ports of dampier and ashburton

annual mooring dive inspection report

Mooring Number:
Vessel/s:
Purchase Order Number:
Invoice Number:
Paid:

SEASON2014/2015

THE MOORING owner/USER IS RESPONSIBLE FOR:

  1. The Mooring owner/user must arrange for an annual mooring dive inspection to be carried out by a Mooring Dive Inspector between1Mayand31 October each year.
  2. The Mooring owner/user must supplythe Mooring Dive Inspector with vessel and hawser details, and as-built / general arrangement design specifications(inclusive of the mooring components design permissible wear rates) of the mooring,prior to the mooring dive inspection being conducted.
  3. Should the as-built / general arrangement design specifications not include the table ofpermissible design wear rates, a review by a Naval Architect will be required. In the 5th Year inspection, please have your Naval Architect advice what mooring components they would like audited.
  4. The Mooring owner/user must submit the completed report to the Dampier Port prior to31st October in the same year.
  5. Your mooring is not approved for use until you have received a PPA licence. Please provide a purchase order on submission of this application if required.

Available on the PPA Website are the contact details of Mooring Dive Inspectors and Naval Architects/Engineersas set out in the Mooring Dive Inspectors and Naval Architects/Engineers List 2014/2015along with the Moorings Handbook,Mooring Licence Terms and Conditions, and other important information you are required to know as a Mooringowner/user.

SECTION 1: Mooring Owner Details- To be completed by the Mooring Owner

Company Name: / ABN:
Contact Person:
Address:
Postal Address:
Phone: / Mobile:
Email Address:

SECTION 2: Mooring Details - To be completed by the Mooring Owner

Mooring Number:
Type of Mooring: / Non Cyclone / Cyclone
Mooring Use: / Recreational / Commercial
Is this a rental mooring? / Yes / No
Position GPS:
Deg,Dec Min (20°42.675) / Latitude: / Longitude:
Depth of Water LAT: / Type of Bottom(e.g. mud/sand/silt):
Nearest Mooring:

SECTION 3: VesselDetails- To be completed by the Mooring Owner

Name of Vessel/s:
Length Overall:
Gross Tonnage:
Hull Type:
Draft:
Condition of Hawser:
Length of Hawser (metres): / Total Swing Room:
Hawser Specifications:
NB: Hawsers must be as per the Naval Architects recommendation. Hawsers must not be left floating free from moorings to prevent damage to other craft.

SECTION 4: Naval Architect/Engineering Review - To be completed by the Mooring Owner

5th Year Review – The Annual Mooring Dive Inspection must include a selective audit of buried or covered sections suitable for consideration by the assessing Naval Architect/Engineer.Refer to section 6 of the Moorings Handbook for further information.
Annual Review:
5th Year Review:

SECTION 5: Inspection Type- To be completed by the Mooring Owner

In Water / Partial Raising / Shore
SHEQ-SYS-T-023 / Issued Date: 17/07/2014 / Rev No: 8 / Page: 1 of 9

ports of dampier and ashburton

annual mooring dive inspection report

SECTION 6: Mooring Component Inspection Record - Please provide clear jpeg photographs, labeled and attach as per the Guidelines for Mooring Dive Inspectors - To be completed by the Dive Inspector

Component / Description
(Type, length etc.) / Measurement as per moorings drawing / Dive Measurement in diameter / Jpeg / Condition & Comments
Ref #
(attached)
GPS POSITION OF GROUND RING / CONNECTING MECHANISM
(deg, dec min e.g. 20°42.675)
BUOY
(clearly showing number and illumination)
ILLUMINATION (TYPE)
(minimum requirement of retro reflective material or cats eyes)
LIST COMPONENTS AS PER THE MOORING DRAWING
SHEQ-SYS-T-023 / Issued Date: 17/07/2014 / Rev No: 8 / Page: 1 of 9

ports of dampier and ashburton

annual mooring dive inspection report

SECTION 7: Changes and Maintenance Details- To be completed by the Dive Inspector

(Report will not be approved if the mooring number and visibility aids are absent from the buoy)

