Anti Fouling & Form F Lily of Sea

You might also like

Download as pdf or txt
Download as pdf or txt
You are on page 1of 3

Certificate No / UTIN : PWR-AFSC-FT-22-00530

INTERNATIONAL ANTI-FOULING SYSTEM CERTIFICATE


(This certificate shall be supplemented by a Record of Anti-Fouling System)
Issued under the International Convention on the Control of Harmful
Anti-Fouling Systems on Ships
under the Authority of the Government of:
PALAU
by INTERNATIONAL REGISTER OF SHIPPING
When a Certificate has been previously issued, this certificate replaces the certificate dated:

Particulars of Ship ¹ :
Name of Ship : LILY OF SEA
Distinctive Number or Letters : T8A3272
Port of Registry : MALAKAL HARBOR
Gross Tonnage : 4015
IMO Number ² : 9176383

An anti-fouling system controlled under Annex 1 has not been applied during or after construction of this ship. --

An anti-fouling system controlled under Annex 1 has been applied on this ship previously, but has been removed by SUEZ SHIPYARD ³
X
on 15-Jul-2022.
An anti-fouling system controlled under Annex 1 has been applied on this ship previously, but has been covered with a sealer coat applied by --
_______________ on ________________.
An anti-fouling system controlled under Annex 1 was applied on this ship prior to ______________ ⁴, but must be removed or covered with
--
a sealer coat prior to ____________ ⁵
THIS IS TO CERTIFY THAT:

1. The ship has been surveyed in accordance with regulation 1 of Annex 4 to the Convention; and

2. The survey shows that the anti-fouling system on the ship complies with the applicable requirements of Annex 1 to the Convention.

Date of completion of the survey on which this certificate is issued: 22-Jul-2022

Issued at PANAMA on 17-Nov-2022

TOLGA TURKELLERI
Verify: https://eships.intlreg.org/CertificateVerification/Verify AUTHORIZED SIGNATORY
It is agreed that International Register of Shipping (hereafter referred as the society), its subsidiaries, bodies, officers, directors, employees and agents shall have no liability for any loss, damage or expense
allegedly caused directly or indirectly by their mistake or negligence, breach of warranty, or any other act, omission or error by them including gross negligence or Willful misconduct by any such person with the
exception of gross negligence or Willful misconduct by the governing bodies or senior executive officers of the society. If any person used the services of the Society or its subsidiaries or relies on any decision
made or information given by or on behalf of them and in consequence suffers a loss, damage or expense proved to be due to their negligence, omission or default, then the Society will pay by way of compensation
to such person a sum limited to the value of fees paid to the Society. Under no circumstances whatsoever shall the individual or individuals who have personally caused the loss, damage or expense is held liable.

1 Alternatively, the particulars of the slip may be placed horizontally in boxes.


2 In accordance with the IMO Ship Identification Number Scheme adopted by the Organization by resolution A.1117 (30)
3 Insert name of the facility.
4 Date of entry into force of the control measure
5 Date of expiration of any implementation period specified in article 4(2) or Annex 1.

Revision : IAFSC-FT-2112 Page : 1 of 3


Certificate No / UTIN : PWR-AFSC-FT-22-00530

RECORD OF ANTI- FOULING SYSTEM


(This Record shall be permanently attached to the International Anti-Fouling System Certificate)

Particulars of the Ship


Name of Ship : LILY OF SEA
Distinctive numbers or letters : T8A3272

IMO number : 9176383

Details of Anti-Fouling System(s) applied :


Type(s) of anti-fouling system(s) used : a TBT-Free Self-Polishing Antifouling System
Date(s) of application of anti-fouling system(s) : 22-Jul-2022

Name(s) of company(ies) and facility(ies)/ location(s) where applied : Suez Shipyard-EGYPT

Name(s) of anti-fouling system manufacturer(s) : Jotun Coatings


Name(s) and colour(s) of anti-fouling system(s) : a TBT-Free Self-Polishing Antifouling
Active ingredient(s) and their Chemical Abstract Services Registry Zineb (CAS Number 12122-67-7) Cuprous Oxide (CAS Number 1317-
Number(s) (CAS number(s)) : 39-1) Copper Pyrithione (CAS Number 14915-37-8)
Type(s) of sealer coat, if applicable : --
Name(s) and colour(s) of sealer coat applied, if applicable : --
Date of application of sealer coat :

THIS IS TO CERTIFY that this Record is correct in all respects.

Issued at: PANAMA

Dated: 17-Nov-2022

TOLGA TURKELLERI
AUTHORIZED SIGNATORY

Revision : IAFSC-FT-2112 Page : 2 of 3


Endorsement of the Records

THIS IS TO CERTIFY that a survey required in accordance with regulation 1(1) (b) of Annex 4 to the Convention found that
the ship was in compliance with the Convention
Details of anti-fouling system(s) applied
Type(s) of anti-fouling system(s) used

Date(s) of application of anti-fouling


system(s)
Name(s) of company (ies) and facility (ies) location(s) where applied

Name(s) of anti-fouling system(s) manufacturer(s)

Name(s) and color(s) of anti-fouling system(s)

Active ingredient(s) and their Chemical Abstract Services Registry Number(s ) (CAS number(s)).................................................

Type(s) of sealer coat, if applicable

Name(s) and color(s) of sealer coat applied, if applicable

Date of application of sealer coat

Signed

(Signature of authorized official issuing the Record)

Place

Date
(Seal or stamp of the Authority)

*This page of the Record shall be reproduced and added to the Record as considered necessary by the Administration

Revision : IAFSC-FT-2112 Page : 3 of 3

You might also like