3. Information required by SOLAS regulation XI-2/9.2.1
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3.1 The ship is provided (SOLAS regulation 9.2.1.1) with valid:
International Ship Security Certificate |
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Interim International Ship Security Certificate |
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3.1.1 The certificate indicated in 3.1 has been issued by
Name of the Contracting Government or the Recognized Security Organization |
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which expires on (date of expiry) |
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3.1.2 If the ship is not provided with a valid International Ship Security Certificate or a valid Interim International Ship Security Certificate, explain why? |
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3.1.2.1 Does the ship have an approved ship security plan on board? (Yes or No) |
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3.2 Current security level (SOLAS regulation XI-2/9.2.1.2) |
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3.2.1 Location of the ship at the time the report is made |
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3.3 List the ten calls
Period (From/To) |
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Port (UNLOCODES), Country, |
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Facility |
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Security level |
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3.3.1 Did the ship, during the period specified 3.3, take any special or additional security measures, beyond those specified in the approved ship security plan? Yes or No |
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3.3.2 If the answer to 3.3.1 is Yes, for each such occasions please indicate the special or additional security measures which were taken by the ship (SOLAS regulation XI-2/9.2.1.4)
Period (From/To) |
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Port (UNLOCODE) |
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Country |
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Facility |
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Special or additional security measures |
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3.4 List the ship-to-ship activities
Period (From/To) |
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Location or Latitude and Longitude |
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Ship-to-ship activity |
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3.4.1 Have the ship security procedures, specified in the approved ship security plan, been maintained during each of the ship-to-ship activities specified in 3.4 (SOLAS regulation XI-2/9.2.1.5)? |
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3.4.2 If the answer to 3.4.1 is NO, identify that ship-to-ship activities for which the ship security procedures were not maintained and indicate, for each, the security measures which were applied in lieu:
Period (From/To) |
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Security measures applied, ship-to-ship activity |
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3.5.2 If the answer to 3.5.1 is YES, provide details or attach a copy of the Dangerous Goods Manifest (IMO FAL Form 7) |
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3.6 A copy of the ship's Crew List (IMO FAL Form 5) is attached (SOLAS regulation XI-2/9.2.1.6 and paragraph B/4.39.4 of the ISPS Code) |
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3.7 A copy of the ship's Passenger List (IMO FAL Form6) is attached (SOLAS regulation XI-2/9.2.1.6 and paragraph B/4.39.6 of the ISPS Code) |
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List the ten calls
Security level set on the ship |
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Operating security level |
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Existence of cargoes loaded on board at the port and to be loaded off in Japan |
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Existence of passenger boarding at the port and to disembark in Japan |
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Entry position into specific area and ETA |
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Entry position into specific area and ETA after departure |
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Possession of Record Book (Yes or No) |
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Record of past port of call in Japan (Yes or No) |
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