Which of the following statements is true concerning the overboard discharge of vessel sewage at sea?

Correct Answer: Option D — All of the above

MARPOL Annex IV and 33 CFR Part 159 regulate sewage discharge. Vessels may discharge comminuted and disinfected sewage beyond three nautical miles, or untreated sewage beyond 12 nautical miles, provided they utilize an approved Marine Sanitation Device (MSD) that meets the specified performance standards for the vessel's size.