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pdfOMB Control No. 0648-0593
Expiration Date: 10/31/2018
Southeast Fisheries Observer Programs - Panama City
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 Expiration: ___ / ____
Vessel Distance Rating: ____ NM
EPIRB
EPIRB present? Y / N
Stowed in a float-free location? Y / N
EPIRB Registration Expiration Date: ___/_____
Hydrostatic Release Exp. Date: ___ / _____ / NA
EPIRB Category: I / II
Registered To: ______________________
Battery Expiration Date: __ / ____
FLARES
3 of any flare required for operations <3nm offshore
3 Parachute, 6 Hand & 3 Smoke required for operations >3nm offshore
Record flare expiration dates:
Hand: ___ / ____
Hand: ___ / ____
Hand: ___ / ____
Hand: ___ / ____
Hand: ___ / ____
Hand: ___ / ____
Smoke: ___ / ____
Smoke: ___ / ____
Smoke: ___ / ____
Parachute: ___ / ____
Parachute: ___ / ____
Parachute: ___ / ____
PFDs AND IMMERSION SUITS (not including observer equipment)
Personal Floatation Device for each POB? Y / N
# of PFDs ____
Immersion suit for each POB*? Y / N
*required in federal waters above 32 N latitude
# of Immersion Suits ____
01-2016
FIRE FIGHTING EQUIPMENT
Vessels <26 ft require 1 B-I unless equipped with an outboard in certain conditions
Vessels >26 ft but <40 ft require 2 B-I or 1 B-II
Vessels >40 ft but <65 ft require 3 B-I or 1 B-II & 1 B-I
Location
1 __________________
2 __________________
3 __________________
Type
_____
_____
_____
STATION BILLS posted? Y / N
Manufacture Date
_______________
_______________
_______________
Green? Y/N
_____
_____
_____
ONBOARD DRILLS logged? Y / N
LIFE RAFTS AND RINGS
Orange ring buoy with line attached? Y / N
Rigid life float? Y / N (>12nm but <20nm until 2015)
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
Hydrostatic release
expiration date
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: ____/_____/_____
01-2016
File Type | application/pdf |
File Title | OMB Control No |
Author | Joe Terry |
File Modified | 2016-02-17 |
File Created | 2016-02-17 |