The International Maritime Organization (IMO) Ballast Water Management Convention requires all vessels over 400 gross tonnage and engaged in international voyages to manage their ballast water to reduce the risk of introducing harmful aquatic organisms and pathogens into new ecosystems. One way vessel owners can meet this requirement is by filing a Ballast Water Reporting Form. The form asks for specific information about the ballast water management system on board the vessel, including date of installation, type of treatment system, and contact information for the responsible party. Filing this form is critical to ensuring that your vessel meets international standards and remains in compliance with maritime law. For more information on ballast water management and how to fill out the Ballast Water Reporting Form, please visit our
Question | Answer |
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Form Name | Ballast Water Reporting Form |
Form Length | 2 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 30 sec |
Other names | YYYY, OMB, IMO, Forepeak |
BALLAST WATER REPORTING FORM
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IS THIS AN AMENDED BALLAST REPORTING FORM? YES |
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NO |
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1. VESSEL INFORMATION |
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2. VOYAGE INFORMATION |
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3. BALLAST WATER USAGE AND CAPACITY |
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Vessel Name: |
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Arrival Port: |
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Specify Units Below (m3, MT, LT, ST) |
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Total Ballast Water on Board: |
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IMO Number: |
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Arrival Date (D/M/YYYY): |
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Owner: |
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Agent: |
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Volume |
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Units |
No. of Tanks in Ballast |
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Type: |
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Last Port: |
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Country of Last Port: |
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GT: |
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Total Ballast Water Capacity: |
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Call Sign: |
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Next Port: |
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Country of Next Port: |
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Volume |
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Units |
Total No. of Tanks on Ship |
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Flag: |
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4. BALLAST WATER MANAGEMENT |
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Total No. Ballast Water Tanks to be discharged: |
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Of tanks to be discharged, how many: |
Underwent Exchange: |
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Underwent Alternative Management: |
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Please specify alternative method(s) used, if any: |
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If no ballast treatment conducted, state reason why not: |
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Ballast management plan on board? |
YES |
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NO |
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Management plan implemented? |
YES |
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NO |
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IMO ballast water guidelines on board [res. A.868(20)]? |
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YES |
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NO |
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5. BALLAST WATER HISTORY: Record all tanks to be deballasted in port state of arrival; IF NONE, GO TO #6 |
(Use additional sheets as needed) |
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Tanks/ |
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BW SOURCE |
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BW MANAGEMENT PRACTICES |
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BW DISCHARGE |
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Holds |
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List multiple |
DATE |
PORT or |
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VOLUME |
TEMP |
DATE |
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ENDPOINT |
VOLUME |
% |
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METHOD |
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SEA |
DATE |
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PORT or |
VOLUME |
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SALINITY |
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sources/tanks |
D/M/YYYY |
LAT. LONG. |
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(units) |
(units) |
D/M/YYYY |
LAT. LONG. |
(units) |
Exch |
(ER/FT/ |
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HT. |
D/M/YYYY |
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LAT. LONG. |
(units) |
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(units) |
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separately |
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ALT) |
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(m) |
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m3 |
C |
m3 |
m3 |
sg |
m3 |
C |
m3 |
m3 |
sg |
m3 |
C |
m3 |
m3 |
sg |
m3 |
C |
m3 |
m3 |
sg |
m3 |
C |
m3 |
m3 |
sg |
m3 |
C |
m3 |
m3 |
sg |
m3 |
C |
m3 |
m3 |
sg |
Ballast Water Tank Codes: Forepeak = FP, Aftpeak = AP, Double Bottom = DB, Wing = WT, Topside = TS, Cargo Hold = CH, Other = O
6. RESPONSIBLE OFFICER’S NAME AND TITLE, PRINTED AND SIGNATURE:
Tanks/
Holds
List multiple sources/tanks separately
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BW SOURCE |
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BW MANAGEMENT PRACTICES |
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BW DISCHARGE |
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DATE |
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PORT or |
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VOLUME |
TEMP |
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DATE |
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ENDPOINT |
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VOLUME |
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% |
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METHOD |
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SEA |
DATE |
PORT or |
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VOLUME |
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SALINITY |
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D/M/YYYY |
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LAT. LONG. |
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(units) |
(units) |
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D/M/YYYY |
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LAT. LONG. |
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(units) |
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Exch |
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(ER/FT/ |
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HT. |
D/M/YYYY |
LAT. LONG. |
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(units) |
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(units) |
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ALT) |
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(m) |
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Ballast Water Tank Codes: Forepeak = FP, Aftpeak = AP, Double Bottom = DB, Wing = WT, Topside = TS, Cargo Hold = CH, Other = O