Ship Inspection Form
Beginning Date of Inspection
-
Month
-
Day
Year
Date
Ending Date of Inspection
-
Month
-
Day
Year
Date
Inspection Location (Port)
Inspector Name
First Name
Last Name
Inspector Email
example@example.com
Inspector Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Vessel and Owner Info
Vessel Owner Name
First Name
Last Name
Vessel Owner Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Vessel Owner Email
example@example.com
Vessel Documentation Number
Hull ID Number
Vessel Length (feet)
Vessel is powered by
Gas
Diesel
Sail
Other
Vessel Type
Inspection Results
Deck Condition
Please Select
Excellent
Fair
Needs Improvement
Needs Replacement
Not Assessed
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Additional comments about deck
Chainplates Condition
Please Select
Excellent
Fair
Needs Improvement
Needs Replacement
Not Assessed
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Additional comments about chainplates
Thurnbuckles Condition
Please Select
Excellent
Fair
Needs Improvement
Needs Replacement
Not Assessed
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Additional comments about thurnbuckles
Window Conditions
Please Select
Excellent
Fair
Needs Improvement
Needs Replacement
Not Assessed
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Additional comments about windows
Boat Safety
Type a question
Rows
Yes
No
Does the vessel have a dewatering device?
1
2
Is the vessel deck clear of hazards?
3
4
Does the vessel meet state and/or local requirements?
5
6
Does the vessel have marine sanitation devices?
7
8
Does the vessel have first aid kits?
9
10
Does the vessel have a valid certificate of compliance?
11
12
Are numbers displayed?
13
14
Are documentation onboard?
15
16
Does the vessel have personal flotation devices in an easily accessible area?
17
18
Does the vessel have fire extinguishers?
19
20
Does the vessel have a functioning ventilation system?
21
22
Does the vessel have a backfire flame control mechanism?
23
24
Does the vessel have sound-producing devices?
25
26
Does the vessel have a pollution placard?
27
28
Inspector Signature
Submit
Should be Empty: