INTERNATIONAL READY FOR RECYCLING CERTIFICATE
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(Note: This certificate shall be supplemented by the
Inventory of Hazardous Materials and the Ship Recycling Plan)
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(Official seal)
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(State)
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Issued under the provisions of the Hong Kong International
Convention for the Safe and Environmentally Sound Recycling of Ships, 2009
(hereinafter referred to as “the Convention”) under the authority of the
Government of
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............................................................................................................................
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(Full designation of the country)
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by
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(Full designation of the person or organization
authorized under the provisions of the Convention)
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Particulars of the Ship
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Name of Ship
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Distinctive number or letters
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Port of Registry
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Gross tonnage
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IMO number
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Name and address of shipowner
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IMO registered owner identification
number
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IMO company identification number
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Date of Construction
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Particulars of the Ship Recycling Facility(ies)
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Name of Ship Recycling Facility
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Distinctive Recycling Company identity
number*
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Full address
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Date of expiry of DASR
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* This
number is based on the Document of Authorization to conduct Ship Recycling
(DASR).
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Particulars of the Inventory of Hazardous Materials
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Inventory of Hazardous Materials identification/verification number:
............................................
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Note: The
Inventory of Hazardous Materials, as required by regulation 5 of the Annex to
the Convention, is an essential part of the International Ready for Recycling
Certificate and must always accompany the International Ready for Recycling
Certificate. The Inventory of Hazardous Materials should be compiled on the
basis of the standard format shown in the guidelines developed by the
Organization.
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Particulars of the Ship Recycling Plan
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Ship Recycling Plan identification/verification number:
..................................................................
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Note: The
Ship Recycling Plan, as required by regulation 9 of the Annex to the
Convention, is an essential part of the International Ready for Recycling
Certificate and must always accompany the International Ready for Recycling
Certificate.
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THIS IS TO CERTIFY:
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1
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that the
ship has been surveyed in accordance with regulation 10 of the Annex to the
Convention;
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2
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that the
ship has a valid Inventory of Hazardous Materials in accordance with regulation
5 of the Annex to the Convention;
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3
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that the
Ship Recycling Plan, as required by regulation 9, properly reflects the
information contained in the Inventory of Hazardous Materials as required by
regulation 5.4 and contains information concerning the establishment,
maintenance and monitoring of Safe-for-entry and Safe-for-hot work conditions;
and
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4
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that the
Ship Recycling Facility(ies) where this ship is to be recycled holds a valid
authorization in accordance with the Convention.
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This certificate is valid until (dd/mm/yyyy)
.....................................................................................
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(Date)
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Issued at
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(Place of issue of certificate)
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(dd/mm/yyyy)
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................................................................................................
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(Date of
issue)
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(Signature of duly authorized official issuing the certificate)
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(Seal or stamp of the authority, as appropriate)
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ENDORSEMENT TO EXTEND THE VALIDITY OF THE CERTIFICATE UNTIL REACHING THE
PORT OF THE SHIP RECYCLING FACILITY FOR A PERIOD OF GRACE WHERE REGULATION
14.5 APPLIESfootnote
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This certificate shall, in accordance with regulation 14.5 of the Annex to the
Convention, be accepted as valid for a single point to point voyage
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from the port of:
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to the port of:
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Signed:
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(Signature of duly authorized official)
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Place:
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Date: (dd/mm/yyyy)
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(Seal or stamp of the authority, as appropriate)
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