Electronic monitoring system inspection request

Revised: 10/05/10

OMB Control No. 0648-0610, Expiration Date: 08/31/2013

Fax, mail, or e-mail completed forms and diagrams to:

ELECTRONIC MONITORING
SYSTEM
INSPECTION REQUEST FORM

North Pacific Groundfish Observer Program
7600 Sand Point Way NE, Bldg 4
Seattle, WA 98115
Ph: 206-526-4007
Fax: 206-526-4066
e-mail: station.inspections@noaa.gov

Note: Inspections will be scheduled within ten (10) working days of receiving a request. Requests for inspections in
Dutch Harbor and Kodiak will be scheduled within ten (10) days, but may be delayed several days due to weather or
logistics.

DIAGRAM ATTACHMENT
You must attach with this request a diagram drawn to scale showing:
♦ All locations where salmon will be sorted
♦ Location of the salmon storage container
♦ Location of each camera and its coverage area
♦ Location of any additional video equipment
Name of Vessel

BLOCK A – VESSEL INFORMATION
Federal Fishery Permit No.:

Name

Requesting Person’s Signature

Date

Business Mailing Address

Business Telephone No.

Business Fax No.

Individual or company responsible for installing and
maintaining the system

Pixel length & width of image:

Business e-mail Address
Individual onboard the vessel responsible for
maintaining the system and assisting observer in its use

BLOCK B – SYSTEM SPECIFICATIONS
File type in which data are recorded: Compression Type:

Frame rate at which data are recorded:

Storage device type and size:

Brand and model number of the cameras:

Brand, model, and specifications of the lenses:

The type, speed, and operating system of any computer that is part of the system:

Inspection Request for Electronic Monitoring System
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Any change to the electronic monitoring system that would affect the system's functionality must be
submitted to, and approved by, the Regional Administrator in writing before that change is made.
Inspections will be conducted on vessels tied to docks at Dutch Harbor, Alaska; Kodiak, Alaska; and in the
Puget Sound area of Washington State.
An electronic monitoring system inspection report, valid for 12 months from the date it is signed by NMFS,
will be issued to the vessel owner if the electronic monitoring system meets the requirements. The vessel
owner must maintain a current electronic monitoring system inspection report onboard the vessel at all times
the vessel is required to provide an approved electronic monitoring system. The electronic monitoring
system inspection report must be made available to the observer, NMFS personnel, or to an authorized
officer upon request.
____________________________________________________________________________________
PUBLIC REPORTING BURDEN STATEMENT
Public reporting burden for this collection of information is estimated to average 2 hours per response, including the time for
reviewing the instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing the burden, to NOAA, National Marine Fisheries Service, Alaska Region, Attn:
Assistant Regional Administrator, Sustainable Fisheries Division, P.O. Box 21668, Juneau, AK 99802-1668 (Attn: Records
Officer).
ADDITIONAL INFORMATION
Before completing this form please note the following: 1) Notwithstanding any other provision of law, no person is required to
respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the
requirements of the Paperwork Reduction Act, unless that collection of information displays a currently valid OMB Control
Number; 2) This information is being used to manage the Chinook PSC Program and commercial fishing efforts under 50 CFR
part 679 and under section 402(a) of the Magnuson-Stevens Act (16 U.S.C. 1801, et seq.) as amended in 2006; 4) Submission of
this information is necessary for NMFS to approve electronic monitoring systems; 5) Responses to this information request are
not confidential.
________________________________________________________________________________________________________

Inspection Request for Electronic Monitoring System
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