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pdfVessel Safety Checklist
V E S S E L N A M E : _________________________________
VESSEL
P E R M I T:___________ ____
Ensure the USCG Commercial Fishing Vessel
Safety decal is not expired based on the
information noted on the face of the decal.
Is the decal valid?
Y N
S U R V I V A L C R A F T:
Number of:________________________
EPIRB: (Visual inspection only. Please leave all testing/handling to crew)
Location(s):_______________________________________
Total capacity:_____________________
Battery exp. date: __________ (expires on date displayed)
# of crew & observer/s on board________
Hydrostatic release expiration date:______/_____ (expires
on date displayed)
Sufficient capacity?
Y N
Survival craft(s) able to float free? (Note:
Y N
some vessels have their rafts in a float free cradle this is an approved cradling system, so long as the
painter line is properly attached to a weak link.)
Service Due decal exp. date:____/____
(expires on date displayed)
Hydrostatic release exp. date:___/_____
(expires on date displayed)
Located in a float free location?:
Y
N
Registered to this vessel (name of vessel displayed):
Y
N
Alphanumeric code on decal matches code on EPIRB:
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
NOAA Registration Decal:
Exp. date: _________ (expires on date displayed)
Signal tested (or asked to see station log in wheelhouse for
most recent test. Signal should be tested monthly):
Your raft assignment:________________
I M M E R S I O N S U I T /PFD S :
Available for everyone on board?
Location(s):________________________
F L A RE S :
(ask captain for assistance)
Location(s):________________________
Expiration dates checked?
F I RE E X T I N G U I S H E R S:
Y N Extinguisher(s) found in every main area/corridor?
Extinguishers in “good and serviceable condition” (gauge in
the green, low amounts of rust, canister in good condition,
unobstructed, hoses attached, service tags available)?
T H RO W A B L E F L O T A T I O N D E V I C E S:
Number of flotation devices appropriate for vessel size?
Y N Easily accessible?:
(expires on date displayed)
Name of vessel displayed on each?
If checked, number of flares:__________
Location(s):_______________________________________
10
ADDITIONAL SAFETY
C H E C K S:
F I R S T A I D M A T E R I A L S:
Factory hydraulic shut-off(s) - know location?
Y N Location(s):_____________________________________
Watertight doors - do they close properly?
Y N Is there an individual trained in CPR/First Aid on board?
Hatches/passageways - are they unobstructed?
Y N Who?:_________________________________________
Discussed safe places to work on deck and in
factory with captain/crew?
Y N
Discussed refrigerant leak procedures?
Y N Radios:
Type of refrigerant used___________________
Discussed reporting/identifying inoperative
alarm/fire systems?
Did you hear the general alarm?
How many SSB and VHF radios?: _________ / ________
Y N Are emergency call instructions posted?
Y N
Y N Were procedures for making an emergency call discussed?
Y N
S A F E T Y O R I E N T A T I O N:
EMERGENCY DRILLS
Where will you go during emergencies:
______________________________________
Fire____________________________________________
If you did not complete drills upon embarking
the vessel, did the captain use this safety
checklist to complete the required vessel safety
orientation?
Did the vessel conduct a safety orientation?
Man Overboard __________________________________
Y N Vessel Flooding/stabilization ________________________
General alarm activation ___________________________
Y N Donning immersion suits ___________________________
Radio/visual distress signals ________________________
(Detail what was covered in the comment
section below)
OBSERVER PERSONAL PROTECTIVE
E Q U I P M E N T:
Personal Locator Beacon?
UIN:__________________________________
NOAA Registration Decal Expiration
Date:__________________________________
Immersion Suit with Strobe Light and
Battery?
Serial #:_______________________________
Personal Flotation Device with Strobe Light
and Battery?
A N D D A T E( S ) C O N D U C T E D:
Abandon Ship ___________________________________
Who gave the orientation? ________________
Were the drills hands-on involving actual gear?
Y N
Did you participate in the drills?
Y N
C O M M E N T S (A L L “N”
C O M M E N T):
R E S P O N S E S RE Q U I RE A
Y N _______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
Y N _______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
Y N _______________________________________________
_______________________________________________
Observer Name: ___________________________________________________________ Cruise #: _______________
Observer Signature: ________________________________________________________ Date: __________________
Captain Name: ____________________________________________________________________________________
Captain Signature (optional): _________________________________________________ Date: __________________
*Did the vessel request a copy of the Checklist? Y N
*If so, were you able to supply a copy?
Blue indicates “no go” items!
