Request to berth with a service or support vessel in a petroleum port

Note:
- Demonstrable need
- Service or support vessel: only for carrying out necessary maintenance

On whose behalf the request is made

Other

Personal Data

Name of applicant

Phone number (contact person)

Company/agency

Address

Address 2

City/Town

ZIP/Postal Code

Country

Ship

Sea Shipping or Inland Shipping

Sea Shipping

Inland Shipping

IMO

Imo number (Fill in the IMO number to get ship details)

Vessel name / registration

ENI

ENI/Ship Registration Number

Ship Name

Berth Selection

Municipality

Considering

Article 5.3 of the 2020 Rotterdam Port By-Laws, which prohibit open flame, smoking and sparking in a Petroleum Harbour;
Article 14.1 of the 2020 Rotterdam Port By-Laws, which includes the obligation to comply with the rules of the Port By-Laws;
Article 1.9 of the 2020 Rotterdam Port By-Laws, in conjunction with the Rotterdam Mandate, Power of Attorney and Authorisation Decree 2021, under which permits/exemptions may be granted by the Harbour Master in mandate, on behalf of the Municipal Executive.

Considering

Article 5.3 of the 2020 Dordrecht Port By-Laws, which prohibit open flame, smoking and sparking in a Petroleum Harbour;
Article 14.1 of the 2020 Dordrecht Port By-Laws, which includes the obligation to comply with the rules of the Port By-Laws;
Article 1.9 of the 2020 Dordrecht Port By-Laws, in conjunction with the Dordrecht Harbour Master’s Mandate, Power of Attorney and Authorisation Decree, on the basis of which exemptions may be granted by the Harbour Master in mandate, on behalf of the Municipal Executive.

Considering

Article 5.3 of the 2019 Vlaardingen Port By-Laws, which prohibit open flame, smoking and sparking in a Petroleum Harbour;
Article 14.1 of the 2019 Vlaardingen Port By-Laws, which includes the obligation to comply with the rules of the Port By-Laws;
Article 1.9 of the 2019 Vlaardingen Port By-Laws, in conjunction with the Dordrecht Harbour Master’s Mandate, Power of Attorney and Authorisation Decree, on the basis of which exemptions may be granted by the Harbour Master in mandate, on behalf of the Municipal Executive.

Berthing/admission time

From

Which conditions cannot be met?

the vessel’s hull consists entirely of non-combustible material

while in the petroleumhaven, the relevant VHF port channel is continuously monitored on an operating VHF radio system

an electrical system is fitted that meets at least the requirements as per Atex Zone 2 of Directive 1999/92/EC

if present, the accommodation area, wheelhouse, engine room or control room provide adequate protection against the ingress of hazardous gases and vapours

if present, heating, cooking or cooling appliances are fitted that run on electricity or a flammable liquid with a flash point of 55 degrees Celsius or higher or these appliances are switched off, and

a shielded motor is fitted that cannot act as an ignition source

Explanation of reason for request for exemption

Details

The undersigned declares that the information in this request form has been filled in truthfully and that any explanatory notes and/or attachments reflect reality.

Sign

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Request to berth with a service or support vessel in a petroleum port

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