Specimen: Document of Compliance For The Carriage of Dangerous Goods

Download as pdf or txt
Download as pdf or txt
You are on page 1of 6

Document No.

123456/147/10/15

DOCUMENT OF COMPLIANCE
FOR THE CARRIAGE OF DANGEROUS GOODS

Issued in pursuance of the requirement of


REGULATION II-2/19.4 OF THE INTERNATIONAL CONVENTION FOR THE SAFETY OF LIFE AT SEA, 1974,
as amended,

under the authority of the Government of

TTTTHE COMMONWEALTH OF THE BAHAMAS

EN
by GERMANISCHER LLOYD

Distinctive
Name of Ship Number Port of Registry Ship Type IMO Number
or Letters

SPECIMEN ABC123 Nassau General Cargo 1234567


IM
THIS IS TO CERTIFY:

1 That the construction and equipment of the above-mentioned ship have been found to comply with the provisions of
EC
regulation II-2/19 of the International Convention for the Safety of Life at Sea, 1974, as amended.

2 That the ship is suitable for the carriage of those classes of dangerous goods as specified in the appendix hereto, subject to any
provisions in the International Maritime Dangerous Goods (IMDG) Code and the International Maritime Solid Bulk Cargoes
(IMSBC) Code for individual substances, materials or articles also being complied with.

This document is valid until 14th July, 2015.


SP

Issued at Hamburg the 14th day of July, 2010.

Friedo Holtermann Christoph Busche

NOTE: There are no special requirements in the above-mentioned regulation II-2/19 for the carriage of dangerous goods of classes
6.2 and 7, and for the carriage of dangerous goods in limited quantities, as required in chapter 3.4 of the IMDG Code, and
excepted quantities, as required in chapter 3.5 of the IMDG Code.
Form No. S360 / 2010-05 Page 1 of 5
Document No. 123456/147/10/15


 

   

 
 
 
 
  



 



     
 

 !"

# 



 (

)
*+
$ %& '

EN
$,$$,-  

$,&   
%,$  
 

%,$
.
/ 
 0 .1
2/ 
 
 

%,%    

%,3200

%,3  4200

3!5%36  
 

&,$
&,%
IM
3%367!7-86 










&,3 91   
 
 


&,3     

',$    

',%
EC
-,$ 91 !5%36  
 

-,$ 91 %367!7-86  
-,$ 91   
-,$    
: 91 !5%36  
 

: 91 %367!7-86    


: 91     

:    
;  
 

SP

;
.
 
<< 200
<1   

 




 





!

 

"
!



!!






#

 $
! 
 %


!



& !'
(




 


!)




& !

!'
 *
!
+

 

 
,-
!

 
./01
-!'
 %


!



& !


2"



3

!
"
 
./01
-!'
 *
!
+

 !"
&

4''

#2/cbu/10-3b

Form No. S360 / 2010-05 Page 2 of 6


Document No. 123456/147/10/15




     

 
 
 
 
  



 


 !!
     
" 

#! !!

+(  #,
 

(
)*
$ %& '

EN
 # -#.#$/0' &1/   
 # #!!#$&/2 '1$
 # #.3#!# &1/   
$/02
 #  !#45! &1/   
 #  !#45!#/$67
 # #!!-!8# '1$ 


%796
 # #!!-!8# 0 


IM
%76$
 # #!!#$0&%
 #!!#$&&9
'1$
'1$








 #!!#$&'& '1$
!#! ! 0
 !-#%090
#$/9/ &1% 

EC
-##$&72 &1/   
- !#3:;#3 &1% 

!##!!##%60/
-: )-:*3!8#%%$9 0
#"3#!##3#! &1% 


#$/69
#!!#$&90 '1$
# #!!#$&6& '1$
! #!!#$&29 '1$
SP

#%%$6 &1% 
3   <


 #$/29)* &1% 

3   <


 #$/29)* &1% 

,
 =
>




3   <


 #$/29)* &1% 
<

> 



 #!!#! #!! '1$
"!#$&00
 #!!#$&02 '1$
:#$/'7 &1$ 




8#:#$&/' &1/   
For footnotes see next page

#2/cbu/10-3b

Form No. S360 / 2010-05 Page 3 of 6


Document No. 123456/147/10/15




     


        
   !     " !  
!!       #  
$ % 

&     !    ' !( ))    ' ! !!     
)

        
   !     " !  
!!       #  
$ ! 


        
   !     " !  
!!       #  
$ ! 
( % 

EN
IM
EC
SP

#2/cbu/10-3b

Form No. S360 / 2010-05 Page 4 of 6


Document No. 123456/147/10/15


 

  

 
 
 
 
  



 



     
 

 

  
#
$%
  !"

EN
!&!!&'

!&(

)&!

)&!
*
+ 
 , *-
.+ 

)&)

)&/.,,

)&/  0.,,

/12)/3

(&!
(&)
IM
/)/3414'53


(&/ 6- 

(&/ 

"&!


"&)

EC
'&! 6- 12)/3

'&! 6- )/3414'53

'&! 6- 

'&! 

7 6- 12)/3

7 6- )/3414'53

7 6- 

7 

SP

8
*
 
99 .,,
9-

         


    !!  "#  $  ! "  $  # ! %&'( )

#2/cbu/10-3b

Form No. S360 / 2010-05 Page 5 of 6


Document No. 123456/147/10/15







   
 

    
  
 
   
  !"  
  
$  
 #  
          
$ %

#  
    
  
 #

$$ &
   
   !  "

EN
$'    #  
$ (   
 $   %   % % &   
      ''()'*
+,      ''(,)'
      %  ''(*)'*
$ % % &   %     
   -. ''/(0)'*
IM + 
 
 -.
   
''/(0)'
 1 
$$ )

 #
  2  % 3   %  
$' *    

  2  % !
$' (
#   ,   
EC
$' &       
$'$ +
  

    
$- ,   , 4     )    %3   % 
  
$/ . 

 

 
$/ 0
  
  (        5 
1 
  
 
$" 
1  2
  4  +3 
SP

$3 
    #    6% 7%    3 -  .
1 
 %3%    1808 6%     
- %3-.  .
$ &
 # #
 # %
$! ( 
      # %

#2/cbu/10-3b

Form No. S360 / 2010-05 Page 6 of 6

You might also like