11
Y N
Y N
____________________________________________________________________________________
Vessel Safety Checklist
V E S S E L N A M E : _________________________________
VESSEL
P E R M I T:___________ ____
Ensure the USCG Commercial Fishing Vessel
Safety decal is not expired based on the
information noted on the face of the decal.
Is the decal valid?
Y N
S U R V I V A L C R A F T:
Number of:________________________
EPIRB: (Visual inspection only. Please leave all testing/handling to crew)
Location(s):_______________________________________
Total capacity:_____________________
Battery exp. date: __________ (expires on date displayed)
# of crew & observer/s on board________
Hydrostatic release expiration date:______/_____ (expires
on date displayed)
Sufficient capacity?
Y N
Survival craft(s) able to float free? (Note:
Y N
some vessels have their rafts in a float free cradle this is an approved cradling system, so long as the
painter line is properly attached to a weak link.)
Service Due decal exp. date:____/____
(expires on date displayed)
Hydrostatic release exp. date:___/_____
(expires on date displayed)
Located in a float free location?:
Y
N
Registered to this vessel (name of vessel displayed):
Y
N
Alphanumeric code on decal matches code on EPIRB:
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
NOAA Registration Decal:
Exp. date: _________ (expires on date displayed)
Signal tested (or asked to see station log in wheelhouse for
most recent test. Signal should be tested monthly):
Your raft assignment:________________
I M M E R S I O N S U I T /PFD S :
Available for everyone on board?
Location(s):________________________
F L A RE S :
(ask captain for assistance)
Location(s):________________________
Expiration dates checked?
F I RE E X T I N G U I S H E R S:
Y N Extinguisher(s) found in every main area/corridor?
Extinguishers in “good and serviceable condition” (gauge in
the green, low amounts of rust, canister in good condition,
unobstructed, hoses attached, service tags available)?
T H RO W A B L E F L O T A T I O N D E V I C E S:
Number of flotation devices appropriate for vessel size?
Y N Easily accessible?:
(expires on date displayed)
Name of vessel displayed on each?
If checked, number of flares:__________
Location(s):_______________________________________
12
ADDITIONAL SAFETY
C H E C K S:
F I R S T A I D M A T E R I A L S:
Factory hydraulic shut-off(s) - know location?
Y N Location(s):_____________________________________
Watertight doors - do they close properly?
Y N Is there an individual trained in CPR/First Aid on board?
Hatches/passageways - are they unobstructed?
Y N Who?:_________________________________________
Discussed safe places to work on deck and in
factory with captain/crew?
Y N
Discussed refrigerant leak procedures?
Y N Radios:
Type of refrigerant used___________________
Discussed reporting/identifying inoperative
alarm/fire systems?
Did you hear the general alarm?
How many SSB and VHF radios?: _________ / ________
Y N Are emergency call instructions posted?
Y N
Y N Were procedures for making an emergency call discussed?
Y N
S A F E T Y O R I E N T A T I O N:
EMERGENCY DRILLS
Where will you go during emergencies:
______________________________________
Fire____________________________________________
If you did not complete drills upon embarking
the vessel, did the captain use this safety
checklist to complete the required vessel safety
orientation?
Did the vessel conduct a safety orientation?
Man Overboard __________________________________
Y N Vessel Flooding/stabilization ________________________
General alarm activation ___________________________
Y N Donning immersion suits ___________________________
Radio/visual distress signals ________________________
(Detail what was covered in the comment
section below)
OBSERVER PERSONAL PROTECTIVE
E Q U I P M E N T:
Personal Locator Beacon?
UIN:__________________________________
NOAA Registration Decal Expiration
Date:__________________________________
Immersion Suit with Strobe Light and
Battery?
Serial #:_______________________________
Personal Flotation Device with Strobe Light
and Battery?
A N D D A T E( S ) C O N D U C T E D:
Abandon Ship ___________________________________
Who gave the orientation? ________________
Were the drills hands-on involving actual gear?
Y N
Did you participate in the drills?
Y N
C O M M E N T S (A L L “N”
C O M M E N T):
R E S P O N S E S RE Q U I RE A
Y N _______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
Y N _______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
Y N _______________________________________________
_______________________________________________
Observer Name: ___________________________________________________________ Cruise #: _______________
Observer Signature: ________________________________________________________ Date: __________________
Captain Name: ____________________________________________________________________________________
Captain Signature (optional): _________________________________________________ Date: __________________
*Did the vessel request a copy of the Checklist? Y N
*If so, were you able to supply a copy?
Blue indicates “no go” items!
