SHIPS WASTE DECLARATION
INFORMATION TO BE NOTIFIED BEFORE ENTRY INTO THE PORT/TERMINALS OF
PAKISTAN
Nam e of Vessel
Call Sign
IMO Numb er
Flag State
Arrival (ETA)
Departure
Previou s Port
Next Port
--
Last Port & dat e when ship generated waste was delivered:
--
Are you delivering (tick appropriate bo x):
All
D
Some
D
None
D
of your waste into port reception facilitie s?
If deli verin g all waste , complete second column as appropriate ; if delivering some or no waste complete all column­
use 'None', ' Unknown' or 'N/A' i f required .
Typ e of Wa ste
Quantity of
wast e to
be
deliver ed
(m3 )
Maximum
dedicated
storage
capacity
(m 3 )
Amount of
Waste
retained on
board (m3 )
Port at
which
remaining
waste will
be delivered
Estimated
amount of wat er
to be generat ed
between
notification and
next port of call
(ml )
1. Waste Oils
Sludge
--
Other (specify):
2. Garbage
Food Waste
Plastic
.
Other (Specify):
--
3. Sewage
Untreated/Partially Treated
4. Cargo-associated Wast e & Residues1' 1
-
111
Sewage may be discharged at sea in accordance with Regulation 11 Annex of Marp ol 73/78 . The corresponding boxes do not need to
be completed if it is the intention to make an authorized discharged at sea.
121
May be estimates
Not e:
This information may be used for Port State Control and other inspection purpose
Members States will determine which bodies will receive copies of this notification
This form is to be completed unless the ship is covered by an exemption in accordance with Article 9 of Directive 2000/59/EC
I confirm that the above details are accurate and correct and there is sufficient dedicated on-board capacity to st ore all
w aste generated between notification and the next port at which waste will be delivered
.
Dat e:
Time: _ _ _ _ _ _ _
Signature :
Tb o ple
a
e
n
d
returned to Mercantile Marine Department
_