Inspection Request, Electronic Monitoring System,

Revised: 12/17/09

OMB Control No. 0648-xxxx, Expiration Date: xx/xx/xxxx

Fax, mail, or e-mail completed forms and diagrams to:

ELECTRONIC MONITORING
SYSTEM
INSPECTION REQUEST FORM

Jason Stern
North Pacific Groundfish Observer Program
7600 Sand Point Way NE, Bldg 4
Seattle, WA 98115
Ph: 206-526-4518
Fax: 206-526-4066
e-mail: [email protected]

Note: Inspections will be scheduled within ten working days of receiving a request. Requests for inspections in
Dutch Harbor and Kodiak will be scheduled within 10 days, but may be delayed several days due to weather or
logistics.

DIAGRAM ATTACHMENT
You must attach with this request a diagram drawn to scale showing:

♦ All locations where salmon will be sorted
♦

Location of the salmon storage container

♦

Location of each camera and its coverage area

♦

Location of any additional video equipment

BLOCK A – VESSEL INFORMATION
Name of Vessel
Federal Fishery Permit No.:
Name

Type of Vessel (check one)
[__] Catcher/processor [__] Mothership
Date

Requesting Person’s Signature

Business Mailing Address

Business Telephone No.

Business Fax No.

Business e-mail Address

Has vessel previously received an electronic monitoring system inspection?
[__] YES

[__] NO

If YES, what is the date of the most recent inspection? _____________________________
Name of individual or company responsible for
installing and maintaining the system

Individual onboard the vessel responsible for
maintaining the system and working with the
observer on its use

Inspection Request for Electronic Monitoring System
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Length (in pixels) of image:

BLOCK B – SYSTEM SPECIFICATIONS
Width (in pixels) of image:
File type in which data are recorded:

Type and extent of compression:

Frame rate at which data are recorded:

Brand and model number of the cameras:
Brand, model, and specifications of the lenses:
Size and type of storage device:
The type, speed, and operating system of any computer that is part of the system:

Any change to the electronic monitoring system that would affect the system's functionality must be
submitted to, and approved by, the Regional Administrator in writing before that change is made.
Inspections will be conducted on vessels tied to docks at Dutch Harbor, Alaska; Kodiak, Alaska; and in the
Puget Sound area of Washington State.
An electronic monitoring system inspection report, valid for 12 months from the date it is signed by NMFS,
will be issued to the vessel owner if the electronic monitoring system meets the requirements. The vessel
owner must maintain a current electronic monitoring system inspection report onboard the vessel at all times
the vessel is required to provide an approved electronic monitoring system. The electronic monitoring
system inspection report must be made available to the observer, NMFS personnel, or to an authorized
officer upon request.
____________________________________________________________________________________
PUBLIC REPORTING BURDEN STATEMENT
Public reporting burden for this collection of information is estimated to average 2 hours per response, including the time for
reviewing the instructions, searching 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 NOAA, National Marine Fisheries Service, Alaska Region, Attn:
Assistant Regional Administrator, Sustainable Fisheries Division, P.O. Box 21668, Juneau, AK 99802-1668 (Attn: Records
Officer).
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 being used to manage the Chinook PSC Program and 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.) as amended in 2006; 4) Submission of
this information is necessary for NMFS to approve electronic monitoring systems; 5) Responses to this information request are
not confidential.
________________________________________________________________________________________________________

Inspection Request for Electronic Monitoring System
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