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Night Transfer Form

Night Transfer Permit

Form FP001/4M - BUNKER / VESSEL FUELLING NOTICE

Transport Operations (Marine Pollution) Act 1995

Details of Proposed Transfer Operation(s)

Select Port *
Cairns
Cairns Marlin Marina
Mourilyan
Karumba
Thursday Island
Horn Island

Vessel Name

Berth

Date of Transfer

Time of Transfer

Type of Transfer *
Ship to Ship
Ship to Shore
Shore to Ship
Type of Cargoes *
Petroleum
Bunkers
LPG
Other

if Other, please describe

Transfer Amount (Litres)

Has a Dangerous Goods list been submitted *
Yes
No

Conditions

1. Full compliance with all applicable legislation including: --- International Marine Dangerous Goods Code --- Transport Operations (Marine Safety) Act 1994 --- International Safety Guide for Oil Tankers & Terminals (ISGOTT) 2. Ports North reserves the right to withdraw this approval at any time without notice 3. Fuel transfers are to be as per vessel's SMS and MSQ Port Procedure Manual

Name

Company

Email

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