RECORD OF SAFETY RADIO EQUIPMENT FOR GMDSS …CE%DE%CF%DF%B5%E7%C9%… · for ships required to fully comply with the GMDSS requirements. ... tools , test 16.4 Capability at Sea Electronic

RECORD OF SAFETY RADIO EQUIPMENT

FOR GMDSS SHIPS CARGO SHIP / PASSENGER SHIP (1)

Under the provisions of the International Convention for the Safety of Life at Sea, 1974, as amended, for ships required to fully comply with the GMDSS requirements.

(This form must be kept on board and be available for inspection by a nominated Surveyor at all times)

Name of Ship Port of Registry Gross

Tonnage Date Keel

Laid IMO Number

Distinctive number or letters: ID for DSC (VHF):

Selcall No. for NBDP: ID for DSC (MF/HF):

1st ID for INMARSAT – A/B: ID for DSC (MF):

2ndID for INMARSAT – A/B: 1st ID for INMARSAT – C:

ID for Satellite EPIRB: 2nd ID for INMARSAT – C:

Sea area in which vessel is certified to operate:

A1 A1 + A2 A1 + A2 + A3 A1 + A2 + A3 + A4

Maintenance Requirements (check all that apply):

Duplication of equipment Shore-based maintenance At-sea maintenance

This form has been completed by a Radio Technician belonging to a Society or approved as subcontractor by UMB The information contained in this record is a correct description of the Safety Radio Equipment on board. Date: Date: Port and country of issuance: Port and country of survey:

UMB Surveyor No.: Name and Signature of Radio Technician: Surveyor’s Name and Signature: Company:

(1) Delete as Appropriate

Form: GMDSS / RECORD Page: 1 / 12

1. GENERAL REQUIREMENT FOR RADIO INSTALLATION (IV/6) Yes No NA

1.1 Are all radio controls for operating the radio installation adequately illuminated?

1.2 Are the vessel’s call sign, ship station identity, and other codes, as applicable, for use of the Radio station posted?

1.3 Is the radio installation(s) protected from adverse environmental conditions?

1.4 Is the radio installation(s) so located that no harmful interference affects its use and so located to ensure the greatest possibility of operational availability

1.5 Are radio logs and the latest edition of radio regulations provided?

1.6 Are spare parts and tools available?

1.7 For “at sea maintenance”, are additional technical documentation, tools, measuring equipment & spare parts available?

1.8 Facilities for bridge wings communications:

1.9 Is the antenna fitted as high as possible, sufficiently separated from other antennas, and fitted in such a position that no obstacles significantly degrade its performance

1.10 In the case of INMARSAT-A or other tracking antenna, is there a means for ensuring continuous supply of ship’s heading information?

2. MAIN SOURCE OF ELECTRICAL POWER (IV/13.1)

Voltage (in V) Capacity (in KVA) Sets (Quantity) 1.

2.

3. RESERVE SOURCE OF ENERGY (battery type) (IV/13.2)

Make and Type Voltage (V)

Capacity (in Ah) Location

3.1 Operating hours:

1 hour or YES NO NA

6 hours YES NO NA


3.2 Equipment operated by reserve source of energy: Yes NO NA

Electrical lighting of radio control

VHF radio installation of primary

VHF radio installation of duplicated MF radio installation

MF/HF radio installation of primary MF/HF radio installation of duplicated

INMARSAT SES of primary INMARSAT SES of duplicated

3.3 Battery charger: Make and type:

Automatic Manual

Full charge current: (Ah)

4. EMERGENCY SOURCE OF ELECTRICAL POWER (IV/13.1 and II-1/42,43)

Source Voltage (V) Capacity (KVA) Sets (Quantity) Location Generator

Battery (*)

(*)Reference is made to regulations II – 1/42.3.2 and 43.3.2 if the emergency source is an accumulator battery (Do not confuse this item with the reserve source of energy in item 3 of this record.) Equipment operated by emergency source of electrical power for: 36 hours 18 hours (**) (**)Cross as appropriate (36 hours for passenger ships, 18 hours for cargo ships)

