Ares Gemi letmecilii A..

FORM MANUAL

Issue Date
Revision No
Revision Date
Issued by
Approved by

: 01.01.2010
: 01
: 31.12.2012
: DPA
: General Manager

SHIP / SHORE SAFETY CHECK LIST

GEM / SAHL EMNYET KONTROL LSTES
Ships name
Geminin ad

: M/T ZEUGMAN

Berth

Port
:....................................................... Liman

Rhtm

Date of arrival
Var tarihi

:.........................................................

Time of arrival
Var saati
: ....../......./.....

: ....../......./.......

INSTRUCTIONS FOR COMPLETION

LSTENN DOLDURULMASI TALMATI
The safety of operations requires that all questions should be answered affirmatively by
clearly ticking () the appropriate box. If an affirmative answer is not possible, the reason
should be given and agreement reached upon appropriate precautions to be taken between
the ship and the terminal. Where any question is considered to be not applicable, then a note
to that effect should be inserted in the remarks column.
Operasyonlarn emniyetli olmalar, ilgili kutularn ak bir ekilde iaretlenerek () btn sorularn olumlu cevap
verilmelerini gerektirir. Eer olumlu cevap mmkn deilse, nedeni belirtilmeli ve gemi ile terminal arasnda
alnacak uygun nlemler konusunda anlamaya varlmaldr. Uygulanmas mmkn olmadklar deerlendirilen
sorular iin de aklamalar stununa not dlmelidir

A box in the columns ship and terminal indicates that checks should be carried out by the
party concerned. If the item concern both parties, they should tick () together.
Kontrol maddesinin ierii, hangi birimin (Gemi ve Terminal) sorumluluu altnda ise, stunu o birim ()
iaretleyecektir. Karlkl sorumluluk hallerinde ise her iki taraf da stunu iaretleyeceklerdir.

The presence of the letters A, P or R in the column Code indicates the following:
Kod stunundaki A, P ve R harflerinin anlamlar aada aklanmtr.

A (Agreement). This indicates an procedure or agreement that should be identified in the

remarks column of the Check List or communicated in some other mutually acceptable
form. In either case, the signatures of both parties should be required.
Belirlenmi yntem veya anlama, bu kontrol listesinin aklamalar stununda veya dier karlkl
anlalarak kabul edilmi form zerinde belirlenmi olacaktr. Her iki durumda da taraflarca imzalanacaktr.

P (Permission). In the case of negative answer, the operation should not be carried out
without the written permission from the appropriate authority.
Olumsuz cevap halinde, uygun otoritelerin yazl izni olmadan operasyon yaplmayacaktr.

R (Re-check) This Indicates items to be re-checked at appropriate intervals, as agreed

between both parties, at periods stated in the decleration.
Deklerasyonda her iki tarafca anlalan sreyi gemeyecek ekilde uygun aralklarla tekrar kontrol edilecek
maddeleri gsterir.

FORM NO: CCL-04

SHIP SHORE SAFETY CHECK LIST

PAGE 1

Issue Date
Revision No
Revision Date
Issued by
Approved by

Ares Gemi letmecilii A..

FORM MANUAL

: 01.01.2010
: 01
: 31.12.2012
: DPA
: General Manager

Note : Following check list must be filled fully without grey columns for both parties. Not :
Aadaki kontrol listesi gri renkle taranm blgeler hari her iki tarafa tamamen doldurulacaktr.
Part A - Bulk Liquid General Physical Checks

