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1、+中华人民共和国出入境检验检疫Entiy-Exit Inspection and Quarantine of P.R.C.编号NO.船舶卫生检查记录表Recording Form for Sanitation Inspection over Vessels船名 船旗Name of vessel_ Flag_登记号/IMO编号Registrantion/IMO NO._/_检查日期/时间 检查地点Time/date of inspection_ Place of inspection_代理 检查人员Agent_ Inspector_检查项目Items inspected要求Requirement
2、s检查结果Results所见证据Evidences Found船员和旅客Crew and passengers1.船员、旅客健康状况良好，无传染病染疫人或染疫嫌疑人，无食物中毒事故。All crew and passengers are in good health. No infected cases,suspects or food-borne diseases are reported.是Yes 否 No 2.船员应持有效健康证明，来自黄热病疫区的人员持有效黄热病预防接种证书。All crew possess valid health certificates.Crew and pass
3、engers from yellow fever infected area possess valid yellow fever vaccination certificates.是Yes 否 No 3厨房工作人员和服务人员具有良好的卫生习惯，了解、掌握食品保存和食品制备的正确方法及要求。Cooks and serving staff display good personal hygiene and are knowledgeable about safe food holding and preparation methods.是Yes 否 No 厨房Galley1. 有完整的日常保洁维
4、护计划或卫生管理制度，在可能导致感染或污染的关键部位张贴清洁维护制度或规程。There is a whole schedule for daily cleaning and maintenance or a sanitation management code in operation,which is posted up at crucial places where food contamination might occur.是Yes 否 No 检查项目Tems inspected要求Requirements检查结果Results所见证据EvidencesFound2.内墙、地面清洁，无
5、积水或油渍（污）All inner walls and floors are clean and free from grease or still water.是Yes 否 No 3.有完好的防尘、防蝇、防鼠设施，无鼠患，虫患不超过控制标准There are well-developed facilities against dust,insects and rats.There is no evidence of rodent infestation,and insect infestation is under control.是Yes 否 No 4.有独立的专用食物处理区，要求与其他的
6、公用活动区域或公用通道相隔离。There are food-handling areas restricted for this purpose only and separated from other public areas or passages.是Yes 否 No 5.厨房的公共用具、家具、食品加工生产、处理及储存等用具保持清洁。Culinary utensils,furniture,and facilities for food producing,processing,and storage are kept clean.是Yes 否 No 6生熟食品应分开加工、存放，摆放有序，
7、防止交叉污染。Raw and cooked food are separately processed and stored,and placed in good order to prevent cross-contamination是Yes 否 No 检查项目Items inspected要求Requirements检查结果Results所见证据Evidentces Found7.有厨工专用洗手设施及清洁用品。There are dedicated hand-washing facilities and cleanser accessible to the galley staff.是Ye
8、s 否 No 8.装有抽气通风装置，运转良好。Exhaust ventilation equipment is adequately provided and works normally.是Yes 否 No 9.有专用的垃圾桶/废弃物箱。There are dedicated garbage/wase bins.是Yes 否 No 10.摆放在服务区及自助餐桌上的食品，应有适宜的展示罩或用其他有效的方法进行防护，应保持合理温度，备有公用用具，并按服务流程摆放。Food served at service area and cafeteria is protected from contami
9、nation with appropriate exhibiting covers or other effective methods,and hold at reasonable temperature.Public utensils are provided and placed according to service flow.是Yes 否 No 食品储藏室和仓库Pantry and stores1.视频来源可靠，清洁、卫生、无杂质或掺杂，在保质期内，分类存放，离地上架。All Food is obtained from reliable sources and is clean,w
10、ithout impurity or adulteration and within expiration dates,All food is stored by sort and kept on shell. 是Yes 否 No 检查项目ItemsInspected要求Requirements检查结果Rensults所见证据Eidences Found2.食品库清洁卫生，远离污染源，不与有毒有害物质共同存放。Storage systems are clean andkeep away from pollutionsource.There are no poisonousor harmful
