危险污染危害性货物安全适运申报单.doc

危险/污染危害性货物安全适运申报单
Declaration on Safety and Fitness of Dangerous Goods / Hazardous Goods
(散装液体物质)
(Bulk Liquids)
进港Arrival□/出港DepartureS
发货人(名称、地址) :###公司##市##路##号
Shipper ( name,address ) :
承运人名称(或其代理人):###公司
Carrier ( or its agent ) :
货物种类(在相应的方框内填上“×”)
Kinds of goods ( Insert “×”in appropriate box ):
□散化□液化气 S散装油类
Bulk chemical Liquefied gas Bulk oil
船名和航次:###轮###航次
Ship’s name & Voyage NO. :
装货港:武汉
Port of Loading:
卸货港:安庆
Port of Discharging :
正确运输名称※;污染物类别;危规编号;数量(吨);闪点(闭杯);可燃上下限;自燃温度;沸点;液体相对密度;蒸气密度;蒸气压力(20℃/℃) ;水中溶解度;粘度;酸度;TLV (ppm),LC50;LC50(口服/皮肤);导电率(ps/m);液化温度和压力
Proper Shipping Name※;IMO pollution Category; UN No; Quantity; Fiash Point(closed cup);Flammability Limits; Autoignition Temperature; Boiling Point; Relative Density of Liquid; Vapour Pressure; Solubility in Water; Viscosity; Acidity; TLV(ppm);LC50;LD50(oral/skin);Conductivity(ps/m);Temperature & Pressure of Liquefaction
残油燃料油;MARPOL附则Ⅰ油类;危规编号1268;3000吨;闪点≥60℃,82℃
注:以上货物特性根据货物种类填写合适项目。
Remarks : Please fill in the proper columns with cargo properties ※不能仅使用贸易或专利名称
According to the cargo classification. Proprietary / trade names alone are not sufficient.
附加资料:
Additional information:
危险货物安全技术说明书、委托证明
货物反应性:
Reactivity of the cargo :
在正常存储和运输条件下稳定;避免与高温、火源、氧化剂接触。
应急措施(溢漏需采取的措施、有效灭火剂、其它应急措施):
Emergency measures (The measures taken for spill, effective fire extinguishing a