572 



(j) Discharge overboard of bilge water containing oil which has 

 accumulated in machinery spaces whilst in port. [*] 



54. Port: 



55. Duration of stay : 



56. Quantity disposed : 



57. Date and place of disposal : 



58. Method of disposal (state whether a separator was used) : 



Date of entry Officer in charge 



Master . 



(k) Accidental or other exceptional discharges of oil : 



59. Date and time of occurrence : 



60. Place or position of ship at time of occurrence : 



61. Approximate quantity and type of oil : 



62. Circumstances of discharge or escape, the reasons therefor and 



general remarks : 



Date of entry Officer in charge .^ 



Master 



(1) Has the oil monitoring and control system been out of operation 

 at any time when discharging overboard. If so give time and 

 date of failure and time and date of restoration and confirm 

 that this was due to equipment failure and state reason if 

 known: ^ 



Date of entry . Officer in charge 



Master 



(m) Additional operational procedures and general remarks : 



For oil tankers of less than 150 gross tons tonnage operating -in 

 accordance with Kegulation 15(4) of Annex I of the Conven- 

 tion, an appropriate oil record book should be developed by the 

 Administration. 



For asphalt carriers, a separate oil record book may be developed by 

 the Administration utilizing sections (a), (b), (c), (e), (h), (j), (k) 

 and (m) of this form of oil record book. 



II— For Ships Other Than Oil Tankers 



Name of ship • 



Operations from (date), to . (date) 



(a) Ballasting or cleaning of oil fuel tanks : 



1. Identity of tank (s) ballasted: 



2. Whether cleaned since they last contained oil and, if not, type 



of oil previously carried : 



3. Date and position of ship at start of cleaning : 



4. Date and position of ship at start of ballasting : 



Date of entry Officer in charge 



Master 



* Where the pump starts automatically and discharges through a separator at all times 

 it will be suflBcient to enter each day "Automatic discharge from bilges through separator." 



