Part C

Survey Questionnaire
Gas Tanker

Ship name:

IMO No:

Date survey completed:

Survey port:

Surveyor's name:

Survey company:

Surveyor's ref. number:

Order club:

Club ref. no.:

This report, and any accompanying documentation or photographs, has been compiled for the sole use of the Club for insurance
purposes only and should not be disclosed to third parties without prior written permission from the Club. The information contained
in this report, and any accompanying documentation or photographs, is not exhaustive as to the general condition of the ship and
should not be relied upon by members or by any other party as any assurance, representation or warranty as to the condition of the
ship and nothing herein shall prejudice the Club's rights under the insurance policy in the event of a dispute between the Club and
the member relating to the condition of the ship.

International Group of P&I Clubs - Ship Technical Committee Condition Survey Report - Version 8.00.03 - Date 26.01.2017
 5. Survey Questionnaire - Gas Tanker

5.1 Cargo tanks and systems

Y N NA NI Remarks

5.1.1 Are cargo tanks suitable for the Yes

carriage of nominated cargoes No N/A NI
(particularly with reference to
types of cargoes and required
temperatures / pressures)?

5.1.2 Are cargo tank coatings in Yes

apparent satisfactory condition No N/A NI
and free from defects which could
impair cargoworthiness?

5.1.3 Is the overall steel structure in Yes

cargo tanks apparently free from No N/A NI
significant corrosion, pitting,
scaling, buckling, dents, fractures,
wastage, doublers, etc?

5.1.4 Is plating under suction bell Yes

mouths in apparent satisfactory No N/A NI
condition?

5.1.5 Are cargo pumps, ballast pumps Yes

and stripping arrangements No N/A NI
apparently operational including
associated monitoring, alarms,
instrumentation and controls?

5.1.6 Are cargo pump emergency stops Yes

properly located and regularly No N/A NI
tested?

5.1.7 Are emergency shutdown Yes

activation points properly located No N/A NI
and regularly tested?

5.1.8 Are cargo and vapour lines clearly Yes

marked and are all lines lagged No N/A NI
effectively?

5.1.9 Are reducers, removable U-bends Yes

and cargo hoses, if carried, in No N/A NI
apparent satisfactory condition?

International Group of P&I Clubs - Ship Technical Committee Condition Survey Report - Version 8.00.03 - Date 26.01.2017
 Y N NA NI Remarks

5.1.10 Are hoses pressure tested, Yes

certificated and in apparent No N/A NI
satisfactory condition?

5.1.11 Are hoses regularly tested for Yes

continuity? No N/A NI

5.1.12 Are spill trays and savealls in Yes

apparent satisfactory condition? No N/A NI

5.1.13 If fitted, is the overside water Yes

spray curtain effective? No N/A NI

5.1.14 Is the ship provided with portable Yes

instruments as required, is span No N/A NI
gas available and are records of
recent calibration kept?

5.1.15 Is the fixed and portable electrical Yes

equipment used suitable for use in No N/A NI
hazardous areas?

5.1.16 Are superstructure and Yes

deckhouse doors, windows, air No N/A NI
inlet flaps, etc. facing the cargo
area in apparent satisfactory
condition?

5.1.17 Is the compressor house / motor Yes

room / re-liquifaction plant space No N/A NI
clean and tidy and are bilges free
from cargo?

5.1.18 Are bulkhead seals between Yes

compressor house and motor No N/A NI
room gas tight and well
lubricated?

5.1.19 Are compressor house / motor Yes

room / re-liquifaction plant space No N/A NI
fans operational?

5.1.20 Is the motor room ventilation Yes

maintaining positive pressure? No N/A NI

International Group of P&I Clubs - Ship Technical Committee Condition Survey Report - Version 8.00.03 - Date 26.01.2017
 Y N NA NI Remarks

5.1.21 Is the compressor room Yes

ventilation maintaining negative No N/A NI
pressure?

5.1.22 Is compressor house / motor room Yes

/ re-liquifaction plant space floor No N/A NI
plating satisfactory?

5.1.23 Are safe compressor house / Yes

motor room / re-liquifaction plant No N/A NI
space procedures identified and
complied with?

5.1.24 Is the cargo heating system Yes

apparently fully operational and No N/A NI
well maintained?

