OMB APINIJOVAL /62.5-004!

INTERNATIONAL OIL POLLUTION PREVENTION CERTIFICATE

(Note: This Certificate shall be supplemented by a Record of Corisituction and Equipment)
Issued undef the. piovisions of the

INTERNATIONAL CONVENTION FOR 'THE PREVENTION

OF POLLUTION FROM SHIPS, 1973

as irmdified by the Protocol a 1978, relating

rlgereco,
(bereiaafter referred to as "the Convention')
under the authority of the Government of
THE UNITED STATES OF AMERICA
by the UNITED STATES COAST GUARD

Oiitlitkiire Number% er
Name of ShIP Letters Fort ct Rtgrgi r G cc To ne :)""ed
bigi1316P NO N atalia i.
w o ) +
G' DE.'X PLCIRER
,
G 42135 F tER P OR T , T X 541 .; ITC) NIA al..07921

Type of ship:
Ti Oil Tanker (Form B Supplement attached)
Ship other than an oil tanker with cargo tanks coming under regulatim 2.2 of Annex I of the
Convention (Form B Supplement attached)
ID Ship other than any of the above (Form A Supplement attached)
THIS IS TO CERTIFY:
1. That the ship has been surveyed in accordance with the requirements of regulation
of Annex I on the Convention; and
That the survey shows that the structure, equipment, systems, fittings, arrangement
and material of the ship and the condition thereof are in all respects satisfactory and
that the ship complies with the applicable requirements of Annex I of Ihe
Convention.
This certificate is valid until*: 419DEC2 01
subject to surveys in accordance with resuggiTrI 6 ufAnoex l of the Convention.

Issued at: TEXAS CITY. TEXAS

9PEC2O11 S H. R BERTSON, CDR, USCG. By Direction

Date of /wee
Of Chirp, Minns U Coln Gourd
Fornillaritorrg
ba the NO Ship ldeatificrian Number Scheme adopiod by I ht °Merril-Abut by =anon A 031:1(t5).
atexpEry as SpeelliKI by et AdminiNhation ie accordant with regulation ][11.1 of Annex I car Ihe CorwerRimn The r.Lay And the 'month of 'kik.
day cpritiporallotfit Erni werenry iitle as cleGeed irr regulazlian C ,2*7 of Annex 1 a the ezinveretem, auks.% wended in ;sewn: axe with repilulLon tO 8 of
Anne_a I of Chi Colmeniiron,
111C C01111 Owed ostiestrixt gut I he am.argte burden far thir, IENRIAE 20 taitIlliec. Yew. may submit drrj. caltIrMir05 CfPNCIFillric the accericy of All. bincice murraie
ur ireil Pligellibni3 For redtacinS this inimical tilraillffedani (CG-3PC9, U.S. -Coast Cued, Wash iegiDn., DC zom-octrn or-Office of M wage eat mid- Blidgcr.
P a p e r w o r k R e d u i .c- k m J o s ( 1 6 2 5 - O N I I a s h i n s t a n D C 2 . 0 5 U .

US. Dept- of Homeland Security, U SCG, C0-5352 (Rev. 1:$1,137) Pagt 1 014 -

PREVIOUS EDITJONSARE OBSOLETE

l; S. Dept. of flornthwaSialtity, LISX;CitCG -5352 (Rev_ 0 L-07) Paige 2 .51'4
ENDORSEMENT FOR ANNUAL AND D1TERMEDIATE SURVEYS
THIS IS TO CERTIFY that at a survey required by regulation 6 of Annex I of the Convention the ship
was found to comply with the relevant provisions of the Couveniion.

Annual Survey: Signed:

Place:
Date:

Signed:

Annual'/Intermediate Survey: Place:

Dale:

Signed:

Date:
Annual*TIntermedia te SIP reey:

Signed:

Place:
Date:
Sury ey: ■ I i I ■ 1 ■ ■ •

* Deem as ariptuptiate
 ANNUALANTERMEDIATE SURVEY IN ACCORDANCE WITH
REGULATION 10.8.3

IRIS IS TO CERTIFY that, at an an survey in accordance with regulation. 10_8..3

of Annex I of the Convention, the ship was found to comply with the relevant provisions of the
Convention'.
Signed;
Pei-.:::-:44
, ,.....--. .
1
(Sigthurtore of -cary authorized official)
,,, , tP l a c e : - '

Date:

ENDORSEMENT TO EXTEND THE CERTIFICATE IF VALID FOR LESS THAN

5 YEARS WHERE REGULATION 10.3 APPLIES

This ship complies with the relevant provisions of the Convention, and this Certificate shall, in
aocordance with regulation 10..3 of Annex I of the Converitioi, be accepted as valid until

Signed
.0
-':.-: :::2 e.
11
(Signature of duly authorizecial)
.
0.0CY:.
l-i Mace:
Date: - -

ENDORSEMENT WHERE THE RENEWAL SURVEY HAS BEEN COMPLETED 1

AND REGULATION 10.4 APPLIES
The ship complies with the relevant provisions of the Upnvention and this lertiflcatc shall, in
accordance with regulation 10..4 of Annex I of the Convention, he accepted as valid until

Signed:
(Sinature o ru y aft t rued official)
• Place
' .
'
—
) 7

' .,.
.. .:tii
-

Date;

* Delete as appropriate_

RJR Digit. aFilorric4mt SecariTy, USCG, CG-5352 (Rev. 01.07) Page 3 af 4

 ENDORSEMENT TO EXTEND THE VALIDITY OF THE CERTIFICATE UNTIL
REACHING THE PORT OF SURVEY OR FOR A PERIOD OF GRACE WHERE
REGULATION 10.• OR 10L6 APPLIES

This Certificate shall, in accordance with regulation 10.5 or 1G.6'of Ariirp..x I cif the Convenfion, be
accepted as valid until

, -„. Signed:
.:.t...11: (Signature of duly authorized officialf -
, 'N.. -•
Place:
tale; _.

ENDORSEMENT FOR ADVANCEMENT OF ANNIVERSARY DATE WHERE

REGULATION 10,8 APPLIES
In accordance with regulation 10.8 of Annex 1 of the Convention the new anniversary date is

Signed:
P. '
4: : . N,
r
(Signature of duly authorized of
• lienb, .
_...„. Place: —

Date:

In accordance with regulation 10-8 of Annex I of the Convention the new anniversary dEtte is

Signed:
:A::: . r .;:c .
.A. .)"... (Signature of duly authorized official)
_,':.'-.44* Place:
Date:

* Delete as. app Ile..

Dep 1. of I lorz ;and Securiry, USCG CG-5352 (Km 01471,