Inspection request for electronic bin monitoring system

Revised: 04/30/2014 OMB Control No. 0648-0330, Expiration Date: 11/30/2015

BIN VIDEO MONITORING SYSTEM Inspection Request

Fax, mail, or e-mail completed forms and diagrams to: North Pacific Groundfish Observer Program 7600 Sand Point Way NE, Bldg 4 Seattle, WA 98115 Ph: 206-526-4007 Fax: 206-526-4066 e-mail: [email protected]

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.

Select Bin Monitoring Option: [__] Line of Sight [__] Video
DIAGRAM ATTACHMENT
Include a diagram drawn to scale showing ● the locations where all catch will be weighed and sorted by the observer ● the location where unsorted catch will be collected ● the location of any video equipment or viewing panels or ports.
VESSEL INFORMATION
Vessel Name
Federal Fisheries Permit Number	Requested Inspection Date
Business Mailing Address	Contact Person On Vessel
Today’s Date	Telephone Number for Contact Person
Location of vessel, including street address and city	Fax Number
	Requesting Person’s Signature

1. Have you received and passed a prior bin monitoring inspection? [__] YES [__] NO

2. If YES, what is the date of the most recent inspection? _____________________________

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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.

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 At-Sea Scales 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 scales to weigh catch at sea; 5) Responses to this information request are not confidential.

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Inspection Request for Bin Monitoring

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