Is there deterioration to components? / Yes / No
Does deterioration exceed the wear rates? / Yes / No
Is maintenance required for this mooring? / Yes / No
Is the mooring intact and installed as per drawing? / Yes / No
Is the mooring number on the buoy and clearly visible? / Yes / No
Does the mooring have appropriate visibility aids (illumination/cats eyes)? / Yes / No
Is this the 5th Year Mooring Inspection? / Yes / No

SECTION 8: Comments and Observations- To be completed by the Dive Inspector

Please note any maintenance required/completed and/or changes which may conflict with the original design drawings and mooring specifications required, as set out in the Moorings Handbook and Mooring Licencing Terms and Conditions:
Observations / Maintenance Identified:

Section 9:Mooring Dive Inspector Details & Inspection Certification

(Date and time of inspection is the date and time the mooring is dived on)

Inspector Name:
Company Name:
Contact Person:
Date of Inspection:
Time of Inspection:
Postal Address:
Email:
Mobile:
By signing this section of the Annual Mooring Dive Inspection Report, the Mooring Dive Inspector declares this to be:
(a) a true and accurate reflection of the inspected mooring at the time of inspection, and that
(b) Section 9 of the Moorings Handbook has been followed in completing this report.
(c) as per the Guidelines for Mooring Dive Inspectors.
Signature: / Name (print): / Date:

SECTION 10: Owner Declaration

Approval for an annual mooring licence may be granted by the Harbour Master if:
maintenance has been completed as per recommended in Section 8 (attach maintenance report with photos);
contains jpeg photos of the mooring components;
contains an ‘as built/general arrangement drawing’ (certified by a Naval Architect) of the mooring;
demonstrates that the permissible design wear rates have not been exceeded;
shows that no alterations have been made to the mooring outside of its design specification;
identifies the vessel nominated for the mooring remains the same; and
contains a naval architect assessment that is no greater than five (5) years old.
Forward to the Harbour Master.
Should PPA require further review, the mooring owner will be requested to submit the report to a Mooring Naval Architect / Engineer for consideration.
If the mooring design drawing does not contain a permissible wear rates table please Forward to the Naval Architect/Engineer for review.
I
(print name)
declare; the contents of this form are; (a) true and correct, and (b) understand my responsibilities and obligations as owner/operator of this mooring as set out in the Moorings Handbook and Mooring Licence Terms and Conditions.
Signature: / Date:
Completed forms should be scanned and emailed to:
Alternatively you may post the form to: Dampier Port, ATTENTION: Moorings Officer,
Locked Bag 5006, KARRATHA WA 6714
IMPORTANT: Once approved, an invoice for the annual mooring licencing fee will be issued (the cost will vary for each mooring.Please refer totheSchedule of Fees which is available for download on the PPA website Your mooring is not approved for use until you have received this licence.

SECTION 11: Naval Architect/Engineer -Certification for Use

IMPORTANT NOTE: Please attach to this report any accompanying technical notes associated with the mooring. Mooring design drawings and specifications (mooring analysis) must accompany this report when mooring designs have changed; where no table of permissible design wear rates are contained in specifications; and/or new vessels have been assigned to the mooring.
Mooring Number:
Maximum Safe Mooring Load:
Date Inspected:
Vessel Name: / Vessel Load on Mooring:
Does mooring comply with design specifications? / Yes / No
Has a table of the Design Wear Rates been included? / Yes / No
Is the mooring suitable for the nominated vessel? / Yes / No
Is the hawser suitable for the mooring/vessel arrangement? / Yes / No
This mooring is safe to use for the /cyclone season: / Yes / No
Report Recommendations/comments:
By signing this section of the Annual Mooring Dive Inspection Report the approved Naval Architect/Engineer declares:
(a) this report accurately reflects the specifications of the mooring design and its compliance to Dampier Port requirements as set out in the Moorings Handbook, and
(b) where applicable, certifies this mooring as suitable and safe to use as a cyclone mooring for the current/upcoming cyclone season based on the inspection report provided.
Company:
Postal Address:
Contact Number: / Mobile:
Email:
Signature:
Name (print):
Date:
PPA office use only
This form is correctly completed and no further information is required. Mooring ______has been approved to be issued an invoice for a mooring licence for the 2014/2015 season.
Signature:
Name (print):
Position:
Date:
SHEQ-SYS-T-023 / Issued Date: 7/10/2014 / Rev No: 9 / Page: 1 of 9