VTS-Scheldt -

Own ship data

Skipper name :

* Skipper name is mandatory

Email :

* Email is mandatory

Phone :

* Phone is mandatory

Did you make a declaration :

* This field is mandatory

Own ship name :

* Own ship name is mandatory

Ship type :

* Ship type is mandatory

Incase of convey, how many containers you had alongside :

Ship dimensions

Lenth :

m * Length is mandatory

Width :

m * Width is mandatory

What was your draft at that moment :

dm * Actual draft is mandatory

What is your maximum draft :

dm * Maximum draft is mandatory

What was your pine tree height and the drainage (+ possibly photo) :

dm * Pine tree height and drainage is mandatory

Load :

* Load is mandatory

Shutters :

* This field is mandatory

Origin of the journey :

* Origin of the journey is mandatory

Destination of the journey :

* Destination of the journey is mandatory

Seagoing data

Sea-going vessel name :

* Sea-going vessel name is mandatory

What was the speed of the sea-going vessel :

* Sea-going vessel speed is mandatory

Was the sea-going ship passing or oncoming :

* Sea-going direction is mandatory

Incident and circumstances

Position incident :

* Position is mandatory

Time incident :

* Time is mandatory

Wind power and direction :

* Wind power and direction is mandatory

Did you inform the central about your wave sensitivity :

* This field is mandatory

What is the reason for wave sensitivity :

* Message with ID: en.WaveDisturbanceForm.txtWavePlaySensitivityReasonValidator not found!

Did you stop in front of the waves :

* This field is mandatory

Did you call the ocean-going vessel when you saw the speed on the AIS :

* This field is mandatory

Message with ID: en.WaveDisturbanceForm.Problem not found! :

* Problem is mandatory

Did water enter your ship :

* This field is mandatory

Were all entrances closed with watertight doors :

* This field is mandatory

Was the size of the wave a problem in general :

* This field is mandatory

Also make a picture of the problem, if you say that the water ran across the shutters, then show on a picture how high your pine tree is and the drainage

Reported to traffic center :

* This field is mandatory

Additional comments :

The form above does not replace a formal declaration, if you wish you must file a report with the police. The disturbance must at all times be reported to the traffic center of the area in which the incident occurred. The disturbance will be analyzed by the Common Nautical Authority, you will receive feedback of the findings and the actions taken.

Attachments (max 5MB) :

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