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1、船船舶舶卫卫生生检检查查记记录录表表 Hessen was revised in January 2021中华人民共和国出入境检验检疫Entiy-Exit Inspectionand Quarantine of 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 _检查日期/时间检查地点Time/date of inspection_ Place ofinspection_代理检查人员Agent_ Insp
2、ector_检查项目Itemsinspected要求Requirements检查结果Results所见证据Evidences Found船员和旅客Crew andpassengers1.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 ingoodhealth.Noinfectedcases,suspectsorfood-bornediseases are reported.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。Allcrewpossessvalidhealthand passenger
3、s from yellow feverinfectedareapossessvalidyellowfevervaccinationcertificates.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 displaygoodpersonalhygieneandareknowledgeableaboutsafefoodholding and preparation methods.是 Yes否 No是 Yes否 No是 Yes否 No厨房Galley1.有完整的日常保洁维护计划或卫生管理制度，在可能导致
4、感染或污染的关键部位张贴清洁维护制度或规程。Thereisawholeschedulefordailycleaningandmaintenanceor a sanitation management codein operation,which is posted upatcrucialplaceswherefoodcontamination might occur.是 Yes否 No检查项目Temsinspected要求Requirements2.内墙、地面清洁，无积水或油渍（污）All inner walls and floors arecleanandfreefromgreaseorst
5、ill water.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Therearewell-developedfacilitiesagainstdust,insectsandis no evidence of rodentinfestation,andinsectinfestation is under control.检查结果Results所见证据EvidencesFound是 Yes否 No是 Yes否 No4.有独立的专用食物处理区，要求与其他的公用活动区域或公用通道相隔离。Therearefood-handlingareasrestricted for this purp
6、ose onlyand separated from other publicareas or passages.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。Culinaryutensils,furniture,andfacilitiesforfoodproducing,processing,and storageare kept clean.是 Yes否 No是 Yes否 No6 生熟食品应分开加工、存放，摆放有序，防止交叉污染。Rawandcookedfoodareseparatelyprocessedandstored,and placed in good orde
7、rto prevent cross-contamination是 Yes否 No检查项目ItemsItemsinspectedinspected要求Requirements7.有厨工专用洗手设施及清洁用品。There are dedicated hand-washingfacilitiesandcleanseraccessible to the galley staff.检查结果Results所见证据Evidentces Found是 Yes否 No8.装有抽气通风装置，运转良好。Exhaust ventilation equipment isadequatelyprovidedandwork
8、snormally.9.有专用的垃圾桶/废弃物箱。There are dedicated garbage/wasebins.是 Yes否 No是 Yes否 No10.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 andcafeteriaisprotectedfromcontaminationwithappropriateexhibitingcoversorothereffectivemethods,andholdatreasonableutensilsarepr
9、ovided and placed according toservice flow.是 Yes否 No食品储藏室和仓库Pantry andstores1.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。AllFoodisobtainedfromreliablesourcesandisclean,withoutimpurityoradulterationandwithinexpirationdates,Allfoodisstoredbysortandkeptonshell.是 Yes否 No检查项目ItemsItemsInspectedInspected要求Requir
10、ements2.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 pollution are no poisonousor harmful substances inside.3.无鼠患。虫患不超过控制标准。There is no evidence of rodentinfestation,andinsectinfestation is under control.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 ina hot-holding
11、apparatus alreadyatatemperaturelfatleast62.8（145F）and maintained at thattemperature until required.5.易腐败的食物、饮料存放在 4一下All perishable food or drind iskept at or below 4（40F）.6.水果和蔬菜保存在冷藏室Fruits and vegetables are storedincool rooms.7.鱼、肉类保存在 0-3左右Meat and fish are maintained at0 to 3(32 to 37F)检查结果Ren
12、sults是 Yes否 No 所见证据Eidences Found是 Yes否 No 是 Yes否 No 是 Yes否 No 是 Yes否 No 是 Yes否 No 8.奶类和奶制品保存在 4左右Milkandmilkproductsaremaintained at 4(40F)9.冷冻食品保存在-12一下Frozen foods are kept below-12(10F)是 Yes否 No 是 Yes否 No 检查项目ItemsItemsinspetedinspeted要求Requirements1.来源可靠，自制或从经许可的港口供水部门获取。Potablewaterisself-made
13、orobtainedfromapprovedwaterproviders of port.2.储水罐位置合理，不受污染或过热影响。Potable water tanks are locatedin reasonableareas where theywillnotbeaffectedbydirt,insects,rodentsorothercontamination or excessive heat.3.储水罐有便于清洁保养的检查罩和独立排水系统。Potablewatertankshaveaninspectioncoverforeasyinspectionandaccessforcleani
14、ng or maintenance,and arefittedwithanindependentdrainage system.4.专用管道配送系统，标识清楚。Alltanks,hoses,valvesandequipmentforhandlingpotablewater should be exclusively forthispurpose and clearly labeled.检查结果Results所见证据Evidences Foud是 Yes否 No 是 Yes否 No 饮用水Potablewater是 Yes否 No 是 Yes否 No 5.配备卤化/加氯等消毒净化设施Potabl
