NBBI NB23-2019 Part 3 National Board Inspection Code - NBIC, 2019 Edition - Part 3 - Repairs and Alterations. Standard by National Board of Boiler and Pressure Vessel Inspectors, 2019.

Submit a Ballast Water Management Report via PDF

NOTE: Adobe Acrobat or Adobe Reader, version 9 or later, is required to use the PDF BWMR form to submit correctly. No other PDF software besides Adobe Acrobat is supported at present. Adobe Reader can be downloaded for free from adobe.com. The latest version of the PDF BWMR form is available below.

LEGALLY BINDING DOCUMENT United States of America All citizens and residents are hereby advised that this is a legally binding document duly incorporated by reference and that failure to comply with such requirements as hereby detailed within may subject you to criminal or civil penalties under the law. Chapter 14 Installation, Inspection, Maintenance, and Repair Requirements. 9 December 2015 SLAC-I-730-0A21S-053-R004 4 of 8 When recommended by the pressure system inspector A pressure system that includes an American Society of Mechanical Engineers (ASME) code designed vessel must be equipped with ASME-rated pressure relief devices. Narragansett Bay Insurance Company (“NBIC”) is a wholly owned subsidiary of Heritage Insurance Holdings, Inc. (NYSE:HRTG) (“Heritage” or the “Company”). Heritage is a property and casualty insurance holding company headquartered in Clearwater, Florida. An American National Standard providing rules and guidelines for inservice inspection, repair, and alteration of pressure-retaining items, the National Board Inspection Code (NBIC) is required in many United States and Canadian jurisdictions.

Extended form: The standard form can report the ballast water history of up to 20 tanks. The Extended Form can report up to 36 tanks.

Completion Instructions

Vessel Information

Vessel name: Enter the name of the vessel. For tug and barge combinations, please list multiple vessel names separated by a hyphen.

ID number: Select 'IMO Number' or 'Official Number' from the pull-down menu, and enter the vessel identification number into the adjacent field. For tug and barge combinations, please list multiple vessel numbers separated by a hyphen.

Country of Registry: Choose from the country pull-down menu.

Owner/operator: Enter the name of the registered owner(s) of the vessel. If under charter, enter operator name.

Type: Select specific vessel type from the pull-down menu. If exact vessel type is not available, select 'Other'.

Gross Tonnage: Enter the Gross Tonnage of the vessel. If reporting a tug-barge combo, report total combined gross tonnage.

Ballast water volume units: Select cubic meters, metric tons, or gallons from the pull-down menu. NOTE: this volume unit will be applied to all volume entries on the BWMR.

Total ballast water capacity: Enter the maximum total volume of ballast water that can be carried in the vessel. If reporting a tug-barge combo, report total combined ballast water capacity.

Number of tanks on ship: Enter the total number of ballast water tanks, cargo holds, and other spaces that are used for carrying ballast water.

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Onboard BW Management System: If the vessel is equipped with an approved Ballast Water Management System, enter the US Coast Guard designated system identification number:

For USCG Type Approved systems, the US Coast Guard Approval Number is on the certificate plate installed on BWMS and looks like: 162.060/#/#.
For USCG accepted Alternative Management Systems the AMS ID is in the AMS Acceptance Letter and looks like: AMS-20##-XXX...XXX-001.
For vessels enrolled in the Shipboard Technology Evaluation Program, enter 'STEP Vessel'.
Otherwise, enter 'None'.

Voyage Information

Arrival port (port and state): Enter the name of the port or place that is the destination for this voyage. No abbreviations please. Select the matching state or territory from the pull-down menu.

Arrival date: Enter the date of arrival to the Arrival port. Use European date format (DD/MM/YYYY).

Last port (port and country): Enter the name of the last location at which the vessel called, either outside the US EEZ or the previous US location. No abbreviations please. Select the Country or US territory of the Last port from the pull-down menu.

Next port (port and country): Enter the name of the next location at which the vessel plans to arrive. Select the Country or US territory of the Next port from the pull-down menu.

Total ballast water on board: Enter the total volume of ballast water on board upon arrival into the Arrival Port. Do not count potable water. (Note: if reporting a tug-barge combo, report total combined ballast water on board.)

Number of tanks in ballast: Enter the total number of ballast water tanks, cargo holds, and other spaces that are carrying ballast water upon arrival to the arrival port.

Number of tanks discharged: Enter the total number of ballast water tanks, cargo holds, and other spaces carrying ballast water discharged at, or en route to, the arrival port.

Alternate BW management conducted, per instructions from COTP: Check this box only if you have received specific instructions from a COTP on how to conduct an alternative BW management on one or more of the BW tanks to be discharged.

Ballast Water History

Record all tanks to be discharged inside coastal waters (12nm) of the US, either en route to or at the Arrival port.

Ballast Water History is reported on a 'BW Event' basis. Rather than reporting discharge, management and source events on a single line, as in earlier BWMR forms, each ballast water event is now reported on a separate line.For each tank, fill in ballast water events in descending date order, with the most recent discharge at the top. Illustrated examples are available at the end of this document.

NOTE: US Coast Guard NOBOB policy also requires vessels entering the Great Lakes and Hudson River (north of the George Washington Bridge) after operating beyond the U.S. EEZ to report the Ballast Water History of empty BW tanks that underwent an alternative management (e.g., Salt Water Flush, conducted a mid-ocean exchange the last time the tanks contained ballast water).

Tank Information

Tank name/number: Enter the specific name and number of the tank, including its location/side (center, port or starboard), e.g. WT 1P.

Tank capacity: Enter the maximum volume that the tank or hold can carry.

Ballast Water Events

Discharge Events

Event: Select either 'Discharge to US waters' or 'Discharge to facility' from the pull-down menu in the top line of the tank block.

Date: Enter the date that ballast water was discharged, using DD/MM/YYYY format.

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Location: Enter the port or place name (including state, territory, or country), or latitude and longitude of the location where ballast water was discharged.

Volume: Enter the volume of ballast water that was discharged.

Management Events

• For discharge to a shore-based facility or another vessel for treatment select 'Discharge to facility' in the Discharge Events section above.

• For ballast water from a US Public Water System select 'Source from PWS' in the Source Events section below.

• If ballast water management was NOT CONDUCTED, skip to the Source Events section below.

• OTHERWISE, select a management event:

Event: Select 'Empty-refill exchange', 'Flow-through exchange', 'Onboard treatment' or 'Salt Water Flush' from the 'Select event' pull-down menu.

NOTE: 'Salt Water Flush' is a US Coast Guard's Best Management Practice for vessels with empty ballast water tanks entering the Great Lakes and Hudson River (north of the George Washington Bridge). Salt water flushing is defin

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