Panama City Vessel PreCheck

OMB Control No. 0648-0593

Expiration Date: 12/31/2021

Southeast Fisheries Observer Programs - Panama City
Pre-Trip Safety Check
OBS TRIP ID

DATE

VESSEL NAME

VESSEL #

Life Saving Equipment (circle Y for yes or N for no)
CGVSE
Safety Examination Decal? Y / N
Decal #

Date of Expiration:

/

Vessel Distance Rating:

NM

EPIRB
EPIRB present? Y / N
Stowed in a float-free location? Y / N
EPIRB Registration Expiration Date:
Hydrostatic Release Exp. Date:
/

EPIRB Category: I / II
/
/ NA

Registered To:
Battery Expiration Date:

/

FLARES
3 of any flare required for operations <3nm offshore
3 Parachute, 6 Hand & 3 Smoke required for operations >3nm offshore
Record flare expiration dates:
Hand:
/
Hand:
Hand:
/
Hand:
Hand:
/
Hand:

/
/
/

Smoke:
Smoke:
Smoke:

/
/
/

Parachute:
Parachute:
Parachute:

/
/
/

PFDs AND IMMERSION SUITS (not including observer equipment)
Personal Floatation Device for each POB? Y / N

# of PFDs

Immersion suit for each POB*? Y / N
*required in federal waters above 32 N latitude

# of Immersion Suits

06-2019

FIRE FIGHTING EQUIPMENT
Vessels <26 ft require 1 B-I unless equipped with an outboard in certain conditions
Vessels >26 ft but <40 ft require 2 B-I or 1 B-II
Vessels >40 ft but <65 ft require 3 B-I or 1 B-II & 1 B-I
Location

Type

Manufacture
Date

Brand

First
Model #

Green
Y/N

Photo
Y/N

1
2
3
*If cannot determine both brand AND model, a photo MUST be taken*
STATION BILLS posted? Y / N

ONBOARD DRILLS logged? Y / N

LIFE RAFTS AND RINGS
Orange ring buoy with line attached? Y / N
Rigid life float? Y / N (>12nm but <20nm until 2015)
Inflatable life raft? Y / N
Capacity for all POB? Y / N
Life raft Capacity
_
Raft Repack Date
/_
Hydrostatic Release Exp. Date:
/
Life raft configured correctly*? Y / N
*Please take picture of configuration

5
Hydrostatic release
expiration date

5 Fabrication Marks Present? Y / N
Upper Fabrication mark towards rope? Y / N

Please provide signatures to verify that a safety check was
conducted and that the information above is accurate.
Observer:

Date:

/

/

Owner/Operator:

Date:

/

/

06-2019