CG-5148 International Certificate of Fitness for the Carriage of

International Certificate of Fitness for the
Carriage of Liquefied Gases in Bulk

Form Approved
OMB No. 1625-0094

Issued under the provisions of the
International Code for the Construction and Equipment
of Ships Carrying Liquefied Gases in Bulk
(resolution MSC.5(48) as amended by resolution MSC.17(58))

Under the authority of the Government of
United States of America
by the UNITED STATES COAST GUARD
Name of Ship

Official Number

Port of Registry

Cargo Capacity
(m 3 )

Ship Type
(Code Paragraph 2.1.2)

Date on which keel was laid or ship was at a similar stage of construction or, (in the case of a converted ship) date on
which conversion to a gas carrier was commenced:
The ship also complies fully with the following amendments to the Code:

The ship is exempted from compliance with the following provisions of the Code:

THIS IS TO CERTIFY:
1 .1 That the ship has been surveyed in accordance with the provisions of 1.5 of the Code;
.2 That the survey showed that the structure, equipment, fittings, arrangements and materials of the ship and the
conditions thereof are in all respects satisfactory and that the ship complies with the relevant provisions of the
Code.
2 That the ship is suitable for carriage in bulk of the products listed on the annexed, signed and dated sheets
numbered 1A provided that all relevant operational provisions of the Code are observed.
3 That the following design criteria have been used:
o
.1 ambient air temperature
C
o
.2 ambient water temperature
C

An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number.
The Coast Guard estimates that the average burden for this report is 30 minutes. You may submit any comments concerning the accuracy of this burden estimate or
any suggestions for reducing the burden to: Commandant (G-MOC-2), U.S. Coast Guard, 2100 2nd St, SW, Washington D.C. 20593-0001 or Office of Management
and Budget, Paperwork Reduction Project (1625-0094), Washington, DC 20503.
USCG, CG-5148 (Rev. 01-03)

.3

TANK TYPE
AND NUMBER **

A

STRESS FACTORS
B
C
D

MATERIAL

MARVS

CARGO PIPING
** Tank numbers referred to in this list are identified on the annexed, signed and dated tank plan numbered 2A.

4
5

o
o
.4 Mechanical properties of the cargo tank material were determined at
C,
F.
1
1
That, in accordance with 1.4 and 2.8.2 , the provisions of the Code are modified in respect to the ship in the manner
shown on the annexed, signed and dated sheets numbered 3A.
That the ship must be loaded:
.1 in accordance with the loading conditions provided in the approved loading manual, stamped and
dated
and signed by a responsible officer of the Administration, or of organization
recognized by the Administration;1
.2 in accordance with the loading limitations appended to this Certificate.1
Where it is required to load the ship other than in accordance with the above instruction, then the necessary
calculations to justify the proposed loading conditions should be communicated to the certifying Administration
which may authorize in writing the adoption of the proposed loading condition.2
3

This Certificate is valid until
of the Code.
Issued at

subject to surveys in accordance with 1.5

,
(Place of issue of Certificate)

(Date of issue)

The undersigned declares that he is duly authorized by the said Government to issue this Certificate.

(Signature of official issuing the Certificate
and/or seal of issuing authority)
Notes on completion of Certificate:
"Ship type": any entry under this line must be related to all relevant recommendations, e.g. an entry "Type 2G" should mean type 2G in all
respects prescribed by the Code.
Paragraphs 2.1 and 2.2: the ambient temperatures accepted or required by the Administration of the purposes of 4.8.1 of the Code to be inserted.
Paragraph 2.3: stress factors and materials as accepted or required by the Administration for the purposes of 4.5.1.4 and 4.5.1.6 of the Code to be
inserted.
Paragraph 2.4: temperature accepted by the Administration for the purposes of 4.5.1.7 to be inserted.
Paragraph 3: only products listed in chapter 19 of the Code or which have been evaluated by the Administration in accordance with paragraph 1.1.6
of the Code or of their compatible mixtures having physical properties within the limitations of tank design should be listed. In respect of the latter
"new" products, any special requirements provisionally prescribed should be noted.
1.
2.
3.

