INTERNATIONAL AIR POLLUTION PREVENTION CERTIFICATE

Issued under the provisions of the Protocol of 1997, as amended, to amend the International Convention for the Prevention of Pollution from Ships, 1973, as modified by the Protocol of 1978 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

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

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

IMO Number............

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

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

THIS IS TO CERTIFY:

1. That the ship has been surveyed in accordance with regulation 5 of Annex VI of the Convention; and

2. That the survey shows that the equipment, systems, fittings, arrangements and materials fully comply with the applicable requirements of Annex VI of the Convention.

This Certificate is valid until (dd/mm/yyyy)............ subject to surveys in accordance with regulation 5 of Annex VI of the Convention.

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

Issued at | ............

(place of issue of Certificate)

Date (dd/mm/yyyy) | ............ | ............

(date of issue) | (signature of duly authorized official issuing the Certificate)

(seal or stamp of the authority, as appropriate)

ENDORSEMENT FOR ANNUAL AND INTERMEDIATE SURVEYS

THIS IS TO CERTIFY that, at a survey required by regulation 5 of Annex VI of the Convention, the ship was found to comply with the relevant provisions of that Annex:

Annual survey | Signed............

(signature of duly authorized official)

Place............

Date (dd/mm/yyyy) ............

(seal or stamp of the authority, as appropriate)

Annual/Intermediate survey | Signed............

(signature of duly authorized official)

Place............

Date (dd/mm/yyyy)............

(seal or stamp of the authority, as appropriate)

Annual/Intermediate survey | Signed............

(signature of duly authorized official)

Place............

Date (dd/mm/yyyy)............

(seal or stamp of the authority, as appropriate)

Annual survey | Signed.............

(signature of duly authorized official)

Place............

Date (dd/mm/yyyy)............

(seal or stamp of the authority, as appropriate)

ANNUAL/INTERMEDIATE SURVEY IN ACCORDANCE WITH REGULATION 9.8.3

THIS IS TO CERTIFY that, at an annual/intermediate survey in accordance with regulation 9.8.3 of Annex VI of the Convention, the ship was found to comply with the relevant provisions of that Annex:

Signed............

(signature of duly authorized official)

Place............

Date (dd/mm/yyyy)............

(seal or stamp of the authority, as appropriate)

ENDORSEMENT TO EXTEND THE CERTIFICATE IF VALID FOR LESS THAN FIVE YEARS WHERE REGULATION 9.3 APPLIES

The ship complies with the relevant provisions of the Annex, and this Certificate shall, in accordance with regulation 9.3 of Annex VI of the Convention, be accepted as valid until (dd/mm/yyyy) ............

Signed............

(signature of duly authorized official)

Place ............

Date (dd/mm/yyyy) ............

(seal or stamp of the authority, as appropriate)

ENDORSEMENT WHERE THE RENEWAL SURVEY HAS BEEN COMPLETED AND REGULATION 9.4 APPLIES

The ship complies with the relevant provisions of the Annex, and this Certificate shall, in accordance with regulation 9.4 of Annex VI of the Convention, be accepted as valid until (dd/mm/yyyy) ............

Signed.............

(signature of duly authorized official)

Place............

Date (dd/mm/yyyy)............

(seal or stamp of the authority, as appropriate)

ENDORSEMENT TO EXTEND THE VALIDITY OF THE CERTIFICATE UNTIL REACHING THE PORT OF SURVEY OR FOR A PERIOD OF GRACE WHERE REGULATION 9.5 OR 9.6 APPLIES

This Certificate shall, in accordance with regulation 9.5 or 9.6 of Annex VI of the Convention, be accepted as valid until (dd/mm/yyyy)............

Signed............

(signature of duly authorized official)

Place............

Date (dd/mm/yyyy)............

(seal or stamp of the authority, as appropriate)

ENDORSEMENT FOR ADVANCEMENT OF ANNIVERSARY DATE WHERE REGULATION 9.8 APPLIES

In accordance with regulation 9.8 of Annex VI of the Convention, the new anniversary date is (dd/mm/yyyy)............

Signed............

(signature of duly authorized official)

Place............

Date (dd/mm/yyyy)............

