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1、TEL:886-2-2506-2711~6（6liens）FAX：886-2-25074722E-Mail：cr.tp@crclass.org漁船檢查/檢驗申請書Inspection/SurveyApplicationFormForFishingVesselsShipName(English)英文船名Nationality國籍ShipName(Chinese)中文船名OfficialNo.船舶編號InspectionLocation檢查地點EstimatedInspectionDate預定檢查日期GrossTonnage總噸位TypeofShip船

2、型OwnerinTaiwan在台船東（務必詳細填寫）CompanyName公司名稱（用中文填寫）UniformInvoiceNumber統一編號Address地址（用中文填寫）Tel.No.電話FaxNo.傳真Inspection/SurveyApplied申請檢查/檢驗種類OnbehalfoftheAdministration代主管官署檢查SpecialInspection特別檢查PeriodicalAnnualInspection定期檢查OccasionalInspection臨時檢查InspectionCondition檢查方式：Afloat

3、水上檢查WithDockingInspection含上架檢查WithTailshaftInspection含抽艉軸檢查IOPPSurvey防止油污染檢驗InitialSurvey初次檢驗CertificateRenewalSurvey換證檢驗IntermediateSurvey中期檢驗MandatoryAnnualSurvey強制檢驗IAPPSurvey防止空氣污染檢驗InitialSurvey初次檢驗CertificateRenewalSurvey換證檢驗IntermediateSurvey中期檢驗MandatoryAnnualSurvey強制檢

4、驗OnbehalfoftheAdministration代主管官署檢查SafetyRadioSurvey安全無線電檢驗ISPPSurvey防止污水污染檢驗InitialSurvey初次檢驗CertificateRenewalSurvey換證檢驗AFSSurvey防污系統檢驗InitialSurvey初次檢驗AsurveywhenAFSSystemsarechangedorreplaced更新檢驗Thesanitationmanagementoffishingvessel’scatchonbehalfofTheFisheriesAgencyCounc

5、ilOfAgriculture代漁業署檢查漁船漁獲物衛生InitialSurvey初次檢驗CertificateRenewalSurvey換證檢驗IntermediateSurvey中期檢驗AgentName國外代理行名稱Tel.No.電話PersonInCharge負責人Applicant申請者CompanyName公司名稱Signature簽名Date日期FormNo.XM38/12.2014