1. There is safe access between the ship and shore.

R
Gemi ile sahil arasnda emniyetli gei var.
2. The ship is securely moored.
R
Gemi emniyetle baland.
3. The agreed ship/shore communication system is operative.
A R
Anlamaya varlan gemi / sahil haberlemesi alyor.
4. Emergency towing-off pennants are correctly rigged
and positioned.
R
Emerg. yedek ekme donanm doru donatld ve yerletirildi.
5. The ships fire hoses and fire-fighting equipment are
positioned and ready for immediate use.
R
Gemideki yangn hortumlar ve yangnla mcadele tehizat
yerlerine kondu ve hemen kullanma hazr.
6. The terminals fire-fighting equipment is positioned and
ready for immediate use.
R
Terminaldeki yangnla mcadele tehizat yerlerine kondu ve
hemen kullanma hazr.
7. The ships cargo & bunker hoses, pipelines and manifolds
are in good condition, properly rigged and appropriate for
the service intended. Geminin yk& yakt hortumlar, devreleri
ve kollar iyi durumda, muntazam ekilde donatld ve yaplacak
ie uygun.
8. . The terminals cargo & bunker hoses, pipelines & manifolds
are in good condition, properly rigged and appropriate for
the service intended. Teminalin yk& yakt hortumlar,devreleri
ve kollar iyi durumda, muntazam ekilde donatld ve yaplacak
ie uygundur.
9. The cargo transfer system is sufficiently isolated and
drained to allow safe removal of blank flanges prior to
connection. Balant ncesi kr flenlerin emniyetle
sklmesi iin yk devreleri yeterli ekilde izole ve dreyn edildi.
10. Scuppers and save-alls onboard are effectively plugged
and drip trays are in position and empty.
R
Gemideki frengiler ve tant kaplar etkin bir ekilde tapaland
ve damlama tavalar yerlerinde ve bo.
11. Temporarily removed scupper plugs will be constantly
monitored.
R
Geici olarak sklen firengi tapalar srekli kontrol edilecek.
12. Shore spill containment and sumps are correctly managed.
R
Sahil kaak toplama kaplar ve toplamlar doru ynetildi.
13. The ships unused cargo and bunker connections are
properly secured with blank flanges fully bolted.
Geminin kullanlmayan yk ve yakt balantlar kr kapaklarn
tm saplamalar takl olarak uygun ekilde emniyete alnd.
14. The terminals unused cargo and bunker connections are
properly secured with blank flanges fully bolted.
Terminalin kullanlmayan yk ve yakt balantlar kr kapaklarn
tm saplamalar takl olarak uygun ekilde emniyete alnd.
15. All cargo, ballast and bunker tank lids are closed.
Tm yk, ballast ve yakt tank kapaklar kapal.
16. Sea and overboard discharge valves, when not in use, are
closed and visibly secured.
Deniz ve overboard boaltma valfleri kullanlmadklar zaman
kapal ve bal.
17. All external doors, ports & windows in the accommodation,
stores and machinery spaces are closed. Engine room
vents may be open.
R
Yaam mahallinin, maazalarn ve makine blgesinin da
alan tm kap, lumboz ve pencereleri kapaldr. Makine
dairesi havalandrmas ak olabilir.
18. The ships emcy fire control plans are located externally.
FORM NO: CCL-04

SHIP SHORE SAFETY CHECK LIST

Ship

Terminal
Ship
Terminal

Ship

Terminal

Ship

Terminal

Ship

Terminal

Ship

Terminal

Bulk Liquid - General

Code

TIME / ZAMAN
Remarks

System:
Backup system:

Movement Limit of
metal Cgo Arm/s:

Location:
PAGE 2

Issue Date
Revision No
Revision Date
Issued by
Approved by

Ares Gemi letmecilii A..

FORM MANUAL

: 01.01.2010
: 01
: 31.12.2012
: DPA
: General Manager

Gemi emerg. yangn kontrol plan geminin d tarafna kondu.

19. Terminal regulations are provided by the load.master?
Terminal kurallar load master dan alndm?

If the ship is fitted, or is required to be fitted, with an Inert Gas System (IGS) the following points should
be physically checked.
Eer Inert Gaz Sistem (IGS) gemide alyorsa veya almas istenmise aaidaki noktalar fiziksel olarak kontrol edilecektir.

19. Fixed IGS pressure&oxygen content recorders are

working.
Sabit IGS basnc ve oksijen miktar kaydedicileri alyor.
20. All cargo tank atmospheres are at positive pressure with
oxygen content of 8% or less by volume.
Tm tank atmosferleri oksijen seviyeleri hacme gre % 8 veya
altnda olarak pozitif basntadr.

