|
INTERNATIONAL FISHING
|
|
VESSEL SAFETY CERTIFICATE
|
| This Certificate shall be supplemented by a
|
| Record of Equipment
|
|
|
|
(Official seal)
|
(State)
|
| Issued under the provisions of the
|
| TORREMOLINOS PROTOCOL OF 1993 RELATING TO
THE
|
| TORREMOLINOS CONVENTION FOR THE SAFETY OF
|
| FISHING VESSELS, 1977
|
| under the authority of the Government of
|
|
|
| ____________________________________
|
|
(name of the State)
|
| ____________________________________
|
| by
|
(person or organization authorized)
|
|
Particulars of vesselfootnote
|
| Name of vessel . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .
|
| Distinctive number or letters . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . .
|
| Port of registry . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . .
|
| Length (L)2
footnote. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.
|
| Date of building or major conversion contract . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . .
|
| Date on which keel was laid or vessel was at a
similar stage of construction in accordance with regulation I/2(1)(c)(ii) or (1)(c)(iii) . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . .
|
| Date of delivery or completion of major conversion .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.
|
| THIS IS TO CERTIFY:
|
| 1
|
That the vessel has been surveyed in accordance with
the requirements of regulation I/6.
|
| 2
|
That the survey showed that:
|
|
|
.1
|
the condition of the hull, mahcinery and equipment, as
defined in the above regulation was in all respects satisfactory and that
the vessel complied with the applicable requirements;
|
|
|
.2
|
the maximum permissible operating draught associated
with each operating condition for the vessel is contained in the approved
stability booklet dated . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . .
|
| 3
|
That an Exemption Certificate has/has notfootnote been issued.
|
| This certificate is valid until . . . . . . . . . . .
. . . . . . . . . . . . . subject to surveys in accordance with regulation
I/6(1)(b)(ii), (b)(iii) and (c)
|
| Issued at . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . .
|
|
(Place of issue of certificate)
|
| . . . . . . . . . . . . . .
|
. . . . . . . . . . . . . . . . . . . . . . . . . . .
.
|
|
(Date of issue)
|
(Signature of authorized official issuing the certificate)
|
|
|
|
|
|
|
|
|
(Seal or stamp of the issuing authority, as appropriate)
|
|
|
|
|
|
|
|
|
ENDORSEMENT TO EXTEND THE VALIDITY OF THE
|
|
CERTIFICATE FOR A PERIOD OF GRACE WHERE
|
|
REGULATION I/11(1) APPLIES
|
| This certificate shall, in accordance with regulation
I/11(1), be accepted as valid until . . . . . . . . . . . . . . .
. . . . . . . . . .
|
|
|
|
|
Signed; . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
|
|
|
|
|
|
(Signature of authorized official)
|
|
|
|
|
Place: . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . .
|
|
|
|
|
Date: . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
|
|
(Seal or stamp of the authority, as appropriate)
|
|
|
|
ENDORSEMENT TO EXTEND THE VALIDITY OF THE
|
|
CERTIFICATE UNTIL REACHING THE PORT
|
|
OF SURVEY OR FOR A PERIOD OF GRACE
|
|
WHERE REGULATION I/11(2) OR
|
|
REGULATION I/11(4) APPLIES
|
| This certificate shall, in accordance with regulation
I/11(2)/regulation I/11(4)
footnote, be accepted as valid until . . . . . . . . . . . . . . .
. . . . . . . . . .
|
|
|
|
|
Signed; . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
|
|
|
|
|
|
(Signature of authorized official)
|
|
|
|
|
Place: . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . .
|
|
|
|
|
Date: . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
|
|
(Seal or stamp of the authority, as appropriate)
|
|
|
|
ENDORSEMENT FOR PERIODICAL SURVEYS
|
|
Equipment survey
|
| THIS IS TO CERTIFY that, at a survey required by
regulation I/6(1)(b)(iii), the vessel was found to comply with
the relevant requirements.
|
|
|
|
|
Signed; . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
|
|
|
|
|
|
(Signature of authorized official)
|
|
|
|
|
Place: . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . .
|
|
|
|
|
Date: . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
|
|
(Seal or stamp of the authority, as appropriate)
|
|
|
|
Radio surveys
|
| THIS IS TO CERTIFY that, at a survey required by
regulation I/6(1)(b)(iii), the vessel was found to comply with
the relevant requirements.
|
| First periodical radio survey:
|
|
|
|
|
Signed; . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
|
|
|
|
|
|
(Signature of authorized official)
|
|
|
|
|
Place: . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . .
|
|
|
|
|
Date: . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
|
|
(Seal or stamp of the authority, as appropriate)
|
| Second periodical radio survey:
|
|
|
|
|
Signed; . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
|
|
|
|
|
|
(Signature of authorized official)
|
|
|
|
|
Place: . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . .
|
|
|
|
|
Date: . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
|
|
(Seal or stamp of the authority, as appropriate)
|
| Third periodical radio survey:
|
|
|
|
|
Signed; . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
|
|
|
|
|
|
(Signature of authorized official)
|
|
|
|
|
Place: . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . .
|
|
|
|
|
Date: . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
|
|
(Seal or stamp of the authority, as appropriate)
|
|
|
|
ENDORSEMENT FOR INTERMEDIATE SURVEYS
|
| THIS IS TO CERTIFY that, at a survey required by
regulation I/6(1)(c), the vessel was found to comply with the
relevant requirements.
|
|
|
|
|
Signed; . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
|
|
|
|
|
|
(Signature of authorized official)
|
|
|
|
|
Place: . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . .
|
|
|
|
|
Date: . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
|
|
(Seal or stamp of the authority, as appropriate)
|