有害物質目録（IHM）第I部に関する証明書および承認証
令和7年5月21日|p.66
左の本文を選ぶと、右側の官報原文画像で該当箇所を照合できます。
Particulars of Part I of the Inventory of Hazardous Materials
Part I of the Inventory of Hazardous Materials identification/verification number: ………………………
Note: Part I of the Inventory of Hazardous Materials, as required by regulation 5 of the
Annex to the Convention, is an essential part of the International Certificate on Inventory of
Hazardous Materials and must always accompany the International Certificate on Inventory
of Hazardous Materials. Part I of the Inventory of Hazardous Materials should be compiled
on the basis of the standard format shown in the guidelines developed by the Organization.
1. that the ship has been surveyed in accordance with regulation 10 of the Annex to the
Completion date of survey on which this certificate0.0based: (dd/mm/yyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyy
This certificate0.0valid until (dd/mm/yyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyy)
(dd/mm/yyyy) (Date of issue) (Signature of duly duthorized official issuing the certificate)
ENDORSEMENT TO EXTEND THE CERTIFICATE IF VALID FOR
LESS THAN FIVE YEARS WHERE REGULATION 11.6 APPLIES
The ship complies with the relevant provisions of the Convention, and this certificate shall, in
accordance with regulation 11.6 of the Annex to the Convention, be accepted as valid until
(dd/mm/yyyy): :
Signed:
(Signature of duly authorized official)
Place……………………………………………………………………………………………………………
Date: (dd/mm/yYyy)…………………………………………………………………………………………………………………………………………………………………………………………………………………………
(Seal or stamp of the authority, as appropriate)
ENDORSEMENT WHERE THE RENEWAL SURVEY HAS BEEN COMPLETED AND
REGULATION 11.7 APPLIES
The ship complies with the relevant provisions of the Convention, and this certificate shall, in
accordance with regulation 11.7 of the Annex the Convention, be accepted as valid until
(dd/mm/yyyy):
Place……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
igned...............................................................................................
(Signature of duly authorized official)
Date: (dd/mm/yYYy)…………………………………………………………………………………………………………………………………………………………………………………………………………………………
(Seal or stamp of the authority, as appropriate)
This page of the endorsement at survey shall be reproduced and added to the certificate as considere
by the Administration.