Ballast Tank Inspection Checklist Form
Use this form to record a ballast tank inspection, note tank condition, capture defects, and document required follow-up actions.
Inspection Details
Inspection date and time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Vessel or asset name/ID
*
Ballast tank name/number/location
*
Inspection type or purpose
*
Routine inspection
Post-maintenance inspection
Pre-departure inspection
Other
Inspector name
*
First Name
Middle Name
Last Name
Company or department
Tank Condition Checklist
Access / Entry Condition
*
Safe
Needs attention
Unsafe
Internal Cleanliness
*
Clean
Minor sludge
Heavy sludge
Contaminated
Corrosion / Rust Level
*
1
2
3
4
5
Coating / Paint Condition
*
Good
Fair
Poor
Very poor
Signs of Leaks or Water Ingress
*
No
Yes
Structural Damage / Cracks / Deformation
No visible damage
Cracks
Deformation
Buckling
Other
Condition of Fittings / Valves / Vents / Manholes
*
Good
Minor issues
Requires repair
Unserviceable
Overall Tank Condition Rating
*
1
2
3
4
5
Defects, Actions, and Sign-off
Defects or Abnormalities Found
Corrective Actions / Maintenance Recommendations
Urgency / Status
*
Please Select
No action needed
Monitor
Repair required
Urgent
Additional Remarks / Notes
Inspector Sign-off Name
*
First Name
Last Name
Submit Inspection
Should be Empty: