Working together for a safer world
FOBAS Witness Sampling Form (WSF) REF: WSF V1.0 - March 2016
FOR ATTENTION OF: FUEL SUPPLIER’S REPRESENTATIVE
NAME OF FUEL SUPPLIER:
FROM: VESSEL MASTER / CHIEF ENGINEER
SHIPS NAME:
IMO NUMBER:
OWNER:
BUNKER PORT:
BUNKER DATE:
GRADE(S) ORDERED:
The taking of a representative manifold sample is critical in being able to determine the quality of the fuel delivered
to a vessel. This vessel uses Lloyd’s Register GMT to determine the quality of the fuel delivered and invites the
supplier's representative to:
1. WITNESS THE TAKING OF THE SAMPLE VIA DRIP SAMPLER AT THE VESSEL MANIFOLD
2. WITNESS THE SPLITTING OF THE SAMPLE IN TO INDIVIDUAL CLEAN BOTTLES
3. WITNESS THE LABELLING AND SEALING OF THE BOTTLES AND ENSURE THAT THEY ARE DISTRIBUTED CORRECTLY FOR
EACH GRADE TO BE DELIVERED
DETAILS OF SAMPLE DISTRIBUTION:
A total of four samples will be taken from the cubitianer used to collect the sample from the drip sampler. They will
be distributed as follows:
1. RETAINED ON BOARD THE VESSEL PENDING ANY FURTHER ANALYSIS
2. HANDED TO THE SUPPLIER'S REPRESENTATIVE FOR THEIR REFERENCE
3. SENT TO LLOYD’S REGISTER GMT FOR QUALITY VERIFICATION
MASTER / CHIEF ENGINEER: SUPPLIERS REPRESENTATIVE:
NAME: NAME:
SIGNATURE: SIGNATURE:
