Inspection request form

Revised: 07/28/2017

OMB Control No. 0648-0330, Expiration Date: 11/30/2017

At-sea Scales, BSAI Longline C/Ps
Video, and Flow Scale:
Fax, mail, or email completed forms
and diagrams to:

INSPECTION
REQUEST FORM
(OBSERVER
SAMPLING
STATION, VIDEO,
and AT-SEA SCALES)

U.S. Department of Commerce
NOAA/NMFS, Alaska Region
PO Box 21668
Juneau, AK 99802-1668
Ph: 907-586-7228
Fax: 907-586-7465
Email:jennifer.watson@noaa.gov

Bin Monitoring, Chinook Salmon
Bycatch Monitoring, and Observer
Sampling Station:
Fax, mail, or e-mail completed forms
and diagrams to:
FMA Observer Program
7600 Sand Point Way NE, Bldg 4
Seattle, WA 98115
Ph: 206-526-4007
Fax: 206-526-4066
Email: 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.
VESSEL INFORMATION
Vessel Name:

Federal Fisheries Permit:

Vessel Contact Phone:

Vessel Contact E-mail:

Address of Vessel Location for Inspection:

Vessel Contact Name:

Phone on Vessel:

VIDEO SYSTEM SELECTION
Select Video Monitoring Systems To Be Inspected:(more than one may be selected)

□ Video Bin Monitoring Option □ Chinook Salmon Bycatch □ BSAI Longline C/Ps □ Flow Scale

Name of Video Installer to install & maintain system:
Will video installer be on site at inspection?

□ Yes

□ No

Person on vessel to maintain system & aid observer:

Requested Inspection Date:

Requested Inspection Time:

VIDEO MONITORING DIAGRAM ATTACHMENT
You must attach a diagram that is clearly labeled and drawn to scale showing:
 Location of each camera & its coverage area
 Location of any additional video equipment, including monitors & hard drives
 All locations where sorting occurs
 Location of motion-compensated flow scale
Chinook Salmon Bycatch Monitoring:
 Location of salmon storage container

Inspection Request
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OBSERVER SAMPLING STATION
Observer Sampling Station and At-Sea Scale Inspections should be scheduled at least one hour apart.
Would you like your observer sampling station inspection on a If YES, what date and time?
different date and time than the video inspection?
Time:
Date:

□ Yes □ No
Diagram for trawl C/Ps & motherships, clearly labeled and drawn to scale showing the location(s)
where all catch will be weighed, the location where observers will sample unsorted catch, and the location
of the observer sampling station, including the observer sampling scale and table.
Diagram for all other vessels, to scale showing the location(s) where catch comes on board the vessel,
the location where observers will sample unsorted catch, the location of the observer sampling station,
including the observer sampling scale and table.
AT-SEA SCALES
Observer Sampling Station and At-Sea Scale Inspections should be scheduled at least one hour apart.
If YES, what date and time?
Would you like your at-sea scale inspection on a different date
and time than the video inspection?
Date:
Time:

□ Yes □ No
Will repair company be on site at inspection?

Repair Company Name:

□ Yes □ No
Prior to the at scale inspection make sure:





The scale is installed in a rigid and level manner
The display & printer are connected and operational
Belts leading to the scale are connected and operational (not applicable to platform and hanging scales)
Test weights & test weight certification documents are available for inspection (platform scales only)
 A crew member will be available to help the inspector transport test materials and conduct the testing

Inspection Request
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PUBLIC REPORTING BURDEN STATEMENT
Public reporting for this collection of information is estimated to average 10 minutes per response,
including the time for reviewing the instructions, searching the 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 Assistant Regional Administrator, Sustainable Fisheries Division, NOAA
National Marine Fisheries Service, P.O. Box 21668, Juneau, AK 99802-1668.
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 mandatory
and is required to manage 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.); 3) Responses to this information request are
confidential under section 402(b) of the Magnuson- Stevens Act. They are also confidential under NOAA
Administrative Order 216-100, which sets forth procedures to protect confidentiality of fishery statistics.

PRIVACY ACT STATEMENT
Authority: The collection of this information is authorized under the Magnuson-Stevens Fishery
Conservation and Management Act, 16 U.S.C 1801 et seq.
Purpose: In order to manage U.S. fisheries, the NOAA National Marine Fisheries Service collects permit
holder information forms for the At-Sea Scales Program, which was developed in response to the need
for catch accounting methods that were more precise and verifiable at the level of the individual haul and
less dependent on estimates generated by at-sea observers. This was necessary due to the
implementation of large-scale catch share programs that required NMFS to provide verifiable and
defensible estimates of quota harvest. NMFS also established a set of performance based standards to
allow shoreside processors to describe how they will ensure that all delivered catch can be effectively
monitored by NMFS-authorized personnel, and that all catch is accurately sorted and weighed by
species.
Routine Uses: The Department will use this information to identify fishery participants and evaluate the
qualifications of the applicants. Disclosure of this information is permitted under the Privacy Act of 1974 (5
U.S.C. Section 552a), to be shared within NMFS offices, in order to coordinate monitoring and
management of sustainability of fisheries and protected resources, as well as with the applicable State or
Regional Marine Fisheries Commissions and International Organizations. Disclosure of this information is
also subject to all of the published routine uses as identified in the Privacy Act System of Records Notice
COMMERCE/NOAA-19, Permits and Registrations for the United States Federally Regulated Fisheries.
Disclosure: Furnishing this information is required to obtain or retain the benefit of participation in either
an at-sea scales program or shore-based catch monitoring program; failure to provide complete and
accurate information will prevent the determination of eligibility for registration in either of these programs.

Inspection Request
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