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Dangerous Goods Declaration Checklist

IMDG Code 39-18

This checklist may be used for verifying dangerous goods declaration against the mandatory
provisions of IMDG Code chapter 5.4 for containerized and non-containerized dangerous goods.
Serial numbers below are in the order as listed in multimodal dangerous goods form in section
5.4.5.1 of IMDG Code and other relevant provisions of the Code.

Booking Number Date

Yes No N/A

1 Name & Address of the shipper (5.4.1.3) …………………………

2 Transport document number---------------------------------------

3 Page(s) numbered consecutively (5.4.1.2.3) --------------------

4 Shipper’s reference----------------------------------------------------
5 Freight Forwarder’s reference--------------------------------------
6 Name & Address of the consignee (5.4.1.3) ---------------------
7 Carrier (to be completed by the carrier)
8 Not applicable for sea transport
9 Additional information- divert attention from the safety,
contradict safety information, duplicate information (Note 5)
10 Vessel and date---------------------------------------------------------
11 Port of loading----------------------------------------------------------
12 Port of discharge-------------------------------------------------------
13 Destination--------------------------------------------------------------
14 Dangerous goods description (5.4.1.4.1)
1 UN number preceded by the letters “UN” ---------------------------
2 Proper shipping name including the technical name enclosed
in brackets for entries assigned with SP 274 or 318------
3 Primary hazard class, including compatibility group letter
for class 1 explosives--------------------------------------------
4 Subsidiary hazard class------------------------------------------
5 Packing group-----------------------------------------------------
Points 14.1 to 14.5 are in the same sequence (5.4.1.4.2)

Information which supplements the proper shipping name (5.4.1.4.3)

1 Technical names for “n.o.s.” and other generic

descriptions: proper shipping names that are assigned
special provision 274 or 318----------------------------

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2 Empty uncleaned packagings, bulk containers and Yes No N/A

tanks containing residue (not applicable to class 7)-
“EMPTY UNCLEANED” or “RESIDUE LAST
CONTAINED” before or after the dangerous goods
description--------------------------------------------------
3 Waste: The proper shipping name preceded
by the word “WASTE” (not applicable to class 7)
4 Elevated temperature substances: The proper shipping
name preceded by word “HOT” ----------------------
5 Marine Pollutants: The words “MARINE POLLUTANT”
(Not applicable when under 2.10.2.7)------------------
6 Flashpoint: For primary or subsidiary hazard of class 3
and a flashpoint of 60°C or below (in °C closed-cup (c.c.))
the minimum flashpoint is mentioned------------------

Total quantity of dangerous goods (5.4.1.5.1)

Number and kind of packages & quantity by volume or mass

Class 1 explosives – Net Explosive Content---------------------------
Salvage packaging – An estimate of the quantity------------------

15 Container No./vehicle registration No. -------------------------

16 Seal number(s) --------------------------------------------------------
17 Container/vehicle size and type-----------------------------------
18 Tare mass (kg)---------------------------------------------------------
19 Total gross mass (including tare) (kg)---------------------------
20 See container packing certificate in page 5
21 Receiving organisation receipt
22 Shipper’s company, name, place, signature & date (5.4.1.6.2) ---

Information required in addition to the dangerous goods description (5.4.1.5)

Classification where new data is available (5.4.1.5.16)

Transport in accordance with 2.0.0.2 statement:

“Classified in accordance with 2.0.0.2”--------------------------

Limited Quantities (5.4.1.5.2.1)

Dangerous Goods in limited quantities the words

“limited quantity” or “LTD QTY”-----------------------------------

Excepted Quantities (5.4.1.5.14)

Dangerous Goods in excepted quantities the words “dangerous

goods in excepted quantities” -------------------------------------

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Yes No N/A

Salvage packaging (5.4.1.5.3)

Dangerous goods transported in salvage packagings the words

“SALVAGE PACKAGING” or “SALVAGE PRESSURE RECEPTACLE” --

Transport of IBCs or portable tanks after the date of expiry of the

last periodic test or inspection (5.4.1.5.13)

“Transport in accordance with 6.7.3.15.6.2” or

Transport in accordance with 6.7.4.14.6.2” as appropriate

Transport of solid dangerous goods in bulk containers (5.4.1.5.12)

For bulk containers other than freight containers the statement

“Bulk container BK(x) approved by the competent authority of …”

Class 1 Explosives (5.4.1.5.9)

