Appendix 5

UNITED KINGDOM AIR POLLUTION PREVENTION CERTIFICATE

Issued under the provisions of The Merchant Shipping (Prevention of Air Pollution from Ships) Regulations 2008 under the authority of the Government of the United Kingdom:

by .........................................................................................................
(Full designation of the competent person or organisation
authorised under the provisions of the Merchant Shipping (Prevention of Air Pollution from
Ships) Regulations 2008)

Type of ship: tanker
                     ships other than a tanker

THIS IS TO CERTIFY:

Completion date of survey on which this Certificate is based ............................. (dd/mm/yyyy)

This certificate is valid until ........................................ subject to surveys in accordance with Regulation 7 or 8 of The Merchant Shipping (Prevention of Air Pollution from Ships) Regulations 2008.

Issued at ................................................................................................
                                                       (Place of issue of certificate)

..........................                            .............................................................
(Date of issue)                                                (signature of duty authorised official
                                                                     issuing the certificate)

(Seal or stamp of the authority,
as appropriate)

ENDORSEMENT FOR ANNUAL AND INTERMEDIATE SURVEYS

THIS IS TO CERTIFY that at a survey required by Regulation 7 or 8 of the Merchant Shipping (Prevention of Air Pollution from Ships) Regulations 2008 the ship was found to comply with the relevant provisions of Annex VI of the MARPOL Convention:

(Seal or stamp of the authority, as appropriate)

(Seal or stamp of the authority, as appropriate)

(Seal or stamp of the authority, as appropriate)

(Seal or stamp of the authority, as appropriate)

_____________
*Delete as appropriate.

SUPPLEMENT TO
UNITED KINGDOM AIR POLLUTION PREVENTION CERTIFICATE
(UKAPP CERTIFICATE)

RECORD OF CONSTRUCTION AND EQUIPMENT

In respect of the provisions of Annex VI of the International Convention for the Prevention of Pollution from Ships, 1973, as modified by the Protocol of 1978 relating thereto (hereinafter referred to as “the Convention'') as implemented in the United Kingdom for ships which are operating solely in United Kingdom waters by the Merchant Shipping (Prevention of Air Pollution from Ships) Regulations 2008.

1.    Particulars of ship

1.1    Name of ship ................................................................................

1.2    Distinctive number or letters ..........................................................

1.3    IMO number ..................................................................................

1.4    Port of registry ...............................................................................

1.5    Gross tonnage ...............................................................................

1.6    Date on which keel was laid or ship was at a similar stage of construction ...........................................................................................

1.7    Date of commencement of major engine conversion (if applicable) (Regulation 21) ......................................................................................

2.    Control of emissions from ships

2.1    Ozone-depleting substances (Regulation 20)

2.1.1    The following systems containing ODS installed before 19 May 2005 may continue in service until 1 January 2020:

2.2    Nitrogen oxides (NO_x) (Regulation 21)

2.2.1    The following diesel engines with power output greater than 130 kW, and installed on a ship constructed on or after 1 January 2000, comply with the emission standards of Regulation 21 in accordance with the NO_x Technical Code:

2.2.2    The following diesel engines with power output greater than 130 kW, and which underwent major conversion per Regulation 21 on or after 1 January 2000, comply with the emission standards of Regulation 21 in accordance with the NO_x Technical Code:

2.2.3    The following diesel engines with a power output greater than 130 kW installed on a ship constructed on or after 1 January 2000, with a power output greater than 130 kW, are fitted to a ship with an exhaust gas cleaning system or other equivalent methods in accordance with Regulation 21 and the NO_x Technical Code and comply with the emission standards of Regulation 21:

2.2.4    The following diesel engines from 2.2.1, 2.2.2 and 2.2.3 above are fitted with NO_x emission monitoring and recording devices in accordance with the NO_x Technical Code:

2.3    Sulphur oxides (SOx) (Regulation 22)

2.3.1    When the ship operates within an SO_x emission control area specified in Regulation 22, the ship uses:

.1    fuel oil with a sulphur content that does not exceed 1.5% m/m as documented by bunker delivery notes; or

.2    unit approved exhaust gas cleaning installation/s issued with a SECA Compliance certificate/s and an approved  Shipboard SECA compliance plan which demonstrates the total SO_x ship emission are reduced to reduce  below 6.0 g SO_x/kW h; or

.3    an approved exhaust gas cleaning direct monitoring system and an approved  Shipboard SECA compliance plan which demonstrates that the total SO_x ship emission are reduced to reduce  below 6.0 g SO_x/kW h; or

.4    other approved technology to reduce SO_x emissions below 6.0 g SO_x/kW h

Note: The relevant SECA Compliance Certificate/s and SECA compliance plan must be attached to this document

2.4    Volatile organic compounds (VOCs) (Regulation 23)

2.4.1    The tanker has a vapour collection system installed and approved in accordance with MSC/Circ.585

2.5    Incinerator (Regulation 24)

2.5.1    The ship has an incinerator:

.1    which complies with MSN 1734 (M+F)

.2    installed before 1 January 2000 which does not comply with MSN 1734 (M+F)

THIS IS TO CERTIFY that this Record is correct in all respects.

Issued at ................................................................................................
(Place of issue of the Record)

..........................                            .............................................................
(Date of issue)                                                (signature of duty authorised official
                                                                     issuing the Record)

(Seal or stamp of the authority, as appropriate)

Annual/intermediate survey in accordance with regulation 9(8)(c)

THIS IS TO CERTIFY that, at an annual/intermediate* survey in accordance with regulation 9(8)(c) of Annex VI of the Convention, the ship was found to comply with the relevant provisions of the Convention:

Signed:………………………………………
(signature of authorized official)

Place:………………………………………

Date (dd/mm/yyyy):………………………

(Seal or stamp of the authority, as appropriate)

Endorsement to extend the certificate if valid for less than 5 years where regulation 9(3) applies

The ship complies with the relevant provisions of the Convention, and this certificate shall, in accordance with regulation 9(3) of Annex VI of the Convention, be accepted as valid until (dd/mm/yyyy):…………………………

Signed:………………………………………
(signature of authorized official)

Place:………………………………………

Date (dd/mm/yyyy):………………………

(Seal or stamp of the authority, as appropriate)

Endorsement to extend the certificate if valid for less than 5 years where regulation 9(4) applies

The ship complies with the relevant provisions of the Convention, and this certificate shall, in accordance with regulation 9(4) of Annex VI of the Convention, be accepted as valid until (dd/mm/yyyy):…………………………

Signed:………………………………………
(signature of authorized official)

Place:………………………………………

Date (dd/mm/yyyy):………………………

(Seal or stamp of the authority, as appropriate)

Endorsement to extend the validity of the certificate until reaching the port of survey or for a period of grace where regulation 9(5) or 9(6) applies

This certificate shall, in accordance with regulation 9(5) or 9(6) of Annex VI of the Convention, be accepted as valid until (dd/mm/yyyy):…………………………

Signed:………………………………………
(signature of authorized official)

Place:………………………………………

Date (dd/mm/yyyy):………………………

(Seal or stamp of the authority, as appropriate)

Endorsement for advancement of anniversary date where regulation 9(8) applies

In accordance with regulation 9(8) of Annex VI of the Convention, the new anniversary date is (dd/mm/yyyy):…………………………

Signed:………………………………………
(signature of authorized official)

Place:………………………………………

Date (dd/mm/yyyy):………………………

(Seal or stamp of the authority, as appropriate)