Ship

Terminal
Ship
Terminal

Ship

Terminal

Terminal

Ship

Ship

Terminal

Ship

Inert Gas System

Terminal

Code

TIME / ZAMAN

Remarks

R
P
R

Part B - Bulk Liquid General Verbal Verification

FORM NO: CCL-04

SHIP SHORE SAFETY CHECK LIST

PAGE 3

FORM NO: CCL-04

Ship

Ship

Terminal

Ship

Terminal

Terminal

Ship

Ship

Ship

Ship

Terminal

Ship

Ship

Terminal

A R

Terminal

A R

Remarks

Nominated
smoking rooms:
Ship

37. Naked light regulations are being observed.

Bulk Liquid - General
plak k kullanma ile ilgi kurallar uygulanyor.
38. Ship/shore telephones, mobile phones and pager
are being
observed.
21. requirements
The ship is ready
to move
under its own power.
Gemi/sahil
mobil
ve pager
Gemi kenditelefon,
makineleri
iletelefon
harekete
hazr. kurallarna uyuluyor.
39.
Hand
torches
(flashlights)
are
of
anattendance
approved type.
22. There is an effective deck watch in
on board
El
fenerleri
onaylanm
tipte.of operations on the ship and in
and
adequate
supervision
40. Fixed
VHF/UHF transceivers and AIS equipment are on the
the terminal.
correct
or vardiyas
switchedtutuluyor,
off. Sabitgemi
VHF/UHF
Gemide power
etkili birmode
gverte
ve
telsizler
ve AIS
ekipman doru
gyeterli
modunda
veya
kapaldr.
Terminalde
operasyonlara
ynelik
kontrol
var.
41.
areboard
of anand
approved
23. Portable
There areVHF/UHF
sufficienttransceivers
personnel on
ashoretype.
to deal
Seyyar
telsizler
onayl tiptir.
with anVHF/UHF
emergency.
Emercensi
duruma mdahale edecek
42. The
ships
maingemide
radio transmitter
aerials are earthed and
yeterli
personel
ve sahilde mevcuttur.
radars
switchedfor
off.cargo,
Gemibunker
ana verici
antenleri
24. The
procedures
andradyo
ballast
handling
toprakland,
radarlar kapal.
have been agreed.
43. Electric
cables
toelleleme
portable konusunda
electrical equipment
Yk, yakt,
ballast
anlamaya within
varld.the
area are
disconnected
fromprocedure
power. to be used
25. hazardous
The emergency
signal
and shutdown
Tehlikeli
blgedeki
tanabilir
cihazlarn&kablolar
g
by the ship
and shore
haveelektrikli
been explained
understood.
kaynandan
ayrld.
Gemi ve sahilin
kullanaca emercensi iaret ve kapatma
44. prosedr
Window type
air conditioning
akland
ve anlald.units are disconnected.
klimalarn
balantlar
kartld.
26.Pencere
Materialtipi
Safety
Data Sheets
(MSDS)
for the cargo transfer
45. have
Positive
pressure
is being
maintained
inside the
been
exchanged
where
requested.
accommodation,
and air yaplan
conditioning
which
stenildiinde operasyonu
ykn intakes,
MSDS bilgi
akmay
var.
the entry
of cargowith
vapours,
are closed. in the
27. permit
The hazards
associated
toxic substances
Yaam
iinde positif
cargomahalli
being handled
havebasn
been korunuyor
identified ve
andyk
understood.
buharlarnn
girmesine
klima ilgili
girileri
Ellelenen yk
iindekimsait
zehirli btn
maddelerle
olankapal.
tehlikeler
46. tanmland
Measures have
been taken to ensure sufficient mechanical
ve anlald.
ventilation
in theShore
pumproom.
28. An
International
Fire connection has been provided.
Pompa dairesinde
yeterli mekanik
havalandrmadan
emin olma
Donatlm
bir International
Sahil Yangn
balants mevcuttur.
alnd.
29. tedbirleri
The agreed
tank venting system will be used.
47. There
is provision
for an emergency
escape.
Kararlatrlan
tank havalandrma
sistemi
kullanlacak
Bir emercensi
kafor
imkan
iinoperations
tedbir alndhave
m. been agreed.
30. The
requirements
closed
48. Kapal
The maximum
and swell gerekleri
criteria for
ykleme wind
operasyonunun
iinoperations
anlald. have
agreed. of the P/V system has been verified.
31. been
The operation
Operasyon
maksimum
rzgar ve swell kriteri karalatrld.
P/V valfleriniin
almalar
grld.
49.
protocols
haveline
been
agreed between
the Ship
32. Security
Where a vapour
return
is connected,
operating
Security
Officer
theagreed.
Port Facility
Security
Officer,
parameters
haveand
been
Yk buharlar
iin
dn
if
appropriate.
devresi
bal ise operasyon karakteristiklerinde anlald.
uygunsa,high
SSOlevel
ve PFSO
arasnda
gvenlik
protokolleriand
33.ayet
Independent
alarms,
if fitted,
are operational
yapld.
have been tested.
50. Where
have been
Mevcut appropriate,
ise, bamszprocedures
high level alarmlar
alragreed
ve testfor
edildi.
receiving
nitrogen
supplied
from
shore,
either
for in
inerting
34. Adequate electrical insulating means are in place
the
or
purging ships
tanks, or for line clearing into the ship.
ship/shore
connection.
Kullanlmas
halinde,
gemi
tanklarnn
inertlenmesi,
veya
Gemi/sahil balantsnda uygun elektriksel izolasyon yapld.
purging veya devrelerin gemiye verilmesi iin sahilden verilen
nitrojenin alnmas iin prosedrler kararlatrld.