Yes NO NA

4.1 VHF radio installation of primary

VHF radio installation of duplicated

4.2 MF radio installation

4.3 MF/HF radio installation of primary

MF/HF radio installation of duplicated

4.4 INMARSAT SES of primary

INMARSAT SES of duplicated


5. COMPOSITION OF RADIO INSTALLATION (check off all boxes that apply) (IV/8, 9,10, 11 & 15)

5.1 Primary system

VHF MF MF/HF INMARSAT SES

5.2 Duplicated system

VHF MF/HF INMARSAT SES

5.3 Secondary means of alerting (IV/8.1, 9.1.3, 10.1.4, 10.2.3)

VHF (DSC) MF (DSC) HF (DSC) INMARSAT –A/B

INMARSAT-C VHF EPIRB 496 mHz EPIRB INMARSAT EPIRB

6. RADIO EQUIPMENT PRIMARY AND DUPLICATED SYSTEM (IV/7, 8, 9, 10 & 11).

6.1 VHF radio installation (IV/7.1)

Transceiver

Make and type Output power (w) Channels Approved by 1

2

Initiation of DSC distress alert transmission on channel 70 from normal navigation position

YES

NO

6.1.1 VHF DSC CONTROLLER:

combined with VHF radio installation or separated from VHF radio installation and Separated VHF DSC controller (encoder):

Make and type Approved by Location

1

2

6.1.2 VHF DSC WATCH RECEIVER:

combined with VHF radio installation or separated from VHF radio installation and Separated VHF DSC watch receiver on channel 70:


1

2

6.2 MF RADIO INSTALLATION (IV/9.1, 10.2) YES NO Transceiver

Make and type Frequency range (KHz) Location Approved by 1

2

Initiation of DSC distress alert transmission on 2187.5 kHz at normal navigation position YES NO


6.2.1 MF DSC FUNCTION:

combined with VHF radio installation or separated from VHF radio installation and Separated MF DSC terminal (encoder):


1

2

6.2.2 MF DSC WATCH RECEIVER:

combined with MF radio installation or separated from MF radio installation and Separated MF DSC watch receiver on 2187.5 kHz:


1

2

6.3 MF/HF RADIO INSTALLATION (IV/10.2.1) YES NO NA

Make and type Frequency range (KHz) Output power (W) Location 1

2

Initiation of DSC distress alert transmission from normal navigation position (IV/9.2) YES NO

6.3.1 MF/HF DSC FUNCTION

combined with MF/HF radio installation or separated from MF/HF radio installation and Separated MF/HF DSC terminal (encoder):


1

2

6.3.2 MF/HF DSC WATCH RECEIVER

combined with MF/HF radio installation or separated from MF/HF radio installation and Separated MF/HF DSC watch receiver:


1

2


6.3.3 DIRECT PRINTING TELEGRAPHY

combined with MF/HF radio installation or separated from MF/HF radio installation and Separated direct printing telegraphy:


1

2

6.4 INMARSAT SHIP EARTH STATION (SES) (IV/10.1.1) YES NO NA

Make and type Standard (A, B, C, etc.) Approved by Location

1

2

Initiation of distress alerts transmission from normal navigation position YES NO

7. FACILITIES FOR RECEPTION OF MARITIME SAFETY INFORMATION (M.S.I)

7.1 NAVTEX RECEIVER (IV 17.1.4)

Make and type Approved by Location 1

2

7.2 INMARSAT EGC (ENHANCED GROUP CALLING) RECEIVER / DECODER (IV / 7.1.5)

YES

NO

NA

combined with INMARSAT SES or separated from INMARSAT SES and Separated EGC receiver / decoder:


2

7.3 HF NARROW BAND DIRECT PRINTING (NBDP) (IV/7.1.5) YES NO NA (for ships engaged exclusively on voyages where HF MSI service is provided):

combined with MF/HF radio installation or separated from MF/HF radio installation and Separated HF NBDP:


2


8 SATELLITE EPIRB – FLOAT FREE (IV/7.1.6) YES NO NA

VHF EPIRB COSPAS-SARSAT (406 MHz)(*) INMARSAT (1.6 GHz)


2

Type of release sensor: (*) Satellite EPIRB Operating on 406 MHz, if installed on or after 4 November 1994, shall be provided with the 121.5 MHz homing beacon.

