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1 Reporting Seite von 5 On Port State Controi FORM A/ REPORT OF INSPECTION IN ACCORDANCE WITH THE PARIS MEMORANDUM OF UNDERSTANDING ON PORT STATE CONTROL ') r-, Romania Naval Authonthy copy to ' master head Office RNA Building Gate n IConstanta Port PSCO 99 Constanta if ship is detained, copy to : recognized organization ifapplicable SHIP PARTICULARS I. Name of ship OLD LADY 2. Flag of ship Comoros 3. Type of ship General cargo - multipurpose 4 Ca, sign D6CL9 5. IMO number Gross tonnage Keeldate Dead Weigt 33 9a. Classification society(ies) responsible for issuance of class certificates : international Naval Surveys Bureau (INSB) 9b. Classification society(ies) responsible for issuance of certificates on behalf of the flag State : International Naval Surveys Bureau (INSB).Full partlculars Of Company (identical to partieulars äs In the ISM DoQ") caferoglu denizcilik ve tic.lt, Samibey Art'87/ 84 Kabatas, Istanbul, Turkey II. Name & address Of Charterer : (Only ships carrying liquid or solid cargoes in bulk, pref. Ist charterer record.) Voyage charterer ' interagro ilc usa, 22 carey avenue, U.S.A 2. nameand signature of masterto certify that the information under is correct: signature INSPECTION PARTICULARS'") 3. Date of first boarding b. Date of final report Place of inspection BRAILA 5. If Vessel is detained : Date of issue of detention notice 6. Type of inspection : Initial inspection 7. Operational controls : - Emergency steering 8. Areas inspected : - Accommodation and galley - Engine and steering room This report mus! be relamed on board for a period of two years and must be ayailable for consullation bv Port State Conlrol al all times. ') This inspection report has been issued solely for the purpose of mforming the master and other port States that an inspection by the port State, mentioned in the heading, has taken place This inspection report cannot be construed äs a seaworthiness cettificate in excess of the certificates the ship is required to carry ") Non-ISM ships. Master to supply and sign under 2. for correct füll partieulars of Company "") Masters. Shipowners and/or Operators are advised that detailed Information on the inspection may be subject to publication (www pansmou org) SCREEN=DetailPSC&P_DRAFT I
2 Reporti ng Seite 2 von 5 - Navigation bridge - Outside decks and forecastle 9, Relevant certificate(s) } International ship security certificate issuing by International Naval Surveys Bureau (INSB) on expiry on ) Cargo ship safety construction issuing by International Nava! Surveys Bureau (INSB) on expiry on surveying by International Naval Surveys Bureau {INSB) on atturkey 3) Cargo ship safety equipment issuing by international Naval Surveys Bureau (INSB) on expiry on surveying by International Naval Surveys Bureau (INSB) on atturkey 4) Cargo ship safety radio issuing by International Naval Surveys Bureau (INSB) on expiry on surveying by International Naval Surveys Bureau (INSB) on at Turkey 5) Document of compliance (DoC) issuing by International Naval Surveys Bureau (INSB) on expiry on surveying by International Naval Surveys Bureau (INSB) on atturkey 6) Load lines certificates issuing by International Naval Surveys Bureau (INSB) on expiry on surveying by international Naval Surveys Bureau (INSB) on atturkey 7) Oil pollution prevention (iopp) issuing by International Naval Surveys Bureau (INSB) on expiry on Ttiis report must be retamed on board for a penod of twg years and musl be available for consultgtion by Port State Controi at all times. *) This inspection report has been issued solely for the purpose of informing the master and other port States that an inspection by the port State. mentioned in the heading, hastaken place. This inspection report cannot be construed äs a seaworthiness certificate in excessjif the certificates the ship is required to carry. **) Non-ISM ships. Master to supply and sign ünder 2. for correct füll particulars of Company ***) Masters, Shipowners and/or Operators are advised that detailed Information on the inspection may be subject to publication (www parismou oi Form A - Page 2 DRAFT I
3 Reporting Seite 3 von 5 surveyingby International Naval Surveys Bureau (INSB) on at Turkey 8) Safety management certificat (SMC) issuing by International Naval Surveys Bureau (INSB) on expiry on ) Safety manning document issuing by Comoros on expiry on 2. Ship related inspection action taken: No record 2. Deficiencies Yes 22. Supporting documentation Q PORT STATE PARTICULARS District Office Capitania Zonala Galati Address Galati, str Domneasca n 4 88 Galati Telephone Telefax NameidulyauthorizedPSCOofreportingauthontyl CZ-GALATI@RNA.RO SARBU Mircea Signatur« SCREEN=DetailPSC&P DRAFT I
