垃 圾 记 录 簿(海事局样本)

垃圾记录簿GARBAGERECORDBOOK船名：Nameofship船舶编号或呼号：Distinctivenumberorletters国际海事组织编号：IMOnumber至：to至：toPeriodfrom•r••^垃圾排放记录

第一部分除货物残余外的所有垃圾(所有船舶)RECORDOFGARBAGEDISCHARGESPARTIForallgarbageotherthancargoresiduesasdefinedinregulation1.2(Definitions)(Allships)船名船舶编号或呼号海事组织编号Ship'sname:DistinctiveNo.orletters:IMONo.:A.塑料B.食品废弃物C.垃圾种类：PlasticsFoodwastesGarbagecategories:D.食用油E.焚烧炉灰F.CookingoilIncineratorashes

生活废弃物(例如，纸制品、布、玻璃、金属、瓶子、陶器等)Domesticwastes(e.g.,paperproducts,rags,glass,metal,bottles,crockery,etc.)操作废弃物G.动物尸体H.渔具I.电子废弃物OperationalwastesAnimalCarcassesFishinggearE-waste按MARPOL附则V第4条(在特殊区域外排放垃圾)、第5条(固定或浮动式平台排放垃圾的特殊要求)、或第6条(在特殊区域排放垃圾)、或极地规则第II-A部分第5章规定排放垃圾DischargesunderMARPOLAnnexVregulations4(Dischargeofgarbageoutsidespecialareas),5(Specialrequirementsfordischargeofgarbagefromfixedorfloatingplatforms)or6(Dischargeofgarbagewithinspecialareas)orchapter5ofpartII-AofthePolarCode日期/时间Date/time船位(经纬度)或垃圾接收港口或垃圾接收船舶名称Positionoftheship(latitude/longitude)orportifdischargedashoreornameofshipifdischargedtoanothership种类Category排放估算量Estimatedamountdischarged焚烧估算量Estimatedamountincinerated(m3)申明：(例如船舶焚烧开始/结束的时间和船位)Remarks:(e.g.start/stoptimeandpositionofincineration;generalremarks)证明/签字Certification/Signature排放入海(m3)Intosea(m3)排放到接收设施或其他船舶(m3)Toreceptionfacilitiesortoanothership(m3)

船长签字日期Master'ssignature:Date:第7条所述例外的排放或意外落失Exceptionaldischargeorlossofgarbageunderregulation7(Exceptions)日期/时间Date/time港口或船位(经纬度和已知水深)Portorpositionoftheship(latitude/longitudeandwaterdepthifknown)种类Category估算的排放或意外落失量(m3)Estimatedamountlostordischarged(m3)垃圾排放或落失的原因申明和一般说明(例如防止或尽量减少垃圾排放或意外损失的预防措施)Remarksonthereasonforthedischargeorlossandgeneralremarks(e.g.reasonableprecautionstakentopreventorminimizesuchdischargeoraccidentallossandgeneralremarks)证明/签字Certification/Signature船长签字日期Master'ssignature:Date:

第二部分货物残余

(载运固体散装货物船舶)PARTIIForallcargoresiduesasdefinedinregulation1.2(Definitions)

(Shipsthatcarrysolidbulkcargoes)船名船舶编号或呼号海事组织编号船名船舶编号或呼号海事组织编号Ship'sname:DistinctiveNo.orletters:IMONo.:垃圾种类：Garbagecategories:J.垃圾种类：Garbagecategories:J.货物残余(对海洋环境无害物质)Cargoresidues(non-HME)K.货物残余(对海洋环境有害物质)Cargoresidues(HME)按MARPOL附则V第4条(在特殊区域外排放垃圾)和第6条(在特殊区域排放垃圾)中所述的排放Dischargesunderregulations4(Dischargeofgarbageoutsidespecialareas)and6(Dischargeofgarbagewithinspecialareas)日期/时间Date/time船位(经纬度)或垃圾接收港口Positionoftheship(latitude/longitude)orportifdischargedashore种类Category排放估算量Estimatedamountdischarged排放入海的开始和结束位置Startandstoppositionsoftheshipfordischargesintothesea证明