| all ☐ | some ☐ | none ☐ |
of your waste into port reception facilities?
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 | ||||||
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”