■ 해상교통안전법 시행규칙 [별지 제28호서식]

외국선박 통제점검보고서

REPORT OF INSPECTION IN ACCORDANCE WITH THE MEMORANDUM OF

UNDERSTANDING ON PORT STATE CONTROL IN THE ASIA-PACIFIC REGION1)

FORM A

(reporting authority) MINISTRY OF OCEANS AND FISHERIES	copy to: master

REPUBLIC OF KOREA

head office

(address)                                                                  PSCO

(telephone)                                                                 if ship is detained, copy to:

(telefax)                       flag State                       (e-mail address)

IMO

recognized organization, if applicable

1   name of reporting authority  REPUBLIC OF KOREA             2 name of ship

3   flag of ship                             4  type of ship                       5 call sign

6   IMO number                            7  gross tonnage                     8 deadweight(where applicable)

9   year of build                           10 date of inspection                  11 place of inspection

12  classification society	13 date of release from detention2)

14  particulars of company

15 name and signature of master to certify that the information under 14 is correct:

name                                                   signature

16 details of ship certificates

a title	b issuing authority           c date of issue and expiry

1

2

3

4

5

6

7

8

9

10

11

d information on last intermediate or annual survey

date	surveying authority	place

1

2

3

4

5

6

7

8

9

10

11

17 deficiencies	[  ] no	[  ] yes (see attached FORM B)

18 ship detained	[  ] no	[  ] yes 3)

19 supporting documentation	[  ] no	[  ] yes (see annex)

issuing office           name

(duly authorized PSCO of reporting authority)

telephone

telefax                          signature

This report must be retained on board for period of two years and must be available for consultation by Port State Control Officers at all times,

1) This inspection report has been issued solely for the purpose of informing the master and other port State that an inspection by the port State, mentioned in the heading, has taken place. This inspection report cannot be construed as a seaworthiness certificate in excess of the certificates the ship is required to carry.

2) To be completed in the event of a detention

3) Masters and companies are advised that detailed information on a detention may be subject to future publication.

210mm×297mm[백상지(80g/㎡) 또는 중질지(80g/㎡)]

외국선박 통제점검보고서

REPORT OF INSPECTION IN ACCORDANCE WITH THE MEMORANDUM OF

UNDERSTANDING ON PORT STATE CONTROL IN THE ASIA-PACIFIC REGION

FORM B

(reporting authority) MINISTRY OF OCEANS AND FISHERIES	copy to : master

REPUBLIC OF KOREA

head office

(address)                                                                  PSCO

(telephone)                                                                 if ship is detained, copy to:

(telefax)                       flag State                       (e-mail address)

IMO

recognized organization, if applicable

2 name of ship	6 IMO number

10 date of inspection	11 place of inspection

20 number  21 code          nature of deficiency 4)	convention     22 action  23 responsible

reference5)       taken6)       RO 5)

name

(duly authorized PSCO of reporting authority)

signature

4) This inspection was not a full survey and deficiencies listed may not be exhaustive. In the event of a detention, it is recommended that full survey is carried out and all deficiencies are rectified before an application for re-inspection is made.

5) To be completed in the event of a detention.

6) Applicable Deficiency Action Codes(see reverse side of copy) to be entered.

※ If the owner of a ship objects to the detention of a vessel, he will have a right of appeal against a detention within 90 days from date of detention.

codes for action taken

Deficiency action code                                         PSC  inspection action code (tick as applicable)

10	deficiency rectified	26        competent security authority informed	[  ]

15	rectify deficiency at next port	27        ship expelled on security grounds	[  ]

16	rectify deficiency within 14days	40        next port informed	[  ]

17	rectify deficiency before departure	45	rectify detainable deficiencies at next port	[  ]

18	rectify conformity within 3 months	50	flag Sate/consul informed	[  ]

30	detainable deficiency	55	flag State consulted	[  ]

99	other (specify in clear text)                      70	classification society informed	[  ]

85	investigation of contravention of discharge provisions(MARPOL)   [  ]