Nuevo Certificado Gas Free

1. Vessel Information

Vessel Name

IMO Number / Registration

Flag State

Port / Berth / Dock

Type of Work Authorized

Hot Work Cold Work Confined Space Entry Inspection

Other:

2. Tanks / Spaces Inspected & Test Results

Tank/Space No.	Location	O₂ (%)	LEL (%)	H₂S (ppm)	CO (ppm)	Result

Table 1: Tank Atmosphere Measurements

3. Equipment Certification

Equipment

Brand

Serial Number

Last Calibration

Valid Until

4. Preparation Verification

Mechanical ventilation operating continuously

Yes

Atmosphere sealed and isolated

Yes

Residues cleared and cleaned

Yes

Lighting proper and safety-rated

Yes

Necessary PPEs available for entry

Yes

5. Certification Statement

The undersigned Certified Gas Technician, duly authorized and competent in occupational health and safety, confined space procedures, and marine atmospherics, hereby certifies that the tanks/spaces listed in Section 2 have been inspected and tested on the date and time specified above, using properly calibrated and certified equipment in accordance with international maritime standards (SOLAS, ISGOTT 6th Edition, IMO Guidelines).

Conditions of Validity

This certificate is VALID FOR HOURS from the time of issue.

Continuous mechanical ventilation must be maintained.
No changes may be made to tank status or pipeline connections.
Constant Fire Watch must be maintained at all hot work sites.
Certificate becomes VOID immediately if ventilation stops or conditions change.

7. Certifying Official

Company / Vessel Requesting Signature & Stamp

Issue Date & Time

Inspector HSE (Print)

Title / Position ---

Company / Prevention Service ---

Signature