15、ewatersystemsincorporateahalpgenation/chlorination systemor other means of disinfectionand decontamination.6.安装防回流设施“Backflow”preventioninstalled.是 Yes否 No is是 Yes否 No 检查项目TtemsTtems inspected inspected要求Requirements7.定期实施水质检验，向供水的港口部门索取水质检测报告Waterqualityisverifiedregularly,andwaterqualitytestreport
16、sfromtheportsupplyshould be requested.8.定期清洁保养Regularcleaningandmaintenanceis implemented1.整洁、通风、温度适宜Tidy,cozy and well ventilated检查结果Results所见证据Evidences Found是 Yes 否 No是 Yes否 No是 Yes否 No住舱区及甲板Cabins anddecks2.无鼠患，虫患不超过控制标准Thereisnoevidenceofrodentinfestation and insect infestation是 Yesis under con
17、trol.否 No3.靠泊期间，缆绳、舷梯有防鼠措施Effectiverat-profingfacilitiesare used on the mooring ropes and是 Yesgangboards while the ship anchors否 Noat port.医疗设施Medicalfacilities1.医疗负责人接受基本医疗急救方面的卫生知识培训。是 YesCrew members in charge of healthonboard are medically trained and否 Noqualified.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T
18、here are adequate valid medicine是 Yesandmedicaldevices.Recordsofmedinineconsumptionand否 Nosupplement are maintained and keptperfectly.检查项目ItemsItems inspected inspected要求Requirements3.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。Thereisadedicatedplaceformedicalexamination/treatment,whichshallbe isolated from re
19、gular areas andfree from rodent,insects or otherpollution sources.4.检查/治疗设施应保持洁净、维护良好Facilitiesformedicalexamination/treatment are properlymaintained5.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Medicaloperationalmanualsorproceduresrespondingtopublichealthemergenciesareestablished,andmedicallogisperfectly mai
20、ntained and kept.检查结果Results所见证据Evidences Found是 Yes否 No 是 Yes否 No 是 Yes否 No 1.无鼠患，虫患不超过控制标准货舱（货物）ThereisnoevidenceofrodentHolds(cargo)infestation and insect infestationis under control.是 Yes否 No 2.无核、生、化污染及其他污染Noevidenceofnuclear,biological,orchemicalhazards and other contamination.是 Yes否 No 是 Yes否
21、 No 检查结果Results所见证据Evidences Found是 Yes否 No 垃圾、固体和医疗废弃物、排泄物Garbage,solidand1.有垃圾、废弃物处理、移运制度或管理文件。Asystemofwastedisposalandtransportation is established anddocumented.检查项目ItemsItems inspected inspected要求Requirementsmedical waste2.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and human所。excretaCoveredcontainersorde
22、dicatedplace shall be provided to holdgarbage,solidandmedicalwaste,andshallbelegiblylabeled.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。Collectionandtransportationofgarbage,foodremainder,solidandmedical waste shall be documentedor 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,
23、foodremainder,andsolidwasteshallundergoharmlesstreatmentbeforedischargeand是 Yesandmedicalwasteshallbe否 No disposed correctly.5.排泄物的储存、排放应符合有关要求。Storageanddischargeofhumanexcreta shall accord with relevantregulations.是 Yes否 No 是 Yes否 No 检查结果Results所见证据Evidences Found是 Yes否 No 机舱Engine room1.无鼠患，虫患不超过
24、控制标准Thereisnoevidenceofrodentinfestation and insect infestationis under control.检查项目ItemsItems inspected inspected要求Requirements2.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 arefreefromrodents,insectsandtheir hosts infestation.1.具备完善的压舱水管理计划并妥善执行。是 YesAcomprehensiveballastwaterman
25、agement plan is established and否 No satisfactorily complied with.2.压舱水关的关闭阀门应处于“关闭”位置压舱水Ballast tanks valves are set inBallast water“off”position.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 dischargeofballastwaterwithoutpermission or risk assessment byquarantine authourties.是 Yes否 No 是 Yes否 No
26、1.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）Nostandingwaterisfoundinareassuchaslifeboatcovers,scuppers,awnings,bilges,air不流动水treatmentplants,tyresandwasteStanding watercontainers.2.积水中没有昆虫媒介孳生Noinsectisfoundinstandingwater是 Yes否 No 是 Yes否 No 检查结果Results检查项目ItemsItems inspected inspected要求Requi
27、rements所见证据Evidences Found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。合格Incaseoflargevessels,inspectionshallbeQualifiedimplemented according to the WHO不合格InterimTechnicalAdviceforDisqulifiedInspectionandIssuanceofShipSanitation Certificates 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I
28、ssue a Sanitation Control Certificate其他条款Otherprovisions 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:remarked with are keyfail to comply with them shall undergo sanitarycontrol 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 ofaccompanyingpersonnel船章Ships Stanp