FishSafe.info

Commercial Fishing Industry Vessel Safety

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Schedule Your FREE 'No Fault' Commercial
Fishing Vessel Dockside Safety Exam Today!

- Commercial Vessels Only -

Information sharing regarding adequate safety training and effective educational tools can help meet the goal of reducing fatalities in the fishing community so that it is no more dangerous than any other segment of the maritime industry.

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Thank you for visiting this site. Your help to increase the relevancy of this mechanism by providing beneficial comments for positive improvements will certainly be appreciated. You’ll be contacted to confirm receipt of your information and follow up with your request.

*I'm Requesting:
A Dockside Free Commercial Fishing Industry Vessel Safety Examination
A FREE copy of the “Federal Requirements for Commercial Fishing Industry Vessels” pamphlet
Other
Other (please specify): *Contact EMail Address: *Contact Phone Number: Contact Person: Contact Address: [ Additional space for your request ]

- Optional Information -

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Vessel Name: Vessel Number:
Enter Vessel Number: Other Identifier: Hull Color: Trim Color: Superstructure Color: Vessel Length: Gross Tonnage: Crew size [Maximum Person On Board (POB)]: Hull Type:
Wood
Aluminum
Fiberglass
Steel
Other
Hull Type: Other (please specify): Vessel Type:
Fishing Vessel
Fish Tender
Fish Processing Vessel
Year Built: Year Converted: Propulsion:
Outboard
Inboard
Inboard/Outboard
Horsepower: Number of Shafts: If A Renewal, Date Last U.S. Coast Guard Commercial Fishing Vessel Safety Examination Decal Issued: Fishing Equipment:
Long Line
Mult-Rig
Troll
Gill Net
Tender
Trawl
Purse Seine
Trap
Bottom
Other
Fishing Equipment: Other (please specify): Fuel:
Gas
Diesel
Portable
Fixed
Number of Fuel Tanks: Lube Oil Capacity (gallons): Hydraulic Oil Capacity (gallons): Fuel Capacity (gallons): Route:
Inland
Waters Inside Coastal Waters
Coastal Waters
Boundary Line:
Inside
Outside
3nm
12nm
20nm
50nm
>100nm
Number of Immersion Suits/PFDs On-Board: Number of Survival Crafts On-Board: Survival Craft Capacity: Name of Vessel Owner: Address of Vessel Owner : Owner Phone: Owner EMail Address: Exam Requested Due To:
At Sea Boarding (4100)
Owner
Family Member
Observer Coverage
Exemption
Other
Exam Requested Due To: Other (please specify): How did requester hear about program? Was this form and its location beneficial to you? Was this form and its location beneficial to you? --Comments:

COLLECTION OF INFORMATION PRIVACY ACT STATEMENT: In accordance with Public law 93-579

AUTHORITY: 46 USC 4502, 46 USC 4504, 46 USC 4507, 46 USC 6104 and 14 USC 89

PURPOSE: Document Commercial Fishing Vessel Safety Voluntary Dockside Examinations, analyze data to effectively enhance fishing vessel safety and promote public awareness and education. Information may be retained on file indefinitely.

ROUTINE USE: This information is to be used for uniform Coast Guard reporting and administration of Voluntary Dockside Examination data. It will be used to record the number of vessels and level of compliance with Coast Guard regulations.

MANDATORY OR VOLUNTARY DISCLOSURE: Providing information here is voluntary. Failure to provide information may delay pertinent actions in following up with your applicable request(s).

Last Modified 10/17/2007