IMO通函《海上事故或事件报告》.docx
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IMO通函《海上事故或事件报告》
ANNEX1
SHIPIDENTIFICATIONANDPARTICULARS
AdministrationsareurgedtosupplytheshipidentificationinformationlistedinthisannexforallmarinecasualtyreportssubmittedtotheOrganization.
SHIPPARTICULARS
1IMONumber:
2NameofShip:
3FlagAdministration:
4TypeofShip:
.1LiquefiedGasTanker☐
.2ChemicalTanker☐
.3OilTanker☐
.4OtherLiquids（non-flammable）Tanker☐
.5BulkDry（general,ore）Carrier☐
.6BulkDry/OilCarrier☐
.7Self-DischargingBulkDryCarrier☐
.8OtherBulkDry（cement,woodchips,ureaandotherspecialized）Carrier☐
.9GeneralCargoShip☐
.10Passenger/GeneralCargoShip☐
.11ContainerShip☐
.12RefrigeratedCargoShip☐
.13Ro-RoCargoShip☐
.14Passenger/Ro-RoCargoShip☐
.15PassengerShip☐
.16High-SpeedCraft☐
.17OtherDryCargo（livestock,barge,heavycargo,etc.）Carrier☐
.18FishCatchingVessel☐
.19FishFactoryShip/FishCarrier☐
.20OffshoreSupplyShip☐
.21OtherOffshoreShip☐
.22ResearchShip☐
.23Towing/PushingTug☐
.24Dredger☐
.25OtherActivitiesShip☐
.26Non-PropelledShips☐
.27OtherShipsStructures☐
5Typeofservice:
（）International
（）Shortinternational
（）Coastalseatrade
（）Inlandwaters
（）Other,pleasestate:
（）Notreported
6Wereanyvoyagerelatedrestrictionlimitsplacedontheship?
Explain:
7GrossTonnage:
8Lengthoverall:
9ClassificationSociety:
10RegisteredShipowner:
11ShipManager/Operator:
12Previousnames:
13PreviousFlag:
14PreviousClassSociety:
15Dateofcontract/keellaid/delivery:
16Dateofmajorconversion:
17Deadweight:
18Hullmaterial:
.1steel☐
.2lightalloy☐
.3ferrocement☐
.4wood☐
.5GRP☐
.6compositematerials☐
19Hullconstruction:
.1singlehull☐
.2doublehull☐
.3doublebottom☐
.4doublesides☐
.5middeck☐
.6other☐
20PropulsionType（type,fuel,etc.）:
SteamDieselOther
.1Bunkers:
HeavyFuelOil（HFO）MediumFuelOil（MFO）MarineDieselOil（MDO）
21Natureofcargo（e.g.,oil,drybulkandgoodsundertheIMDGCode）:
22Buildingyard:
23Hullnumber:
24Dateoftotalloss/constructivetotalloss/scrapping:
25NumberofCrewonship’scertificate:
26NumberofPassengersonship’scertificate:
27Numberofpersonsonboardatthetimeofthecasualty/accident:
.1Crew:
____________
.2Passengers:
_______
.3Others:
___________
PRELIMINARYCASUALTYDATA
28Dateandtime（localonboard）:
29Position/location:
30Initialevent*:
☐collision
☐stranding/grounding
☐contact
☐fireorexplosion
☐hullfailure/failureofwatertightdoors/ports,etc.
☐machinerydamage
☐damagestoshiporequipment
☐capsizing/listing
☐missing:
assumedlost
☐accidentswithlife-savingappliances
☐other
31Consequences:
☐totallossoftheship
¨shiprenderedunfittoproceed**
¨
☐shipremainsfittoproceed***
☐pollution
☐lossoflife
☐seriousinjuries
32Summaryofevents:
***
ANNEX2
DATAFORVERYSERIOUSANDSERIOUSCASUALTIES
CASUALTYDATA
1Dateandlocaltimeofcasualty:
（24hrclock）（dd/mm/yyyy）:
2Positionofcasualty（Latitude,Longitude）:
3Locationofcasualty:
3.1Atberth☐
3.2Anchorage☐
3.3Port☐
3.4Portapproach☐
3.5Inlandwaters☐
3.6Canal☐
3.7River☐
3.8Archipelagos☐
3.9Coastalwaters（within12miles）☐
3.10Opensea☐
4Pilotonboard:
☐
5Typeofcasualty（initialevent）:
5.1Collision:
strikingorbeingstruckbyanothership（regardless☐
ofwhetherunderway,anchoredormoored）.
5.1.1IMONumberofothershipinvolved.（notcoded）
5.1.2
5.1.2Nameofothershipinvolved.（notcoded）
5.2Strandingorgrounding:
beingaground,orhitting/touchingshore☐
orseabottomorunderwaterobjects（wrecks,etc.）.
5.3Contact:
strikinganyfixedorfloatingobjectotherthanthose☐
includedinNo.1or2.
5.4Fireorexplosion.☐
5.5Hullfailureorfailureofwatertightdoors,ports,etc.:
notcaused☐
byNos.1to4.
5.6Machinerydamage:
notcausedbyNos.1to5,andwhich☐
necessitatedtowageorshoreassistance.
5.7Damagestoshiporequipment:
notcausedorcoveredbyNos.1to6.☐
5.8Capsizingorlisting:
notcausedbyNos.1to7.☐
5.9Missing:
assumedlost.☐
5.10Accidentswithlife-savingappliances.☐
5.11Other:
allcasualtieswhicharenotcoveredbyNos.1to10.☐
6Typeofsubsequentevents:
6.1Collision:
strikingorbeingstruckbyanothership（regardless☐
ofwhetherunderway,anchoredormoored）.