Delete as appropriate.
Instead of being incorporated in the Certificate, this text may be appended to the Certificate if duly signed and stamped.
Insert the date of expiry as specified by the Administration in accordance with 1.5.6.1 of the Code. The day and the month of this date
correspond to the anniversary date as defined in 1.3.3.3 of the Code, unless amended in accordance with 1.5.6.8 of the Code.

ENDORSEMENT FOR ANNUAL AND INTERMEDIATE SURVEYS
THIS IS TO CERTIFY that, at a survey required by 1.5.2 of the Code, the ship was found to comply with the
relevant provisions of the Code:
Annual Survey:
Signed:
(Signature of authorized official)
Place:
Date:
(Seal or stamp of the authority, as appropriate)
Annual 1 /Intermediate 1
Survey:

Signed:
(Signature of authorized official)
Place:
Date:
(Seal or stamp of the authority, as appropriate)

Annual 1 /Intermediate 1
Survey:

Signed:

(Signature of authorized official)

Place:
Date:
(Seal or stamp of the authority, as appropriate)
Annual Survey:

Signed:

(Signature of authorized official)

Place:
Date:
(Seal or stamp of the authority, as appropriate)

Annual/intermediate survey in accordance with 1.5.6.8.3

THIS IS TO CERTIFY that, at an annual/intermediate 1 survey in accordance with 1.5.6.8.3 of the Code, the ship was
found to comply with the relevant provisions of the Code.
Signed:
(Signature of authorized official)
Place:
Date:
(Seal or stamp of the authority, as appropriate)

Endorsement to extend the Certificate if valid for less than 5 years where 1.5.6.3 applies
The ship complies with the relevant provisions of the Code, and this Certificate should, in accordance with 1.5.6.3 of the
Code, be accepted as valid until
Signed:

(Signature of authorized official)

Place:
Date:
(Seal or stamp of the authority, as appropriate)
1.

Delete as appropriate.

Endorsement where the renewal survey has been completed and 1.5.6.4 applies
The ship complies with the relevant provisions of the Code, and this Certificate should, in accordance with 1.5.6.4 of the
Code, be accepted as valid until
Signed:

(Signature of authorized official)

Place:
Date:
(Seal or stamp of the authority, as appropriate)

Endorsement to extend the validity of the Certificate until reaching the port of survey or
for a period of grace where 1.5.6.5/1.5.6.6 1 applies

This certificate should, in accordance with 1.5.6.5/1.5.6.6 1 of the Code, be accepted as valid
until
Signed:
(Signature of authorized official)
Place:
Date:
(Seal or stamp of the authority, as appropriate)

Endorsement for advancement of anniversary date where 1.5.6.8 applies
In accordance with 1.5.6.8 of the Code, the new anniversary date is
Signed:

(Signature of authorized official)

Place:
Date:
(Seal or stamp of the authority, as appropriate)
In accordance with 1.5.6.8 of the Code, the new anniversary date is
Signed:

(Signature of authorized official)

Place:
Date:
(Seal or stamp of the authority, as appropriate)

1.

Delete as appropriate.

ENCLOSURE 1A to the Certificate of Fitness for the Carriage of Liquefied Gases in Bulk
PRODUCTS AND CONDITIONS LIST
Products

Conditions of Carriage (tank numbers, minimum
temperature, MARVS, maximum density, tank
loading conditions, etc.)

Tank numbers referred to in this list are identified on the annexed, signed and dated tank plan numbered 2A.

Signature of official issuing the certificate and/or
seal of issuing authority
Date of issue

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ENCLOSURE 2A to the Certificate of Fitness for the Carriage of Liquefied Gases in Bulk

TANK PLAN
Cargo Tanks Above/Below Main Deck
BOW

STARBOARD

PORT

STERN

Signature of official issuing the certificate and/or
seal of issuing authority
Date of issue

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ENCLOSURE 3A to the Certificate of Fitness for the Carriage of Liquefied Gases in Bulk
Equivalents to the provisions, procedures, or arrangements required by the Code:

Signature of official issuing the certificate and/or
seal of issuing authority
Date of issue

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