船 舶 载 运 危 险 货 物 申 报 单.doc

船 舶 载 运 危 险 货 物 申 报 单_20470DeclarationFormforSolidBulkCargoesCarriedByShip船名:Ship’sName:航次:VoyageNo.:□进港Arrival始发港:PortofDeparture:抵港时间:TimeofArrival:国籍:Nationality:经营人:Manager:□出港Departure作业泊位:Berth:作业时间:TimeofLoading:,本轮具备装载上述货物的适装条件,货物配装符合要求,货物资料齐全。申报内容准确无误。Iherebydeclarethat,ordancewiththeprovisionsofthesafetransportationofsolidbulkcargoesbyshipsandpollutionprevention,thisshiphasmettherequirementsoffitnessforcarryingtheabovedeclaredgoods;ordingtotherequirements;、:Master/Declarator:船长/申报员证书编号:CertificateNo.:船舶/代理人(盖章)Ship/Agent(Seal)日期:Date:紧急联系人姓名、电话、传真、电子邮箱:EmergencyContactPerson’sName,TelephoneNo.,Fax,andE-mail:此申报单一式三份,其中两份退申报人留持并分送港口作业部门,一份留主管机关存查。Thisdeclarationshouldbemadeintripartite,oneiskeptbytheAdministrationforfile,