Форма акта сюрвейерского отчета.

BUNKER SURVEY REPORT # ______12345-67_______

NAME OF VESSEL: TBN	OWNER OR OPERATOR: BShipper
MASTER’S NAME: FOLW	PLACE AND DATE OF SURVEY: SPB
PORT OF REGISTRY: ANTWERP	SURVEY CARRIED OUT BY: FCSC
CONTRUCTION: 2010

This is to certify,

That the Undersigned Surveyor of _____________________FCSC_____________did,

at the request of INFLOT Agency attend on board the m/v “_________TBN________” on the _________21 SEP___________, 2012, at____________12-00___________ LT whilst she was lying afloat alongside berth No.___05______of at the Fishing port of St. Petersburg for the purpose if conduction the Bunker Survey at the moment of completion of cargo operations

and no reports as follows:

Ship’s Draft: Fore___5.1____m; Aft___5.2_____m; Trim___0.1____m; list____0_____^o

Kinds of Fuel Oil Tanks:

Fuel Oil, IFO 180, density at__0.91______C^o:___16_____

Diesel Oil, MDO, density at_0.91_______C^o:___16_____

SOUNDING RECORDS FUEL OIL

TANK#	SOUNDING, CM	VOLUME, CUB.M	TEMP. Co	DENSITY		METRIC TONS
1Л
2Л	14	10,08	16	0,91		9,17
3Л
4Л
5Л
6Л
7Л
8Л
9Л
10Л
1 П
2 П
3 П
4 П
5 П
6 П
7 П
8 П
9 П
10 П
TOTAL:					9,17

DIESEL OIL

TANK#	SOUNDUNG, CM	VOLUME, CUB.M	TEMP. Co	DENSITY		METRIC TONS
1Л
2Л
3Л
4Л
5Л
6Л
7Л
8Л
9Л
10Л
1 П
2 П	28	20,16	16	0,91		18,35
3 П
4 П
5 П
6 П
7 П
8 П
9 П
10 П
TOTAL:					18,35

Quantity of Bunker measure at present survey at __________________LT on the _______________, 2012.

FO___9,17____mt MDO___18,35____mt

QUANTITY OF BUNKER AT THE MOMENT ON HIRE:

OUTPUT OF MAIN ENGINE:_________10000______HP

DAILY CONSUMPTION:

AT SEA, SPEED____14____kn: FO________17______mt,DO______2.5 ______mt

AT THE PORT: WITH C/Op. FO_______0________mt,DO______2.5 ______mt

WITHOUT C/Op. FO_______0________mt,DO______1.8 ______mt

Estimated Bunker consumption from the time and place of present

Bunker Survey up to the time and place or delivery:

#	ITEM	MILES		DURATION, Hours		CONSUMTION, mt
						IFO		MDO
1	Distance between Vessels on-hire position and Pilot Station	180		12,9		9,18		1,34
2	Anchorage awaiting Pilot	0		9		0,24		1,04
3	Maneuvers awaiting Pilot	4,2		1
3	Approaching channel maneuvers	11		1,6		0,28		0,16
4	Vessel on-birth with COP	0		23		0		2,39
5	Vessel on-birth without COP	0		5		0		0,38
TOTAL:			195,2		52,5		9,7		5,31

Estimate Quantity of Bunker on Board of the said vessel at the moment on hire:

FO_______18,87______mt

DO_______23,66_____mt

Remarks:

This Report is issued without prejudice to the rights and/or liabilities of whomsoever it may concern.

Attending Surveyor _______________________