and resolutions or circulars refer to those adopted by the International Maritime Organization.
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