JRC JCY-1800 - Annual Inspection; Declaration on Completion of Annual Inspection for VDR

15. Annual Inspection
JCY-1800/1850 VDR/S-VDR Installation Guide
175
DOC No. 7ZPJD0387C
15. ANNUAL INSPECTION
15.1. Declaration on completion of annual inspection for VDR
DECLARATION ON COMPLETION OF ANNUAL INSPECTION
FOR VDR PERFORMANCE TEST
To
Date:
Vessel :
(Name)
IMO Number :
1. This is to certify that the annual inspection for the VDR on board the captioned vessel have been completed
satisfactorily as follows.
1) Date of Completion of Inspection:
2) Place of Inspection:
3) Name/Model of VDR:
4) Serial Number:
5) Manufacturer:
6) Certificate Number of Type approval:
2. The items of performance test have been examined and recorded in accordance with the requirements of SOLAS
V/18.8 and found to be in compliance with the IMO Resolution A.861(20) .
□ Annual Inspection Check □ Ship’s Information up-date
□ General Condition □ Verification of the VDR Functions
□ Verification of Input Data and Data Stored in the Capsule
(□ Tick as appropriate)
Inspection Company:
Signature of Inspector:
(Name: )