CG-5577 (07/19) Intermodal Container Non-Deficiency Inspection Report

DEPARTMENT OF HOMELAND SECURITY

U.S. Coast Guard
INTERMODAL CONTAINER NON-DEFICIENCY INSPECTION REPORT

OMB No: 1625-New
Exp. Date: mm/dd/yyyy

INSTRUCTIONS
The Intermodal Container Non-Deficiency Inspection Report is intended to provide documentation to the various parties
associated with the shipment of intermodal containers on the outcome of an International Safe Container Act safety
examination, an International Maritime Dangerous Goods Code compliance verification examination, or a U.S. Federal
Hazardous Materials (HAZMAT) Transportation Law compliance examination conducted by the U.S. Coast Guard. The
Intermodal Container Non-Deficiency Inspection Report must be used when any of the aforementioned examinations result in
no deficiencies being identified.
Guidance for completing the CG-5577A Form:
1. Specific block guidance:
Block 1: Create a MISLE Container Inspection Activity before conducting the examinations and place it in this block.
Block 2: Date should be in DDMMMYYYY format (e.g., 14MAR2014).
Block 3: Enter the Captain of the Port (COTP) where container inspections are being conducted.
Block 4: Enter facility/company where container(s) were inspected.
Block 5: Check whether or not the inspection was part of a Multi-Agency Strike Force Operation.
Block 6: Inspected Container Information:
No. - Add successive numeric designator for each container inspected (e.g., 1, 2, 3, 4, etc.).
Container Identification - Enter container identification, which includes owner code: three letters;
equipment category identifier: one letter; serial number: six numerals; and check digit: one numeral
(e.g., USAU6543217).
Seal Removed - Enter the removed container seal number.
Replacement Seal - Enter the replacement container seal number.
Declared (Hazard Class)/General Cargo/Other - Enter the Inspection Type. For a Declared
inspection, enter primary and subsidiary Hazard Class(s) identified.
Freight/Tank/Reefer - Place a mark in the appropriate Container Type box.
Country of Origin - Enter the country in which the shipment originated. This information is reported
to the IMO and accuracy is of utmost importance. If the info is not known, do not arbitrarily insert a
country.
Block 7: Enter any additional comments.
2. Attain the appropriate involved party's (e.g., facility representative, owner, shipper, agent, custodian, etc.) signature,
acknowledging receipt of the form and the information contained, and provide them and any other appropriate party a
copy.
3. Enter the qualified USCG Container Inspector's printed name, rate/rank, and signature.
4. Original CG-5577A shall be given to the involved party and the copy retained for USCG purposes.

CG-5577A (07/19)