11、substances inside.是 Yes否 No 3.无鼠患。虫患不超过控制标准。There is no evidence of rodent infestation,andinsect infestation is under control . 是 Yes否 No 4.保热食物存放在至少达到62.8的保温设备中。Food to be held hot is placed in a hot-holding apparatus already at a temperature lf at least 62.8（145F）and maintained at that temperature
12、 until required.是 Yes否 No 5.易腐败的食物、饮料存放在4一下All perishable food or drind is kept at or below 4（40F）.是 Yes否 No 6.水果和蔬菜保存在冷藏室Fruits and vegetables are stored incool rooms.是 Yes否 No 7.鱼、肉类保存在0-3左右Meat and fish are maintained at 0 to 3(32 to 37F)是 Yes否 No 8.奶类和奶制品保存在4左右Milk and milk products are maintain
13、ed at 4(40F)是 Yes否 No 9.冷冻食品保存在-12一下Frozen foods are kept below -12(10F)是 Yes否 No 检查项目Items inspeted要求Requirements检查结果Results所见证据Evidences Foud饮用水Potable water1.来源可靠，自制或从经许可的港口供水部门获取。Potable water is self-made or obtained from approved water providers of port.是 Yes否 No 2.储水罐位置合理，不受污染或过热影响。Potable wa
14、ter tanks are located in reasonable areas where they will not be affected by dirt,insects,rodents or other contamination or excessive heat.是 Yes否 No 3.储水罐有便于清洁保养的检查罩和独立排水系统。Potable water tanks have an inspection cover for easy inspection and access for cleaning or maintenance,and are fitted with an
15、independent drainage system.是 Yes否 No 4.专用管道配送系统，标识清楚。All tanks,hoses,valves and equipment for handling potable water should be exclusively for thispurpose and clearly labeled.是 Yes否 No 5.配备卤化/加氯等消毒净化设施Potable water systems incorporate a halpgenation/chlorination system or other means of disinfectio
16、n and decontamination.是 Yes否 No 6.安装防回流设施“Backflow”prevention is installed.是 Yes否 No 检查项目Ttems inspected要求Requirements检查结果Results所见证据Evidences Found7.定期实施水质检验，向供水的港口部门索取水质检测报告Water quality is verified regularly,and water quality test reports from the port supply should be requested.是Yes 否No 8.定期清洁保养
17、Regular cleaning and maintenance is implemented是Yes 否 No 住舱区及甲板Cabins and decks1. 整洁、通风、温度适宜Tidy,cozy and well ventilated是Yes 否 No 2. 无鼠患，虫患不超过控制标准There is no evidence of rodent infestation and insect infestation is under control.是Yes 否 No 3. 靠泊期间，缆绳、舷梯有防鼠措施Effective rat-profing facilities are used
18、on the mooring ropes and gangboards while the ship anchors at port.是Yes 否 No 医疗设施Medical facilities1. 医疗负责人接受基本医疗急救方面的卫生知识培训。Crew members in charge of health onboard are medically trained and qualified. 是Yes 否 No 2. 配有足量有效的药品器械，保留完整规范的药品消耗、补充记录There are adequate valid medicine and medical devices. R
19、ecords of medinine consumption and supplement are maintained and kept perfectly. 是Yes 否 No 检查项目Items inspected要求Requirements检查结果Results所见证据Evidences Found3.有与日常活动相隔离的检查/治疗专用场所，无鼠患、媒介和其他污染源。There is a dedicated place for medical examination/treatment,which shall be isolated from regular areas and fre
20、e from rodent,insects or other pollution sources.是 Yes否 No 4.检查/治疗设施应保持洁净、维护良好Facilities for medical examination/treatment are properly maintained是 Yes否 No 5.具有规范的操作手册或应对公共卫生事件的程序；保留有医学日志，记录完整Medical operational manuals or procedures responding to public health emergencies are established,and medica
