Under Keel Clearance Form

Under Keel Clearance Form

SHIP:  
For US Waters Under Keel Clearance Ref. Regulations 33 CFR 157.455
Prior to completing this form 33 CFR 157.455 must be read and thoroughly understood.
Under Keel Clearance Calculation
Port  
Date  
Time  
Section 1 – Deepest Navigational Draft
Facility Anchorage Transit Area
1 Mean Draft Metres/Feet
2 Trim Metres/Feet
3 Increase Draft Due List Metres/Feet
4 Intended Transit Speed Knots
5 Anticipated Squat Metres/Feet
6 FW/DW Allowance Metres/Feet
7 Corrected Maximum Draft Metres/Feet
Section 2 – Anticipated Controlling Depth
Facility Anchorage Transit Area
8 Chart Depth Metres/Feet (Min)
9 Height of Tide Metres/Feet (+ or -)
10 Sea State Metres/Feet (+ or -)
11 Past Weather Impact Metres/Feet (+ or -)
12 Controlling Depth Metres/Feet
* or listed controlling depth from latest Data
Section 3 – Anticipated Under Keel Clearance
Facility Anchorage TransitArea
7 Maximum Draft Metres/Feet
12 Controlling Depth Metres/Feet
13 Under Keel Clearance Metres/Feet
Port UKC Requirements Metres/Feet
Complies Yes/No
Master Pilot Date

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