AMOCO VESSEL SCREENING QUESTIONNAIRE
(Issue 3/95)
PART I VESSEL, OWNERSHIP, OPERATION, AND MANAGEMENT PARTICULARS
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1. Vessel name
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2. Previous name(s)
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3. Official Number/LR Number
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4. Year Built / Builder & Yard
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5. Country of Registry (Flag)
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6. Classification Society and Class
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7. List any changes of Registry or Class with
the reason and when affected.
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8. Nationality of Officers? Crew? Officers: Crew:
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9. DWT/NRT/GRT
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10.Summer DWT Draft/Ballast Draft
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11. T.P.I./T.P.C.
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12. L.O.A./L.B.P.
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13. Beam/BCM
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14.KTM/Moulded Depth
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15. Can vessel warrant the max height of Yes/No
manifold above the water will not exceed 55
ft. during discharge ? Max Height:
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16. Full style of registered owner. Name.
Address:
Telephone:
Fax:
Telex:
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17. Full style of parent company. Name:
Address
Percent Ownership
Telephone:
Fax:
Telex:
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18. Years owned by current owner.
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19. Number of tankers in owners/parent
company fleet.
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20. Full style of time charterer Name:
(Name, address. tel, fax. tlx) Address:
Telephone:
Fax
Telex:
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21. Commencement and length of time charter
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22. Full style of operational manager. (Name, Name:
address, tel, fax, tlx) Address:
Telephone;
Fax:
Telex:
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23.Name(s) and telephone number(s) of Name:
owners/managers for contract on 24 hour
basis in the event of an emergency. Telephone:
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24. Length of time that this vessel has been
managed by current manager.
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25. Number of tankers in manager's fleet.
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26.A) Owner/Manager has contracted with A) MSRC or NRC
MSRC or NRC for OPA response.
B) Owner/Manager warrants that a Vessel B) VRP YES/NO
Response Plan, (VRP) is in place/on board.
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27. Qualified Individual's Name:
Full Style: Address:
Telephone:
Fax:
Tel:
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28. Owner's P&I Club
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29. Doer vessel comply with I.T.F.
requirement ? Does vessel have I.T.F. blue
card?
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30. MARPOL Classed- SBT/CBT/COW?
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31. Cargo tank capacity M3 and BBLS 98% CAP.
at 98% Number and location of cargo, Tanks No. Location M3 BBLS
ballast tanks, and slop tanks by
segregation
Cargo:
Ballast:
Slops:
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32. Is vessel coiled? Warranted maximum
temperature and rare of increase
deg/day.
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33. Number and capacity of stripping pumps
TPH/SW M3/hour @ head.
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34. Number and capacity of eductors.
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35. In vessel fitted with separate stripping YES/NO
system ?
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36. A) Type/maker of remote closed tank A)
gauging system.
B) IS vessel fitted with calibrated B)
vapor locks that allow cargo tank ullages,
temps, and samples to be taken without
breaching the IGS pressure? Maker?
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37. Number and S.W.L. of cargo hose
derricks/cranes.
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38. Number of mooring winches and brake ____winches ____ drums
capacity at first layers. Number/size Brake Cap(lst Layer)_____
mooring wires/ropes fitted. #____wires L____ x dia___
#____ropes L____ x circ__
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39. Number, type make. S.W.L. of bow chain ______stoppers _____SWL
stoppers fitted. Are S.P.M. Mooring Type/Maker:____________
arrangements in accordance with
O.C.I.M.F. standards? YES/NO Number/Size Bow Chock____
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40. Number and type closed chocks/fairleads No. Bow: Ste:
fitted bow/stern for STS mooring. Type:
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41. Is fhe vessel double-sided or double-hulled
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42. If double-hull. are fhe double bottoms YES/NO
subdivided.
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43. Are rhe cargo tanks flrred with oiltight YES/NO
centerline/swash bulkheads. (Specify type)
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PART II TIME SPECIFIC INFORMATION
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44. Are the necessary proceedures, placed on
the vessel, instructing the Master and YES/NO
officers of the complex intact stability
requirements of doubl hull tankers.
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45. Last vessel chartered by owner/manager to
Amoco.
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46. Last three charterers and cargoes.
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47. Owners warrants that all Class and Flag
administration certificates are and will YES/NO
remain valid for the duration of this
charter.
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48. Port and date of issue of U.S.C.G. Tank Port:
Vessel Exam Letter. Date:
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49. Port and date of last call in the United Port:
States. Date;
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50. Port and date of last flag state inspection. Port:
Date:
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51. List any outstanding/deficiencies by
Class/Flag/U S C.G. (Port State),
including, but not limited to safety
and fire fighting equipment, cargo
handling or vent systems, navigation
equipment or other SOLAS type requirements.
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52. Date of last call at the intended Load Port:
Load/discharge port. Date:
Disport:
Date:
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53. Owners to confirm that no major crew
changes have been effected for at
least 30 days prior to this charter
and that none are planned during the
term of this charter
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54. Do the master and chief officer Master:
understand spoken and written
English ? Chief Officer:
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55. Are owners presently planning to sell
vessel or change ownership during fhe
period of the proposed charter.
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56. Dates/place shipyards for last 2 drydock Date:
periods. Yard:
Date:
Yard:
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57. Date of last Special Survey.
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58. Details of any pollution incidents (either
cargo or bunkers) over last 24 months
(When, where. type. extent, and fine
imposed.)
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60. Details of any general average, salvage,
significant mexhanical failure, stranding
or collision or other such incidents/accidents
over the past 36 months
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61. Is inert gas system in good working order
and all tanks inerted under 8%?
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62. Has vessel performed STS lightering
operation previously?
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63. War last voyage STS lightering service? If
yes, how many consecutive lightering ?
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64. Are additional deck officers carried for STS
lightering operations ?
Number/Rating
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