PROVISIONAL REPORT

OF
BREAKING SEALING

FILE/ORDER NO. :
APPLICANT : PT. Sucofindo Gresik
CARGO LOADED : NPK Phonska Fertilizer @ 50 kg = 4.650,00 Kg
VESSEL : MV. Tunas Tiga
DATE AND PLACE OF : On August 03, 2015 at up to hrs lt on board of the vessel
INSPECTION whilst lying alongside berth of Public Port, Lhokseumawe
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THIS IS TO REPORT That upon request of Principal, we attended on board of the mentioned vessel for
the purpose of conducting Breaking Sealing of Hatch/Cargo Covers and manhole.
SEALING POSITION :
Before Commenced Discharging the Cargo on board from all the hatch/cargo covers/manhole we have
Check All sealed with the following position :
-Hatch Cover Hold No. 1 = 4 Pcs Seal No. 6080488, 6080511, 6080512 and 6080513
-Manhole Hatch No. 1 forward starboard side = 1 Pcs Seal No. 6080486
-Manhole Hatch No. 1 after part port side = 1 Pcs Seal No. 6080514
-Hatch Cover Hold No. 2 = 4 Pcs Seal No. 6080516, 6080517, 6080518 and 6080519
-Manhole Hatch No. 2 fore ward port side = 1 Pcs Seal No. 6080515
-Manhole Hatch No. 2 after part starboard side = 1 Pcs Seal No. 6080520

PARTIES PRESENT : - Chief officer of MV TUNAS TIGA

- PT. Sucofindo (Surveyor)
- Official of Consignee

CONCLUTION : As result of our Findings the above seal positions at the Hatch/cargo
Covers and manhole were found in good condition

Acknowledged : Witnessed by : Lhokseumawe, August 03, 2015

MV. Tunas Tiga Official of Consignee, Sucofindo Lhokseumawe Office

(____________) ( ) (Munir Hs)

Surveyor

INCO-FO-46/00 27-10-03