Inspection request form

7/31/2017

Create Inspection Request Form | NOAA Fisheries Alaska Regional Office

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Catch Monitoring Program Inspection Requests
Inspection Request Form for Observer Sampling Station, Video Monitoring, and At-Sea Scales
Vessel Information

Vessel Name (Required)

Please enter a value
Federal Fisheries Permit No. (Required)

Vessel Contact Name (Required)

Vessel Contact Phone (Required)

Vessel Contact Email (Required)

[email protected]
Phone On Vessel (Required)

Address of Vessel Location for Inspection (Required)

Below you can request observer sample station inspections, scale inspections, and video inspections. You can request all inspections at one time, or you can request only one inspection. For any
inspections you are not requesting, leave those sections blank.

Video System Selection

Select Video monitoring Systems to be Inspected (more than one item may be selected by holding down the control key)

None
Video Bin Monitoring Option
Chinook Salmon Bycatch
BSAI Longline C/Ps
Flow Scale
Name of video installer to install and maintain system

Person on vessel to maintain system and aid observer

Requested Inspection Date and Time

Will video installer be onsite at inspection?
YES

NO

Observer Sampling Station

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Create Inspection Request Form | NOAA Fisheries Alaska Regional Office

*NOTE: Observer Sampling Station and At-Sea Scale Inspections should be scheduled at least one hour apart.

Requested Inspection Date and Time

*NOTE: You must attach a diagram (in the attachments section below) that is clearly labeled and drawn to scale showing:
Location of each camera and its coverage area
Location of any additional video equiipment, including monitors and hard drives
All locations where sorting occurs
Location of motion-compensated flow scale
Trawl C/Ps and motherships, clearly labeled and drawn to scale showing the location(s) where all catch will be weighed, the location where observers will sample unsorted catch, and the location of the
observer sampling station, including the observer sampling scale and table.
All other vessels, clearly labled and drawn to scale showing the location(s) where catch comes on board the vessel, the location where observers will sample unsorted catch, the location of the observer
sampling station, including the observer sampling scale and table.
If you would like an observer sampling station inspection on a different date and time than your video inspection, please request them below.

Attachments

Attach diagrams below for:
Allowed file types are: .pdf, .jpg, .jpeg, .gif,.tif,.tiff,.png,.doc,.docx,.xls,.xlsx, and .vsd of up to 10 megabytes in size.
If you need to attach multiple files, click add attachment for each file.

Add Attachment...

At-Sea Scales

*NOTE: Observer Sampling Station and At-Sea Scale Inspections should be scheduled at least one hour apart.
If you are only requesting a platform scale inspection or would like your at-sea scale inspection on a different date and time, please request them below.

Requested Inspection Date and Time

Will the repair company be on site at the time of the inspection?
YES

NO

Repair Company Name

*NOTE: Prior to the at scale inspection make sure:
The scale is installed in a rigid and level manner
The display and printer are connected and operational
Belts leading to the scale are connected and operational (not applicable to platform and hanging scales)
Test weights and test weight certification documents are available for inspection (platform scales only)
A crew member will be available to help the inspector transport test materials and conduct the testing

Complete CAPTCHA and Submit Inspection Request

Please type in the value from the image above, so that we know you are a human and not a robot. If you cannot read the Captcha, Click Here to get a new one.

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Create Inspection Request Form | NOAA Fisheries Alaska Regional Office

Submit Inspection Request

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