21、l log is perfectly maintained and kept.是 Yes否 No 货舱（货物）Holds(cargo)1.无鼠患，虫患不超过控制标准There is no evidence of rodent infestation and insect infestation is under control.是 Yes否 No 2.无核、生、化污染及其他污染No evidence of nuclear,biological,or chemical hazards and other contamination.是 Yes否 No 垃圾、固体和医疗废弃物、排泄物Garbage
22、,solid and1.有垃圾、废弃物处理、移运制度或管理文件。A system of waste disposal and transportation is established and documented.是 Yes否 No 检查项目Items inspected要求Requirements检查结果Results所见证据Evidences Foundmedical waste and human excreta2.配备有标志清楚、专门盛装垃圾、固体和医疗废弃物的带该容器或专用场所。Covered containers or dedicated place shall be provi
23、ded to hold garbage,solid and medical waste,and shall be legibly labeled.是 Yes否 No 3.有船上生活垃圾、剩余食物、固体废弃物和医疗废弃物等的收集移运记录或证明。Collection and transportation of garbage,food remainder,solid and medical waste shall be documented or certified.是 Yes否 No 4.船上生活垃圾、剩余食物、固体废弃物移运前应经无害化处理；生物医疗废弃物应经正确处理后移运。Garbage,f
24、ood remainder,and solid waste shall undergo harmless treatment before discharge and transportation.Biological and medical waste shall be disposed correctly.是 Yes否 No 5.排泄物的储存、排放应符合有关要求。Storage and discharge of human excreta shall accord with relevant regulations.是 Yes否 No 机舱Engine room1.无鼠患，虫患不超过控制标
25、准There is no evidence of rodent infestation and insect infestation is under control.是 Yes否 No 检查项目Items inspected要求Requirements检查结果Results所见证据Evidences Found2.发动机外壳或绝缘体不应受到鼠类等啮齿动物、昆虫媒介/宿主侵扰的痕迹Engine casings and insulation are free from rodents,insects and their hosts infestation.是 Yes否 No 压舱水Ballast
26、 water1.具备完善的压舱水管理计划并妥善执行。A comprehensive ballast water management plan is established and satisfactorily complied with.是 Yes否 No 2.压舱水关的关闭阀门应处于“关闭”位置Ballast tanks valves are set in “off”position.是 Yes否 No 3.不存在未经比准或未经风险评估扇子排放压舱水的情形No evidence of illegal discharge of ballast water without permission
27、 or risk assessment by quarantine authourties.是 Yes否 No 不流动水Standing water1.救生船罩或船底、排水孔、排水沟、空气处理装置、轮胎及其他船上废弃的容器等不应存在积水（不流动水）No standing water is found in areas such as lifeboat covers,scuppers,awnings,bilges,air treatment plants,tyres and waste containers.是 Yes否 No 2.积水中没有昆虫媒介孳生No insect is found in
28、 standing water是 Yes否 No 检查项目Items inspected要求Requirements检查结果Results所见证据Evidences Found其他条款Other provisions在检查大型船舶时，根据世界卫生组织的临时技术建议，作相应检查。In case of large vessels,inspection shall be implemented according to the WHO Interim Technical Advice for Inspection and Issuance of Ship Sanitation Certificate
29、s合格Qualified不合格Disqulified 签发免予卫生控制措施证书Issue a Sanitation Control Exemption Certificate 签发卫生控制措施证书Issue a Sanitation Control Certificate 建议 Recommendations 卫生控制措施 Sanitation control measures注：带的项目为关键项，如评定为否，必须实施卫生控制；检查结论仅对本次检查结果负责。Notice:1.Items remarked with are key requirements.Vessels fail to comply with them shall undergo sanitary control measures.2.The conclusion is only responsible for this inspection.检查人员Inspectors检查日期Date陪同检查人员签字Signature of accompanying personnel船章Ships Stanp