Safety checklist

OMB Control No. 0648-0593

Expiration Date: 09/30/2012

Southeast Fisheries Observer Programs

UPDATED 01/2010

Pre-Trip Safety Check
OBS TRIP ID_____________

DATE ____________

VESSEL NAME __________________

VESSEL #_______________

Life Saving Equipment (circle Y for yes or N for no)
CGVSE
Safety Examination Decal? Y / N
Decal #________________
Date of Issuance: ___/____
Date of Expiration: ___ / ____
(after 2008 CGVSE good for 1 year)
Vessel Distance Rating: ____ NM

EPIRB
EPIRB present? Y / N
EPIRB Registration Date: ___/_____
Battery Exp. Date: __ / ____
Stowed in a float-free location? Y / N

Registered To: ______________________
Hydrostatic Release Exp. Date: ___ / _____

FLARES
Distress flares present? Y / N
3 Parachute Flares? Y / N
6 Hand Flares? Y / N
3 Smoke Flares? Y / N

PFDs AND IMMERSION SUITS
Personal Floatation Device for each POB? Y / N

# of PFDs ____

Immersion suit for each POB*? Y / N
*required above 32 N latitude

# of Immersion Suits ____

FIRE FIGHTING EQUIPMENT
3 B Type Fire Extinguishers charged and mounted? Y / N
Location 1__________________
Location 2__________________
Location 3__________________

STATION BILLS posted? Y / N

ONBOARD DRILLS logged? Y / N

LIFE RAFT
Orange ring buoy with line attached? Y / N
Inflatable life raft? Y / N
Capacity for all POB? Y / N
Life raft Capacity ______
Raft Repack Date ___ / ______
Hydrostatic Release Exp. Date: ___ / _____
Life raft configured correctly*? Y / N
*Please take picture of configuration

5 Fabrication Marks Present? Y / N
Upper Fabrication mark towards rope? Y / N

Please provide signatures to verify that a safety check was
conducted and that the information above is accurate.
Observer: ________________________________ Date: ____/_____/_____
Owner/Operator: __________________________ Date: ____/_____/_____

5
Hydrostatic release
expiration date