Code

35. Shore lines are fitted with a non-return valve, or procedures

to avoid back filling have been discussed.
P R
Sahil devreleri geri dndrmez valf ile donatld, veya ykn geri
dnnden saknmak iin prosedr kararlatrld.
36. Smoking rooms have been identified and smoking
A R
TIME / ZAMAN
requirements are being observed.
Sigara ime salonlar
belirlendi ve sgara ime kurallarna uyuluyor.

Terminal

Bulk Liquid - General

Terminal

Code

FORM MANUAL

Terminal
Ship
Terminal

TIME / ZAMAN

: 01.01.2010
: 01
: 31.12.2012
: DPA
: General Manager

Terminal
Ship
Terminal

Issue Date
Revision No
Revision Date
Issued by
Approved by

Ares Gemi letmecilii A..

Remarks

R
A R

R
H2S content:

A R
R
A

Benzene cont:

Method:
Stop cargo at:
Disconn at:
Unberth at:

A
A R
A R
A P
A R

SHIP SHORE SAFETY CHECK LIST

PAGE 4

Issue Date
Revision No
Revision Date
Issued by
Approved by

Ares Gemi letmecilii A..

FORM MANUAL

: 01.01.2010
: 01
: 31.12.2012
: DPA
: General Manager

Ship

Terminal
Ship
Terminal

Ship

Terminal

Ship

Terminal

Ship

Terminal

Ship

Terminal

Inert Gas System

Code

TIME / ZAMAN

Remarks

If the ship is fitted, or is required to be fitted, with an Inert Gas System (IGS) the following statements

Onaylanm Ham Petrolle Ykama (COW) El Kitabnn iinde

olduu ekilde var ncesi Ham Petrolle Ykama Kontrol
Listesi tatminkar bir ekilde dolduruldu.
58. The Crude Oil Check Lists for use before, during and after
COW, as contained in the approved Crude Oil Washing
Manual, are available and being used.
Onaylanm Ham Petrolle Ykama (COW) El Kitabnn iinde
olduu ekilde, Ham Petrolle Ykamadan nce, sresince ve
sonrasnda olarak Ham Petrolle Ykama Kontrol Listeleri var ve
kullanlmaktadr.

