You are here: Home >

Port Reception Facilities

Revised Consolidated Format for Reporting Alleged Inadequacies of Port Reception Facilities

The Master of a ship having encountered difficulties in discharging waste to reception facilities should forward the information below, together with any supporting documentation, to the administration of the flag State and, if possible, to the competent Authorities in the port State. The flag State shall notify the IMO and the port State of the occurrence. The port State should consider the report and respond appropriately informing IMO and the reporting flag State of the outcome of its investigation.

* Compulsory fields.

1 Ship's Particulars

*	1.1 Name of ship:
*	1.2 Owner or Operator:
*	1.3 Distinctive number or letters:
*	1.4 IMO Number²:
	1.5 Gross tonnage:
	1.6 Port of registry:
	1.7 Flag State³:
	1.8 Type of ship:
	Oil tanker	Chemical tanker
	Bulk carrier	Other cargo ship
	Passenger ship	Other (specify)

2 Port Particulars

*	2.1 Country:
*	2.2 Name of port or area:
*	2.3 Location/Terminal Name: (beth/terminal/jetty)
*	2.4 Name of company operating the reception facility (if applicable):
	2.5 Type of port operation:
	Unloading port	Loading port
	Shipyard	Other (specify)
*	2.6 Date of arrival (dd/mm/yyyy):
	2.7 Date of occurrence (dd/mm/yyyy):
	2.8 Date of departure (dd/mm/yyyy):

3 Inadequacy of Facilities

3.1 Type and amount of waste for which the port reception facility was inadequate and nature of problems encountered.
			Problems encountered
Type of Waste	Amount for discharge (m³)	Amount not accepted (m³)	Indicate the problems encountered by using one or more of the following code letters, as appropriate. A No facility available B Undue delay C Use of facility technically not possible D Inconvenient location E Vessel had to shift berth involving delay/cost F Unreasonable charges for use of facilities G Other (please specify in paragraph 3.2)
MARPOL Annex I-related Type of oily waste:
Oily bilge water
Oily residues (sludge)
Oily tank washings (slops)
Dirty ballast water
Scale and sludge from tank cleaning
Other (please specify)
MARPOL Annex II-related Type of NLS ⁴ residue/water mixture for discharge to facility from tank washings:
Category A substance
Category B substance
Category C substance
Category D substance
MARPOL Annex IV-related Sewage
MARPOL Annex V-related Type of garbage:
Plastic
Floating dunnage, lining, or packing materials
Ground paper products, rags, glass, metal, bottles, crockery, etc.
Cargo residues, paper products, rags, glass, metal, bottles, crockery, etc.
Food waste
Incinerator, ash
Other (please specify)
MARPOL Annex VI-related
Ozone-depleting substances and equipment containing such substances
Exhaust gas-cleaning residues
3.2 Additional information with regard to the problems identified in the above table:

3.3 Did you discuss these problems or report them to the port reception facility?
Yes
No
If Yes, with whom (please specify):
If Yes, what was the response of the port reception facility to your concerns?

3.4 Did you give prior notification (in accordance with relevant port requirements) about the vessel's requirements for reception facilities?
Yes
No
Not applicable
If Yes, did you receive confirmation on the availability of reception facilities on arrival?
Yes
No

4 Additional Remarks/Comments

Your contact details

Your name
Contact detaills
Email address	(a confirmation email will be sent to this address)
Date:

¹ This format was approved by the [fifty-third] session of the Marine Environment Protection Committee in [July 2005].

² In accordance with the IMO ship identification number scheme adopted by the Organization by Assembly resolution A.600(15).

³ The name of the State whose flag the ship is entitled to fly.

⁴Indicate, in paragraph 3.2, the proper shipping name of the NLS involved and whether the substance is designated as 'solidifying' or 'high viscosity'.

If you have any supporting documentation, please attach the document using the "Browse" button below, then submit your request.

Please do not upload large files. The maximum allowable size for a file upload is 8 mb

Having Difficulties?

If you have difficulty submitting this form, you may print it out and fax it to (02) 6279 5026 (bh).

last updated: August 2005