GRIPSHOLM SHIPPING S.A.

SHIP MANAGEMENT

FAMILIARISATION CHECK LIST

M/V _______________________

THIS IS TO CERTIFY THAT MR. ____________________________________________ WHO JOINED

AS _______________________ (RANK) ON ______________________ (DATE) AT _______________
(PORT) IS ABLE TO :

PART A :
(TO BE COMPLETED FOR ALL SEAFARERS)
1. COMMUNICATE ON SAFETY MATTERS o
2. UNDERSTAND SHIPS SAFETY MATTERS o
3. UNDERSTAND SIGNS o
4. RECOGNISE ALARM SIGNALS o
5. REACT PROPERLY WHEN MAN OVERBOARD o
6. REACT PROPERLY TO FIRE OR SMOKE o
7. REACT PROPERLY TO A FIRE ALARM o
8. REACT PROPERLY TO AN ABANDON SHIP ALARM o
9. IDENTIFY THE MUSTER STATION o
10. IDENTIFY THE EMBARKATION STATION o
11. IDENTIFY THE EMERGENCY ESCAPE ROUTE o
12. LOCATE A LIFE JACKET o
13. PUT ON A LIFE JACKET o
14. RAISE THE ALARM o
15. USE A PORTABLE FIRE EXTINGUISHER o
16. TAKE LOCAL ACTION IF ANYONE HAS AN A
ACCIDENT / MEDICAL EMERGENCY o
17. OPERATE FIRE DOORS o
18. OPERATE WEATHERTIGHT DOORS o
19. OPERATE WATERTIGHT DOORS o

PART B :
(TO BE COMPLETED FOR SEAFARERS WITH DESIGNATED RESPONSIBILITIES FOR
SAFETY OR POLLUTION PREVENTION)
20. PERFORM PERSONAL SURVIVAL TECHNIQUES o
21. PERFORM FIRE PREVENTION AND FIRE FIGHTING o
22. PERFORM FIRST AID o
23. PERFORM PERSONAL SAFETY AND SOCIAL RESPONSIBILITIES o
24. DEMONSTRATE COMPETENCE ON ALL ABOVE o
25. DEMONSTRATE APPROPRIATE TRAINING CERTIFICATE o

CHECK COMPLETED : TIME _____________________ DATE ______________

CONFIRMED BY :

SEAFARER _____________________ (name) _________________ (rank) ____________________Signature

TRAINING OFFICER : _______________________(name) __________________(rank) _________________Signature

MASTER : _______________________ (name) __________________________ Signature

Master to hand one copy to each rating upon joining the vessel. Master to arrange for an experienced Officer or
Petty officer to give the rating a guided tour of the vessel with induction training so that this checklist to be handed
to the Master by the rating prior to sailing.
1 Copy - Gripsholm Shipping s.a.; 1 Copy - Ships Records; 1 Copy On-Signer. GRIP FORM-80