P
R
R

Ship

Terminal
Ship
Terminal

Ship

Terminal

Ship

Terminal

Ship

Terminal

Ship

Terminal

R
Code

51. The IGS is fully operational and good working order.

IGS operasyona tamamen hazr ve iyi alr durumda.
52. Deck seals, or equivalent, are in good working order.
Deck Sealler veya e deeri iyi alr durumda.
53. Liquid levels in Pressure/Vacuum breakers are correct.
Basn/vakum krclarnn sv seviyeleri doru.
54. The fixed and portable oxygen analysers have been
calibrated and are working properly.
Sabit ve tanabilir
oksijen
lm cihazlar kalibre edilmi ve tamamen alyorlar.
TIME
/ ZAMAN
55. All the individual tank IG valves (if fitted) are correctly set
and locked. Eer varsa, tm Inert Gaz tank bran valfleri
doru ayarlanm ve kilitlenmi.
56. All persons in charge
of cargo
operations are aware that,
Crude
Oil Washing
in the case of failure of the inert gas plant, discharge
operations should cease and the terminal be advised.
olanWashing
tm ahslar
inertCheck
gaz sisteminde
57.Yk
Theileminden
Pre-Arrivalsorumlu
Crude Oil
(COW)
List, as
bir
arza olmas
durumunda
operasyonunu
contained
in the
approvedboaltma
COW manual,
has been
durduracan
terminale haber vereceini biliyor.
satisfactorilyve
completed.

Remarks

should be addressed:
Eer Inert Gaz Sistem (IGS) gemide alyorsa veya almas istenmise aadaki ifadeler yerine getirilecektir:

If the ship fitted with a crude oil washing (COW) system, and intends to crude oil wash, the following
statements should be addressed:
Eer gemide ham petrolle ykama sistemi varsa ve ham petrolle ykama yaplmas dnlyorsa, aadaki ifadeler yerine

getirilecektir.

If the ship is planning to tank clean alongside, the following statements should be addressed.
Eer gemi iskelede tank temizlii yapmay planlyorsa, aadaki ifadeler yerine getirilecektir.
Tank Cleaning

Ship

Terminal

59. Tank cleaning operations are planned during the ships

stay alongside the shore installation. Geminin sahil tesisi
Yes*/ No*
Yes*/ No*
iskelesinde duruu esnasnda tank temizlii operasyonu
yaplmas planland.
60. If yes, the procedure and approvals for tank cleaning have
been agreed.
Eer evetse, prosedr ve onaylamalar kararlatrld.
61. Permission has been granted for gas freeing operations.
FORM NO: CCL-04
SHIP SHORE SAFETY
CHECK
LIST
Yes*/ No*
Yes*/
No*
Gazfree operasyonu iin izin alnd.

Code

Remarks

PAGE 5

Issue Date
Revision No
Revision Date
Issued by
Approved by

Ares Gemi letmecilii A..

