Initial Swim Test Evaluation

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OMB Control Number: 0648-0822
Expiration Date: 05/31/2027
NOAA Form 57-03-39
(12-23)

U.S. DEPARTMENT OF COMMERCE
NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION

INITIAL SWIM TEST EVALUATION
DIVING CANDIDATE LAST NAME

FIRST NAME

MIDDLE INITIAL DATE OF TEST

INSTRUCTIONS

The Unit Diving Supervisor (UDS), or UDS designee should proctor the candidate’s NOAA Diver initial swim test as per the NOAA
Diving Standards and Safety Manual (NDSSM). Personnel attending the NOAA Diving Center training course are also required to
successfully perform this test during the first day of the course, or they will be sent home.
All skills must be successfully demonstrated during a single pool session. It is suggested that the underwater be completed first,
followed by the uninterrupted surface swim, and then the 30 minute water tread. A 10-15 minute rest period is recommended
between each element.

WATERMANSHIP CRITERIA
UNDERWATER SWIM

The candidate must swim a distance of 25 yards (22 meters) underwater without surfacing and without the use of fins.
Was the 25 yard underwater swim completed successfully?		Yes

		No

UNINTERRUPTED SURFACE SWIM

			
Time (mm:ss) required to complete the 550 yard swim:

:

THIRTY (30) MINUTE TREAD

						
Was the 30 minute water tread completed successfully?		Yes

		No

Is the candidate’s swimming ability satisfactory, according to the requirements in the NDSSM? 		Yes

		No

PROCTOR RATING
PROCTOR COMMENTS (OPTIONAL)

AUTHORIZATION

I certify that the candidate named above has satisfactorily demonstrated all the watermanship skills above in a single pool session
as required by the NOAA Diving Program.

PROCTOR NAME

ORGANIZATION / DIVING UNIT

PROCTOR SIGNATURE

TELEPHONE NUMBER

DATE

SUBMISSION

Please proctor the test, fill out the form, and then submit this completed form via email to [email protected].

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information collection has a currently valid OMB Control Number. The approved OMB Control Number for this information collection
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Privacy Act Statement
Authority: The collection of this information is authorized under 29 CFR 1910, Subpart T, Commercial Diving Operations. Additional
authorities include 29 U.S.C. 653, 655, 657; 40 U.S.C. 333; 33 U.S.C. 941; Secretary of Labor's Order No. 8-76 (41 FR 25059), 9-83 (48 FR
35736), 1-90 (55 FR 9033), 6-96 (62 FR 111), 3-2000 (65 FR 50017), 5-2002 (67 FR 65008), 5-2007 (72 FR 31160), or 4-2010 (75 FR
55355) as applicable, and 29 CFR 1911.
Purpose: NOAA is collecting this information to assess an individual’s medical fitness to dive, proficiency, and further training.
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Disclosure: Furnishing this information is voluntary. However, the failure to provide complete and accurate information will exclude
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