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船舶载运危险货物污染危害性货物申报单散装液体物质

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l valid plete; the ship’s construction, equipment and arrangements are in good condition and meet the requirements of fitness for carrying the above declared goods; the documentation of goods plete and the declaration is ture and correct.Р附送以下单证、资料:船舶国籍证书、适航证书、油污损害民事责任保险证书、燃油污染损害民事责任保险证书、舱单、委托证明РThe following document(s) and information are submitted in addition:Р船长/申报人员:张三船舶/代理人(盖章)РMaster/declarer: Ship / Agent (Seal)Р船长证书编号/申报人员培训备案编号:####01 日期:2015-04-15РCertiticate No: Date:Р主管机关签证栏РRemarks by the AdministrationР紧急联系人姓名、电话、传真、电子邮箱:张三,手机137########РEmergency Contact Person’s Name, Tel, Fax and E-mail :Р此申报单一式三份,其中两份申报人留持和分送港口作业部门,一份留主管机关存查。РThis declaration should be made in tripartite, one is kept by the Administration for file, and two for the declarer and port operator respectively.

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