Chapter 10

Form M 000

REQUISITION FORM-SPARE PARTS

M.V.......Grand Ferry ......……… Date....18.04.2018................……………
Department ...Engine.……………………........

Machinery Name :       Name of Manufacturer: Impa 6 th edition

Machinery Type : Spare parts
Serial No. :      
Year Built :      
Other Details (Relevant jobs/tasks) :      

Approximately when required :Urgent

S/N ITEMS Plate Drwg No. Part Number Quantity Quantity
Require Onboard
d
1 Rotary hand pump ‘’1’’ 61 48 61 40 07 1pc 0
2 Hose bands, stainless steel 61 49 61 40 66 10pc 0
3 Hose bands, stainless steel 61 49 61 40 68 10pcs 0
4 Hose bands, stainless steel 61 49 61 40 70 10pcs 0
5 Hose bands, stainless steel 61 49 61 40 71 10pcs 0
6 Hose bands, stainless steel 61 49 61 40 72 10pcs 0
7 Hose bands, stainless steel 61 49 61 40 73 10pcs 0
8 Hose bands, stainless steel 61 49 61 40 74 10pcs 0
9 File handles 61 52 61 45 61 10pcs 0
10 Universal pipe wrench 320mm 61 64 61 13 41 2pcs 0
11 Universal pipe wrench 320mm 61 64 61 13 42 2pcs 0
12 WD 40 lubricant 45 12 45 07 02 10pcs 0
13 MolySlip Anti-Seize compound,copaslip 45 8 45 05 66 5pcs 0
500grm.
14 Nickelslip 500grm 45 8 45 05 98 5pcs 0
15 Emery type,50mm #60 61 54 61 47 28 3rols 0
16 Emery type,50mm #150 61 54 61 47 32 3rols 0
17 Emery type,50mm #320 61 54 61 47 35 3rols 0
18 Emery cloth, abrasive 61 54 61 46 89 10sh-ts 0
19 Emery cloth, abrasive 61 54 61 46 93 10sh-ts 0
20 Emery cloth, abrasive 61 54 61 46 86 10sh-ts 0
21 Hand riveter kit 61 62 61 52 33 1set 0
22 Plastic chipping goggles 33 103 33 11 42 40pcs 0
23 Faceshield 33 103 33 11 44 5pcs 0
24 Faceshield spare glass 33 103 33 11 48 5pcs 0
This form is to be sent in for every item of spare parts ordered, whether direct order or through the Company.

2/ Engineer and/or Master’ Signature :…………………………………

From Company:
Approved
Spares delivered onboard on      

Go Shipping & Management Inc Safety Management System Manual

Forms
Issue No. : 01 Date of issue : 02/2016
Amendment No. : 00 Date of Amendment :-