Discharging Ship’s Name:
| Receiving Ship’s Name: |
| Date of Transfer: |
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Discharging Ship Checked |
Receiving Ship Checked |
Remarks |
| 1. Are cargo hoses properly drained prior to hose disconnection? |
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| 2. Are cargo hoses or manifolds blanked? |
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| 3. Is the transfer side of the ship clear of obstructions (including hose lifting equipment)? |
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| 4. Secondary fenders are correctly positioned and secured for departure ? |
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| 5. Has the method of unberthing and of letting go Moorings been agreed with the other ship? |
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| 6. Are fenders, including fender pennants, in Good order? |
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| 7. Is power on winches and windlass? |
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| 8. Are there rope messengers and rope stoppers at all mooring stations? |
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| 9.Are the crew standing by at their mooring stations? |
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| 10.Are communications established with mooring personnel and with the other ship ? |
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| 11.Shipping traffic in the area has been checked ? |
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| 12. Main engine(s) and steering gear have been tested and are in a state of readiness for departure? |
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| 13. Mooring personnel have been instructed to let go only as requested by the maneuvering ship ? |
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| 14. Navigational warnings have been cancelled (when clear of other ship )? |
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| 15. Has the other ship been advised that Check List 5 is satisfactorily completed? |
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| FOR DISCHARGING SHIP/RECEIVING SHIP (Delete as appropriate) |
| Name: |
| Rank: |
| Signature: Date: |
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