A
|
SHIP’S NAME
|
|
|
|
|
FLAG
|
|
|
|
|
CALL SIGN
|
|
|
|
|
IMO NO
|
|
|
|
|
MMSI NO
|
|
|
|
B
|
DATE AND TIME (UTC)
|
|
|
|
C
|
REPORTING POSITION (LAT/LONG)
|
|
|
|
F
|
CONTINUOUS MANOEUVRING SPEED (in knots including decimals)
|
|
|
|
G
|
PORT OF DEPARTURE
|
|
|
|
H
|
DATE, TIME AND POINT OF ENTRY INTO VTS AREA (UTC)
|
|
|
|
I
|
PORT OF DESTINATION
|
|
|
|
J
|
REQUEST PILOT (YES/NO)
|
|
|
|
|
ISTANBUL STRAIT
|
|
|
|
|
MARMARA SEAİ
|
|
|
|
|
ÇANAKKALE STRAIT
|
|
|
|
O
|
FORWARD AND AFT DRAFT, MAX AIR DRAFT (AT THE ENRTRANCE)
|
|
|
|
|
AZAMİ HAVA ÇEKİMİ (BOĞAZ GİRİŞİNDE)
|
|
|
|
P
|
CARGO (TYPE AND QUANTITY)
|
|
|
|
Q
|
DEFECTS/DAMAGE/DEFICIENCIES/OTHER LIMITATING REASONS
|
|
|
|
R
|
DESCRIPTION OF DANGEROUS, NUCLEER AND POLLUTANT GOODS
|
|
|
|
|
( UN NO / NAME / CLASS / QUANTITY )
|
|
|
|
T
|
SHIP’S AGENT/REPRESANTATIVE TAX NO
|
MARDAŞ MARMARA DNZ.İŞLT.A.Ş.
|
|
|
ULAŞTIRMA VD. 6120049788
|
|
U
|
SHIP TYPE
|
|
|
|
|
LOA / BEAM (METRES)
|
|
|
|
|
GRT/NRT
|
|
|
|
X
|
P&I INFORMATIOM
|
|
|
|
|
P&I CLUB NAME
|
|
|
|
|
|
|
|
|
|
POLICY NUMBER
|
|
|
|
|
VALIDITY
|
|
|
|
(X)
|
DETAILED INFORMATION FROM THE SHIP RELATED WITH HER CARGO
MAY BE REQUESTED FOR SAFETY CONSIDERATIONS.
|
|
|
|
(X)
|
BUNKER DETAILS ( IFO, MGO, LUBRICAN ) ON BOARD
|
|
|
|
(X)
|
CREW NUMBER ON BOARD
|
|
|
|
(X)
|
LST PSC EXPIRE DATE AND ISSUED PLACE
|
|
|
|