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To: Notary Public port of …………. Date:

 

STATEMENT OF SEA PROTEST

 

I, …….., Master of the m/v …… (type and name) of …….. (port of registry) Register number … of …… gross tonnage, which sailed from …… on or about ….. day of …….. (month) bound for …. with the cargo of …tonns and arrived at ……. on the …. day of ……. (month).

The vessel was tight, staunch and strong, well-manned, victualled and sound and in every respect fit to perform the intended voyage.

During the voyage on the ………. (dates) the vessel encountered the ……….. (weather information according to the Log book and the details of the voyage).

Though I, the Master, and the crew have taken every precaution to safeguard the ship, her cargo and the crew according to good seamanship, some loss or damage might be caused to the said ship or her appurtenances or cargo or some other property on board by reason of ….(reasons).

I hereby declare this Sea Protest against any claims by all persons or a person whom it shall or may concern and I reserve the right to extend the same at time and place convenient.

…………………………

(signature)

 

Master m/v ……………

 

 

Witnesses to the Sea Protest:

1.

2.

3.

CASUALTY REPORT

M/v “Pink Panther”. Master Oleg Popov. Sailing under the flag of the Russian Federation, gross tonnage 15,897 net tonnage 8,092 LOA 107 m, registered at the port of Nakhodka, Russia, sailed from Tokyo (Japan), bound for Hilo (Hawaii,USA) with 1352 tonns of general cargo on board.

Proceeding to Hilo port at 0915 UTC on April 15, 2005 in position Lat. 32015’N Lon. 078016’W, fire broke out in hold #3 due to spontaneous combustion of the cargo of mineral oil.

Weather at the moment of the accident: wind force 5 to 7, rough to very rough seas, visibility moderate. The forecast was unfavourable: strong gale becoming storm force, high seas, dense fog.

Vessel suffered rolling and pitching, list up to 200 to either side.

The crew did all the best to put out fire and one hour later fire was extinguished by flooding CO2 into the hold.

As a result of the fire the vessel sustained the following damages:

- 16 barrels of mineral oil completely gutted (destroyed);

- partly burnt paint on 60 barrels;

- 1 pump burnt out;

- 15 metres of power cable line inside hold #3 destroyed;

- 45 square metres of sidewalls paint of the hold burnt.

Conclusion: the accident happened due to the absence of due attention of the cargo mate (2-nd officer) to his duties. He did not monitor the temperature in cargo spaces in good time as prescribed by the rules.

 

(or: The accident occurred due to the force-majeure circumstances as mineral oil is liable to self ignition)

 

 

  Form – 19100 Part B alleged Accident & Incident Report Investigation on Vessel Revision No.: Date Effective: Approved:
Форма – 19100 Часть В Доклад о происшествиях Расследование на судне Версия No.: Дата: Утверждено:

 

This form is to be completed in respect of every alleged accident or incident. See Procedure for further guidance

Эта форма должна быть заполнена в отношении любого подозрительного происшествия. Смотрите процедуру для дальнейшего руководства

 

Vessel/Судно Master/Капитан Client/ Клиент Ref./ Ссылка    

 

Describe actual events or circumstances leading up to the incident/ Описать действительные случаи или обстоятельства, приведшие к происшествию.    

Investigation results/Результаты расследования


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