AMERICAN BUREAU OF SHIPPING

CHECK SHEET ON SOLAS SURVEYS AIS RADIO TECHNICIANS SURVEY

(ORIGINAL TO BE RETAINED ONBOARD BY VESSELS MASTER)
VESSEL CLASS NO.
Associated REPORT NO. DATE
AUTOMATIC IDENTIFICATION SYSTEM (AIS) Test Re!"t

S#$s %et&$'s(
CALL SIGN MMSI NUMBER
PORT O REGISTRY
IMO NUMBER GROSS TONNAGE
DATE !EEL LAID OICIAL NUMBER
I)se*t$!) Det&$'s
NAME O RADIO TEC"NICIAN COMPANY
INSPECTION DATE INSPECTION LOCATION
#. I$sta%%atio$ detai%s
Ite& Stat's
#.# AIS t(a$s)o$de( t*)e+
#., T*)e a))(o-a% ce(ti.icate
#./ I$itia% i$sta%%atio$ co$.i0'(atio$ (e)o(t o$ 1oa(d2
#.3 D(a4i$0s )(o-ided2 (A$te$$a56 AIS5a((a$0e&e$t a$d 1%oc7 dia0(a&)
#.8 Mai$ so'(ce o. e%ect(ica% )o4e(6
#.9 E&e(0e$c* so'(ce o. e%ect(ica% )o4e(6
#.: Ca)acit* to 1e -e(i.ied i. t;e AIS is co$$ected to a 1atte(*
#.< Pi%ot )%'0 $ea( )i%ots o)e(ati$0 )ositio$2
#.= #,> V AC )(o-ided $ea( )i%ot )%'02 (Pa$a&a a$d St. La4(e$ce (e?'i(e&e$t)
,. AIS )(o0(a&&i$0 5 Static i$.o(&atio$
,.# MMSI $'&1e(
,., IMO $'&1e(
,./ Radio ca%% si0$
,.3 Na&e o. s;i)
,.8 T*)e o. s;i)
,.9 S;i) %e$0t; a$d 1ea&
,.: Locatio$ o. GPS a$te$$a
#. AIS )(o0(a&&i$0 5 D*$a&ic i$.o(&atio$
/.# S;i)s )ositio$ 4it; acc'(ac* a$d i$te0(it* stat's (So'(ce+ GNSS)

/., Ti&e i$ UTC (So'(ce+ GNSS)
/./ Co'(se o-e( 0(o'$d (COG) (4i%% .%'ct'ate at doc7side) (So'(ce GNSS)
/.3 S)eed o-e( 0(o'$d (SOG) (@e(o at doc7side) (So'(ce+ GNSS)
/.8 "eadi$0 (So'(ce+ G*(o)
/.9 Na-i0atio$a% stat's
/.: Rate o. t'($6 4;e(e a-ai%a1%e (ROT)
/.< A$0%e o. ;ee%6 )itc; a$d (o%%6 4;e(e a-ai%a1%e

AIS5TEC" Re-isio$ > Pa0e # o. ,
VESSEL CLASS NO.
Associated REPORT NO. DATE
,. AIS )(o0(a&&i$0 5 -o*a0e (e%ated i$.o(&atio$
3.# S;i)s d(a'0;t
3., T*)e o. ca(0o
3./ Desti$atio$ a$d ETA (at &aste(s disc(etio$)
3.3 Ro'te )%a$ (o)tio$a%)
3.8 S;o(t sa.et*5(e%ated &essa0es
8. Pe(.o(&a$ce test 'si$0 &eas'(i$0 i$st('&e$t
8.# (e?'e$c* &eas'(e&e$ts AIS c;. # a$d ,6 GMDSS c;. :>
8., T(a$s&itti$0 o't)'t6 AIS c;. # a$d ,6 GMDSS c;. :>
8./ Po%%i$0 i$.o(&atio$ c;. :>
8.3 Read data .(o& AIS
8.8 Se$d data to AIS
8.9 C;ec7 AIS (es)o$se to A-i(t'a% -esse%sA
9. AO$ ai(A )e(.o(&a$ce test
9.# C;ec7 (ece)tio$ )e(.o(&a$ce
9., Co$.i(& (ece)tio$ o. o4$ si0$a% .(o& ot;e( s;i)BVTS
9./ Po%%i$0 1* VTSBs;o(e i$sta%%atio$
E'e*t"!+&,)et$* $)te"-e"e)*e -"!+ AIS !.se"/e% t! !t#e" $)st&''&t$!)s0+



R&%$! Te*#)$*$&)1s Re+&"2s+





T;e AIS ;as 1ee$ tested acco(di$0 to IMO SNBCi(c.,,: a$d (eso%'tio$ MSC.:3(9=)6 a$$eC /
Radio Tec;$icia$Ds Si0$at'(e

Co&)a$*

Date
AIS5TEC" Re-isio$ > Pa0e , o. ,