SIRE 200 QUESTIONNAIRE SAFETY MANAGEMENT 1. IS A SATISFACTORY LEVEL OF ____safety_____ DEMONSTRATED? 2. IS A safety oficer ____ APPOINTED? 3.

HAS THE _operetors________ THE LAST SIX MONTHS? ___representative___ VISITED THE VESSEL WITHIN __management____ BEING

4. IS THERE A RECENT OPERATORS AUDIT REPORT AVAILABLE, WERE ____non_____ ___conformormities___ IDENTIFIED, AND S THERE A CLOSED-OUT SYSTEM IN PLACE? 5. ARE ___smoking______ 00:46 ___regulation___ POSTED AND BEING ADHERED TO?

6. ARE ____smokin grooms_____

IDENTIFIED? __doors____, PORTS AND WINDOWNS KEPT

7. ARE ALL REQUIRED ___external______ CLOSED IN PORT?

8. ARE THERE ____sufficient_____ __cew____ ON BOARD AT THE TIME OF THE INSPECTION TO HANDLE EMERGENCY SITUATIONS? 9. IS A ___fare______ ___ control___ plan _________ EXHIBITED WITHIN THE ACCOMODATION AND ALSO AVAILABLE EXTERNALLY? 10. ARE NECESSARY ____safety_____ __sings____ AND OTHER IMPORTANT INFORMATION PROMINENTLY DISPLAYED? 01:29 11. IS PERSONAL PROTECTIVE EQUIPMENT SUCH AS ___boiler______ __suit____, SAFETY FOOTWEAR, ____eye_____ AND ___ear______ ______ AND SAFETY HARNESSES, ETC, PROVIDED AND AS REQUIRED, BEING WORN? 12. IS THE ACCOMODATION ____air_____ __conditioning____ ___sistem_______ ON RECIRCULATION DURING CARGO OPERATIONS? 13. IS THE ____emergency_____ SYSTEM CLEARLY MARKED? 14. ARE REGULAR ___safety______ RECORDED? __stop____ FOR THE ACCOMODATION VENTILATION

__meeting____ HELD AND ARE MINUTES

15. IS ALL ___loose______ __gear____ ON DECK, IN STORES, INTERNAL SPACES, IN THE ENGINE ROOM AND THE STEERING COMPARTMENT __properly_______ __secured____ ? 02:24 16. IS A COMPLETED ISGOTT SHIP/SHORE ____safety_____ _________AVAILABLE? 17. IS THE VESSEL PROVIDED WITH A ___safe______ __cheklist____

__means____ OF ACCESS?

18. ARE ALL MEANS OF ACCESS ___properly______ __rigged____ , INCLUDING THE PROVISION OF A SAFETY NET, LIFEBUOY AND LINE? 19. IS A ___gangway______ PROVIDED?

20. ARE ____accommodations_____ __ladder____, GANGWAYS, ___pilot______ __ladder____ AND PILOT HOISTS, IF FITTED, IN A SATISFACTORY CONDITION? 03:06 21. DOES THE ACCOMODATION LADDER LEAD AFT, WHERE THE ___freeboard______ EXCEEDS 9 METERS AT THE ACCESS POINT? 22. IF A ___helicopter______ MEET ICS GUIDELINES?] ___landing___ OR WINCHING AREA IS PROVIDED, DOES IT

23. IN THE EVENT OF A ____colision_____ , GROUNDING, _____fire____ , EXPLOSION, GAS OR ____toxic_____ __vapour____ RELEASE, ARE ADEQUATE WRITTEN EMERGENCY PROCEDURES, AS APPLICABLE, IN PLACE? 24. ARE OFFICERS FAMILIAR WITH THE ___operations______ _of__firefight___ , LIFE SAVING AND OTHER ___emergency______ __equipament____? 25. ARE OFFICERS FAMILIAR WITH THE DONNING OF ____breathing_____ __aparatus____ AND THE OPERATION OF OXYGEN RESUSCITATION EQUIPMENT, FIXED FIRE FIGHTING SYTEMS, THE MAIN AND EMERGENCY ___fire______ __pumps____, THE EMERGENCY STEERING GEAR AND OTHER EMERGENCY EQUIPMENT? 04:08 26. IS THE VERBAL COMMUNICATION BETWEEN ___ship______ ______shore______ ACCEPTABLE? ___and___