1 N.O.S. Entries: Statement: “Transport under this entry approved by

the competent authority of …” followed by the State’s
distinguishing sign used on vehicles in international road
traffic of the country of the competent authority -----------
2 Less Water/Phlegmatizer: Statement “Transport under this
entry approved by the competent authority of …” followed
by the State’s distinguishing sign used on vehicles in
international road traffic of the country of the competent
authority----------------------------------------------------------------
3 Package “as approved by the competent authority”:
Statement “Packaging approved by the competent authority
of …” followed by the State’s distinguishing sign used on
vehicles in international road traffic of the country of the
competent authority-----------------------------------
4 Indication of hazards not in IMDG Code--------------

Firework classification reference (5.4.1.5.15) ----------------------

Class 2 Gases (5.4.1.5.8)

Indication of the capacity of aerosol when above 1000 ml-----

Viscous substances

Viscous substances transported in accordance with 2.3.2.5

Statement: “Transport in accordance with 2.3.2.5 of the IMDG Code.”
Temperature control

Stabilization by means of temperature control (5.4.1.5.4)

Control temperature: … °C Emergency temperature: … °C” ----

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Yes No N/A
Class 4.1 self-reactive substances, 5.2 organic Peroxides &
polymerizing substances (5.4.1.5.5)
“Control temperature: … °C Emergency temperature: … °C” ----

Explosive subsidiary hazard label dispensed (5.4.1.5.5.1)

Class 4.1 self-reactive substances, 5.2 organic peroxides

& polymerizing substances statement included--------------

Sample shipments

Sample self-reactive substances (2.4.2.3.2.4.2) or

organic peroxides (2.5.3.2.5.1) a statement to this effect is
included in the declaration (5.4.1.5.5.3) ----------------------------

Class 6.2 Infectious substances (5.4.1.5.6)

The full address of the consignee and the name of a

responsible person and his telephone number------------------

Class 7 – Radioactive material, see, 5.4.1.5.7

Class 9 – Engines (UN Nos. 3528, 3529 and 3530)

Statement:” Transport in accordance with special provision 363”

Segregation

Shipper assigned segregation group(s) (5.4.1.5.11.1)-

Same is mentioned in DGD------------------------------------------------

When substances are loaded together in a cargo transport

unit in accordance with 7.2.6.3 the statement:
“Transport in accordance with 7.2.6.3 of the IMDG Code”
(5.4.1.5.11.2)--------------------------------------------------

Acids & Alkalis of class 8 loaded together in a cargo transport unit

in accordance with 7.2.6.4 the statement: “Transport in
accordance with 7.2.6.4 of the IMDG Code” (5.4.1.5.11.3) -------

Additional documents (5.4.4.1)

In certain circumstances, special certificates or other documents are required such as:

a weathering certificate; as required in the individual entries of the Dangerous Goods

List; - a certificate exempting a substance, material or article from the provisions of the
IMDG Code (such as, see individual entries for charcoal, fish meal, seed cake); - for new
self-reactive substances and organic peroxides or new formulation of currently assigned
self-reactive substances and organic peroxides, a statement by the competent authority
of the country of origin of the approved classification and conditions of transport.

Any other certification or document as required by special provision(s).

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Container/vehicle packing certificate

(5.4.2.1)

Container number(s)

Yes No N/A

1. The container/vehicle was clean, dry and apparently fit to

receive the goods------------------------------------------

2. Packages which need to be segregated in accordance

with applicable segregation requirements have not been
packed together onto or in the container/vehicle (unless
approved by the competent authority concerned in
accordance with 7.3.4.1);--------------------------------------

3. All packages have been externally inspected for damage, and

only sound packages have been loaded;-------------------

4. Drums have been stowed in an upright position, unless otherwise

authorized by the competent authority, and all goods have been
properly loaded and, where necessary, adequately braced with
securing material to suit the mode(s) of transport for the
intended journey;------------------------------------------------

5. Goods loaded in bulk have been evenly distributed within

the container/vehicle;------------------------------------------

6. The container/vehicle and packages are properly marked,

labelled and placarded, as appropriate;--------------------

7. When substances presenting a risk of asphyxiation are used for

cooling or conditioning purposes (such as dry ice (UN 1845) or
nitrogen, refrigerated liquid (UN 1977) or argon, refrigerated
liquid (UN 1951)), the container/vehicle is externally marked in
accordance with 5.5.3.6 -----------------------------------------

8. A dangerous goods transport document, as indicated in 5.4.1,

has been received for each dangerous goods consignment
loaded in the container/vehicle.----------------------------------

Remarks

Checked by Signature

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