ANNEX 11 - Safety checklist for bunkering fuel

Number: ......... Year: .........

Bunker boat / Bunker station / Tank truck	Bunkering Vessel
Name:	Name:
Unique European Vessel identification number / Official number:	Unique European Vessel identification number / Official number:
Boatmaster:	Boatmaster:
Bunkering attendant:	Responsible person for the bunkering procedure (bunker watch):

	Filler necks			Total
	1	2	3
Position of filler neck (e.g. port side aft; bow thruster tank; ...)
Tank capacity of the tanks to be filled via the respective filler neck:
Tank content before beginning of the bunkering according to reading of tank level:
Free capacity of the tanks immediately after the filler neck:
Agreed takeover quantity:

General:

Ο The mooring between the bunkering vessel and the bunker boat / bunkering station is correct and has been checked.

Ο The lighting is sufficient to supervise the bunkering procedure.

Ο Communication between bunker attendant and bunker watch is ensured.

Ο The hose lines are not subject to tensile forces nor to torsion; the minimum bending radii are respected.

Bunkering procedure Ο with Ο without overfill protection (automatic stopping device)

In case of use of a fuelling hose with flange or quick coupling:

Ο The connection of the fuelling hose with the filler neck has been checked and is in good working condition.

In case of use of a fuelling hose with nozzle:

Ο The bunker watch is familiar with the operation of the nozzle and is capable to activate an emergency stop.

Ο The nozzle reaches deep enough into the filler neck and has been secured in its position.

Date: ..............................

Place (River-km respectively berth number): ..............................................

Beginning of bunkering procedure (Time): ..........................................

Bunkering attendant: Bunker watch:

........................................ ...................................

Signature Signature

End of bunkering procedure (Time): ..............................