pre arrival questionnaire

8/22/2019 Pre Arrival Questionnaire

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Masters need only complete the one form most approp

Should Masters elect to use the worksheet and type in t

to allow entry into empty cells only. Additional informa

Forms may be completed by hand in which case they sh

Agency.

Tugs and Barges

PORT OF RAS LAFFAN PRE - ARRIVA

Included as a separate tab, are questionnaires for compl

LNG Tankers

Tankers calling at the SPM

Tankers calling at LPB's (Liquid Product Berths ins

General Cargo Vessels (Included will be bulk carri

The intention of publishing these questionnaires is to re

Feedback on the effectiveness of this aim as well as any

Please send any such comments etc to rlcregulating@q


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iate to their vessel.

e information, please note that each worksheet has been form

ion should be submitted on additional pages.

uld be either faxed or scanned and emailed to Nakilat Shipping

QUESTIONNAIRE

etion by different categories of vessels:

ide the port of Ras Laffan which includes vessels calling to load

ers calling to load dry bulk)

uce the number of forms Master's are required to complete.

comments or suggestions on improvements are welcome.

.com.qa addressed to Port Regulator.


3/18

atted

PG)


4/18

Vessel's Current Security Level : ISSC Issue & Exp Date :

PORT OF RAS LAFFAN PRE - ARRIVAL QUESTIONNAIRE

FOR LNG VESSELS

Vessel Name: IMO No: Call Sign:

Flag: Port of Registry: ETA:

PART - A. (Vessel General Information)

Vessel Inmarsat No, Telex, Fax, Email:

LOA: Breadth: Summer Draft:

Thrusters:Prplsn Power:

Arr. Drafts F & A: Dep. Drafts F & A :

GT: NT: SDWT: Summer Disp:

Owner/ Charterer Details:

Arr Disp:

P&I Club Name & Validity:

PART - B. (ISPS Related Information)

Hull & Mach Insurance Name & Validity:

Pollution Cover & Ammount :

Validity of ISM DOC/SMC and issuing authority :

Copy of Ras Laffan Port Regulations on board : (Yes/No)

Country Security Level Declaration

Issued?

Ship to Ship

activity?

SSO Name/Rank :

Name & ID # of the Company :

CSO Name & Contact details 24H :

Details of the last 10 port of call

Additional

security?

Departure

Date

Port

Are there any security related matters you wish to report: (Yes/No)

Form Date 2010/07/01 Page 4 o


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PART - C. (Cargo / Operational Information)

Size, Rating & Standard of Cargo Mnfld Conctn :

Advise quantity of Clean Segregated Ballast to be discharged at this Port:

Amount and Grade of Cargo required:

Advise any vessel defect affecting cargo operations or manoeuvring or mooring ability

Confirm Tank High Level and Pressure Alarms operational

Confirm Smoke / Fire Detection and Fixed Fire Extinguishing System fully operational :

Confirm that remotely operated manifold valves have been operated through a complete open/closed cycle,ensure

correct functioning and advise valve type (ball, gate, etc) and actual closing time. (Note subject valves must close

within 30 seconds of operation with the final 20% of closure taking at least 6 secs).

Confirm Cargo Transfer Emergency Stops fully operational and date of last test :

F & A Springline Fairleads dist. fm Mnfld Center:

Dist. Bow to Center of Manifold:

Confirm Gas Detection System operational :

Dist. b/w Manifold Flanges Center:

Dist. fm Mnfld Face to First Full Restraining Bracket:

Confirm fully operational Inert Gas System :

Manifold dist. fm ship side :

Max. Loading Rate :

Condition of Tanks on arrival :

Ht. of Manifold above Keel :

I confirm the information provided is correct and that I have read and understood the contents of Part D below.

Ship's StampSignature & Date

Master's Name

Dist. Stern to Center of Manifold:

PART - D. (Restrictions, Recommendations & Information)

Anticipated Loading Time :

Please note that fishing / swimming / photography are not allowed at Ras Laffan Port.

Restrictions applying at Ras Laffan Port :

ETA advised at least 7 Days, 72 Hours and 24 Hours before arrival.