27. ARE ANCLOSED SPACE AND ___space______ __pumproom____entr __procedure_____IDENTIFIED AND COMPLIED WITH? 28. ARE ____space_____ ______ ___________ PERMITS, AS DESCRIBED IN ISGOTT APPENDIX I OR THE EQUIVALENT, BEING USED AND COMPLIED WITH? 29. ARE THE ___pumproom______ ______ PROCEDURES BEING COMPLIED WITH? ?

30. ARE THE PUMPROOM SPACES ADEQUATELY ___ventilated______ 31. ARE THE ____pumprom_____ MODE? 04 49 32. ARE THE ___pumproom______ SATISFACTORY CONDITION?

_fans being_____ OPERATING IN EXTRACTION

___fire___ AND FLOODING DAMPERS IN A

33. IS THERE A PERMANENT ARRANGEMENT FOR LIFTING unconscious _________ ___person___ FROM PUMPROOM, INCLUDING PROVISION OF A SUITABLE STRETCHER OR HARNESS? 34. ARE SPECIFIED PROCEDURES UTILIZED FOR ___hot______ __work____?

35. ARE THE _________ ______ ____work_______ SPECIFIED IN ISGOTT APPENDIX F BEING OBSERVED? 05 30 36. IS ___eletctric______ ___welding___ EQUIPMENT IN SATISFACTORY CONDITIONS AND ARE WRITTEN SAFETY GUIDELINES AVAILABLE? 37. IS _____gas____ CONDITION? __welding____ AND BURNING EQUIPMENT IN SATISFACTORY

38. IS FIXED PIPING INSTALLED FROM THE ___gas______ OPERATING POSITION?

__cylinder____ TO THE

39. ARE ___spare______ __ _oxgen___ AND ACETYLENE CYLINDERS STORED APART IN A DEDICATED STORAGE AND IS STORAGE IN A CLEARLY MARKED, WELL VENTILATED POSITION OUTSIDE THE ACCOMODATION AND ENGINE ROOMM? 40. DOES THE FIRE FIGHTING EQUIPMEMNT MEET ___solas______ 06 20 41. ARE ___specialy____ KEPT UP TO DATE? __requiment____?

___record_____ AND INVENTORY LISTS MAINTAINED AND

42. ARE FIRE MAINS, ___pumps_____ , ___hoses______ AND NOZZLES IN SATISFACTORY CONDITION AND ___visible_____ FOR IMMEDIATE USE? 43. IS THE ____emergency___ ____fire_____ ____pump_____ FULLY OPERATIONAL AND ARE STARTING INSTRUCTIONS CLEARLY DISPLAYED? 44. ARE ISOLATING VALVES IN ___fire____ AND ____fuel_____SYSTEM LINES CLEARLY MARKED, AND IN SACTISFACTORY CONDITIONS? 45. DO ____portable______ __fire_____ EXTINGUISHERS APPEAR TO BE IN SATISFACTORY CONDITION WITH OPERATING INSTRUCTIONS CLEARLY MARKED? 07 15 46. ARE FIREMAN OUTFITS, INCLUDING __breathing___ _aparatus_____ , IN A SATISFACTORY CONDITIONS AND READY FOR IMMEDIATE USE? 47. ARE BREATHING APPARATUS SETS FITTED WITH FULLY PRESSURISED __air__ ___cilinders___? 48. ARE SUFFICIENT FULLY CHARGED __spread____ __air____ AVAILABLE? ___cilinder___