13
Y N
Y N
Vessel Safety Checklist
V E S S E L N A M E : _________________________________
VESSEL
P E R M I T:___________ ____
Ensure the USCG Commercial Fishing Vessel
Safety decal is not expired based on the
information noted on the face of the decal.
Is the decal valid?
Y N
S U R V I V A L C R A F T:
Number of:________________________
EPIRB: (Visual inspection only. Please leave all testing/handling to crew)
Location(s):_______________________________________
Total capacity:_____________________
Battery exp. date: __________ (expires on date displayed)
# of crew & observer/s on board________
Hydrostatic release expiration date:______/_____ (expires
on date displayed)
Sufficient capacity?
Y N
Survival craft(s) able to float free? (Note:
Y N
some vessels have their rafts in a float free cradle this is an approved cradling system, so long as the
painter line is properly attached to a weak link.)
Service Due decal exp. date:____/____
(expires on date displayed)
Hydrostatic release exp. date:___/_____
(expires on date displayed)
Located in a float free location?:
Y
N
Registered to this vessel (name of vessel displayed):
Y
N
Alphanumeric code on decal matches code on EPIRB:
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
NOAA Registration Decal:
Exp. date: _________ (expires on date displayed)
Signal tested (or asked to see station log in wheelhouse for
most recent test. Signal should be tested monthly):
Your raft assignment:________________
I M M E R S I O N S U I T /PFD S :
Available for everyone on board?
Location(s):________________________
F L A RE S :
(ask captain for assistance)
Location(s):________________________
Expiration dates checked?
F I RE E X T I N G U I S H E R S:
Y N Extinguisher(s) found in every main area/corridor?
Extinguishers in “good and serviceable condition” (gauge in
the green, low amounts of rust, canister in good condition,
unobstructed, hoses attached, service tags available)?
T H RO W A B L E F L O T A T I O N D E V I C E S:
Number of flotation devices appropriate for vessel size?
Y N Easily accessible?:
(expires on date displayed)
Name of vessel displayed on each?
If checked, number of flares:__________
Location(s):_______________________________________
14
ADDITIONAL SAFETY
C H E C K S:
F I R S T A I D M A T E R I A L S:
Factory hydraulic shut-off(s) - know location?
Y N Location(s):_____________________________________
Watertight doors - do they close properly?
Y N Is there an individual trained in CPR/First Aid on board?
Hatches/passageways - are they unobstructed?
Y N Who?:_________________________________________
Discussed safe places to work on deck and in
factory with captain/crew?
Y N
Discussed refrigerant leak procedures?
Y N Radios:
Type of refrigerant used___________________
Discussed reporting/identifying inoperative
alarm/fire systems?
Did you hear the general alarm?
How many SSB and VHF radios?: _________ / ________
Y N Are emergency call instructions posted?
Y N
Y N Were procedures for making an emergency call discussed?
Y N
S A F E T Y O R I E N T A T I O N:
EMERGENCY DRILLS
Where will you go during emergencies:
______________________________________
Fire____________________________________________
If you did not complete drills upon embarking
the vessel, did the captain use this safety
checklist to complete the required vessel safety
orientation?
Did the vessel conduct a safety orientation?
Man Overboard __________________________________
Y N Vessel Flooding/stabilization ________________________
General alarm activation ___________________________
Y N Donning immersion suits ___________________________
Radio/visual distress signals ________________________
(Detail what was covered in the comment
section below)
OBSERVER PERSONAL PROTECTIVE
E Q U I P M E N T:
Personal Locator Beacon?
UIN:__________________________________
NOAA Registration Decal Expiration
Date:__________________________________
Immersion Suit with Strobe Light and
Battery?
Serial #:_______________________________
Personal Flotation Device with Strobe Light
and Battery?
A N D D A T E( S ) C O N D U C T E D:
Abandon Ship ___________________________________
Who gave the orientation? ________________
Were the drills hands-on involving actual gear?
Y N
Did you participate in the drills?
Y N
C O M M E N T S (A L L “N”
C O M M E N T):
R E S P O N S E S RE Q U I RE A
Y N _______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
Y N _______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
Y N _______________________________________________
_______________________________________________
Observer Name: ___________________________________________________________ Cruise #: _______________
Observer Signature: ________________________________________________________ Date: __________________
Captain Name: ____________________________________________________________________________________
Captain Signature (optional): _________________________________________________ Date: __________________
*Did the vessel request a copy of the Checklist? Y N
*If so, were you able to supply a copy?
Blue indicates “no go” items!
15
Y N
Y N
16
17
File Type | application/pdf |
File Title | untitled |
File Modified | 2012-04-03 |
File Created | 2012-04-03 |