Pre Arrival Notification

The vessel Master is to submit this form at least 24 hours before the vessel’s arrival. *Mandatory fields.

Vessel Masters Pre-Arrival Declaration – Port of Broome

This form must be submitted by the master or respective agents of any vessel equal to or greater than 35.0 metres no earlier than 6 days before the vessel’s ETA and no later than 2 days (48 hours) before the vessel’s ETA. Ideally it must be submitted soonest after departure from the previous port of call.

1. GENERAL

1.1 Vessel name(Required)

1.2 IMO Number(Required)

1.3 LOA (m)(Required)

1.4 Beam (m)

1.5 Summer DWT

1.6 Arrival Displacement

1.7 GT / GRT

1.8 Agent

1.9 Vessel's E-Mail

1.10 Vessel's Telephone

1.11 Company Name (as per DOC)

1.12 Name of DPA / Tech Manager

1.13 Contact E-Mail(Required)

1.14 Contact Tel Nos(Required)

2. PORT CALL INFORMATION

KPA operations must be kept informed of the latest ETA.

2.1 ETA at Broome Pilot Boarding Station / Anchorage (dd/mm/yyyy hh:mm)(Required)

2.2 Anchorage required on Arrival(Required)

Yes

2.3 Anchorage required on Departure(Required)

Yes

If Yes, Date of final departure from Port(Required)

2.4 Pilot required for arrival(Required)

Yes

If Pilot is not required, details of PEC Master must be provided.

2.4 If No, PEC number(Required)

2.4 Name of PEC Master(Required)

2.4 Date of PEC Masters last Exempt run in Broome(Required)

2.5 Pilot required for departure(Required)

Yes

If Pilot is not required, details of PEC Master must be provided.

2.5 If No, PEC number(Required)

2.5 Name of PEC Master(Required)

2.5 Date of PEC Masters last Exempt run in Broome(Required)

PEC Masters must ensure that their PEC certificate is valid for the duration of the port call, and that the elapsed time from their last exempt run in Broome does not exceed 6 months. Conditions/Restrictions mentioned in the PEC (eg Daylight only) will apply.

2.6 Arrival drafts (m) – Forward(Required)

2.6 Arrival drafts (m) – Midship(Required)

2.6 Arrival drafts (m) – Aft(Required)

2.7 Estimated departure drafts (m) – Forward(Required)

2.7 Estimated departure drafts (m) – Midship(Required)

2.7 Estimated departure drafts (m) – Aft(Required)

2.8 Does the vessel have any existing Conditions of Class?(Required)

Yes

2.9 If yes, details to be provided(Required)

3. PILOT BOARDING ARRANGEMENT

3.1 Does the Pilot Boarding Arrangement onboard comply with SOLAS Chapter V, Regulation 23?(Required)

Yes

3.2 Does the Pilot ladder comply with the requirements of KPA LMN 08-2023 (or superseding notice)?(Required)

Yes

3.3 Date of manufacture for Pilot Ladder in use as per manufacturers certificate (dd/mm/yyyy)(Required)

3.4 Date of manufacture for Manropes in use as per manufacturers certificate (dd/mm/yyyy)(Required)

4. MAIN ENGINE / AUXILIARY ENGINES / EMERGENCY GENERATOR & THRUSTERS

4.1 Is the main engine fully functional with no known defects?(Required)

Yes

4.2 Are all auxiliary engines (generators), and emergency generator fully functional with no known defects?(Required)

Yes

4.3 Are the Bow and Stern thrusters (if fitted) functional with no known defects?(Required)

Yes

N/A (No Thrusters)

Total KW of Bow Thruster(s) (kW)

Total KW of Stern Thruster(s) (kW)

4.4 If 'No' to any of the above (3) questions, details and nature of defect to be provided.(Required)

5. STEERING

5.1 Is the steering gear system including emergency steering system fully functional with no known defects?(Required)

Yes

5.2 If No, details of equipment and nature of defect to be provided:(Required)

6. NAVIGATION

6.1 Is all bridge and navigation equipment in good working order?(Required)

Yes

Bridge and Navigation equipment include the following: Radar / Magnetic and gyro compasses and repeaters / Hand and NFU steering modes / Steering Gear systems including steering motors, telemotor systems etc / Helm indicators and repeaters / Main engine telegraph / Main engine rpm indicators / Rate of turn indicators / Echo sounders and displays / Whistles / Course recorders / ECDIS / Wind indicators / Speed Log / GPS / Automatic identification system (AIS) / Navigation Lights / Anchors, windlasses, mooring winches etc.

