GMDSS Radio & VDR/S-VDR APT Survey – Pre-Questionnaire

Ship particulars
Ship’s name
Call Sign
MMSI
IMO
Class
Flag

PART 1. GMDSS SYSTEM

VHF Handheld No. 1

Manufacturer
Model
Lithium ( Emergency ) Battery Expiry date
Rechargeable battery condition ( G or N.G. )
Condition

VHF Handheld No. 2

Manufacturer
Model
Lithium ( Emergency ) Battery Expiry date
Rechargeable battery condition ( G or N.G. )
Condition

VHF Handheld No. 3

Manufacturer
Model
Lithium ( Emergency ) Battery Expiry date
Rechargeable battery condition ( G or N.G. )
Condition

MF/HF
Manufacturer
Model
Last BQ from Earth Station
GMDSS Radio & VDR/S-VDR APT Survey – Pre-Questionnaire

Printer
Condition

Inm-C No. 1
Manufacturer
Model
PV Test Results
Printer
IMN
ISN
Condition

Inm-C No. 2
Manufacturer
Model
PV Test Results
Printer
IMN
ISN

SSAS
Manufacturer
Model
IMN
ISN
Condition
Buttons

VHF/DSC No. 1
Manufacturer
Model
Individual Test Results
Condition

VHF/DSC No. 2
Manufacturer
Model
GMDSS Radio & VDR/S-VDR APT Survey – Pre-Questionnaire

Individual Test Results

Condition

AIS
Manufacturer
Model
Pilot Plug
Condition

SART No. 1
Manufacturer
Model
Expiry date of battery
Location of SART

SART No. 2
Manufacturer
Model
Expiry date of battery
Location of SART

EPIRB
Manufacturer
Model
Type of EPIRB (automatic or manual activation)
Expiry date of battery
Expiry date of hydrostatic release unit
Last time SBM Certificate onboard available

Any Fault on GMDSS / Radio Equipment ?

Name of Equipment
Manufacturer
Model
Fault Details Description
GMDSS Radio & VDR/S-VDR APT Survey – Pre-Questionnaire

Error Code Details Description

Spare part require ( If any, please tell specific )

PART 2. VDR / S-VDR SYSTEM

1) Documentation
VDR manufacturer Model Date of Last APT / Service supplier Certificate of Compliance is available onboard

YES NO

2) UPS / Dedicated Reserve battery ( Please find out the expiry date from label on VDR or from last year’s APT report )
Expiry date of the VDR/S-VDR UPS Battery

3) Capsule type & information

Please select your ship’s Capsule type:
A. Fixed type Capsule B. Float-Free type Capsule C. We have both A and B
Please write the information about your Capsule:
AA. Fixed Capsule located at compass deck Maker Model
Expiry date of Acoustic Underwater Beacon battery Beacon condition

BB. Float-Free Capsule Located at compass deck Maker       Model      
Expiry date of Lithium battery       Expiry date of Hydrostatic Release      

4) Alarm ( Very important information for APT )

Any ALARM from Remote alarm unit / Operation Panel unit YES NO
if YES, Please indicate alarm / Error Code      

5) Crew requirements and Ship borne tests

5-1: Power supply:
The VDR must have been connected to the ships mains supply and been powered up for at least Confirmed
24 hours preceding the testing engineers visit, This ensure the back-up batteries are fully charged
(Please switch off AC power from AC breaker and confirm VDR is operanational on internal battery)

5-2: Bridge equipment service reports

The test engineer will required copies of, or access to, Service report for any of the bridge Confirmed
equipment
connect to the VDR that has been repaired or replaced since the original installation or the last APT
5-3: Keys for the Main unit
The vessel will have been left with two set of keys for the main unit, It is essential that these are Confirmed
available, As the test engineer will need to gain access to the system

6) Any other fault information on Ship’s VDR/S-VDR?

(If yes, Please state in below box)
YES NO
 GMDSS Radio & VDR/S-VDR APT Survey – Pre-Questionnaire

     

Important Notes:

Please make sure all navigational equipment are switched on 12 hours prior to scheduled time of the annual survey.

If this form is not completed fully and a service results from inadequate information and the APT is not done or a
service is done in place of the APT, we reserve the right to invoice for the hours spent onboard.