• 1. Ballast

Ballast

The Report Form for Coastal Ballast Water is to be submitted for each vessel calling at Port of Oakland facilities. It is the only ballast water report form required to be submitted to the Port. The completed form is to be submitted to the Chief Wharfinger by facsimile (510 627-1840), or mailed to the Chief Wharfinger, Port of Oakland, 530 Water Street, Oakland, CA 94607, USA, at the time of each vessel call. If there are any differences between actual ballast water discharges and the discharge information reported, the operator or owner of a vessel shall provide an amendment to the form prior to the vessel's departure from San Francisco Bay.

View or print the reporting form in pdf format.

Date Form Completed: Fill in date form completed in European format, day/month/year.
Vessel IMO Number: Fill in identification number of the vessel used by the International Maritime Organization.
Vessel Type: List specific vessel type. Use the following abbreviations: bulk (bc), roro (rr), container (cs), other (ot).
Vessel Name: Print the name of the vessel clearly.
Arrival Date at Port of Oakland: Fill in arrival date at Port of Oakland in European format, day/month/year.
Arrival Berth: Print the berth number of arrival at the Port of Oakland.
Is this an Amended Report Form?: Circle YES or NO. An amendment should be submitted if there are any differences between actual ballast discharges and discharge information reported in a prior form. Please circle "YES" if this form amends a previously submitted Report Form for Coastal Ballast Water.
Will the vessel discharge ballast water that originated from locations within 200 miles of the West Coast of North America between the southern boundary of Baja California and the northern boundary of Alaska into San Francisco Bay or the Gulf of the Farallones National Marine Sanctuary? Please circle YES or NO. If the response is "NO", go directly to item #9. If the response is "YES", fill out the following information in the table.
Ballast Water Source, Port or Latitude and Longitude: Report location of ballast water uptake for water taken on within 200 miles of the west coast of North America between the southern boundary of Baja California and the northern boundary of Alaska for water to be discharged into San Francisco Bay or the Gulf of the Farallones National Marine Sanctuary. No abbreviations for ports. If the ballast water uptake occurred over an extended distance, list the end point latitude and longitude. If the ballast water to be discharged was taken on from more than one location, report each location on a separate line of the table.
Ballast Water Volume: Report volume of this ballast water to be discharged with units (M3, MT, LT, ST). If the ballast water to be discharged was taken on from more than one location, report each volume on a separate line of the table.
Location of Ballast Water Discharge, Port or Latitude and Longitude: Report location of discharge of this water into San Francisco Bay, Gulf of the Farallones National Marine Sanctuary. If the ballast water discharge occurred over an extended distance, list the end point latitude and longitude. No abbreviations for ports.

Responsible Officer's Name and Title, Printed and Signature: Print name and title, include signature.

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