1、固体散装货物安全适运申报单Declaration Form for Solid Bulk Cargoes 散装货物运输名称(BCSN) 无烟煤托运人： KOREA KANGBONG TRADING (Shipper) CORPORATION 运输单证编号(Transport document Number)收货人(Consignee) 日照港盛能源有限公司 承运人(Carrier) 运输工具的名称/方式(Name/means of transport) MERRY OCEAN出发港口/地点 朝鲜大安(Port/place of departure)目的港口/地点：黄岛前湾煤码头(Port/pl
2、ace of destination)指南或其他事项(Instructions or other matters)货物的一般性描述（货物种类/颗粒尺寸）黑色固体，粒度 0-20mmGeneral description of the cargo(Type of material/particle size)总重（千克/吨）Gross mass (kg/tonnes) 5291MT/5291MT如适用，散装货物的特殊说明(Specifications of bulk cargo, if applicable:)：积载因数(Stowage factor) ：1.1如适用，静止角(Angle of
3、repose, if applicable)：平舱程序(Trimming procedures)：如有潜在危险性，其化学特性(Chemical properties if potential hazard*)：*无*例如：类别和联合国编号或仅在散装运输时具有化学危险的物质(* e.g., Class & UN No. or “MHB”)货物组别(Group of the cargo)A和B组*( Group A & B*) V A组*( Group A*) B组(Group B) C组(Group C)* 易流态化货物（A组和A及B组货物）* For cargoes which may liq
4、uefy (Group A and Group A and B cargoes)适运水份极限 (Transportable Moisture Limit)运输时的水份含量 6.9%(Moisture content at shipment)货物相关特殊性质（例如可快速溶于水）Relevant special properties of the cargo(e.g., highly soluble in water) 额外证书*Additional certificate(s)* 水份含量和适运水份极限证书Certificate of moisture content and transport
5、able moisture limit 风化证书(Weathering certificate) 免除证书(Exemption certificate) 其它（需说明）Other (specify)*如需要(* If required)声 明(DECLARATION)兹声明：托运货物已完全并准确地予以说明。据我所知并相信所给出的试验结果和其它说明准确无误，可被视为拟装货物的代表。(I hereby declare that the consignment is fully and accurately described and that the given test results and 签字人姓名/身份，公司/组织名称Name/status, company/organization of signatory张福亮 青岛德明国际物流有限公司地点和日期 2011-07-15Place and dateother specifications are correct to the best of my knowledge and belief and can be considered as representative for the cargo to be loaded.)代表托运人签字Signature on behalf of shipper中华人民共和国海事局监制
