Marine pollution prevention — air pollution - Australian Maritime ...
Marine pollution prevention — air pollution - Australian Maritime ...
Marine pollution prevention — air pollution - Australian Maritime ...
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Forms Schedule 1Form MO<strong>—</strong>97/2<strong>Marine</strong> Orders, Part 97 (<strong>Marine</strong> Pollution Prevention <strong>—</strong> Air Pollution)Local Fuel Oil Suppliers* Initial DeclarationPlease complete this form and return by mail or fax to:Manager, <strong>Marine</strong> Environment StandardsGPO Box 2181Canberra ACT 2601, AustraliaFax: +61 2 6279 50261 Name of Company2 Street Address3 Postal Address4 Contact Name5 Telephone Number6 Fax Number7 Email address8 Fuel Oil Supplier **9 Ports supplied (attachseparate page if spaceis insufficient)10 Method of delivery(circle one or more)11 Type of fuel supplied(circle one or more)road tanker / barge / offshore supply vessel / direct from shore /otherHFO / MGO / diesel / otherSignature: ______________________________ Date: __________Name & Position: ___________________________________________* The Local Fuel Oil Supplier is the person or company responsible for deliveringthe bunkers to the ship or installation by barge, offshore supply vessel, roadtanker or direct from shore.** The Fuel Oil Supplier is the person responsible for the final blend of fueldelivered to the ship. In some cases the Fuel Oil Supplier will also deliver thefuel to the ship, taking on the additional responsibilities and obligations of theLocal Fuel Oil Supplier.<strong>Marine</strong> Order 97 (<strong>Marine</strong> <strong>pollution</strong> <strong>prevention</strong> <strong>—</strong> <strong>air</strong> <strong>pollution</strong>) 2007 19MO97 modcomp-130613Z.docx
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