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King's Lynn Conservancy Board.


Pilotage order form to be received 24 hours prior to arrival.


NO PILOT WILL BE SUPPLIED UNLESS FULLY COMPLETED AND FAXED TO 01553 763431



Vessels Name…………………………………………………….


Port of Registry/Flag.……………………………………………


IMO Number…………………………………..……………..……


Last Port……………….…………………………………………..


ETA in Roads…..………………………….…..………………….


Intended Tide for Arrival…………………………..……………..


Indicate Intended Berth      A.Dk…...B.Dk…...R.S.Q……

Note: to include any Instructions for which side too.


Vessels maximum Length…………………..………….Metres


Vessels maximum Beam……………………………….Metres


Vessels maximum Arrival Draught…………………….Metres


Vessels Gross Tonnage………………..…….…G.T. (ITC69)


Bow Thruster fitted and operational      Yes         No                .                       


Any Defects to Vessel                           No          Yes                           


Type of Cargo…………..……………………………….


Hazardous Cargo.                                 No             Yes       


Cargo UN No…………………………..


IMDG Class…………………………….


Vessel ISPS Compliant                           Yes         No                .                       

Note: If vessel not compliant further information will be required.


Vessels Security level                               1         2        .   3        . 

Note: If vessel not on Level 1 further security information will be required.

           

Terminal operator has accepted vessel.  Yes         No               .                       


Signed……………………………………….. Date……………….2010


AGENCY………………………………………     

   

KINGS LYNN PORT ID 28630                     LOCATOR CODE: GBKLN                             PORT FACILITY NO: 0171