MODEL FORM OF RECORD OF ANTI-FOULING SYSTEMS
[Treedt in werking per 17-09-2008]
RECORD OF ANTI-FOULING SYSTEMS
This Record shall be permanently attached to the International Anti-Fouling System
Certificate
Particulars of ship
Name of ship: ........................................................................................
Distinctive number or letters: ...............................................................
IMO number: .........................................................................................
Details of anti-fouling system(s) applied
Type(s) of anti-fouling system(s) used .................................................
.................................................................................................................
Date(s) of application of anti-fouling system(s) ..................................
.................................................................................................................
Name(s) of company(ies) and facility(ies)/location(s) where applied .......................................................................................................
.................................................................................................................
Name(s) of anti-fouling system manufacturer(s) .................................
.................................................................................................................
Name(s) and colour(s) of anti-fouling system(s) .................................
.................................................................................................................
Active ingredient(s) and their Chemical Abstract Services Registry Number(s) (CAS
number(s)) ....................................................................
.................................................................................................................
Type(s) of sealer coat, if applicable .....................................................
.................................................................................................................
Name(s) and colour(s) of sealer coat applied, if applicable ................
.................................................................................................................
Date of application of sealer coat .........................................................
THIS IS TO CERTIFY that this Record is correct in alle respects.
Issued at .................................................................................................
(Place of issue of Record)
.................................................................................................................
(Date of issue) (Signature of authorized offıcial issuing the record)