FORM MANUAL

: 01.01.2010
: 01
: 31.12.2012
: DPA
: General Manager

* Delete Yes or No as appropriate

Part C Bulk Liquid Chemicals Verbal Verification

Ship

Terminal
Ship
Terminal

Ship

Terminal

Ship

Terminal

Ship

Terminal

Ship

Terminal

Bulk Liquid - Chemical

Code

TIME / ZAMAN

Remarks

1.Material Safety Data Sheets (MSDS) are available giving the

necessary data for the safe handling of the cargo.
Ykn emniyetle ellelenmesi bilgilerini veren MSDS gemide var.
2.A manufacturers inhibition certificate, where applicable,
Has been provided.
P
Uyguland ise yapmc inhibition certificate temin edildi.
3.Sufficient protective clothing and equipment (including selfcontained breathing apparatus) is ready for immediate use
and is suitable for the product being handled.
Yeterli miktarda koruyucu elbise ve techizat (self- contained
breathing apparatus dahil) acil durum kullanmna hazr ve
ellelenen yke uygundur.
4.Countermeasures against accidental personal contact with
the cargo have been agreed. Kaza ile personelin yke
temaslarna kar nlem tedbirleri kararlatrld.
5.The cargo handling rate is compatible with the automatic
shutdown system, if in use. ayet kullanmda ise, ykn
A
ykleme hz otomatik shutdown sistemi ile uyumludur.
6.Cargo system gauges and alarms are correctly set and in
good order. Yk gey sistemi ve alarmlar alr durumda ve
doru set edildi.
7.Portable vapour detection instruments are readily available
for the products being handled.
Elelenen yk iin seyyar gaz bulma cihazlar kullanma hazr.
8.Information on fire-fighting media and procedures has been
exchanged. Yangnla mucadele aralar ve prosedrleri iin
bilgi alverii yapld.
9.Transfer hoses are of suitable material, resistant to the
action of the products being handled.
Transfer hortumlar ellelenen ykn operasyonuna uygun
malzemeden ve direnlidir.
10.Cargo handling is being performed with the permanent
installed pipeline system. Ykn ellelenmesi sabit olarak
P
monte edilmi devreler ile yaplyor.
11.Where appropriate, procedures have been agreed for
receiving nitrogen supplied from shore, either for inerting
or purging ships tanks, or for line clearing into the ship.
A P
Kullanlmas halinde, gemi tanklarnn inertlenmesi, veya
Purging veya devrelerin gemiye verilmesi iin sahilden verilen
nitrojenin alnmas iin prosedrler kararlatrld.

DECLARATION
DEKLERASYON

We, the undersigned, have checked the above items in Parts A and B parts, and where
appropriate Part C, in accordance with the instructions, and have satisfied ourselves that the
entries we have made are correct to the best of our knowledge.
We have also made arrangements to carry out repetitive checks as necessary and agreed that
those items with the letter R in the Check-List should be re-checked at intervals not
exceeding ___________ hours.
If to our knowledge the status of any items changes, we will immediately inform the other
party.
FORM NO: CCL-04

SHIP SHORE SAFETY CHECK LIST

PAGE 6

Ares Gemi letmecilii A..

FORM MANUAL

Issue Date
Revision No
Revision Date
Issued by
Approved by

: 01.01.2010
: 01
: 31.12.2012
: DPA
: General Manager

Biz aada imzas bulunanlar, uygun olan yerlerde birlikte olarak, yukardaki A ve B blmlerdeki ve
uygulabildiinde C blmndeki maddeleri talimatlara uygun olarak kontrol ettik ki; yaptmz kaytlarn
bilgilerimizin en iyi ekliyle doru olduundan tamamen eminiz.
Biz ayn zamanda gerektiinde takip eden kontroller yapmak zere dzenleme yaptk ve kontrol listesinde R
harfi ile belirtilmi maddelerin _____________ saati gemeyen aralklarla tekrar kontrol edilmeleri konusunda
anlatk.
Koullarda deiiklik olduu bilgisini almamz halinde, acilen kar taraf haberdar edeceiz.

For Ship ( Gemi )

For Shore ( Sahil )

Name / sim:

Name / sim:

Rank / Grevi:

Position / nvan:

Signature/ mza:

Signature / mza:

Date

Time

Tarih : ........./........./.......

Saat : ...........................hrs

Record of repetitive checks / Tekrar kontrol kayd :

Date / Tarih
Time / Zaman
Initials for Ship / Gemi paraf
Initials for Shore / Sahil paraf

Date / Tarih
Time / Zaman
Initials for Ship / Gemi paraf
Initials for Shore / Sahil paraf

FORM NO: CCL-04

SHIP SHORE SAFETY CHECK LIST

PAGE 7

Ares Gemi letmecilii A..

FORM MANUAL

Issue Date
Revision No
Revision Date
Issued by
Approved by

: 01.01.2010
: 01
: 31.12.2012
: DPA
: General Manager

Date / Tarih
Time / Zaman
Initials for Ship / Gemi paraf
Initials for Shore / Sahil paraf

Date / Tarih
Time / Zaman
Initials for Ship / Gemi paraf
Initials for Shore / Sahil paraf

Note :This check list should be completed, signed by the ship & terminal repr. before & during the cargo operations at the
terminals.
Not : Bu Kontrol Listesi gemi ve terminal temsilcisi tarafndan terminallerdeki yk operasyonlar ncesi ve srasnda doldurulacak ve
imzalanacaktr.

FORM NO: CCL-04

SHIP SHORE SAFETY CHECK LIST

PAGE 8