
APPENDIX 1
SURVEY PLANNING QUESTIONNAIRE
FOR A BULK CARRIER
Prior to the development of the Survey Programme, the Survey Planning Questionnaire should be
completed by the Owner/Manager. It is essential that up-to-date information is provided when
completing this questionnaire.
1. Particulars
Ship name:
IMO (LR) number:
Flag State:
Port of registry:
Owner:
Recognized organization (RO):
Gross tonnage:
Deadweight (metric tonnes):
Date of delivery:
A specific Survey Programme shall be worked out in advance of the renewal Survey by the
Owner/Manager in co-operation with Lloyds Register. The Survey Programme shall be in written
format and the Survey shall not commence until the Survey Programme has been agreed upon.
Recognised Organisation (RO): This indicates the Classification Society.
Document no; ESP_R10.0_2007_BULK
APPENDIX 1
SURVEY PLANNING QUESTIONNAIRE
FOR A BULK CARRIER

2. Information on access provision for close-up surveys and thickness measurement
The means of access to the structures subject to close-up examination and thickness measurement
shall be indicated in the table below. A close-up examination in an examination where the details
of structural components are within the close visual inspection of the Surveyor, i.e. preferably
within reach of hand.
Hold/Tan
Structure
k No.
Temporary
Rafts
Staging
F.P.
Fore Peak
A.P.
Aft Peak
Hatch side
coamings
Topside sloping
plate
Cargo Holds
Upper stool plating
Cross deck
Side shell, frames
and brackets
Transverse bulkhead
Hopper tank plating
Lower stool
nks
Ta
Underdeck structure
de
psi
To
Tank top
Document no; ESP_R10.0_2007_BULK
Ladders
Direct
Other means
Access
(please specify)
Side shell and

APPENDIX 1
SURVEY PLANNING QUESTIONNAIRE
FOR A BULK CARRIER
structure
Sloping plate and
structure
Webs and
bulkheads
Hopper sloping
plate and structure
Side shell and
structure
Hopper Tanks
Bottom structure
Webs and
bulkheads
Double bottom
structure
Upper stool internal
structure
Lower stool internal
Underdeck and
structure
Carriers
Wing tanks of double Ore
structure
Side shell and
structure
Side shell vertical
Document no; ESP_R10.0_2007_BULK

APPENDIX 1
SURVEY PLANNING QUESTIONNAIRE
FOR A BULK CARRIER
web and structure
Longitudinal
bulkhead and
structure
Longitudinal
bulkhead web and
structure
Bottom plating and
structure
Cross ties/stringers
Document no; ESP_R10.0_2007_BULK

APPENDIX 1
SURVEY PLANNING QUESTIONNAIRE
FOR A BULK CARRIER
3. Assessment of Corrosion Risk
The information below may assist in the assessment of corrosion risk and determination of areas
subject to close-up examination and thickness measurement.
History of bulk cargoes of a corrosive nature (e.g. high sulphur content)
Document no; ESP_R10.0_2007_BULK
4. Owner’s inspections
APPENDIX 1
SURVEY PLANNING QUESTIONNAIRE
FOR A BULK CARRIER

The owner should provide details of the results of their inspections over the last 3 (three) years for
the tanks/spaces that are subject to Survey.
Hold/Tank
No.
Corrosion
protection
(1)
Coating
extent
(2)
Coating
condition
(3)
Cargo holds
Topside tanks
Hopper tanks
Document no; ESP_R10.0_2007_BULK
Structural
deterioration
(4)
Hold and tank history
(5)

APPENDIX 1
SURVEY PLANNING QUESTIONNAIRE
FOR A BULK CARRIER
Double skin
side tanks
Double
bottom tanks
Upper stools
Document no; ESP_R10.0_2007_BULK

APPENDIX 1
SURVEY PLANNING QUESTIONNAIRE
FOR A BULK CARRIER
Lower stools
Wing tanks
(ore tankers)
Fore peak
Aft peak
Miscellaneous
other spaces:
Document no; ESP_R10.0_2007_BULK

APPENDIX 1
SURVEY PLANNING QUESTIONNAIRE
FOR A BULK CARRIER
Note: Indicate tanks which are used for oil/ballast
(1)
(2)
(3)
(4)
(5)
HC = hard coating; SC = soft coating; A = anodes; NP = no protection
U = upper part; M = middle part; L = lower part; C = complete
G = good; F = fair; P = poor; RC = recoated (during the last 3 years)
N = no findings recorded; Y = findings recorded, description of findings should be
attached to this questionnaire
DR = Damage & Repair; L = Leakages; CV = Conversion (Description to be attached to
this questionnaire)
Document no; ESP_R10.0_2007_BULK
APPENDIX 1
SURVEY PLANNING QUESTIONNAIRE
FOR A BULK CARRIER

5. Reports of Port State Control inspections
List the reports of Port State Control inspections containing hull structural related deficiencies, relevant
information on rectification of the deficiencies:
6. Safety Management System
List non-conformities related to hull maintenance, including the associated corrective actions:
Document no; ESP_R10.0_2007_BULK

APPENDIX 1
SURVEY PLANNING QUESTIONNAIRE
FOR A BULK CARRIER
Document no; ESP_R10.0_2007_BULK
APPENDIX 1
SURVEY PLANNING QUESTIONNAIRE
FOR A BULK CARRIER

7. Name and address of the approved thickness measurement company:
Name of Owner’s representative:
………………………………………………………………………
……………………………
Signature:……………………………………...
Date:……………………………………………
Document no; ESP_R10.0_2007_BULK