8.1 VHF EPIRB FOR DSC CHANNEL 70 AND LOCATING BY SART (IV/8.3) (IN LIEU OF THE SATELLITE EPIRB)


9 9 GHz RADAR TRANSPONDER (III/6.2.2, IV/7.1.3)

RADAR TRANSPONDER (Two (2) sets for every passenger ship and on every cargo ship of 500 GT and upwards; for cargo ships of 300 GT and upwards but less than 500 GT one (1) set only)


2

One (1) of these Radar transponders is the radar transponder required by

Regulation IV/7.1.3 ? YES

NO

NA

10 TWO-WAY VHF RADIOTELEPHONE APPARATUS (III/6.2.1) YES NO NA (Three (3) sets for every passenger ship and on every cargo ship of 500 GT and upwards; for cargo ships of 300 GT

and upwards but less than 500 GT two (2) sets only)

Make and type Channels Power Supply Location 1

2

3

Comply with performance standards of the Organization? YES NO NA

If rechargeable batteries are used and a charging arrangement available? YES NO NA


11 RADIO DIRECTION – FINDING APPARATUS (V/12(p)) YES NO NA

Make and type Frequency range Approved by Location

1

12 RADIOTELEPHONE DISTRESS FREQUENCY WATCH YES NO NA RECEIVER ON 2182 KHz (IV/7.2)

Make and type Location

1

13 RADIOTELEPHONE ALARM SIGNAL GENERATOR YES NO NA ON 2182 KHz (IV/7.3)

Make and type Location 1

14 RADAR (V/12 (g)(h))

Make and type Power supply Size of display (mm) Approved by

1

2

1. Describe facilities for plotting:

2. State which radar operates on 9gHz:

15. AUTOMATIC RADAR PLOTTING AID (ARPA) (V/12(J))

Make and type Connection Power supply Approved by

Separate

1 To Radar No.1

To Radar No.2


16 MAINTENANCE REQUIREMENTS

ITEM (SOLAS REG)

MAKER, TYPE AND LOCATION

16.1

Availability of Equipment ensure by using methods (IV / 15.6 and 15.7). In sea areas A1 and A2 at least one (1) method; in sea areas A3 and A4 at least two (2) methods. Refer Resolution A.702(17) concerning radio maintenance guidelines for the global maritime distress and safety system related to sea areas A3 and A4.

16.2 Duplication of Equipment:

Maker: Type:

16.2.1 Duplicated VHF Radio Installation (IV 7.1)

Location:

Maker: 16.2.2 Duplicated VHF DSC Encoder Type: Location:

Maker: Type:

16.2.3 Duplicated MF/HF Radio Installation (IV/10.2.1)

Location:

Maker: Type:

16.2.4 Duplicated INMARSAT Ship Earth Station (SES) (IV, 10.1.1)

Location:

COPY OF CONTRACT ATTACHED…………… NAME OF CONTRACTOR:

16.3.5 Shore-Based Maintenance

DATE OF ISSUE:

NAME OF MAINTAINER: CERTIFICATE No: DATE OF ISSUE: Issued By: Additional technician documents, tools , test

16.4 Capability at Sea Electronic Maintenance

Equipment and spare parts………………

16.5 Equipment is readily accessible (Reg. IV/15.2)……………………………….

16.6 Adequate information provided (Reg. IV/15.3)……………………………….

16.7 Adequate tools and spare are provided (Reg. IV/15.4)………………………..


17

RADIO PERSONNEL (REG.IV/16) AND ITU RR ART.56).

1. Name: Type and No. of Certificate: Rank: Issue By: Date of Issue:




18 DOCUMENTS AND CODE OF SIGNAL (REG.IV/17)

18.1 Radio License is issued by the Administration (ITU RR Art.24

18.2 Radio Log is provided and properly maintained (ITU RR App. II)

18.3 Alphabetical List of Call signs of Coast, Coast Earth; ship and Ship Earth Station, etc

18.4(*) List of Coast Stations and Coast Earth Station

18.5(*) List or Radio Determinations and Special Service Stations

18.6(*) List of Ship Stations

18.7(*) Manual for Use by the Maritime Mobile and Maritime Mobile Satellite Services

18.8 International Code of Signals

18.9 Operation Manuals for all equipment (IV/15)

18.10 Manual for all equipment when at sea maintenance is the declared option (IV/15)

(*) Ship engaged exclusively on voyages within Sea Area A1 may not carry 18.4, 18.5, 18.6, 18.7.


