CG-11410 (01/18) Marine Transportation System Recovery Essential Elements

DEPARTMENT OF HOMELAND SECURITY

OMB No.1625-0127

U.S. Coast Guard
MARINE TRANSPORTATION SYSTEM RECOVERY
ESSENTIAL ELEMENTS OF INFORMATION

Expires: 04/30/2021

U.S. Coast Guard policy requires Sector Commanders to create, and update annually, Essential Elements of Information
regarding the Marine Transportation System within their Captain of the Port Zones. This form is used to capture data and
compare data gathered with information maintained by the U.S. Coast Guard.
SECTION I: FACILITY CONTACT INFORMATION
1. Facility Name
2. Facility Point of Contact
3. Position/Title
4. Telephone

5. Email

6. Fax

7. Location

8. Lat-Long
SECTION II: CARGOES

9. Products or goods received (liquid or dry bulk cargo by name(s), containers, autos etc.)
Cargo Name
Liquid

Dry

Container

Liquid

Dry

Container

Liquid

Dry

Container

Liquid

Dry

Container

Liquid

Dry

Container

Liquid

Dry

Container

Cargo Name
Cargo Name
Cargo Name
Cargo Name
Cargo Name
SECTION III: SHIP - BARGE ARRIVALS
10. On a weekly basis, how many ships/barges call at this facility?
Vessel Type/Name

Arrivals per week

Cargo

Vessel Type/Name

Arrivals per week

Cargo

Vessel Type/Name

Arrivals per week

Cargo

Vessel Type/Name

Arrivals per week

Cargo

Vessel Type/Name

Arrivals per week

Cargo

Vessel Type/Name

Arrivals per week

Cargo

CG-11410 (01/18)

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SECTION IV: CRITICALITY OF CARGO TO RECOVERY
11. Does facility transfer cargoes critical* to port recovery? Yes

No

(If yes, list critical cargoes below)

*Criticality may reflect the need of this cargo to the port or region. Ex: The product received is needed to support port
recovery or emergency response efforts; or to another process based on unique components/design/ limited supply source.
Cargo Name
Liquid

Dry

Container

Liquid

Dry

Container

Liquid

Dry

Container

Liquid

Dry

Container

Liquid

Dry

Container

Liquid

Dry

Container

Cargo Name
Cargo Name
Cargo Name
Cargo Name
Cargo Name
Provide any additional information pertinent to the cargo criticality

Privacy Act Statement
Authority: 33 U.S.C. §1225, 46 U.S.C. §70103, and 50 U.S.C. §191 authorize the collection of this information.
Purpose: Gathering essential elements of information before a port disruption enables the U.S. Coast Guard to establish a normal port condition baseline.
Then, following a port disruption, the port's condition can be measured against the normal baseline to provide critical input to those federal, state, and local
response organizations that are engaging in restoring the port to its pre-disruption condition.
Routine Uses: It is used by the U.S. Coast Guard Marine Transportation System Recovery Unit to assess the condition of the port, prioritize recovery efforts,
and gauge the effectiveness of the response. A complete list of the routine uses can be found in the system of records notice associated with this form,
“Department of Homeland Security/U.S. Coast Guard-013 - Marine Information for Safety and Law Enforcement (MISLE).” The Department's full list of system
of records notices can be found on the Department's website at http://www.dhs.gov/system-records-notices-sorns.
Disclosure: This is a voluntary solicitation for information and is not mandatory; however the U.S. Coast Guard cannot properly prioritize recovery efforts
without this valuable input.
An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number.
The Coast Guard estimates that the average burden for this report is 30 minutes. You may submit any comments concerning the accuracy of this burden
estimate or any suggestions for reducing the burden to: Commandant (CG-FAC), U.S. Coast Guard Stop 7318, 2703 Martin Luther King Jr Ave SE,
Washington,DC 20593-7318 or Office of Management and Budget, Paperwork Reduction Project (1625-0127), Washington, DC 20503.

CG-11410 (01/18)

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