866710388.
docx
1. Vessel Particulars
Type IMO No
Built By Year
Registry Call Sign
Name Owner
Crew / Manning and Passengers
Master’s Name
Officer Crew LSA Cert Accommodation
Total Total Total Cert Total
Air Draft Forecastle Raised Yes / No
Length OA Depth Moulded GRT
Length BP Draft at LBP NRT
Beam Moulded Draft, Summer Displacement,
Summer / DWT
Classification
Vessel Ice Class
Classification
Classed by Last Survey
M/C Classification
Classified by Last Survey
Drydock Drydock
Last Date Last Place
Certification
Load Line issued Valid till
by
Last Survey Place
Date
Safety Equipment Valid till
Cert issued by
Last Survey Place
Date
Radio License Valid till
issued by
Page 1 of 6
866710388.docx
Suez Canal Cert Yes / No Panama Yes / No
Canal Cert
Stability Guidelines Section 8
Stability Book Approved by Date
Navigation Equipment Make Type
Navigation System
Navigation System
Navigation System
Compass (Gyro)
Compass (Magnetic)
(corrected date)
Radar 1
Radar 2
Echo Sounder
Charts adequate and
updated
Navigational Equipment Or Restricted Tow
adequate for
unrestricted tow
Communications Make Type
Transmitter
Receiver
VHF
VHF Portable (Qty)
Engine Make & Type Total No
Propeller Make & Type Total No
(with Nozzle Y / N )
Thruster Bow BHP /
Thrust
Thruster Stern BHP /
Thrust
Generator KW
Page 2 of 6
866710388.docx
Generator, Emergency KW
Brake Horsepower and Bollard Pull
BHP Total Continuous @ RPM Maximum
Speed (knots)
Bollard Pull Continuous Certified / Estimate Certified by
Bollard Pull Maximum Certified / Estimate Certified Date
Towing Winches Guidelines Section 5
Main Drums Pull, Brake,
Type Max Rated Max Rated
Second Drums Pull, Brake,
Type Max Rated Max Rated
General comments and details of emergency operation of towing winches
Page 3 of 6
866710388.docx
Construction Tensile Grade Hard Eyes Breaking Dia- Length L x BL / BL / Cont Certified by Certified Condition
Load meter (Meters) Cont BP BP Date
(Tons) (mm)
Tow Wire,
Main
Tow Wire,
Spare
Tow
Pennant
Tow
Pennant
Tow
Pennant
Stretcher,
Main
Stretcher,
Spare
Tow Wire, Spare Guidelines Section 5.5.3
Stowed on Reel Yes / No Easily accessible for spooling onto towing drum? Yes / No Reel or storage drum powered? Yes / No
Page 4 of 6
866710388.docx
Shackles Guidelines Section 5.5.11
Make & Type SWL Use / Function Qty
/ BL
Additional Type Capacity Qty Capacity
Equipment (Total)
Salvage Pumps, TPH TPH
Fixed
Salvage Pumps, TPH TPH
Portable
Gas Cutting -
Gear
Welding -
Equipment
Deck Tugger SWLT -
Winches
Deck Capstans SWLT -
Consumables Grade Capacity Onboard Consumables Grade Capacity Onboard
Fuel Oil Lubrication Oil
MDO Fresh Water
Specific Towage (if Section A only)
Approval
Tow of From
During (Season) To
Subject to
Surveyor Date
Critical Spares
Boats / Rafts Type Capacity Qty Capacity
Page 5 of 6
866710388.docx
(Total)
Life Boats Pax Pax
Life Rafts Pax Pax
Work Boats Pax Pax
Anchors Type Weight Cable Cable
Dia Length
Port
Starboard
Spare
Does Vessel comply with Noble Denton Guidelines for the Approvability of Towing Vessels?
Yes / No For Category R1, R2, R3, U
Deficiencies
How was information obtained?
Surveyor Name Place Date Signature
Page 6 of 6
