| 海安全[2002]187号 2002年4月15日 各直属海事局，各有关地方海事局(港航监督)： 为规范涉外事故调查处理行为，提高事故调查处理水平，现发布“水上交通事故调查处理文书英文格式"(见附件)，作为《关于启用“水上交通事故调查处理文书格式”的通知》(海安全字[2001]146号)的补充内容。此英文格式自发布之日起实施。 附件：《水上交通事故调查处理文书英文格式》 二○○二年四月十五日 附件： 水上交通事故调查处理文书英文格式 目 录 Contents 1．水上交通事故报告书 Marine Accident Report 2．水上交通事故调查询问笔录 Marine Accident Investigation and Inquiry Record 3．水上交通事故现场勘查记录 Marine Accident on Site Survey Record Marine Accident Report M／V Date： Port： To： M．S．A．of the P．R．C．I，the master of M／V which arrived this port at about (time) ,hereby report that my vessel was involved in a marine accident that occurred at about (time) in (position) ,and now submit to you this report attached with necessary papers and documents of set(s)．Please make an investigation and verification． Yours sincerely, (Master signature) (Ship’s stamp) Date： Particulars of Ship Ship’s name |
| Nationality |
| Port of registry |
| Ship’s owner/operator |
| Address |
| Tel. |
| Ship’s agent/ charterer |
| Address |
| Tel. |
| Port of departure |
| Port of destination |
| Kind of cargo/quantity |
| L.O.A |
| Molded breadth |
| Molded depth |
| Hull material |
| GT |
| NT |
| DWT/allocation |
| Age of ship |
| Kind of ship |
| Summer draft | F: A: | Draft while the accident occurring | F: A: | Draft when arriving at this port | F: A: | Min. stroke |
| Min. turning radius |
| Max. speed |
| Type of main engine |
| Power |
| Number of cargo holds |
| Radar type | Max. range | Blind area | Bearing error | Distance error |
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| Type of GPS |
| Type/error of gyrocompass |
| Type/error of magnetic compass |
| Officers on duty | Name | No. of Certificate | Range | Grade | Rank | Duty officer |
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| Duty engineer |
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Details of navigation and collision avoidance (Collision) The other ship | Ship’s name |
| Port of registry |
| Nationality |
| Kind of ship |
| Hull material |
| Ship’s owner |
| Port of departure |
| Port of destination |
| First sighting | Time |
| Distance |
| Bearing of other ship |
| Course of other ship |
| Speed of other ship |
| Speed of own ship |
| Position of own ship |
| Course of own ship |
| Position of captain |
| Method of observation |
| Communication method between two vessels |
| Lights/shapes of own ship |
| Lights/shapes of other ship |
| Radar observing | Observer |
| Time of first sighting |
| Range |
| Distance |
| Bearing of first sighting |
| Situation of both ships when sighting |
| Action to prevent collision | Own ship | Other ship | Time/distance to make avoidance | ／ | ／ | First action to be taken |
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| Time/type of making sound signal |
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Action to prevent collision afterward | Own ship | Other ship | Time | Action | Time | Action | Time/course/speed of changing |
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| Other actions and time |
| VHF equipped or not | Auto bell recorder equipped or not | Auto course recorder equipped or not | VDR equipped or not |
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| Time of collision |
| Place of collision |
| Part of collision | Own ship |
| Other ship |
| True course of own ship when colliding |
| Collision angle of both ships |
| Actions taken by both ships after collision | Own ship |
| Other ship |
| Salvage measures and actions |
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Detailed Process of the Accident Sketch of the Accident Wind direction |
| Wind force |
| Wave direction/force |
| Current direction |
| Current speed |
| Tide |
| Visibility |
| Weather |
| Temperature |
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| Note: ship’s name, time, position and track required to be marked |
Loss and Damage Loss and damage of own ship | Person | Died: | Missing: | Injured: | Ship |
| Cargo |
| Other damage |
| Sketch of damaged part of own ship: | Loss and damage of other ship |
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Marine Accident Investigation and Inquiry Record The Case: Time: Place: Person Inquired: Nationality: Sex: Age: Company/Ship/Rank: Address: Phone No.: Postcode: Inquirer: Recorder: The record has been read by the person inquired and is exactly correct. Signature of Inquirer: Signature of Person Inquired: Page: ,Total Pages: Marine Accident Investigation and Inquiry Record The record has been read by the person inquired and is exactly correct. Signature of Inquirer: Signature of Person Inquired: Page: ,Total Pages: Marine Accident on Site Survey Record The case |
| Time of accident |
| Place of accident |
| Vessel/facility surveyed |
| Owner |
| Place of survey |
| Time of survey | From to | Sketch and description of damaged parts of vessel, facility or wharf | Other damage | Signature of surveyor | Name | Place of work |
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| Witness of vessel/facility surveyed |
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附件：7.7.11 关于启用“水上交通事故调查处理文书英文格式”的通知 |