NORD N Dampskibsselskabet “NORDEN” A/S, 49, Amaliegade, DK-1256 Copenhagen K.

Telephone + 45 33 15 04 51. Telefax + 45 33 93 15 99 Tanker. Telefax + 45 33 93 37 33 Technical.

Telex 22445. E-mail: tankers@ds-norden.com. Comtext A53DK0 33. www.ds-norden.com Vessel

Voyage no. R.O.B. - CARGO TANK INSPECTION CERTIFICATE

(DRY CERTIFICATE)
Prior Loading After discharging
Date
Port: :

Terminal: Draft: FWD AFT: Trim:

Cargoes: API Temp:

Ullage Trim Correct Trim cor. Free Liquid by Gross

Nonliquid
Tank Innage correct ullage/in. volume water wedge on board
BBLS/M3
inch/cm inch/cm inch/cm BBLS/M3 BBLS/M3 BBLS/M3 volume

TOTAL

Total on board volume : BBLS/M3 This is to certiffy that all cargo tanks on board the above
named ship has today been inspected/controlled and all
Less free water : BBLS/M3 tanks,lines and pumps have been found empty and well
Gross on board volume : BBLS/M3 drained.

Liquid by wedge : BBLS/M3

Non liquid : BBLS/M3
Above volume was not pumpable by vessel’s fixed pumps. Remarks:

________________________ ________________________________ __________________________

Chief Officer Terminal Representative Surveyor

________________________________
Master

Form tk10