GMDSS Pre-survey Form.pdf

Mackay World Service service@mackaymarine.com

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GMDSS Pre-Survey Form

Version: 2018 Mar 1; MWS * indicates required fields.

VESSEL DETAILS

Vessel Name *

IMO Number *

Vessel Flag *

Vessel Class Society *

PREREQUISITES *

Conduct the SSAS test prior to entering port – have results available for technician.

Please note: SSAS test must be conducted no more than 90 days prior to radio survey date.

Have LRIT COC available for technician.

REPORT ANY OPEN DEFICIENCIES FROM PORT STATE CONTROL AND / OR CLASS

CONDUCT THE SELF-TESTS FOR ALL GMDSS EQUIPMENT AND REPORT ANY ALARMS OR FAILURES

LIVE RADIO CHECK RESULTS AND DATES *

VOICE Test DSC Test TELEX Test

Last MF/HF Test Date:

Comments/remarks:

Last VHF #1 Test Date:

Comments/remarks:

Last VHF #2 Test Date:

Comments/remarks:

Last Inmarsat C #1 P.V. Test Date: Remarks:

Last Inmarsat C #2 P.V. Test Date: Remarks:

EQUIPMENT MAKE / MODEL * BATTERY CONDITION & EXPIRATION DATE *

GMDSS Reserve Batteries

-- Batteries Fully Charged -- YES (Check to confirm GMDSS batteries have a full charge on them.)

SART #1

SART #2

EPIRB

EPIRB Hydrostatic Release Unit

2nd EPIRB (on bridge)

2nd EPIRB Hydrostatic Release Unit

GMDSS Hand Held Radio #1

GMDSS Hand Held Radio #2

GMDSS Hand Held Radio #3

LICENSES EXPIRATION DATE *

Shore Based Maintenance Certificate

Ship’s Radio Station License

MARITIME ITU AND GMDSS PUBLICATIONS YEAR OF EDITION ON BOARD *

List of Ship Stations and Maritime Mobile Service Identity Assignments (List V)

List of Coast Stations and Special Service Stations (List IV)

Manual for Use by the Maritime Mobile and Maritime Mobile-Satellite Services

Global Maritime Distress and Safety System Manual [GMDSS Manual] mailto:service@mackaymarine.com https://www.mackaycomm.com/