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Application to Load or Unload or Transfer Bulk Liquids



Phone No: Email: Confirm Email: Commencement of Proposed handling / transfer
Date: Time:

The Shipping Company, by its Agent, applies to:
dangerous goods and/or bulk liquids to/from the ship, as specified in the attached Dangerous Goods / Bulk Liquids List and, more particularly to:
Handle goods other than dangerous goods in a hold in which dangerous goods are stowed as specified in the attached Dangerous Goods List
Handle goods other than dangerous goods on or above open deck space on which dangerous goods are stowed as specified in the attached Dangerous Goods List
Retain on ship dangerous goods in transit as specified in the attached Dangerous Goods List
Handle dangerous goods between the hours or sunset and sunrise as specified in the attached Dangerous Goods List
Handle goods other than dangerous goods between the hours or sunset and sunrise on a ship which has on board dangerous goods as specified in the attached Dangerous Goods List
Transfer of non-hazardous bulk liquids (eg tallow, vegetable oil etc)

I certify to the best of my knowledge, information and belief (tick whichever applicable)
I am duly authorised to make this application on behalf of the Shipping Company.

This application will incur a fee of $295.44 GST INC

Signature Date of Application

Dangerous Goods / Bulk Liquids List

BerthDateTimeCorrect Technical NameU.N. No (1)I.M.D.G. Class (2)Marpol (3)Flash Point (C)L-Load U-Unload C-Cargo in TransitStowage or proposed stowage on shipNet Weight or Volume [Metric] B Consignor or ConsigneePhone #  
              
(1) - Include Packaging Group if applicable
(2) - Include Subsidiary risk if applicable
(3) - Insert P or PP for a marine Pollutant as designated by the IMDG Code, or Category letters A, B, C, or D as appropriate

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