Name of
ship:
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IMO
number/call sign:
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Flag
State:
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Gross
tonnage:
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Deadweight (where appropriate):
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Date of
report:
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Report
by:
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Classification Society:
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Recognized Organization involved:
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Did you
receive the notification of detention? (tick the box if the answer is
'yes
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Action
taken
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a) Deficiencies
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b) Cause
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c) Action taken
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Additional Information:
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