Safety Checklist

Vessel Safety Checklist
All highlighted equipment and safety topics must be checked off before you leave port.
Do not deploy if any are not verified or current.
Vessel Name:
USCG/State Registration #:
LIFE RAFTS
 Inflatables

USCG DECAL
 Buoyant apparatus

Total capacity:

 None

 N/A

Be sure the following fields are
checked:

Total # people on board:

List full names of crew members present on the reverse side.

 Documented

Life raft able to float free?  Yes

 Expiration month

 No

Service sticker expiration date*:

 Locations

Hydrostatic release expiration **:

 Expiration year

Life raft equipment?  SOLAS A  SOLAS B
 PA

 PB

 Coastal

 Yes

 No



FLARES

 Yes

 No

One for each person?  Yes

 No

Required (unless inside 3 miles); 6 handheld, 3 Parchute, 3 Smoke

 N/A

Location(s):

Location:

Handheld: how many:

PFD for each person?  Yes

 No

Location:
FIRE EXTINGUISHERS
 Yes

 No

Serviceable?  Yes

 No

Present?

the vessel.

 Ocean Service

IMMERSION SUITS
On board?

Is the decal valid?

Complete the above sticker as it appears on

Exp. date*:

Parachute: how many:

Exp. date*:

Smoke: how many:

Exp. date*:

Meteor: how many:

Exp. date*:

TYPE IV THROWABLE
How many?

 Ring

 Cushion

 Lifesling

Easily accessible?  Yes

Location:

Number:

 No

Location(s):

Other signaling devices:
EPIRBS
Present?  Yes  No  N/A In float-free location?  Yes  No Registered to this vessel?  Yes  No Signal tested?  Yes  No

Decal’s alphanumeric code matches EPIRB code?  Yes  No Location(s):
Battery exp. date*:

Hydrostatic release exp. date*:

NOAA registration sticker:

Exp. date:

ADDITIONAL CHECKS
First aid materials present?  Yes

 No Location:

Who besides you is CPR Certified? (Name & position):
Working radios: how many?

Type:

Watertight doors/hatches working properly?

 Yes  No

Digital selective calling (DSC) enabled radio present?  Yes

 No

Hatches/passageways unobstructed?

 Yes  No

DSC registered & radio interfaced with GPS?

 Yes

 No

Did you hear the general/high water alarms?

 Yes  No

Is there a Station Bill posted?

 Yes

 No

Is there adequate means of escape?

 Yes  No

Did you see the bilge pumps?

 Yes  No

Is there an anchor present?

 Yes

 No

Were you given emergency directions?

 Yes

Was a wheel watch arranged?

 Yes

 No

(complete line below if yes)

 No

What were the emergency instructions?
Observer signature:
Date:

Print:
* Expires the last day of the month displayed.
** Hydrostatic releases are valid for two years from installation date.
OMB Control No. 0648-0593 exp. 12/31/2021

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CREW MEMBERS

Provide full names of crew present
1. Captain:

4. Deckhand:

2. Deckhand:

5. Deckhand:

3. Deckhand:

6. Deckhand:

ADDITIONAL NOTES

COMPLETED VESSEL SAFETY CHECKLIST

AŌer compleƟng the checklist, sign the form, print your name and date it. Email, text, or fax a copy of the checklist and
all associated notes to your provider (CS) or coordinator (NCS). If you have any safety quesƟons or concerns, please
contact the following coordinators:

John LaFargue, CA Coordinator
427 F Street #217
Eureka CA 95501
Ofϐice: 707.443.3228
Cell: 530.604.7386
email: [email protected]

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Scott Leach, WA/OR Coordinator
Hatϐield Marine Science Center
2032 SE OSU Dr
Newport OR 97365
Ofϐice: 541.351.8250
Cell: 541.366.8080
Fax: 541.867.0505
email: [email protected]