Pre-Arrival Information sent latest with 72 Hours ETA.

Only SBT allowed to be discharged : No Clean Ballast.

Supreme Council Qatar have issued a directive regarding Ballast water. Masters are required to take all

necessary precautions to minimize and control the introduction of unwanted Aquatic Organisms and Pathogens

from the vessels Ballast water.

It is a State of Qatar requirement that the vessel carries out Ballast Water Exchange and Sediment

Removal Programme in accordance with the relevant IMO guidelines and recommendations.

Must be able to Closed-Load at all times.

Maximum draft within Port Limits is 12.5 metres.

No alcoholic drinks to be consumed / distributed / landed while the vessel is in Qatari waters. The bonded

stores should be kept locked. Smoking on deck, cargo spaces and gangway is prohibited. No prohibited items

viz. Pork, Pornographic CDs to be distributed / landed whilst the vessel is in Port as per Qatari Rules.

Both anchors to be cleared away and main engine tested astern before Pilot boards.



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The following information is supplied via the vessels Agent :

Attn : The Quarantine Officer.

Has the vessel any suspected case (s) of : Plague, Cholera, Yellow Fever, Typhus or any other infectious

disease ?

Vessel shall comply strictly with ISPS Regulations. Officers and crew are not allowed to leave the vessel

unless valid shore leave pass is arranged by Agents with the Immigration. Normally the same will be issued

only for specific reasons viz. medicals, prior appointment etc.

Please note only domestic garbage can be deposited in the garbage skips provided near to the berths of

condensate and sulphur vessels. No chemicals / dunnage materials can be landed into these garbage skips or on

the quay, and have to be retained onboard.

Radio Pratique is obtainable through Agents if :

No serious illness on board for preceding 30 days.

The Standard International Declaration of Health is available and completed on arrival.

Number and Nationality of Officers and Crew.

Port (s) visited during the last 21 days.

List of documents to be prepared and handed over to the attending boarding agent :

Vaccination List = 2 Nos. Original of Last Port Clearance = 1 No.

Crew Effects Declaration = 2 Nos. Maritime Declaration of Health = 2 Nos.

Ship Store List = 2 Nos. Bond Stores List = 2 Nos.

Nil List (Arms, Birds) = 2 Nos. Voyage Memo = 1 No.

List of ships certificates (only photocopy) to be handed over to the attending boarding agent :

Hull and Machinery Insurance Certificate.

Certificate of Registry.

Protection and Indemnity Club Insurance Certificate.

International Tonnage Certificate.

Ships ISPS Certificate.

For easy access Port Regulations can be downloaded using following web link :http://www.raslaffan.com.qa/raslaffan/rlc.nsf/web/downloads

Crew List (all to be signed and stamped in original) = 6 Nos.

http://www.raslaffan.com.qa/raslaffan/rlc.nsf/web/downloads


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FOR TANKERS CALLING AT SPM

PART - A. (Vessel General Information)Vessel Name: IMO No: Call Sign:




Summer Disp:

Arr Disp: Prplsn Power: Thrusters:



GT: NT: SDWT:

SSO Name/Rank :




Declaration

Issued?

Ship to Ship

activity?







Port Country Departure

Date

Security Level Additional

security?




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PART - C. (Cargo / Operational Information)Advise quantity of Clean Segregated Ballast to be discharged at this Port:

Anticipated Loading Time :


Manifold dist. fm ship side : Ht. of Manifold above Keel :

Ship's Stamp







Master's Name

Signature & Date

State in detail if vessel has multiple Deadweight measurement certificates on board.

PART - D. (Restrictions, Recommendations & Information)Restrictions applying at Ras Laffan Port :



Both anchors to be cleared away and main engine tested astern before Pilot boards.Only SBT allowed to be discharged : No Clean Ballast.


Maximum arrival / departure drafts should not exceed 22.0 metres.

Vessel shall comply strictly with ISPS Regulations. Officers and crew are not allowed to leave the vessel.

No Shore leave is permitted at SPM however in case of Serious illness/Emergency repatriation the request may

be accepted and all cost in form of arranging crew boat/ tug, visa, transport and handling etc will be on the

ships account.


