Selkirk Marine Railway Dry Dock Regulations, 1989 (SOR/89-331)

• Department of Public Works and Government Services
  • Selkirk, Manitoba
• I (We), the undersigned, hereby make application for the vessel described below to be dry-docked in the Dry Dock, for the purpose and time stated, on the day of , 19 
• Name of Vessel
• Port of Registry
• Owner’s Name
• Owner’s Address
• Master’s Name
• Master’s Address
• Agent’s Name
• Agent’s Address
• Gross Tonnage
• Length, Overall
• Length between Perpendiculars
• Breadth, Extreme
• Draft, Forward
• Draft, Aft
• Type of Vessel (screw, sailing, not self-propelled, etc.)

  Engines:	Steam, Gasoline or Oil
  Fuel:	Coal or Oil
  Keel:	Bar or Flat (If bar, state depth)

• Rise of Floor Amidships
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• Is there any explosive matter on board? (If so, describe)
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• Does this vessel carry, or did it carry on its last voyage, any oil with a flash-point below 23°C?
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• Is there any oil escaping from the vessel? (If so, to what extent?)
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• Estimated number of days dock is required
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• Purpose for which dock is required
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• Special features of ship, such as the length of “cut up” forward and aft, camber of keel, if any, and underwater form (State if “usual”; if “unusual”, give particulars)
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  • 
• (1) 

  
  • (Signature of Agent)
• (2) 

  
  • (Signature of Witness)

Date 19