What are guidelines for completing Ballast Water Reporting Form ?


Ship’s Name:  Print the name of the ship.

Owner:   The registered owners or operators of the ship.

Flag:   Country of the port of registry.

Last port and country:  Last port and country at which the ship called before arrival in the current port – no abbreviations, please.

Next port and country:   Next port and country at which the ship will call, upon departure from the current port – no abbreviations, please.

Type:  The ship type is …..

GT:  Gross tonnage.

Arrival Date:  Arrival date at current port.  Please use the European date format (DDMMYY)

IMO Number:  Identification number of the ship used by the International Maritime Organization is ……..

Call Sign:  Official call sign is ……..

Agent:  Agent used for this voyage.

Arrival Port:  This is the current port.  No abbreviations, please.


(Note: Segregated ballast water = clean, non-oily ballast)

Total ballast water on board:  Total segregated ballast water upon arrival at current port – with units.

Total ballast water capacity:  Total volume of all ballastable tanks or holds – with units.


Count all tanks and holds separately (e.g. port and starboard tanks should be counted separately)

Total No. of Tanks on board:  (   ) tanks and holds can carry segregated ballast water.

Ballast Water Management Plan on board?:  Do you have a ballast water management plan, specific to your ship, onboard?   Circle Yes or No.

Management Plan Implemented?:  Do you follow the above plan?   Circle Yes or No.

No. of Tanks in Ballast:  Number of segregated ballast water tanks and holds with ballast at the start of the voyage to the current port.   If you have no ballast water on board, go to section 5.

No. of Tanks Exchanged:  This refers only to tanks and holds with ballast at the start of the voyage to the current port.

No. of Tanks Not Exchanged:  This refers only to tanks and holds with ballast at the start of the voyage to the current port.


BW Source:  Please list all tanks and holds that you have discharged or plan to discharge in this port.  Carefully write out, or use codes listed below the table.   Follow each tank across the page, listing all source(s), exchange events, and/or discharge events separately.  If the ballast water history is identical (i.e. the same source, exchange and discharge dates and locations), sets of tanks can be combined (example:  wing tank 1 with wing tank 2, both water from Belgium, exchanged 02.11.97, mid ocean).   Additional pages to include the arrival date, ship’s name and IMO number at the top.

Date:  Date of ballast water uptake.  Use European format (DDMMYY).

Port or Latitude/Longitude:  Location of ballast water uptake.

Volume:  Volume of ballast water uptake, with units.

Temperature:  Water temperature at time of ballast water uptake, in degrees centigrade (Celsius).

BW Exchange:  Indicate Exchange Method:  Circle empty/refill or flow through.

Date:  Date of ballast water exchange.  Use European format (DDMMYY).

Endpoint or Latitude/Longitude:  Location of ballast water exchange.  If it occurred over an extended distance, list the end point latitude and longitude.

Volume:  Volume of ballast water exchanged, with units.

Percentage exchanged:  Percentage of ballast water exchanged.  Calculate this by dividing the number of units of water exchanged by the original volume of ballast water in the tank.  If necessary, estimate this based on pump rate.  (Note: For effective flow‑through exchange this value should be at least 300%).

Sea Height (m):  Record the sea height in metres at the time of the ballast exchange (Note:  this is the combined height of the wind seas and swell, measured from crest to trough.   It does not refer to the depth).

BW Discharge: 

Date: Date of ballast water discharge.  Use European format (DDMMYY).

Port or Latitude/Longitude:   Location of ballast water discharge, no abbreviations for ports.

Volume:   Volume of ballast water discharged, with units.

Salinity:   Record salinity of ballast water at the time of discharge, with units, (i.e. specific gravity (sg) or parts per thousand (ppt)).

If exchanges were not conducted, state other control action(s) taken:  If exchanges were not made on all tanks and holds to be discharged, what other actions were taken?   E.g. transfer of water to a landbased holding facility, or other approved treatment.

If none, state reasons why not:   List specific reasons why ballast exchange was not done.   This applies to all tanks and holds being discharged.


IMO Ballast Water Guidelines On Board?:  Do you have IMO Resolution A.868(20) on board your ship?   Circle Yes or No.

Responsible Officer’s name and title (Printed) and signature:  e.g.  the First Mate, Captain, or Chief Engineer must print his name .


Record of ballast water management on board

Ship …………………………………Port of Registry ……………………..        IMO number …………………….

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