Reset

HAZARDOUS MATERIALS CONTAINER INSPECTION GUIDANCE B. STRUCTURAL INTEGRITY/SAFETY APPROVAL PLATE
• References noted below are formatted as follows: [49 CFR
1. Structurally serviceable [International 453.1 / Domestic
part / International Maritime Dangerous Goods (IMDG) cite],
33 CFR 160.109].
unless otherwise noted.
2. Valid CSC safety approval plate attached to the
container [453 / International Convention for Safe
Containers (CSC)].
A. GENERAL PROCEDURES
1. Establish communications plan.
3. Safety approval plate contains the following in this
2. Inspect, calibrate, energize and don all required
order [451 / CSC]:
personal protective equipment (PPE).
(a) “CSC SAFETY APPROVAL”.
3. Select containers for inspection.
(b) Country of approval and approval reference number.
(c) Date (month & year) of manufacture.
4. Conduct safety brief, covering:
(d) Manufacturer's ID number or number allotted by
(a) Operational risk assessment (ORM).
Administration.
(b) Assignment of roles and duties.
(e) Maximum operating gross weight (kg & lbs).
(c) Required use of PPE.
(d) Best work practices.
(f) First exam date and subsequent exam dates or
(e) Emergency egress muster location.
Approved Continuous Examination Program
(f) Known facility hazards.
(ACEP) marking as close as practicable to plate
(g) Accidental exposure procedures.
[452.1 & 452.7 / CSC].
5. Identify the contents of containers selected for inspection:
C. SHIPPING PAPERS
(a) Shipping papers for Declared HAZMAT.
1. All hazardous materials observed are listed [172.200 /
(b) Bill of Landing for General Cargo.
5.4.1.1.1].
6. Stage containers for inspection.
2. UN ID #, proper shipping name, hazard class, and
7. Establish a safety watch, review safety procedures and
packing group are correct and in sequence [172.202(a)
create a safe working zone around container(s).
8. Conduct a visual external assessment, remaining alert for
(1-4) / 5.4.1.4.2].
3. Total quantity by weight or volume indicated [172.202
signs of cargo leakage and severe container damage.
(a)(5) / 5.4.1.5.1].
9. Place atmospheric monitoring equipment at foot of door
4. Additional information used where required [172.203 /
sill.
5.4.1]:
10. Properly attach a container safety strap to container
locking bars.
(a) Name and address of the Shipper [172.203(i)(1) /
11. Remove original container security seal and document
5.4.1.3].
its serial number.
(b) Technical Name [172.203(k) / 5.4.1.4.3.1].
12. Open right side container door and assess tailgate area
(c) Empty Packaging [172.203(e) / 5.4.1.4.3.2].
for shifted cargo. Remove safety strap from left side
(d) Elevated Temperature Cargoes [172.203(n) /
container door and if safe to proceed, use safety strap
5.4.1.4.3.4].
to open right side container door at least 180 degrees.
(e) Marine Pollutant [172.203(l) / 5.4.1.4.3.5].
13. Allow ventilation of container for 15 minutes before
(f) Minimum Flashpoint [172.203(i)(2) / (5.4.1.4.3.6].
returning to the tailgate for inspection of cargo.
(g) Limited Quantity or “LTD QTY” [172.203(b) /
Additional ventilation required for Poisonous Inhalation
5.4.1.5.2].
Hazards (PIH) & fumigated cargoes. See
(h) Self-reactive sub. and organic peroxides [172.203
COMDTINST M16616.11 and CGTTP 3-72.3.
(o) / 5.4.1.5.4].
(i) Radioactive Material [172.203(d) / 5.4.1.5.7].
14. Test the atmosphere at the tailgate, taking
(j) DOT-SP or DOT-E [172.203(a)].
measurements at head and waist levels.
15. Conduct the tailgate inspection. Additional safety
(k) Hazardous Substance “RQ” [172.203(c)].
required for enclosed space entry. See COMDTINST
(l) Poisonous Materials [172.203(m)].
5. Shipper's certification and signature [172.204 / 5.4.1.6].
M16616.11 and CGTTP 3-72.3.
6. Container packing certificate [176.27 / 5.4.2].
16. Complete a CG-5577 or non-deficiency “short” form,
7. Emergency response telephone number listed on
documenting all findings.
17. Close container doors and affix USCG container seal.
shipping papers [172.201(d) & 172.604, exceptions:
172.604(d)].
If necessary, apply detention stickers to the container.
8. Hazardous waste manifest [172.205].
18. Deliver completed CG-5577 or alternate form to
9. Emergency response information [172.602 / 5.4.3.2].
appropriate involved party.
19. U.S. DOT HAZMAT Registration Number is described
in 49 CFR 107.601-.717. Merchant vessels engaged
in any of the activities requiring registration and
transporting, transiting, or transshipping packaged
HAZMAT within 12 miles of the U.S. must have a U.S.
DOT HAZMAT Registration Number. HAZMAT
Registration Numbers can be verified at:
https://hazmatonline.phmsa.dot.gov/services/
companylookup.aspx
CG-5577A (07/19)

