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1、船舶卫生检查记录材料表 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 ins
2、pected 要求 Requirements 检查结果 Results 所见证据 Evidences Found 船员和旅客 Crew and passengers 1.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 hea
3、lth certificates.Crew and passengers from yellow fever infected area possess valid yellow fever vaccination certificates.是 Yes否 No3 厨房工作人员和服务人员具有良好的卫生习惯，了解、驾驭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.
4、是 Yes否 No厨房 Galley 1. 有完整的日常保洁维护安排或卫生管理制度，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 Re
5、sults 所见证据 EvidencesFound2.内墙、地面清洁，无积水或油渍（污）All inner walls and floors are clean and free from grease or still water. 是 Yes否 No3.有完好的防尘、防蝇、防鼠设施，无鼠患，虫患不超过限制标准 There are well-developed facilities against dust,insects and rats.There is no evidence of rodent infestation,and insect infestation is under c
6、ontrol. 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。There are food-handling areas restricted for this purpose only and separated from other public areas or passages. 是 Yes否 No5.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 kep
7、t clean. 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。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 Itemsinspected 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
8、 cleanser accessible to the galley staff. 是 Yes否 No8.装有抽气通风装置，运转良好。Exhaust ventilation equipment is adequately provided and works normally. 是 Yes否 No9.有专用的垃圾桶/废弃物箱。There are dedicated garbage/wase bins. 是 Yes否 No10.摆放在服务区及自助餐桌上的食品，应有相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
9、area and cafeteria is protected from contamination 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食品贮存室和仓库 Pantry and stores1.视频来源牢靠，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
10、obtained from reliable sources and is clean,without 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 ItemsI I nspected要求 Requirements 检查结果 Rensults 所见证据 Eidences Found 2.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 and keep away
11、 from pollution source.There are no poisonous or harmful substances inside.是 Yes 否 No 3.无鼠患。虫患不超过限制标准。 There is no evidence of rodent infestation,andinsectinfestation 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 temperatu
12、re lf at least 62.8 （145°F）and maintained at that temperature 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（40°F）. 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 maintaine
13、d at 0 to 3(32 to 37°F) 是 Yes 否 No 8.奶类和奶制品保存在 4左右 Milk and milk products are maintained at 4(40°F) 是 Yes 否 No 9.冷冻食品保存在-12一下 Frozen foods are kept below-12(10°F)是 Yes 否 No 检查项目 Itemsinspeted要求 Requirements 检查结果 Results 所见证据 Evidences Foud 饮用水 Potable water 1.来源牢靠，自制或从经许可的港口供水部门获得。Potabl
14、e 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 water 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 wate
15、r tanks have an inspection cover for easy inspection and access for cleaning or maintenance,and are fitted with an independent drainage system. 是 Yes 否 No 4.专用管道配送系统，标识清晰。All tanks,hoses,valves and equipment for handling potable water should be exclusively for thispurpose and clearly labeled. 是 Yes
16、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 disinfection and decontamination. 是 Yes 否 No 6.安装防回流设施Backflowprevention is installed. 是 Yes 否 No 检查项目 Ttemsinspected 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
17、测报告 Water quality is verified regularly,and water quality test reports from the port supply should be requested. 是 Yes 否 No8.定期清洁保养 Regular cleaning and maintenance is implemented 是 Yes 否 No住舱区及甲板 Cabins and decks1. 整齐、通风、温度相宜 Tidy,cozy and well ventilated 是 Yes 否 No2. 无鼠患，虫患不超过限制标准 There is no evid
18、ence of rodent infestation and insect infestation is under control. 是 Yes 否 No3. 靠泊期间，缆绳、舷梯有防鼠措施 Effective rat-profing facilities are used 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学问培训。Crew members in charge of health o
19、nboard are medically trained and qualified.是 Yes 否 No2. 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. Records ofmedinine consumption and supplement are maintained and kept perfectly. 是 Yes 否 No检查项目 Itemsinspected 要求 Requirements 检查结果 Results 所见证据 Evidences Found
20、3.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 free from rodent,insects or other pollution sources.是 Yes 否 No 4.检查/治疗设施应保持干净、维护良好 Facilities for medical examination/treatment are properly maintained是 Yes
21、 否 No 5.具有规范的操作手册或应对公共卫生事务的程序；保留有医学日志，记录完整 Medical operational manuals or procedures responding to public health emergencies are established,and medical log is perfectly maintained and kept.是 Yes 否 No 货舱（货物）Holds(cargo)1.无鼠患，虫患不超过限制标准 There is no evidence of rodent infestation and insect infestation
22、 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,solid and 1.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 Itemsinspected 要求 R
23、equirements 检查结果 Results 所见证据 Evidences Found medical waste and human excreta 2.配备有标记清晰、特地盛装垃圾、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 provided 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
24、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,food remainder,and solid waste shall undergo harmless treatment before discharge and transportation.Biological and medical waste sh
25、all 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 room 1.无鼠患，虫患不超过限制标准 There is no evidence of rodent infestation and insect infestation is under control. 是 Yes 否 No 检查项目 Itemsinspected 要求 Requ
26、irements 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 host’s infestation. 是 Yes 否 No 压舱水 Ballast water 1.具备完善的压舱水管理安排并妥当执行。A comprehensive ballast water management plan is established and satisfactori
27、ly 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 offposition. 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 or risk assessment by quarantine authourties. 是 Yes 否 No 不流淌水 Standing water 1.救生船罩或船底、排水孔、排水沟、空气处理装置
28、、轮胎及其他船上废弃的容器等不应存在积水（不流淌水）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 standing water是 Yes 否 No 检查项目 Itemsinspected 要求 Requirements 检查结果 Results 所见证据 Evidences Found
29、 其他条款 Other provisions 在检查大型船舶时，依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 Certificates 合格 Qualified 不合格 Disqulified 签发免予卫生限制措施证书 Issue a Sanitation Control Exemption Cert
30、ificate 签发卫生限制措施证书 Issue a Sanitation Control Certificate 建议 Recommendations 卫生限制措施 Sanitation control measures注：带的项目为关键项，如评定为否，必需实施卫生限制；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陪伴检查人员签字 Signature of accompanying personnel船章 Ship’s Stanp