4 Reporting Seite 4 von 5 Ort Port State Control FORM B/ REPORT OF INSPECTION IN ACCORDANCE WITH THE PARIS MEMORANDUM OF UNDERSTANDING ON PORT STATE CONTROL *) Romania Naval Authorithy RNA Building Gate n IConstanta Port 99 Constanta copy to : master head Office PSCO If ship is detained, copy to : flag state recognized organization, if applicable. narne of ship OLD LADY 2. Imo number 3. Date of final report Place of inspection Braila Defective item ) Convention reference 2} Defective item D Convention reference 2) Defective item Convention reference 2) Defective item ) Convention reference 2} Defective item D Convention reference 2) :ies FOUND AND FOLLOW UP ACTIONS "*) ISM related deficiencies Documentation - Incomplete - Not detainable, Within 3 months some records not äs per Company s.m System ISM resated deficiencies Resources and personnel - Missing - Not detainable, Within 4 days familiarisation forms;working and rest periods;internal/external audit reports Safety of navigation Nautical publications - Not upto date - Not detainable, Within 4 days notice to mariners Safety of navigation Nautical publications - Missing - Not detainable, Within 4 days captain's night Orders Structural safety Hüll - corrosion - Corroded - Not detainable, Master instructed to... some parts of decks and hatchcovers rusted publication ( mmanded that a füll survey is carried ou only) n B - Page SCREEN=DetailPSC&P_DRAFT _I... 28,9.27
5 Reporting Seite 5 von 5 Accommodation Defective item ) Lighting - Inoperative - Convention reference 2) Not detainable, Before departure some bulbs broken Accommodation Defective item ) Furnishings - Damaged - Convention reference z) Not detainable, Master instructed to... flooring in general Ship's certificates and documents Defective item ) Other (certificates)- Other - Convention reference 2 Not detainable, Within 4 days test certificate for anchor chain cables missing Name (duly authorized PSCO of reporting autrtority) SARBU Mircea Signature ) Masters, Shipowners and/or Operators are advised that detailed Information on the inspection may be subject!o publication (www parismou org) ) This inspection was not a füll survey and deficiencies iisted may not be exhaustive. In the event of a detention, it is recommanded that a füll suwey is carried ou and an def elendes are rectified betöre an application for re-inspection is made 2) To be completed in event of a detention (for non-convention ships <5 GT for reference only) Form B - Page ,9.27
6 Sirenac 2 Seite l von l Detail Inspection Ust Softw Ship's informations IMO Number Call Sign Type of Ship Flag D6CL9 Gen cargo multipurp. Comoros Name Of Ship Gross Tonnage Keel date Detail of a Port State Control Country of Inspection Portof inspection date of inspection detention #of deficiencies Romania Braila N 8 Areas inspected Description Accommodation and galley Outside decks and forecastle Engine and steering room Navigation bridge Observations Operational controls Description Emergency steering Observations Summary of deficiencies found Nbr Item Documentation Resource & personnel Nautical publication Nautical publication Hüll - corrosion Lighting Furnishings Other (certificates) Default Incomplete Missing Not up to date Missing Corroded Inoperative Damaged Other Initial action taken Within 3 months Within 4 days Within 4 days Within 4 days Master instructed to Before departure Master instructed to Within 4 days Final action taken Within 3 months Within 4 days Within 4 days Within 4 days Master instructed tc Before departure Master instructed tc Within 4 days Print Report ] DRAFT_INSP_REP,ID=&P_INSP._R
7 Sirenac 2 Seite von l Ship's informations IMO Number Call Sign Type of Ship Flag Target Factor Target Factor D6CL9 Gen cargo multipurp. Comoros Target Factor Name Of Ship Gross Tonnage Keel date 42 Usc Softw Generic Factor: 22 Flag with number of detention above average Targeted ship type Not EU recognized class Age of ship Not all convention ratified by flag Class with deficiencies ratio above average History Factor: 2 Not entering in region in last 2 months Not inspected in last 6 months Ship detained in last 2 months Number of deficiencies Number of pending deficiencies 2 Close W DRAFT INSP_REP ID=&P SHIP
8 Sirenac 2 Seite l von l History of Particulars Us< Softw Ship's informations IMO Number Call Sign Type of Ship Flag D6CL9 Gen cargo multipurp. Comoros Name Of Ship Gross Tonnage Keel date History of names Name of ship OLD LADY OLD LADY Date of record History of flags Flag of ship Comoros Korea Democratic People's Rep. Malta Malta Date 5 History of class certificates Class Society ABS ABS INSB Date of issue Date of expiry Date of effect Status Status Delivered Withdrawn Delivered _INSP_REP_D=&P_SH
FORM A 3 PORT STATE PARTICULARS 3 FORM B 4 DEFICIENCIES FOUND AND FOLLOW UP ACTIONS**) 4 NOTICE OF DETENTION FOR THE MASTER 5
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