Master’s Review of Ship Performance for

BSM Form: SMM 03

Environment Management System

Use this form ONLY if LPSQ PAL is not available

Ship Period covered Date of Report
From
To
(Additional sheets can be used if needed)

Note: This review addresses the effectiveness of the implementation of the EMS. It is not
a review of the EMS.

1 Effectiveness of EMS implementation on board Y/N

Are all crew aware of their environment related roles and responsibilities? (Verify with spot
checks during weekly inspections)
Are all crew aware of the Company Environmental Policy? (Verify with spot checks during
weekly inspections)
Are Officers aware of the environmental impacts? (Refer to impact table in the Environmental
Manual appendix)
Was the EMS reviewed in the review period?
Are plans to prevent oil pollution in place? Are relevant emergency response documents
(SOPEP, SMPEP, EU MRV, SEEMP and VRP) up to date, approved and requirements complied
with?
Is Form EMS 01 completed and sent to office every month?
Are all visitors made aware of their responsibility to comply with the Company requirements?
Are environmental objectives and targets set for the ship? Is compliance with these monitored
regularly?
Master’s comment:

2 Feedback from Company Y/N

Is the outcome of the yearly evaluation of the EMS target and objectives by the Company
available on board?
Are comments and feedback received from the office after review of ship reports (Form EMS 01)
Were all environmental issues resolved on time? If not, were you made aware of the reasons for
the delay?
Are all issues related to EMS documents, maintenance, operations, requisitions resolved?
Have you considered the contents of previous Master’s review of EMS? (State outstanding
issues in this section)
Master’s comment:

3 EMS Incident reporting, investigation and follow up Y/N

Rev: 01 Page 1 of 3
 Master’s Review of Ship Performance for
BSM Form: SMM 03
Environment Management System

Use this form ONLY if LPSQ PAL is not available

Was the ship free of EMS related incident since last Master’s review?
Were all EMS related incidents reported to the Company and discussed on board?
Has an investigation been done to identify the root cause?
Are corrective / preventive action implemented?
Have the incident reports received from office been discussed on board and checks done to
ensure similar conditions do not exist on board?
Master’s comment:

4 External and internal EMS audit findings Y/N

Was an internal audit carried out within the last 12 months?
Are findings of internal and external audits closed out within the agreed time frame? (State
outstanding findings below)
Is the corrective action taken on audit findings verified by Master and found to be effective?
Is evidence of corrective and preventive action maintained along with audit reports for future
reference?
Master’s comment:

5 Effectiveness of shipboard training Y/N

Is training provided to crew in environment management system and plans (EMS manual,
BWMP, SOPEP, SMPEP, VRP, VOC)?
Is the Chief Officer trained for his role as Environmental Officer?
Is the training material provided on board used properly (posters, CD, Videos and computer
based modules)?
Are EMS drills conducted in real time scenarios and proper records maintained of the actions
taken during the drill?
Are debriefing sessions held and documented after drills? Is feedback considered to make
improvements?
Are records of training and drills maintained?
Master’s comment:

6 Surveys, inspections and certification status Y/N

Was the last ship inspection by Superintendents free of EMS issues?
Are environment related certificates and records in order (IOPP, IAPP, ISPP, Oil Record Book(s),
Ballast exchange, Crude Oil Tanker VOC emission calculations, Garbage disposal)?
Rev: 01 Page 2 of 3
 Master’s Review of Ship Performance for
BSM Form: SMM 03
Environment Management System

Use this form ONLY if LPSQ PAL is not available

For U.S. calls:
 Does the ship comply with the Vessel General Permit Best Practice Guide?
 Are periodic inspections carried out and records maintained as evidence of compliance?
 Are conditions compliant with the VGP?
Master’s comment:

7 Maintenance Y/N
Is the oil pollution response equipment properly maintained?
Is planned maintenance done on all equipment with an environmental impact?
Are garbage bins in good condition, kept covered and segregation done as per GMP?
Is the oily water separator (and ODME on tankers) properly calibrated and fully functional?
Are cargo domes, P/V valves and other openings on tankers maintained to prevent inadvertent
release of cargo vapour?
Master’s comment:

8 Comments / review by Office

Master’s name Designated Person

Note: Always add a comment if a question is answered “No”. Add comments to issues
not covered by the questions.

Rev: 01 Page 3 of 3