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 PLETION:为保证安全作业, 下列所有问题得答复均就是肯定得, 可在相应得方格内清楚地打上(√)标号
假如不能给予肯定回答, 应说明理由, 而且船舶与码头之间均达成关于应实行得适当预防措施得协议
假如认为有得问题不适用, 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”与“码头”栏目下得方格, 表示由负责方实施检查