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PRE-ARRIVAL NOTIFICATION Form

Pre-arrival Notification

Vessel / Operator Particulars

Non-Resident
Yes
No
HST
Yes
No
Date of Canadian Oil Response Agreement

Voyage Routing


Last 10 Ports (starting from last port):

Marsec Level - Port 1
I
II
III
Security Declaration - Port 1
Yes
No
Marsec Level - Port 2
I
II
III
Security Declaration - Port 2
Yes
No
Marsec Level - Port 3
I
II
III
Security Declaration - Port 3
Yes
No
Marsec Level - Port 4
I
II
III
Security Declaration - Port 4
Yes
No
Marsec Level - Port 5
I
II
III
Security Declaration - Port 5
Yes
No
Marsec Level - Port 6
I
II
III
Security Declaration - Port 6
Yes
No
Marsec Level - Port 7
I
II
III
Security Declaration - Port 7
Yes
No
Marsec Level - Port 8
I
II
III
Security Declaration - Port 8
Yes
No
Marsec Level - Port 9
I
II
III
Security Declaration - Port 9
Yes
No
Marsec Level - Port 10
I
II
III
Security Declaration - Port 10
Yes
No
Trade
Canadian Government Vessel
Yes
No

Crew and Passengers

Crew List attached
Yes
No
Canadian Vessel: Repairs Undertaken Abroad
Yes
No

Certificates (date valid to)

Safety Construction
Derat
Loadline
Safety Equipment
Safety Radio
Civil Liability (oil)
Last Port State Inspection Date

Berthing Details

Arrival Date / Time
:
Departure Date / Time
:
Shifting - Arrival Date / Time
:
Shifting - Departure Date / Time
:
2nd shift - Arrival Date / Time
:
2nd shift - Departure Date / Time
:

Cargo Details

Description of Cargo

Tonnage Containerized

Tonnage Break Bulk

 Tonnage Bulk

 Number of 20' Containers

Number of 40' Containers

Number of Empty Containers

Dangerous Goods Onboard
Yes
No
Dangerous Goods Manifest
Yes
No

Other Services Required

Garbage to be Discharged at Port:
Yes
No
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