(seal or stamp of the authority, as appropriate)

In accordance with regulation 9.8 of Annex VI of the Convention, the new anniversary date is (dd/mm/yyyy)............

Signed............

(signature of duly authorized official)

Place............

Date (dd/mm/yyyy)............

(seal or stamp of the authority, as appropriate)

SUPPLEMENT TO INTERNATIONAL AIR POLLUTION PREVENTION CERTIFICATE (IAPP CERTIFICATE)

RECORD OF CONSTRUCTION AND EQUIPMENT

Notes

1. | This Record shall be permanently attached to the IAPP Certificate. The IAPP Certificate shall be available on board the ship at all times.

2. | The Record shall be at least in English, French or Spanish. If an official language of the issuing country is also used, this shall prevail in case of a dispute or discrepancy.

3. | 3 Entries in boxes shall be made by inserting either: a cross (x) for the answers “yes” and “applicable”; or a dash (–) for the answers “no” and “not applicable”, as appropriate.

4. | Unless otherwise stated, regulations mentioned in this Record refer to regulations of Annex VI of the Convention and resolutions or circulars refer to those adopted by the International Maritime Organization.

1. Particulars of ship

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

1.2. IMO Number............

1.3. Date of build

1.3.1. Date of building contract (dd/mm/yyyy) .....

1.3.2. Date on which keel was laid or ship was at a similar stage of construction (dd/mm/yyyy) .....

1.3.3. Date of delivery (dd/mm/yyyy) .....

1.4. Length (L) metres ............

2. Control of emissions from ships

2.1 Ozone-depleting substances (regulation 12)

2.1.1. The following fire-extinguishing systems, other systems and equipment containing ozone-depleting substances, other than hydrochlorofluorocarbons (HCFCs), installed before 19 May 2005 may continue in service:

System or equipment | Location on board | Substance

2.1.2. The following systems containing HCFCs installed before 1 January 2020 may continue in service:

System or equipment | Location on board | Substance

2.2 Nitrogen oxides (NOx) (regulation 13)

2.2.1. The following marine diesel engines installed on this ship are in accordance with the requirements of regulation 13, as indicated:

Applicable regulation of MARPOL Annex VI (NTC = NOx Technical Code 2008) (AM = approved method) | Engine #1 | Engine #2 | Engine #3 | Engine #4 | Engine #5

1 | Manufacturer and model

2 | Serial number

3 | Use (applicable application cycle(s) – NTC 3.2)

4 | Rated power (kW) (NTC 1.3.11)

5 | Rated speed (rpm) (NTC 1.3.12)

6 | Identical engine installed ≥ 1/1/2000 exempted by 13.1.1.2 | □ | □ | □ | □ | □

7 | Identical engine installation date (dd/mm/yyyy) as per 13.1.1.2

8a | Major conversion (dd/mm/yyyy) | 13.2.1.1 & 13.2.2

8b | 13.2.1.2 & 13.2.3

8c | 13.2.1.3 & 13.2.3

9a | Tier I | 13.3 | □ | □ | □ | □ | □

9b | 13.2.2 | □ | □ | □ | □ | □

9c | 13.2.3.1 | □ | □ | □ | □ | □

9d | 13.2.3.2 | □ | □ | □ | □ | □

9e | 13.7.1.2 | □ | □ | □ | □ | □

10a | Tier II | 13.4 | □ | □ | □ | □ | □

10b | 13.2.2 | □ | □ | □ | □ | □

10c | 13.2.2 (Tier III not possible) | □ | □ | □ | □ | □

10d | 13.2.3.2 | □ | □ | □ | □ | □

10e | 13.5.2 (Exemptions) | □ | □ | □ | □ | □

10f | 13.7.1.2 | □ | □ | □ | □ | □

11a | NOx Tier III Emission Control Areas | 13.5.1.1 | □ | □ | □ | □ | □

11b | 13.2.2 | □ | □ | □ | □ | □

11c | 13.2.3.2 | □ | □ | □ | □ | □

11d | 13.7.1.2 | □ | □ | □ | □ | □

12 | AM | installed | □ | □ | □ | □ | □

13 | not commercially available at this survey | □ | □ | □ | □ | □

14 | not applicable | □ | □ | □ | □ | □