19. SPECIAL MEASURES FOR PASSENGER SHIPS (IV/6 & IV/7)

(Applicable at the first periodical survey after 1 July 1997) YES NO NA

19.1 Distress panel installed at conning position comprising:

1. single button to initiate the distress alert: (IV/6.4)

2. ship’s position continuously and automatically provided to the radio equipment used in initial alert distress: (IV/6.5)

19.2 Distress alarm panel installed at conning position showing visual and aural indications of alerts received on board: (IV/6.6)

19.3 Means for two-way on-scene radio communications for search and rescue purposes using the aeronautical frequencies 121.5 MHz and 123.1 MHz from

the position from which the ship is normally navigated: (IV/7.5)

20. ADDITIONAL EQUIPMENT OF RADIO FACILITIES Radio life-saving appliances and ship borne navigational equipment (e.g. GPS,etc.):

EQUIPMENT MANUFACTURER TYPE / SERIAL No. LOCATION

21 EXEMPTION FROM VHF DSC (IV/9.4, 10.4 & 11.2) 21.1 Other Radio Exemptions

22 Particular or Any Special Features or Additional Information


23 RENEWAL, ALTERATIONS AND/OR ADDITIONAL EFFECT OF EQUIPMENT SINCE THE RECORD WAS PREPARED.

ITEM No.

DESCRIPTION

DATE

THIS IS TO CERTIFY THAT : This Record is correct in all respects.

Issued at:

(Place of the issue of the Record)

Date of issue Name and signature of duly authorized official issuing the Record

By:


Form: CSSR/GMDSS/SR Page 1 of 8

SURVEY REPORT OF SAFETY RADIO EQUIPMENT

FOR GMDSS SHIPS CARGO SHIP / PASSENGER SHIP (1)

Under the provisions of the International Convention for the Safety of Life at Sea, 1974, as amended, (For ships required to fully comply with the GMDSS requirements.)

Initial Survey Periodical Survey (Annual) Renewal Survey Additional Survey (occasional)

Name of Ship

Distinctive Number or

Letters

Port of Registry

Gross Tonnage

IMO number

Type of Ship Radio License (Number and Expiry date)

Date on which keel was laid or ship was at a similar stage of construction or, where applicable, alteration or modification of a major character was commenced

Owner / Operators:

Date of Survey / commenced:

completed:

Place of Survey:

Name of Surveyor:

This vessel has been approved to sail within the Sea Area (Reg. IV/2.1.12, 2.1.13, 2.1.14, 2.1.15)

A1 A1+A2 A1+A2+A3 A1+A2+A3+A4

Note: Mark in box Fit or Yes - Unfit or No N/A Not Applicable

A. DOCUMENTATION

A.1 Valid radio license (copy to be attached)……………………………………………………...

A.2 Radio operator’s certificates of competence with endorsement (copy to be attached)………..

A.3 Radio Records (Radio Log) Available on Board ……………………………………………..

A.4 The latest edition of the ITU Publications is provided and updated ………………………….

A.5 International Code of Signals.. ……………………………………………………………..…

A.6 Operating Manual for all radio equipments ………………………………………….………..


(1) Delete as Appropriate B. GENERAL PROVISIONS FOR RADIO INSTALLATION

B.1 Adequate for approved sea area ………………………………………………………………

B.2 Two separated and independent means of ship-to-shore distress alerts ………………………

B.3 Adecuate location ....…………………………………………………………………………..

B.4 Protected against adverse environmental conditions ……………...…………………………..

B.5 Provided with electrical lighting ………………………………………………………………

B.6 Clearly marked with: call sign, ship station identity and other codes as applicable for use of the Radio Installation ………………………………………………………………………

B.7 Visual Checking of all antennas (insulation and safety) ……………………………………...

B.8 Examining the reserve source of energy ………………………………………………………

B.9 The charger (s) are capable of recharging the reserve battery within 10 hours ……………….

C. VHF Radio Installation (IV/6)

C.1 Checking for operation on channels 6,13 & 16 ….…………………………………………....

C.2 Checking frequency tolerance, transmission line quality and radio-frequency power output ..

C.3 Checking for correct operation of all controls…………………………………………………

C.4 Main, emergency (if provided) and reserve sources of energy ……………………………….

C.5 Operation of the VHF control unit (s) or portable VHF equipment provided for navigational safety ………………………………………………………………………………………….

C.6 Correct operation by on-air contact with a Coast Station or other ship ………………………

C.7 Examining the VHF DSC controller and channel 70 DSC watch receiver …………………

D. RADAR TRANSPONDER (III/6.2.2; IV/7.1.3 & 14).

D.1 Position and mounting ………………………… ….………………………………………….

D.2 Monitoring response on ship’s 9 GHz Radar …………………………………………………

D.3 Checking the battery ……………………….………………………………………………….

D.4 Expiry date of battery:


E. TWO-WAY VHF RADIOTELEPHONE APPARATUS (III/6.2.1 & IV/14).

E.1 Correct operation on channel 16 and one other channel …………….…………………….…..

