■ 해사안전법 시행규칙 [별지 제25호서식] <개정 2015.12.17.>
외국선박 통제점검보고서	FORM A
REPORT OF INSPECTION IN ACCORDANCE WITH THE MEMORANDUM OF UNDERSTANDING ON PORT STATE CONTROL IN THE ASIA-PACIFIC REGION1)
(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 12 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	FORM B
REPORT OF INSPECTION IN ACCORDANCE WITH THE MEMORANDUM OF UNDERSTANDING ON PORT STATE CONTROL IN THE ASIA-PACIFIC REGION
(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 reco㎜ended 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) □
210mm×297mm[백상지(80g/㎡) 또는 중질지(80g/㎡)]