FORM S/2
Clasification Society 2024 - Version 9.40
Statutory Documents - IMO Publications and Documents - Resolutions - Marine Environment Protection Committee - Resolution MEPC.357(78) - 2022 Guidelines for Inspection of Anti-Fouling Systems on Ships - (adopted on 10 June 2022) - Annex - 2022 Guidelines for Inspection of Anti-Fouling Systems on Ships - Appendix 1 - Sampling - FORM S/2

FORM S/2

RECORD SHEET FOR THE SAMPLING PROCEDURE FOR COMPLIANCE WITH THE CONVENTION IN TERMS OF THE PRESENCE OF ORGANOTIN AND/OR CYBUTRYNE ACTING AS A BIOCIDE IN ANTI-FOULING SYSTEMS ON SHIP HULLS
     
  RECORD NUMBER     (country-code / IMO number / dd-mm-yy)
                   
Name of ship _______________________________   IMO number : ___________________________________  
                   
SAMPLING PARTICULARS
1. Date & time initiated:     2. Date & time completed      
3. Name of paint manufacturer:                
4. AFS product name & colour:                
5. Reason for sampling:   Port State control     Survey & certification   Other flag State compliance inspection  
6. Sampling method ________________________________________________________________________________________________
7. Hull areas sampled:   Port side     Starboard side   Bottom  
  Number of sampling points: _____________________ ________________________________ __________________________________  
8. Back-up samples' storage location:
(e.g. port State inspection office) 		           
9. Photos taken of the sample points Comments: _____________________________________  
10. Paint samples (wet) Comments: _____________________________________  
11. Case A - Analysis of organotin only    
  First-stage analysis for organotin Comments: _____________________________________  
Second-stage analysis for organotin Comments: _____________________________________  
12. Case B - Analysis of cybutryne only Comments: _____________________________________  
  One-stage analysis for cybutryne ______________________________________________  
13. Case C - Simplified approach to detect organotin and cybutryne ______________________________________________  
  One-stage analysis for organotin and cybutryne ______________________________________________  
14. Comments concerning sampling procedure  
 
                   
15. Sampling company       Name      
            Date      
            Signature      
                   
PORT STATE PARTICULARS
Reporting authority: _________________________________ District office: _______________________________________________________
Address: ___________________________________________________________________________________________________________________________
    ___________________________________________________________________________________________________________________________
Telephone/Fax/ Mobile: ___________________________________________________________________________________________________________________________
E-mail: ___________________________________________________________________________________________________________________________
Name:
(duly authorized inspector of reporting authority) 		___________________________________________________________________________________________________________________________
Date:   Signature:  
Parent topic: Appendix 1 - Sampling
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