E.2 Battery charging arrangements (where rechargeable batteries are used) ..……………………

E.3 Expiry date of primary batteries:

E.4 Where appropriate, checking any fixed installation provided in a survival craft ………...…..

F. NAVTEX EQUIPMENT (IV/7 & 14)

F.1 Correct operation by monitoring incoming messages or inspecting recent hard copy ………..

F.2 Running the self-test programmed (if provided) …………………………...………………….

G. INMARSAT EGC RECEIVER (ENHANCED GROUP CALLING) (IV 7.1.5 & 14)

G.1 Correct operation and area by monitoring incoming messages or by inspecting recent hard copy ……..

G.2 Running the self-test programmed (if provided) …...……………………...………………….

H. 406 MHZ SATELLITE EPIRB (COSPAS-SARSAT) (IV/7 & 14)

H.1 Position and mounting for float-free operation ..….…………………………………………..

H.2 Carrying out visual inspection for defects…………………………………………………….

H.3 Carrying out the self-test routine ……………..……………………………………………….

H.4 Checking that the EPIRB ID is clearly marked on the outside of the equipment …………….

H.5 EPIRB ID No.

H .6 Expiry date of Battery:

H.7 Expiry date of hydrostatic release (if provided)


I. INMARSAT 1.6 GHZ SATELLITE EPIRB (IV/7 & 14)

I.1 Position and mounting for float-free operation ..….…………………………………………..

I.2 Carrying out visual inspection for defects…………………………………………………….

I.3 Carrying out the self-test routine ……………..……………………………………………….

I.4 Checking that the EPIRB ID is clearly marked on the outside of the equipment …………..…

I.5 EPIRB ID No.

I .6 Expiry date of Battery:

I.7 Expiry date of:

hydrostatic release (if provided) J. 2182 KHZ RADIOTELEPHONE DISTRESS FREQUENCY WATCH RECEIVER (IV/7.2 & 14)

J.1 Checking the mute / demute function ……………………………….………………………..

J.2 Receiver sensitivity against known stations ………....……………………………………….

J.3 Audibility of the loudspeaker …………..……………………………………………………. K. 2182 KHZ RADIOTELEPHONE ALARM SIGNAL GENERATOR (IV 7.3 & 14)

K.1 Correct operation of the radiotelephone alarm-signal-generating device …….……………..

L. VHF EPIRB (IV/8 & 14)

L.1 Position and mounting for float-free operation ..….…………………………………

L.2 Carrying out visual inspection for defects………………………………………………

L.3 Carrying out the self-test routine ……………..…………………………………….

L.4 Checking that the EPIRB ID is clearly marked on the outside of the equipment ………

L.5 VHF EPIRB ID No.

L .6 Expiry date of Battery:

L.7 Expiry date of: hydrostatic release (if provided)


M. MF RADIO INSTALLATION (IV/9.1, 10.2)

M.1 Checking that the equipment operates from the main, emergency (if provided) and reserve sources of energy ……………………………..……………………………………………...

M.2 Checking the off-air self-test programme ..…….……………………………………………..

M.3 Confirming that only distress and safety DSC frequencies are being monitoring …..…...…..

M.4 Correct operation by means of a test call from a Coast Station or other ship or inspecting recent hard copy ……………………………………………………………………………...

N. MF / HF RADIO INSTALLATION (IV/10.2.1)

N.1 Checking that the equipment operates from the main, emergency (if provided) and reserve sources of energy …………………..…………………………………………….……….….

N.2 Checking the antenna tuning in all appropriate bands …………………………..………….

N.3 The equipment is within frequency tolerance on all appropriate bands ……………..……….

N.4 Correct operation by contact with a Coast Station and / or measuring transmission line quality and radio frequency output …………………………………………………………..

N.5 Receiver performance by monitoring known station on all appropriate bands …………….

N.6 Correct operation of the Radiotelephone alarm-signal-generating device on a frequency other than 2182 KHz ………………………………………………………………………...

N.7 Correct Maritime Mobile Service identity is programmed in the equipment………………

N.8 Checking the off-air self-test programme ………………………………………………….

N.9 Operation by means of a test call on MF and /or HF to a Coast Radio Station if the rules of the berth permit the use of MF/HF transmissions …………………………………………….

N.10 Checking the audibility of the MF/HF DSC alarm ………………………………………….

N.11 Confirming that only distress and safety DSC frequencies are being monitored …………...

N.12 Checking that a continuous watch is being maintained whilst keying MF/HF radio transmitters …………………………………………………………………………………..