6.2 If No, details and nature of defect to be provided:(Required)

7. BERTHING & MOORING

7.1 Bow to Bridge distance (m)(Required)

7.2 Stern to Bridge distance (m)(Required)

7.3 Distance of Bunker Manifold from bow (m)(Required)

7.4 Type of Mooring Lines (All lines must be in good condition and without joints or splices)(Required)

Synthetic

Wire

7.5 Maximum Diameter of mooring lines (mm)(Required)

7.6 Number of mooring lines intended to be used in Broome – Forward(Required)

7.6 Number of mooring lines intended to be used in Broome – Aft(Required)

7.7 Are all mooring lines eyes fitted to a 2-metre light rope tail to be connected to heaving line.(Required)

Yes

7.8 Confirmation that there is NO Protrusion or overhang from the ships side (e.g. Rubbing Strake, Door Sills, Davits, Lights etc)? Answer 'No' if there is a protrusion or overhang(Required)

Yes

If No to 7.8

Details of the protrusion must be provided. Suitable plan diagrams clearly indicating the location and size of the protrusion(s) must also be attached with the pre arrival declaration.

Height from W/L (m)(Required)

Distance from Bow (m)(Required)

Length of the protrusion (m)(Required)

Depth/ outward reach (m)(Required)

Protrusion details(Required)

8. DOCUMENTS REVIEWED PRIOR ENTRY INTO THE PORT OF BROOME (Mandatory)

Copies of above are obtainable from agents / port website

Port of Broome Handbook(Required)

Reviewed

Local Marine Notices(Required)

Reviewed

PEC and Pilot Handbook(Required)

Reviewed

9. ATTACHMENTS (Must be attached with this form, unless already provided to KPA earlier)

Copies of above are obtainable from agents / port website

Vessel Particulars

Attached

Pilot Card

Attached

Mooring arrangement plans (Fwd and Aft)

Attached

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Vessel particulars, Pilot Card, Forward & Aft Mooring arrangement plan and details of any overhangs (if applicable).

10. I DECLARE THAT THE ABOVE FACTS ARE TRUE AND ACCURATE

10.1 Full name of Master(Required)

10.2 Date and time of declaration (dd/mm/yyyy hh:mm)(Required)

Vessel Masters Pre-Arrival Declaration – Port of Broome

1. GENERAL

2. PORT CALL INFORMATION

3. PILOT BOARDING ARRANGEMENT

4. MAIN ENGINE / AUXILIARY ENGINES / EMERGENCY GENERATOR & THRUSTERS

5. STEERING

6. NAVIGATION

7. BERTHING & MOORING

If No to 7.8

8. DOCUMENTS REVIEWED PRIOR ENTRY INTO THE PORT OF BROOME (Mandatory)

9. ATTACHMENTS (Must be attached with this form, unless already provided to KPA earlier)

10. I DECLARE THAT THE ABOVE FACTS ARE TRUE AND ACCURATE

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Pre Arrival Notification

Vessel Masters Pre-Arrival Declaration – Port of Broome

1. GENERAL

2. PORT CALL INFORMATION

3. PILOT BOARDING ARRANGEMENT

4. MAIN ENGINE / AUXILIARY ENGINES / EMERGENCY GENERATOR & THRUSTERS

5. STEERING

6. NAVIGATION

7. BERTHING & MOORING

If No to 7.8

8. DOCUMENTS REVIEWED PRIOR ENTRY INTO THE PORT OF BROOME (Mandatory)

9. ATTACHMENTS (Must be attached with this form, unless already provided to KPA earlier)

10. I DECLARE THAT THE ABOVE FACTS ARE TRUE AND ACCURATE

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