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1、水上交通事故调查处理文书英文格式目 录Contents1. 水上交通事故报告书Marine Accident Report2. 水上交通事故调查询问笔录Marine Accident Investigation and Inquiry Record3. 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
2、) , 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) ( Ships stamp
3、) Date:Particulars of ShipShips name NationalityPort of registryShips owner/operatorAddress Tel.Ships agent/chartererAddressTel.Port of departurePort of destinationKind of cargo/quantityL.O.AMolded breadthMolded depthHull materialGTNTDWT/allocationAge of shipKind of shipSummer draftF: A:Draft while
4、the accident occurringF: A:Draft when arriving at this portF: A:Min. strokeMin. turning radiusMax. speedType of main enginePowerNumber of cargo holdsRadar typeMax. rangeBlind areaBearing errorDistance errorType of GPSType/error of gyrocompassType/error of magnetic compassOfficers on dutyNameNo. of C
5、ertificateRangeGradeRankDuty officerDuty engineerDetails of navigation and collision avoidance (Collision)The other shipShips namePort of registryNationalityKind of shipHull materialShips ownerPort of departurePort of destinationFirst sightingTimeDistanceBearing of other shipCourse of other shipSpee
6、d of other shipSpeed of own shipPosition of own shipCourse of own shipPosition of captainMethod of observationCommunication method between two vesselsLights/shapes of own shipLights/shapes of other shipRadar observingObserverTime of first sightingRangeDistanceBearing of first sightingSituation of bo
7、th ships when sightingAction to prevent collisionOwn shipOther shipTime/distance to make avoidance/First action to be takenTime/type of making sound signalAction to prevent collision afterwardOwn shipOther shipTimeActionTimeActionTime/course/speed of changingOther actions and timeVHF equipped or not
8、Auto bell recorder equipped or notAuto course recorder equipped or notVDR equipped or notTime of collisionPlace of collisionPart of collisionOwn shipOther shipTrue course of own ship when collidingCollision angle of both shipsActions taken by both ships after collisionOwn shipOther shipSalvage measu
9、res and actionsDetailed Process of the AccidentSketch of the AccidentWind directionWind forceWave direction/forceCurrent directionCurrent speedTideVisibilityWeatherTemperatureNote: ships name, time, position and track required to be markedLoss and DamageLoss and damage of own shipPersonDied:Missing:
10、Injured:ShipCargoOther damageSketch of damaged part of own ship:Loss and damage of other shipMarine Accident Investigation and Inquiry RecordThe Case:Time: Place:Person Inquired: Nationality: Sex: Age: Company/Ship/Rank:Address: Phone No.: Postcode:Inquirer: Recorder:The record has been read by the
11、person inquired and is exactly correct.Signature of Inquirer: Signature of Person Inquired: Page : , Total Pages:Marine Accident Investigation and Inquiry RecordThe record has been read by the person inquired and is exactly correct.Signature of Inquirer: Signature of Person Inquired: Page : , Total
12、Pages:Marine Accident on Site Survey RecordThe caseTime of accidentPlace of accidentVessel/facility surveyedOwnerPlace of surveyTime of surveyFrom toSketch and description of damaged parts of vessel, facility or wharfOther damageSignature of surveyorNamePlace of workWitness of vessel/facility surveyed13