船 / 岸 安 全 检 查 表SHIP/SHORE SAFETY CHECK LISTShip’s Name 船名 ………………………………………
Berth 泊位 ………………………………………Port 港口 ………………………………………
Date of Arrival 抵达日期 ……………………………………
Time of Arrival抵达时间 ……………………………………
填表须知INSTRUCTIONS FOR COMPLETION :为保证安全作业,下列所有问题的答复均是肯定的,可在相应的方格内清楚地打上(√)标号
假如不能给予肯定回答,应说明理由,而且船舶和码头之间均达成关于应实行的适当预防措施的协议
假如认为有的问题不适用, 应在备注栏里加以说明
The safety of operations requires that all questions should be answered affirmatively by clearly ticking (√ ) in the appropriate box
If an affirmative answer is not available, 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
“船舶" 和“码头" 栏目下的方格,表示由负责方实施检查