Eikano Shipping & Trading SA .

SAFETY MANAGEMENT SYSTEM FORMS INDEX

N NAVIGATION FORMS

No. Form Name Timing of use Copy to office

N-01 Voyage Plan Before every Voyage ✔
N-02 Pre-arrival checklist Before arrival ✖
N-03 Pre-departure checklist Before departure ✖
N-04 Pilot card Before arrival ✖
N-05 Anchorage and anchor watch Before/during Anchorage ✖
N-06 Navigation in Special Conditions Occasionally ✖
N-07 Navigation in Coastal Waters Occasionally ✖
N-08 Navigation in Deep Sea Occasionally ✖
N-09 Noon Report Daily ✔

B BRIDGE FORMS

No. Form Name Timing of use Copy to office

B-01 Vessel Inspection Report Monthly ✔
B-02 Safety Meetings Monthly ✔
B-03 Master Review Occasionally ✔
B-04 Drills Monthly ✔
B-05 Requisition Occasionally ✔
B-06 Plans & Drawings Inventory Occasionally ✔
B-07 Inspection History Monthly ✔
B-08 Monthly Medicine Inventory Monthly ✔
B-09 Monthly Medicine Record Monthly ✔
B-10 Publication Inventory Monthly ✔
B-11 Master Handover Report Occasionally ✔

D DECK FORMS

No. Form Name Timing of use Copy to office

D-01 Stevedores Damage Report Occasionally ✔
D-02 Non-Conformities Report Occasionally ✔
D-03 Monthly Work Report Monthly ✔
D-04 Repair History Monthly ✔
D-05 Cargo and Ballast History 3 Months ✔
D-06 Entry into Enclosed Spaces Permit Occasionally ✔
D-07 Hot Work Permit Occasionally ✔
D-08 Permit to Work Aloft Occasionally ✔
D-09 Electrical Work Permit Occasionally ✔
D-10 Deck Inventories Monthly ✔
D-11 Safety Checklist for Loading/Unloading Bulk Cargo Occasionally ✔
D-12 Bulk Carriers Cargo Spaces and Ballast Water Tanks Occasionally ✔

S SAFETY FORMS

No. Form Name Timing of use Copy to office

S-01 FFA & LSA Maintenance Reports Weekly ✔
S-02 FFA & LSA Maintenance Reports Monthly ✔
S-03 FFA & LSA Maintenance Reports Quarterly ✔
S-04 FFA & LSA Maintenance Reports 6 Months ✔
S-05 FFA & LSA Maintenance Reports Annually ✔
Eikano Shipping & Trading SA .
SAFETY MANAGEMENT SYSTEM FORMS INDEX

R RISK FORMS

No. Form Name Timing of use Copy to office

R-01 Initial Risk Assessment Occasionally ✔
R-02 Identified Risk Proposal Occasionally ✔
R-03 Identified Risk Record Occasionally ✔

M MLC FORMS

No. Form Name Timing of use Copy to office

M-01 Application Form Occasionally ✔
M-02 Qualification Record Monthly ✔
M-03 Familiarization Occasionally ✔
M-04 Table of Watchkeeping & Rest Hours Monthly ✔
M-05 Rest Hours Report Monthly ✔
M-06 Appraisal Form Monthly ✔
M-07 Complaint Report Occasionally ✔
M-08 Medical Report Occasionally ✔
M-09 Wages Account Monthly ✔
M-10 Accommodation Inspection Report Weekly ✔
M-11 Sign Off Request Occasionally ✔
M-12 Crew Change Record Occasionally ✔

E ENGINE FORMS

No. Form Name Timing of use Copy to office

E-01 Chief Engineer Handover Occasionally ✔
E-02 ME Cyl. Liner & Piston Rings Occasionally ✔
E-03 ME Piston Pin Bush Gauging Occasionally ✔
E-04 ME Crank Shaft Deflection 6 Months ✔
E-05 ME Main Bearings Inspection Occasionally ✔
E-06 ME Performance Report Monthly ✔
E-07 AE Overhauling Report Occasionally ✔
E-08 AE Crank Shaft Deflection 6 Months ✔
E-09 Megger Test 6 Months ✔
E-10 Batteries Log Weekly ✔
E-11 Critical Equipment Checklist Occasionally ✔
E-12 Bunkering Checklist Occasionally ✔
E-13 Monthly Consumption Monthly ✔
E-14 Monthly Work Report Monthly ✔
E-15 Repair History Monthly ✔
E-16 Engine Room Inventories Monthly ✔
E-17 Machinery Survey Report Occasionally ✔
E-18 Monthly Working Hours for Machineries Monthly ✔
E-19 Checklist for GMDSS Batteries Monthly ✔
E-20 Lubricants / Chemicals Gases/ Oil Residues Inventory Monthly ✔
Eikano Shipping & Trading SA .
SAFETY MANAGEMENT SYSTEM FORMS INDEX

SSP SECURITY FORMS

Form Name When to Use Copy to office When to

No.
Send
1 Report of an unlawful act When Needed ✔ Monthly
2 Breach of Security When Needed ✔ Monthly
3 Declaration of Security Every Port Entrance ✔ Monthly
4 Port Contact Information Sheet Every Port Entrance ✖ --
5 Company Contact Information Sheet Updated ✖ --
6 Internal Security Audit Annually ✖ --
7 CPAR When Needed ✔ If Used
8 Document Change Note When Needed ✔ If Used
9 Ports Visited and Security Setting Every Port Entrance ✔ Monthly
10 Security Equip. Maintenance / Calibration Annually ✔ Annually
11 Record of Change in the security Level When Needed ✔ If Used
12 Port of Call Security Level Record Every Port Entrance ✔ Monthly
13 Record of Security Threats When Needed ✔ If Used
14 Record of Security Drills When Needed ✔ Monthly
15 Alert System Maintenance / Calibration Sheet Monthly ✔ Monthly
16 Visitors Logbook At Every Port ✔ Monthly
17 Drill Forms When Used ✔ 3 Months
18 Training Forms When Used ✔ 3 Months

CSP CYBER SECURITY FORMS

Form Name When to Use Copy to office When to

No.
Send
CSP-08
Initial Incident Investigation Report When Needed ✔ Monthly
CSP-08
Follow Up Incident Investigation Report When Needed ✔ Monthly
CSP-08
Hazard-Root Cause Map When Needed ✔ Monthly
CSP-03
Cyber Risk Assessment Form When Needed ✔ Monthly
CSP-03
Company Cyber Security Self-Assessment Monthly ✔ Monthly
CSP-03
Vessel Cyber Security Self-Assessment Monthly ✔ Monthly

CSA CYBER SECURITY ASSESMENT

Form Name When to Use Copy to office When to

No.
Send
CRA-01 Communication systems When Used ✔ 3 Months
CRA-02 Bridge Systems When Used ✔ 3 Months
Propulsion and machinery management When Used ✔ 3 Months
CRA-03
and power control systems
CRA-04 Access control systems When Used ✔ 3 Months
CRA-05 Cargo management systems When Used ✔ 3 Months
CRA-06 Core infrastructure systems When Used ✔ 3 Months
CRA-07 Administrative and welfare systems When Used ✔ 3 Months