N.13 Correct operation by means of a test call from a coast station or other ship ………………


O HF DIRECT – PRINTING TELEGRAPHY (N.B.D.P.) (IV/10 & 11)

O.1 Checking that the equipment operates from the main, emergency (if provided) and reserve sources of energy …………………..…………………………………………….……….….

O.2 Confirming that the correct selective calling number is programmed in the equipment…….

O.3 Correct operation by inspection of recent hard copy or by a test with a Coast Radio Station.

O.4 Correct operation by monitoring incoming messages or inspecting recent hard copy ………

O.5 Running the self-test programme if provided ………………………………….…………….

P. INMARSAT SHIP EARTH STATION (S.E.S.) (IV/10)

P.1 Checking that the equipment operates from the main, emergency (if provided) and reserve sources of energy …………………..…………………………………………….……….….

P.2 Checking distress function by means of an approved test procedure where possible….…….

P.3 Correct operation by inspection of recent hard copy or by test call …………………………

Q. MAINTENANCE REQUIREMENT (IV/15)

Q.1 Duplication of Equipment

Q.1.1 VHF Radio installation …………………………………………………………..…..

Q.1.2 VHF DSC Encoder …………………………………………………………………..

Q.1.3 MF/HF Radio installation ……………………………………………………………

Q.1.4 INMARSAT ship earth station (S.E.S.) ……………………………………………..

Q.2 Shore-Based maintenance

Q.2.1 Copy of contract …..…………………………………………………………..…..

Q.2.2 Expiry date of contract:

Q.3 At sea Electronic Maintenance

Q.3.1 Copy of the Certificate ………………………………………………………………

Q.3.2 Additional technical documents, tools, test equipment and spare parts ……………..


R. SPECIAL MEASURES FOR PASSENGER SHIPS (IV/6 & 7): NOTE: (Applicable to passenger ships at the first periodical (annual) survey after 1 July 1997)

R.1 Distress panel installed at conning position comprising:

R.1.1 Single button to initiate the distress alert (IV/6.4) .……………………………..…..

R.1.2 Ship’s position continuously and automatically provided to the radio equipment for the use in initial alert distress (IV/6.5) …………………………………………………

R.2 Distress alarm panel installed at conning position showing visual and aural indications of alerts received on board (IV/6.6) …………………………………………………………….

R.3 Means for two-way on-scene radio communications for search and rescue purposes using the aeronautical frequencies (121.5 MHz and 123.1 MHz) from the position from which the ship is normally navigated (IV/ 7.5) ………….………………………………………………

S. EXEMPTIONS

S.1 Exemption from VHF DSC, Regulations IV/9.4, 10.4 & 11.2 ………………………….…

S.2 Other radio exemptions ……………………………………………………………………… T. REPORT WITH DETAILED INFORMATION ABOUT EQUIPMENT OF RADIO FACILITIES

REGARDING:

T.1 Repairs and / or changes ……………………………………………………………………..

T.2 Outstanding items to complete the survey ..…………………………………………………


U. DEFICIENCIES, REQUIREMENTS, REMARKS, RECOMMENDATIONS:

V. FINAL RECOMMENDATION:

It is recommended that:

V.1 A Full Term Cargo Ship Safety Radio Certificate / Passenger Ship Safety Certificate (1) may be issued

valid for a period of twelve (12) months / five (5) years. (1) ………………………………………….

V.2 No Full Term Cargo Ship Safety Radio Certificate / Passenger Ship Safety Certificate (1) to be issued

until the survey is completed. …………………………………………………………………………..

V.3 The Existing Cargo Ship Safety Radio Certificate No. has been endorsed at:

the , of of (Place of issue of endorsement) (Day) (Month) (Year)

V.4 I have issued the Interim Cargo Ship Safety Radio Certificate / Passenger Ship Safety Certificate (1)

No

at:

the

, of

of

(Place of issue of Interim CSSR) (day) (month) (year)

Valid until , of of - (day) (month) (year)

THIS IS TO CERTIFY THAT: This survey report is correct in all respects.

Witnessed by: Name and Signature of Radio Technician:

Surveyor to : Name and Signature of duly authorized official

issuing the survey report.

Port: Port:

Date: Date:

(1) Delete as Appropriate

Documents

RECORD OF SAFETY RADIO EQUIPMENT FOR GMDSS …CE%DE%CF%DF%B5%E7%C9%… · for ships required to fully comply with the GMDSS requirements. ... tools , test 16.4 Capability at Sea Electronic