ANNEX
“ANNEX II
INFORMATION TO BE NOTIFIED BEFORE ENTRY INTO THE PORT OF … (Port of destination as referred to in Article 6 of Directive 2000/59/EC)
1.Name, call sign and, where appropriate, IMO identification number of the ship:
2.Flag State:
3.Estimated time of arrival (ETA):
4.Estimated time of departure (ETD):
5.Previous port of call:
6.Next port of call:
7.Last port and date when ship-generated waste was delivered, including the quantities (in m3) and the types of waste that were delivered:
8.Are you delivering (tick appropriate box):
| all ☐ | some ☐ | none ☐ |
of your waste into port reception facilities?
9.Type and amount of waste and residues to be delivered and/or remaining on board, and percentage of maximum storage capacity:
If delivering all waste, complete second and last columns as appropriate. If delivering some or no waste, complete all columns.
| a Sewage may be discharged at sea in accordance with Regulation 11 of Marpol Annex IV. The corresponding boxes do not need to be completed if it is the intention to make an authorised discharge at sea. | ||||||
| b May be estimates. | ||||||
| c Cargo residues shall be specified and categorised according to the relevant Annexes of Marpol, in particular Marpol Annexes I, II and V. | ||||||
| Type | Waste to be delivered(m3) | Maximum dedicated storage capacity(m3) | Amount of waste retained on board(m3) | Port at which remaining waste will be delivered | Estimated amount of waste to be generated between notification and next port of call(m3) | Waste that has been delivered at the last port of delivery identified under point 7 above(m3) |
|---|---|---|---|---|---|---|
| Waste oils | ||||||
| Oily bilge water | ||||||
| Oily residues (sludge) | ||||||
| Other (specify) | ||||||
| Sewage a | ||||||
| Garbage | ||||||
| Plastics | ||||||
| Food Wastes | ||||||
| Domestic wastes (e.g. paper products, rags, glass, metal, bottles, crockery, etc.) | ||||||
| Cooking Oil | ||||||
| Incinerator ashes | ||||||
| Operational wastes | ||||||
| Animal carcass(es) | ||||||
| Cargo residues b (specify)c | ||||||
Notes
1.This information may be used for port State control and other inspection purposes.
2.Member States will determine which bodies will receive copies of this notification.
3.This form is to be completed unless the ship is covered by an exemption in accordance with Article 9 of Directive 2000/59/EC.
I confirm that:
the above details are accurate and correct, and
there is sufficient dedicated onboard capacity to store all waste generated between notification and the next port at which waste will be delivered.
Date …
Time …
Signature”