Reset

D. MARKING/LABELING/PLACARDING
HAZARDOUS MATERIALS TANK INSPECTION GUIDANCE
1. Non-Bulk Packages marking requirements [172.301 /
A. GENERAL PROCEDURES
5.2.1]:
1. Same General Procedures as identified in HAZMAT
(a) Proper shipping name and ID number.
Container Inspection Guidance Paragraph A, steps 1-9.
(b) Technical names.
2. Visual assessment [173.32 & 178.274 / 4.2.1 / IMO
(c) DOT-E or DOT-SP.
Circ 138]:
(d) Consignee's or Consignor's name and address.
(a) Structurally sensitive components.
2. Bulk Packages marked with ID number and DOT-E or
(b) Shell and insulation jacket.
SP [172.302].
(c) Piping, valves, flanges, gaskets, pressure relief
3. Additional package markings present where required:
devices, gauges, and other service equipment.
(a) Radioactive Materials [172.310 / 5.2.1.5].
(b) Orientation Arrows for liquid HAZMAT in
(d) Compressed Air Connection.
(e) Required markings for legibility.
combination packages [172.312 / 5.2.1.7].
3. Corrosion, leakage, or other unsafe conditions
(c) Poisonous HAZMAT and PIH [172.313].
[173.32(e)].
(d) Limited Quantities [172.315 & 172.301(a) / 5.2.1.9
& 3.4.5].
B. MARKING/PLACARDING OF PORTABLE TANKS
(e) ORM-D Material [172.316].
1. Portable tank marking [172.326 / 5.3.2]:
(f) Explosive HAZMAT [172.320].
(a) Shipping name on two opposing sides.
(g) Marine Pollutants [172.322 / 5.2.1.6 & 5.3.2.3].
(h) Hazardous Substance (RQ) and Waste [172.324].
(b) Owner's name.
(i) Freight Container [172.301(a)(3) & 172.331(c) /
(c) ID numbers [172.326(c)].
5.3.2].
2. Portable tank ID plate, marked accordingly [178.274(i) /
6.7.2.20].
4. Labeling packages with primary and subsidiary hazards
3. Portable tank periodic testing and inspections marked
[172.400 & 172.402 & 172.406, exceptions 172.400(a) /
on ID plate [180.605(k)].
5.2.2.1].
4. CSC safety approval plate [178.274(a) / CSC].
5. Additional labeling requirements [172.402 / 5.2.2.1 5.2.2.1.12].
6. Overpacks are marked, labeled and marked with the
word "OVERPACK" [173.25 / 5.1.2.1].
7. Placarding visible on all four sides of container
[172.504(a) / 5.3.1.1.4].
8. Placarding subsidiary hazards PIH, Uranium
Hexafluoride, and Class 4.3 [172.505].
E. PACKAGING/STOWAGE/ SEGREGATION
1. Packaging used is appropriate for each commodity
[171.2 / 4.1.1]:
(a) Specific requirements [172.101 Column 7 & 8 /
DGL Column 8 & 9].
(b) Specifications for Cylinders [178.35 / 6.2.2].
(c) Non-bulk Performance-Oriented Packaging
[178.503 / 6.1.3].
(d) IBC Performance-Oriented Standards [178.703 /
6.5.2].
2. Packages secured to prevent shifting or movement
[176.76 / 7.3.3.6].
3. HAZMAT segregation within freight container [176.83
(d) / 7.3.4.1].
(a) Class 1 Segregation Table [176.144 \ 7.2.7.1.4].
(b) General Segregation Table [176.83 (b) / 7.2.4].

CG-5577A (07/19)

Reset

DEPARTMENT OF HOMELAND SECURITY

U.S. Coast Guard
INTERMODAL CONTAINER NON-DEFICIENCY INSPECTION REPORT
1. MISLE Activity Number

2. Date of Inspection

3. Captain of the Port (COTP) Zone

4. Facility/Company

5. Inspection conducted as part of Multi-Agency Strike Force Operation?

Yes

OMB No: 1625-New
Exp. Date: mm/dd/yyyy

No

6. Container(s) Inspected and Identified as without Deficiency
No.

Container Identification

Seal Removed

Replacement Seal

Declared (Hazard Class /
Freight
General Cargo / Other)

Tank

Reefer

Country of Origin

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
7. Additional Comments

Involved Party:

(Owner/Shipper/Agent/Custodian - Printed Name)

(Signature)

(Qualified Container Inspector - Printed Name)

(Signature)

USCG Container Inspector:

CG-5577A (07/19)

Reset

Page 1 of 2

Privacy Act Statement
Authority: 46 U.S.C. § 70011; 46 U.S.C. § 80503; 49 U.S.C. § 5101-5128; 33 CFR § 160; 49 CFR § 171-177; and 49 CFR § 453
Purpose: To document the outcome of International Safe Container Act safety examinations, International Maritime Dangerous Goods Code compliance
verification examinations, or U.S. Federal Hazardous Materials (HAZMAT) Transportation Law compliance examinations conducted by the U.S. Coast Guard
when no deficiencies have been identified.
Routine Uses: This information will be used to assist the Department of Homeland Security in responding to incidents that may occur as a result of hazardous
material transportation operations, and may be disclosed externally as a “routine use” pursuant to DHS/USCG-013, Marine Information for Safety and Law
Enforcement (MISLE), 74 Federal Register 30305 (June 25, 2009).
Disclosure: Furnishing this information is voluntary. However, failure to provide this information may result in the delay of transportation authorization or other
enforcement actions.
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 number.
The Coast Guard estimates that the average burden for this report is 6 minutes. You may submit any comments concerning the accuracy of this burden
estimate or any suggestion for reducing the burden to: Commandant (CG-FAC), U.S. Coast Guard Stop 7501, 2703 Martin Luther King Jr Ave SE, Washington,
DC 20593-7501 or Office of Management and Budget, Paperwork Reduction Project (1625-new), Washington, DC 20503.

CG-5577A (07/19)

Reset

Page 2 of 2