5.1.25 Is the tank insulation (as viewed Yes

from void spaces) in apparent No N/A NI
satisfactory condition? Confirm no
visible cold spots as seen from
void space?

5.1.26 Is the cargo re-liquefaction plant Yes

and associated machinery in No N/A NI
apparent satisfactory
condition?

5.1.27 If appropriate, are fire wires in Yes

apparent satisfactory condition No N/A NI
and properly rigged?

5.1.28 Has the ship been inspected by Yes

OCIMF-Sire and / or CDI recently? No N/A NI

Additional information

5.2 Inert Gas System

Y N NA NI Remarks

5.2.1 Is the IGS, including Yes

instrumentation, alarms, trips, and No N/A NI
pressure / oxygen recorders,
apparently fully operational and
with calibration records
maintained?

International Group of P&I Clubs - Ship Technical Committee Condition Survey Report - Version 8.00.03 - Date 26.01.2017
 Y N NA NI Remarks

5.2.2 If fitted, is the nitrogen generator Yes

system apparently operating No N/A NI
satisfactorily?

5.2.3 Are the inter barrier space Yes

temperatures and pressure No N/A NI
monitored and recorded?

5.2.4 Are fans, scrubber, deck seals, Yes

p/v breakers and non-return valve No N/A NI
in apparent satisfactory condition?

Additional information

5.3 Closing appliances

Y N NA NI Remarks

5.3.1 Are closing devices, associated Yes

gaskets and securing No N/A NI
arrangements on the freeboard
deck in apparent satisfactory
condition?

5.3.2 Are tank domes, hatches, gaskets Yes

and securing devices in apparent No N/A NI
satisfactory condition?

5.3.3 Are the cargo tank venting Yes

arrangements in apparent No N/A NI
satisfactory condition?

5.3.4 Are the cargo tank, void spaces Yes

and inter barrier spaces (where No N/A NI
fitted) relief valves set correctly
and in apparent satisfactory
condition?

5.3.5 Are air locks between gas Yes

dangerous spaces and gas safe No N/A NI
spaces, if fitted, in an operational
state and in apparent satisfactory
condition?

Additional information

International Group of P&I Clubs - Ship Technical Committee Condition Survey Report - Version 8.00.03 - Date 26.01.2017
 5.4 Cargo Control
Y N NA NI Remarks

5.4.1 Are primary and secondary cargo Yes

monitoring indicators, controls No N/A NI
and panels in apparent
satisfactory condition?

5.4.2 Are detailed cargo handling and Yes

tank cleaning plans prepared and No N/A NI
are operations carried out and
logged in accordance with the
agreed plan?

5.4.3 Is the tank gauging system Yes

operational? No N/A NI

5.4.4 Is the means for emergency Yes

discharge inspected and results No N/A NI
recorded?

5.4.5 Are gas detection systems and Yes

bilge alarms operational, regularly No N/A NI
tested and with results recorded?

5.4.6 If fixed gas detection and Yes

monitoring system is not fitted, No N/A NI
are routines in place for regular
monitoring with portable
instruments?

5.4.7 Are safety guidelines regarding Yes

static hazards in place and strictly No N/A NI
adhered to?

5.4.8 Is appropriate cargo specific Yes

information including Material No N/A NI
Safety Data Sheets available on
board?

Additional information

International Group of P&I Clubs - Ship Technical Committee Condition Survey Report - Version 8.00.03 - Date 26.01.2017
 5.5 Safety and Operational test (were the following tests carried out and found satisfactory?)

Y N NA NI Remarks

5.5.1 Engine room bilge high level Yes

alarms. No N/A NI

5.5.2 Emergency fire pump with two fire Yes

hoses on separate hydrants. No N/A NI

5.5.3 Emergency power sources and Yes

emergency lighting. No N/A NI

5.5.4 Engine room remote stops and Yes

shutdowns. No N/A NI

5.5.5 Relevant cargo high level alarms. Yes

No N/A NI

5.5.6 Decontamination showers and Yes

eye baths on deck (operational No N/A NI
under all ambient weather
conditions?)

5.5.7 Emergency shut down system, Yes

including trips and valve timings. No N/A NI

5.5.8 Deck spray system. Yes

No N/A NI

Additional information

International Group of P&I Clubs - Ship Technical Committee Condition Survey Report - Version 8.00.03 - Date 26.01.2017