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pdfOMB Control No. 0648-0593
Expiration Date: 12/31/2021
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:
/
EPIRB Category: I / II
/
/ NA
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
06-2019
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
Type
Manufacture
Date
Brand
First
Model #
Green
Y/N
Photo
Y/N
1
2
3
*If cannot determine both brand AND model, a photo MUST be taken*
STATION BILLS posted? 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:
/
/
06-2019
File Type | application/pdf |
Author | simon.gulak |
File Modified | 2019-06-19 |
File Created | 2019-06-19 |