Are all Cargo Tanks Inerted to 8% or less Oxygen by volume and under positive pressure?


Max. Loading Rate :

Last 3 Cargoes:

Size, Rating & Standard of Cargo Mnfld Conctn. (floating hoses 2X20" terminating into 16" tails):

Dist. Bow to Center of Manifold: Dist. Stern to Center of Manifold:

Vessel must arrive with the propeller immersed and with a minimal stern trim, which should not exceed 3

metres.

Please note that fishing / swimming / photography are not allowed at Ras Laffan SPM.

Ras Laffan SPM ISPS level is 1, Master to declare ships ISPS Level on 72 Hours ETA notice. Please be

informed that the attending Loading Supervisor is the appointed PFSO in addition to his loading operations

therefore the attending loading supervisor will sign the Declaration of Security upon boarding of your vessel.

Fit a length of rope of 3 metres to the eye of the Fire Wires.



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Maritime Declaration of Health = 2 Nos.





No serious illness on board for preceding 30 days.






disease ?

List of documents to be prepared and handed over to the attending Loading Master in one

envelope.

(Mark the envelope - FOR NAKILAT AGENCY COMPANY)

Arrival Crew List (all to be signed and stamped in original) = 1 Nos.

Crew Effects Declaration = 2 Nos.



List of ships certificates (only photocopy) to be included in the envelope:








We will email vessel's immigration/customs clearance copies to you after the vessel has berthed.

The attending RasLaffan Pilot will be issuing Port Clearance upon completion of loading and departure.

Departure Crew List (all to be signed and stamped in original) = 1 Nos.Arrival / Departure Passenger List (if any) = 1 No.



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Declaration

Issued?

Ship to Ship

activity?





Date


security?


SSO Name/Rank :






P&I Club Name & Validity:Hull & Mach Insurance Name & Validity:

Summer Disp:



GT: NT: SDWT:





FOR TANKERS CALLING AT LPB's

PART - A. (Vessel General Information)Vessel Name: IMO No: Call Sign:

Form Date 2010/07/01 Page 10 of


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Size, Rating & Standard of Cargo Mnfld Conctn. (Shore Loading Arms 16" ):


meters.

State in detail if vessel has multiple Deadweight measurement certificates on board.

Ras Laffan SPM ISPS level is 1, Master to declare ships ISPS Level on 72 Hours ETA notice. Please be

Vessel shall comply strictly with ISPS Regulations. Officers and crew are not allowed to leave the vessel

unless valid shore leave pass is arranged by Agents with the Immigration. Normally the same will be issued

only for specific reasons viz. medicals, prior appointment etc.

Please note that fishing / swimming / photography are not allowed at Ras Laffan SPM.


necessary precautions to minimize and control the introduction of unwanted Aquatic Organisms and Pathogens

from the vessels Ballast water.

It is a State of Qatar requirement that the vessel carries out Ballast Water Exchange and Sediment

Removal Programme in accordance with the relevant IMO guidelines and recommendations.



Maximum arrival / departure drafts at the LBP's within the port is 12.5 meters.

Fit a length of rope of 3 metres to the eye of the Fire Wires.

PART - D. (Restrictions, Recommendations & Information)Restrictions applying at Ras Laffan Port :




Only SBT allowed to be discharged : No Clean Ballast.

Master's Name

Signature & Date Ship's Stamp




Are all Cargo Tanks Inerted to 8% or less Oxygen by volume and under positive pressure?



Max. Loading Rate : Anticipated Loading Time :


Manifold dist. fm ship side : Ht. of Manifold above Keel :


Dist. Bow to Center of Manifold: Dist. Stern to Center of Manifold:


Last 3 Cargoes:

PART - C. (Cargo / Operational Information)Advise quantity of Clean Segregated Ballast to be discharged at this Port:



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For easy access Port Regulations can be downloaded using following web link :








Departure Crew List (all to be signed and stamped in original) = 3 Nos.

Arrival / Departure Passenger List (if any) = 1 No.

Crew Effects Declaration = 2 Nos. Maritime Declaration of Health = 2 Nos.


No serious illness on board for preceding 30 days.The Standard International Declaration of Health is available and completed on arrival.





Arrival Crew List (all to be signed and stamped in original) = 3 Nos.







Please note only domestic garbage can be deposited in the garbage skips provided near to the berths of

condensate and sulphur vessels. No chemicals / dunnage materials can be landed into these garbage skips or on

to the quay and have to be retained onboard.



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Port




Thrusters:


NT: SDWT: Summer Disp:

IMO No: Call Sign:

GT:




FOR GENERAL CARGO/ SULPHUR VESSELS

PART - A. (Vessel General Information)Vessel Name:

Breadth: Summer Draft:LOA:

Arr Disp: Prplsn Power:

PART - B. (ISPS Related Information)Vessel's Current Security Level :




security?

Declaration

Issued?

Ship to Ship

activity?



SSO Name/Rank :


Country Departure

Date

ISSC Issue & Exp Date :




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Maximum draft with in the port limit is 12.5 mtrs. Max draft at Ro-Ro/ Heavy Lift berth is 7.5 or 8.0 mtrs.

Restrictions applying at Ras Laffan Port :

Pre-Arrival Information sent latest with 72 Hrs ETA.

Vessel must arrive with the propeller immersed and with a minimal stern trim, which should not exceed 3 meters.

Kindly confirm all crew onboard vessels calling at Ras Laffan Port for loading/discharging, must possess valid

seaman books.

All passengers onboard should have valid pre-arranged Qatari entry visas. Those nationalities who can obtain 'Visa

On Arrival' should possess valid passports.

Any Heavy Lift & its tools O/B:

The responsibility of unloading Heavy Lift/Oversized Cargoes (20 freight tons and above) shall remain at all times

the responsibility of the Vessel. Shipowners and Masters of Vessels calling at the Port must ensure that the cargo

handling equipment onboard are suitable and in good working order for the loading/unloading of the cargo and that

the crew are qualified and experienced in the safe and efficient handling of such cargo. Port Users are reminded

that failure to comply with the above, will result in the Vessel being refused entry to the Port.

Confirm Smoke / Fire detection and fixed fire extinguishing system fully operational:

Fit a length of rope of 3 meters to the eye of the Fire Wires.

Final stowage plan & Discharge sequence:

PART - D. (Restrictions, Recommendations & Information)

Please confirm vessel readiness to work continuously on overtime basis

Advise any vessel defect affecting cargo operations or manoeuvring or mooring ability:

Crew to break all seafastenings and keep cargo ready for discharge:

Cargo Gears:

Advise quantity of clean segregated ballast to be discharged at this Port:

PART - C. (Cargo / Operational Information)Type Of Vessel :


Berthing side Preferences (Port/Starboard):

Last 3 Cargoes:

No. of Stevedoring Gangs Required:

TEUs:

Any forklift requirements: Nos. and capacity:

Quantity of cargo loaded from each port (No. of pkgs/cbm) to be discharged at Ras Laffan Port:

Kindly let us know any Dangerous cargo on board for discharge at Ras Laffan or in transit. If yes, kindly let us

have a copy of Dangerous cargo manifest.


Master's Name





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Supreme Council Qatar have issued a directive regarding Ballast water. Masters are required to take all necessary

precautions to minimize and control the introduction of unwanted aquatic organisms and pathogens from the

Vessels ballast water.

It is a State of Qatar requirement that the Vessel carries out ballast water exchange and sediment removal

programme in accordance with the relevant IMO Guidelines and Recommendations.





Notice of Readiness = 03 Originals. (For Agent, Receiver & Master)




Crew List (with only seaman book number and without passport details) = 06 Originals

Radio Pratique is obtainable through Agents if :No serious illness on board for preceding 30 days.

Arrival / Departure Passenger List (if any) = 1 No.

Nil List (Arms, Birds) = 2 Originals Voyage Memo = 1 Originals


Vessel shall comply strictly with ISPS Regulations. Officers and crew are not allowed to leave the vessel unless

valid shore leave pass is arranged by Agents with the Immigration. Normally the same will be issued only for

specific reasons viz. medicals, prior appointment etc.

