危险货物污染危性货物安全适运申报单.doc

危险货物/污染危害性货物安全适运申报单DeclarationonSafetyandFitnessofDangerousGoods/HazardousGoods(包装货物)(Packaged)进港Arrival□/出港Departure□发货人:Shipper:收货人:Consignee:承运人Carrier船名和航次:Ship’sname&VoyageNO.:装卸港:PortofLoading:卸货港:PortofDischarging:货物标记和编号,如适用,组件的识别符号或登记号:Marks&Nos,oftheGoods,ifapplicable,identificationorregistrationnumber(s)Oftheunit正确运输名称*、危险类别、危规编号;包装类**、包件的种类和数量、闪点℃(闪杯)**、控制及应急温度**、货物为海洋污染物**、应急措施编号***Propershippingname*,IMOhazardclass/division,UNnumber,packaginggroup**,numberandkindofpackages,flashpoint(℃.),controlandemergencytemperature**,identificationofthegoodsasMARINEPOLLUTANT**,EmsNo.***总重(kg)净重/净量Totalweight(weight(kg)交付装运货物的形式:Goodsdelivedas:□杂货Breakbulkcargo□成组件Unitizedcargobox□散货包装Bulkpackages□散装固体Solidinbulk组件类型:Typeofunit:□集装箱Container□车辆Vehicle□罐柜Portabletank□开敞式Open□封闭式Close如适合,在方框内划“×”Inset“×”inappropriatebox*仅使用专利商标/商品名称是不够的,如适合:(1)应在品名前加“废弃物”;(2)“空的未经清洁含有残余物-上一次盛装物”;(3)“限量”**如需要,见《国际危规》***需要时*Proprietary/:(1)theworld“WASTE”shouldproceedname;(2)”EMPTY/UNCLEANED”or“RESIDUE-LASTCONTAINED”;(3)”LIMITEDQUANTITY”theshouldbeadded.**,volume2oftheIMDGCode;***Whenrequired附送以下单证、资料:Thefollowingdocuments(s)andinformationaresubmitted:在某种情况下,需提供特殊资料证书,详见《国际危规》。Incertaincircumstancesspecialinformationcertificatesarerequired,,:上述拟交付船舶装运的危险货物/污染危害性货物已按规定全部并准确地