Report data

Vessel attended

Report code

Name of specialist

Place of attendance

Start date/time
End date/time


Equipment description

Date of report

Who requested attendance?

Reason of the attendance

Condition of equipment found

Service performed

Job performed

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Type all recommendations here

Type conclusion of report here

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.