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Appendix IV — Form of Exemption Certificate for UNSP Barges Internationaal Verdrag ter voorkoming van verontreiniging door schepen, 1973, zoals gewijzigd door het Protocol van 1978 daarbij

Form of Exemption Certificate for UNSP Barges

INTERNATIONAL OIL POLLUTION PREVENTION EXEMPTION CERTIFICATE FOR UNMANNED NON-SELF-PROPELLED (UNSP) BARGES

Issued under the provisions of the International Convention for the Prevention of Pollution from Ships, 1973, as modified by the Protocol of 1978, as amended, relating thereto (hereinafter referred to as “the Convention”) under the authority of the Government of:

..........

(full designation of the country)

by ..........

(full designation of the competent person or organization authorized under the provisions of the Convention)

Particulars of ship

* Alternatively, the particulars of the ship may be placed horizontally in boxes.

Name of ship ..........

Distinctive number or letters..........

Port of registry..........

Gross tonnage ..........

THIS IS TO CERTIFY:

1. That the UNSP barge has been surveyed in accordance with regulation 3.7 of Annex I to the Convention;

2. That the survey shows that the UNSP barge:

.1 is not propelled by mechanical means;

.2 carries no oil (as defined in regulation 1.1 of Annex I to the Convention);

.3 has no machinery fitted that may use oil or generate oil residue (sludge);

.4 has no oil fuel tank, lubricating oil tank, oily bilge water holding tank and oil residue (sludge) tank; and

.5 has neither persons nor living animals on board; and

3. That the UNSP barge is exempted, under regulation 3.7 of Annex I to the Convention, from the certification and related survey requirements of regulations 6.1 and 7.1 of Annex I to the Convention.

This certificate is valid until (dd/mm/yyyy) ..........

subject to the exemption conditions being maintained.

Completion date of the survey on which this certificate is based (dd/mm/yyyy) ..........

Issued at ..........

(place of issue of certificate)

.......... | ..........

(date of issue) (dd/mm/yyyy) | (signature of duly authorized official issuing the certificate)

(seal or stamp of the authority, as appropriate)

Regeling
Internationaal Verdrag ter voorkoming van verontreiniging door schepen, 1973, zoals gewijzigd door het Protocol van 1978 daarbij
Afkortingen
MARPOL, MARPOL 73/78
Soort
Verdrag
Geldend vanaf
01-03-2026
BWB-id
BWBV0003241
Versie
2026-03-01_0

In de hele regeling · Officiële tekst op wetten.overheid.nl