6.1.1IMONumberofothershipinvolved.（notcoded）
6.1.2Nameofothershipinvolved.（notcoded）
6.2Strandingorgrounding:
beingaground,orhitting/touching☐
shoreorseabottomorunderwaterobjects（wrecks,etc.）.
6.3Contact:
strikinganyfixedorfloatingobjectotherthanthose☐
includedinNo.1or2.
6.4Fireorexplosion.☐
6.5Hullfailureorfailureofwatertightdoors,ports,etc.☐
6.6Machinerydamagewhichnecessitatedtowage☐
orshoreassistance.
6.7Damagestoshiporequipment.☐
6.8Capsizingorlisting.☐
6.9Missing:
assumedlost.☐
6.10Accidentswithlife-savingappliances.☐
6.11Other:
alleventswhicharenotcoveredbyNos.1to10.☐
7Consequencesofthecasualty:
7.1Consequencestotheshipinvolvedinthecasualty:
7.1.1Totalloss☐
7.1.2Shiprenderedunfittoproceed☐
7.1.3Shipremainsfittoproceed**☐
7.2Consequencesrelatedtohumanbeings:
7.3
7.2.1Numberofdeadormissingcrew_______
7.2.2Numberofdeadormissingpassengers_______
7.2.3Numberofotherdeadormissingpersons_______
7.2.4Numberofcrewbeingseriouslyinjuredinthecasualty_______
7.2.5Numberofpassengersbeingseriouslyinjuredin
thecasualty_______
7.2.6Numberofotherpersonsbeingseriouslyinjuredin
thecasualty_______
7.3Consequencestotheenvironment（pollution）:
7.3.1Oilinbunkers:
☐
7.3.1.1TypeofoilQuantityspilled
☐Heavyfuel_______
☐Diesel_______
☐Lubeoils_______
☐Other_______
7.3.2Oilcargo:
☐
7.3.2.1Typeofoil（notcoded）Quantityspilled
☐Crudeoil_______
☐Persistentrefined_______
oilproducts
☐Non-persistentrefined_______
oilproducts
☐Others_______
7.3.3Chemicalsinbulk:
☐
Category（AppendixItoAnnexIIofMARPOL）
Quantityintonsspilled
☐X_______
☐Y_______
☐Z_______
☐OS_______
7.3.4DangerousGoodsinpackagedform:
☐
Class（IMDGCode）ProperUNnumbersQuantitylost
Shippingoverboard
Names
1☐__________________
2☐__________________
3☐__________________
4.1☐__________________
4.2☐__________________
4.3☐__________________
5.1☐__________________
5.2☐__________________
6.1☐__________________
6.2☐__________________
7☐__________________
8☐__________________
9☐__________________
8Primarycausesoftheinitialevent:
Codingprinciple:
aThehumanelementisacomplexmulti-dimensionalissuethataffectsmaritimesafetyandmarineenvironmentalprotection.Itinvolvestheentirespectrumofhumanactivitiesperformedbyships’crews,shorebasedmanagement,regulatorybodies,classificationsocieties,shipyards,legislatorsandotherrelevantparties.
bEffectiveremedialactionfollowingmaritimecasualtiesrequiresasoundunderstandingofthehumanelementinvolvementinaccidentcausation.Thiscomesbythethoroughinvestigationandsystematicanalysisofcasualtiesforcontributoryfactorsandthecausalchainofevents.
8.1Internalcauses（relatedtotheshipwherethecasualtyoccurred）:
☐
8.1.1Humanviolationsorerrorsbythecrew:
☐
.1Humanviolations☐
.2Humanerror☐
8.1.2Humanviolationsorerrorsbythepilot:
☐
.1Humanviolations☐
.2Humanerror☐
8.1.3Structuralfailuresoftheship:
☐
8.1.4Technicalfailureofmachinery/equipmentincludingdesignerrors:
☐
.1Failureofpropulsionmachinery☐
.2Failureofessentialauxiliarymachinery☐
.3Failureofsteeringgear☐
.4Failureofclosingarrangementsorseals☐
.5Failureorinadequacyofnavigationalequipment☐
.6Failureofbilgepumping☐
.7Failureofelectricalinstallation☐
.8Failureorinadequacyofcommunicationequipment☐
.9Failureorinadequacyoflifesavingappliances☐
.10Shipdesignerrors（i.e.insufficientstability）☐
.11Other☐
8.1.5Theship’scargo:
☐
.1Cargoshifting☐
.2Fireorexplosionincargo☐
.3Improperstowageofcargo☐
.4Spontaneouscombustion☐
.5Cargoliquefaction☐
.6Other☐
8.2Externalcauses（outsidetheship）:
☐
8.2.1Anothershiporships（improperactions,etc.）☐
8.2.2Theenvironment:
☐
.1Heavysea☐
.2Wind☐
.3Currentsortides☐
.4Icing☐
.5Iceconditions☐
.6Restrictedvisibility☐
8.2.3Navigationalinfrastructure:
☐
.1Failuresinaidstonavigation☐
.2Inaccuratechartsornauticalpublications☐
.3Chartsornauticalpublicationsunavailableforthesea☐
.4VTS☐
8.2.4Criminalacts:
☐
8.2.5Other“external”causes（i.e.notassociatedwiththeshipitself）:
☐
.1Tugboatoperations☐
.2Failureorincorrectoperationofshoreequipmentor
installation☐
.3Otherthan.1and.2☐
8.3Unknowncauses:
☐
9Violationsanderrortypes:
9.1Violation（deliberatedecisiontoactagainstaruleorplan）:
☐
9.1.1Routine（cuttingcorners,takingpathofleasteffort,etc.）☐
9.1.2Necessary（duetoinad
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