Title Page
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Date:
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Name of Ship/Unit:
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Flag:
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Certificate Number:
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Address:
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Service Address/Site:
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Registration Number:
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Order Number:
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We hereby certify that the systems and equipment specified below have been inspected and serviced in accordance with Relevant Australian Standards and Marine requirements.
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Comments to all Service Charts are summarized on Service Chart S – ‘Summary of actions’ where Performed/Recommended, Maintenance, Repair & Replacement are specified.
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Add system or fire appliance
System/Fire Appliance
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Specify System or Fire appliance:
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No off:
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Service interval:
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Last P/Test:
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Capacity:
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Pass or fail?
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Comments or repairs required:
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This Certificate is only Valid when the certificate and defined service charts are duly signed by approved technicians.
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Technician Name & Signature:
