Page 286 - Rules of Navigation2020

APPENDIX NO. 1
SHIPS SAFETY DECLARATION
DECLARATI ON “I ”
VESSELS CARRYI NG DANGEROUS CARGOES
(Packaged / Bulk Dangerous Cargoes)

I, the undersigned, ………………………………………………………...

Master of M/V ………………………………………………………...

Owned by ………………………………………………………...
(1)
carrying dangerous cargoes …………………………………………….
as shown on list herewith, enclosed and established according to Suez Canal

Rules of Navigation for vessels carrying dangerous cargo, do hereby declare and

certify, on behalf of the owners, as follows:

(2)
(1) The vessel is specially classed for the carriage of ………………….
(3)
and Classed …………………………………………………………
(2) The vessel’s safety equipment and radio telegraphy were inspected under

(4)
the authority of . . . . . . . . . . . . . . . . . . , and are in good working conditions.
(5)
(3) The cargo has been packed, stowed and segregated in accordance with
IMDG code, and has not been disturbed.

(4) The vessel (has been/has not been) rendered gas free or free from explosive

gases .
(6)
Place and Date: .………………….

Master’s Signature: .………………

1 ) State the type of cargoes, packaged or bulk.
2 ) State the kind of cargoes according to IMO codes.
3 ) State in which of the IACS societies the vessel is classed and still under supervision.
4 ) Inspector, Port Authority officials, etc., as the case may be.
5 ) Only for packaged dangerous goods.
6 ) Only for ballast tanker which carried Grade A or Grade B petroleum or liquefied inflammable gases in bulk.

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