ANEXO B

BALLAST WATER REPORTING FORM

Rectifier Rectifier
BallastWaterTreatment System
√ BallastWater Exchange BallastWater Exchange X Ballast Water Treatment System
1. SHIP INFORMATION 2. BALLAST WATER AND TANKS INFORMATION
Vessel Name: MEGHNA ROSE ArrivalPort MINA SAQR Total Number. of Ballast Tanks on Number of Tanks in Ballast: 22
Board: 22
IMO Number / CallSign: 9351725 / S2AV4 Arrival Date at the Port: 08.11.2020 Number of Tanks with Ballast Water Number of Tanks without Ballast
Exchange: 22 Water Exchange: NIL
Flag: BANGLADESH Previous Port and Country CHATTOGRAM, Total Ballast Water on Board(m³): Total Ballast Water Capacity (m³):
BANGLADESH **
Type of Vessel / Gross Tonnage: BULK CARRIER Next Port and Country CHATTOGRAM, 15679.9
/ 31,254 MT BANGLADESH
Owner: UNIQUE CEMENT INDUSTRIES LTD Agent : KANETIC SHIPPING SERVICES LLC

3. BALLAST WATER HISTORY (Register all tanks that will discharge ballast water on the arrival port – If none go to item 5)
BALLAST WATER SOURCE INFORMATION BALLAST WATER EXCHANGE INFORMATION BALLAST WATER DISCHARGE
Tanks (*) INFORMATION
(List multiple sources per Date Portor Volume Temp. Salinity Date Lat/Long Volume % Local Exchange Date Portor Volume Salinity
dd/mm/yy Lat/Long (m³) (ºC) dd/mm/ (Endpoint) (m³) Exchange Depth (m) Method(* dd/mm/yy Lat/Long (m³)
tank separately) yy *)
FP 27.10.20 CTM 1190.3 34 1.000 05.11.20 20°05.4’N 1766.5 99 3000 3 08.11.20 MINA 1189.5 1.025
O/A 068°26.6’E SAQR
WBT 1 (P) & 5 (S) 16.10.20 CTM 1531.7 37 1.000 29.10.20 17°53.8’N 1600.8 98 2186 3 08.11.20 MINA 1591.3 1.025
17.10.20 O/A 089°45.0’E SAQR
WBT 1 (S) & 5 (P) 16.10.20 CTM 1529.3 37 1.000 30.10.20 14°36.9’N 1600.8 98 2900 3 08.11.20 MINA 1597.2 1.025
17.10.20 O/A 087°50.0’E SAQR
WBT 2 (P) & 4 (S) 16.10.20 CTM 1709.2 37 1.000 30.10.20 13°11.0’N 1721.3 98 3100 3 08.11.20 MINA 1717.1 1.025
17.10.20 O/A 087°30.0’E SAQR
WBT 2 (S) & 4 (P) 16.10.20 CTM 1708.6 37 1.000 31.10.20 10°46.6’N 1721.3 98 3450 3 08.11.20 MINA 1718.5 1.025
17.10.20 O/A 085°03.8’E SAQR
WBT 3 (P & S) 17.10.20 CTM 2111.3 37 1.000 31.10.20 09°41.0’N 2123.4 98 3630 3 08.11.20 MINA 2108.1 1.025
O/A 084°17.0’E SAQR
TST 1 (P) & 5 (S) 26.10.20 CTM 822.5 33 1.000 05.11.20 20°57.9’N 831.7 99 2870 3 08.11.20 MINA 816.4 1.025
O/A 067°47.8’E SAQR
TST 1 (S) & 5 (P) 26.10.20 CTM 816.9 33 1.000 03.11.20 11°38.5’N 831.7 99 500 3 08.11.20 MINA 783.1 1.025
22.10.20 O/A 24 074°30.3’E SAQR
TST 2 (P) & 4 (S) 19.10.20 CTM 991.8 37 1.000 03.11.20 12°53.6’N 996.8 99 1200 3 08.11.20 MINA 918.3 1.025
27.10.20 O/A 34 073°38.9’E SAQR
TST 2 (S) & 4 (P) 19.10.20 CTM 996.1 37 1.000 04.11.20 15°58.0’N 996.8 99 2045 3 08.11.20 MINA 933.2 1.025
27.10.20 O/A 34 071°26.9’E SAQR
TST 3 (P & S) 19.10.20 CTM 996.3 37 1.000 04.11.20 17°10.0’N 996.8 99 2516 3 08.11.20 MINA 969.2 1.025
O/A 070°34.0’E SAQR
AP 28.10.20 CTM 446.0 35 1.000 05.11.20 20°05.4’N 492.1 97 3000 3 08.11.20 MINA 458.7 1.025
O/A 068°26.6’E SAQR
(*) Codes for Ballast Water Tanks: Forepeak = FP / Aftpeak = AP / Double Bottom = DB / Wing = WT / Topside = TS / Cargo Hold = CH / Other – O
(**) Exchange Method: Dilution (1) / Flow Through (2) / Empty/Refill (3)

3.1. OTHER INFORMATION OF BALLAST WATER EXCHANGE
If exchanges were not conducted, state other control action(s) taken: N/A
If no action was taken, state why not: N/A
5. ADDITIONAL INFORMATION:
Is There a Ballast Water Management Plan on
Board? (√)YES ( ) NO
Was the Ballast Water Management Plan
Implemented? (√) YES ( ) NO
4. INFORMATION ON BALLAST WATER TREATMENT SYSTEM
System’s Trade Name: N/A Installation Date: N/A
Manufacturer: N/A International Certificate’s Expiration Date: N/A
Is There the International Convention on Board? NASIM AKTHER RAJ ( CHIEF OFFICER)
(√) YES ( ) NO RESPONSIBLE OFFICER’S NAME AND TITLE (CAPITAL LETTER)
Is There the IMO Resolution A.868 (20) on Board?
(√) YES ( ) NO
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