49. IS THE INTERNATIONAL SHIP/SHORE CONNCETION READILY AVAILABLE AND __is the location___ _clearly_marked_ ? 50. ARE THE FIXED DECK, ___pumproon____ AND __engine___ ___roon___ FIRE EXTINGUISING SYSTEMS, WHERE FITTED, IN A SATISFACTORY CONDITION AND ARE CLEAR OPERATING INSTRUCTIONS POSTED? 08 08 51. ARE MEASURES IN PLACE TO EFFECTIVELY ____exelation_____ TO ACCOMODATION, MACHINE AND SERVICE SPACES? ___manutention___

52. ARE ____acommodation_____ CLEARLY MARKED? 53. ARE ____fire_____

AND _________

______ STOPS OPERATIONAL AND

__flaps____ IN SATISFACTORY CONDITION? SYSTEMS FULLY

54. ARE FIXED ___fire______ ___detection___ AND____alarm_____ OPERATIONAL AND TESTED REGULARLY?

55. ARE THE FIRE DETECTION AND ALARM SYSTEMS IN THE ACCOMODATION , ____engineroon_____ __pumproon____,_________ , AND OTHER SPACES WHERE FITTED, IN SATISFACTORY CONDITION? 08 57 56. IF A SYSTEM TO MONITOR ___flamable______ ___atmosphere___ IN NON-CARGO SPACES IS FITTED, ARE RECORDERS, ALARMS AND THE MANUFACTURERS TESTS PROCEDURES IN ORDER? 57. IS THERE A PROCEDURE TO _________ THE CARGO AREA? ______ NON-CARGO SPACES ADJACENT TO

58. ARE THE EMERGENCY _________ ________ ______ (FIRE WIRES) IN SATISFACTORY CONDITION? 59. ARE THEY OF _________ RECOMMENDATIONS? ______AND DO THEY CONFORMO TO OCIMF

60. ARE THE EMERGENCY TOWING-OFF WIRES (FIRE WIRES) _________ MEET TERMINAL REQUIREMENTS? 09 52 61. ARE SHIP-SPECIFIC _________ APPLIANCES ON BOARD? 62. ARE ALL _________ ______ AND _________

______ TO

MANUALS FOR LIFESAVING

______ IN SATISFACTORY CONDITION?

63. ARE_________ , INCLUDING EQUIPMENT AND LOWERING MECHANISMS AND _________ LIFERAFTS, IN SATISFACTORY CONDITION? 64. ARE _________ ______, IF FITTED TO LIFERAFT CORRECTLY ATACHED IN SATISFACTORY CONDITION, AND IS SERVICING IN DATE? 65. ARE _________ ______ _________ VHF AND SEARCH AND RESCUE RADAR TRANSPONDERS (SARTS) IN SATISFACTORY CONDITION AND CHARGED? 10 47 66. ARE LIFEBOAT AND LIFERAFT _________ ______DISPLAYED?

67. ARE _________ , _________ ______, QUICK RELEASE MECHANISMS ANS SELF ACTIVATING SMOKE FLOATS IN SATISFACTORY CONDITION? 68. ARE ________________________, INCLUDING THE THWROWING APPARATUS IN DATE AND IN SACTISFACTORY CONDITION? 69. IS _________ ______ EQUIPMENT AVAILABLE? AVAILABLE? 11:34

70. IS A SUITABLE _________

71. ARE THE LOCATION OF _________

______ MARKED WITH IMO SYMBOLS?

72. IS THERE A _________ ______ IN PLACE FOR THE SERVICING OF LIFEBOAT ON-LOAD RELEASE GEAR AND IS IT SUBJECTED TO THOROUGH EXAMINATION AND TEST CARRIED OUT AT LEAST ONCE EVERY FIVE YEARS? 73. ARE _______ _________ REQUIREMENTS? __________ HELD IN ACCORDANCE WITH THE SOLAS

74. HAVE THE LIFEBOAST BEEN _________ WITHIN THE LAST THREE MONTHS OR, IN CASE OF _________ ______ _________ , SIX MONTHS?