No alcoholic drinks to be consumed / distributed / landed while the vessel is in Qatari waters. The bonded stores

should be kept locked. Smoking on deck, cargo spaces and gangway is prohibited. No prohibited items viz. Pork,

Pornographic CDs to be distributed / landed whilst the vessel is at SPM as per Qatari Rules.

Please note only domestic garbage can be deposited in the garbage skips provided near to the berths of condensate

and sulphur vessels. No chemicals / dunnage materials can be landed into these garbage skips or on to the quay and

have to be retained onboard.

Required Hot Work permit. If yes, please complete attached form duly sign/stamp and fax back to Nakilat on +974-

4733219 or email: [email protected]

Crew Effects Declaration = 2 Originals Maritime Declaration of Health = 1 Original

Ship Store List = 2 Originals Bond Stores List = 2 Originals






Vaccination List = 2 Originals Original of Last Port Clearance = 1 No.





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Date


security?

Declaration

Issued?

Ship to Ship

activity?

SSO Name/Rank :



PART - B. (ISPS Related Information)Vessel's Current Security Level : ISSC Issue & Exp Date :







Summer Disp:



GT: NT: SDWT:





FOR SMALL CRAFT (TUGS & BARGES)PART - A. (Vessel General Information)

Vessel Name: IMO No: Call Sign:



17/18

It is mandatory that personnel arriving as passengers onboard the vessel are on the passenger list and the list

indicates the names, nationalities, professions, passport numbers, expiry dates and duly signed & stamped by last

port immigration (Do not include seaman book number).

It is mandatory that the crew list indicate crew names, seaman book numbers, expiry dates, nationalities and rank

duly sign & stamped by last port immigration (Do not include passport number) :

It is mandatory for passenger/s onboard to hold a pre-arranged Qatari visa/s to clear the vessel into Ras Laffan port.

No alcoholic drinks to be consumed / distributed / landed while the vessel is in Qatari waters. The bonded stores

should be kept locked. Smoking on deck, cargo spaces and gangway is prohibited. No prohibited items viz. Pork,

Pornographic CDs to be distributed / landed whilst the vessel is in Port as per Qatari Rules.

Owners/ charters are responsible to pre-arrange the Qatari visa (not seaman visa) for the passengers onboard the

Offshore passes for the passengers onboard the vessel and visitor's to be arranged/ obtained directly from the

respective end-user/ contractor :


PART - D. (Restrictions, Recommendations & Information)In the event if any cargo on board the vessel, necessary customs import clearence process to be completed prior to

vessel arrival or a customs NIL cargo manifest has to be placed on board from the last port duly sign & stamped by

the customs :

All crew onboard the vessel must be in possession of valid seaman book & passport. Crew holding Seaman cards

or Interim Certificates will not be accepted and vessel will not be cleared by immigration :


Master's Name

Party responsible for port, marine, husbandry & agency charges:

Estimated number of crew changes intends to perform per month:

Please forward copy of the vessel registry certificate:

Please forward copy of the vessel ISPS certificate for vessel above 500 GRT:

Field/ location (offshore) intends to work & scope of work intends to carry out:

Any other required services:

Confirm Smoke / Fire detection and fixed fire extinguishing system fully operational:

Any residency status requirements (If req'd, SRF form should be completed)

Pilot exemption requirements:

Intended number of subsequent port calls expected during the stay:

Type Of Vessel :

Official agency appointment:

Duration of stay in Raslaffan port & field:

PART - C. (Cargo / Operational Information)



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Berthing will be subject to completion of customs, immigration clearance documentation, and availability of berth.


Nakilat Agency Company will not prepare any visas other than seaman visas for crew onboard the vessel for sign-

on and sign-off purpose.

Please confirm that a copy of the Ras Laffan Port Regulation onboard and ensure Master of the vessel is fully

aware of the regulations. The RLC Port regulations can be down loaded from www.raslaffan.com.qa under down

load zone.

Please ensure that vessel has the required up to date marine charts (BA 3781 and BA 3791) onboard prior to

proceeding to Ras Laffan. Further, if the vessel is calling/ departing Ras Laffan with a TOW, it is mandatory that

the vessel is covered with a valid towage certificate.

pre arrival questionnaire

Documents