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VESSEL SAFETY CHECK (VSC)
VESSEL SAFETY CHECK (VSC)

To be completed by a U. S. Coast Guard approved Vessel Examiner.
See the back of this form for a brief explanation of required items.
A federal Requirements Pamphlet is also available.


Owner / Operator has attended a CGAUX, USPS, State or
[ ] Boating Safety Class: Yes [ ] No [ ]
VSC Decal: Awarded [ ] not Awarded [ ]
Number:
Replaced decal was: Last Year [ ] Outdated [ ] First time [ ]
Date of VSC: [ ]
Owner/Operator Name:
Registration or Doc. No.
VESSEL INFORMATION:
Location of VSC - County: State:
HIN:
Length <16 [ ] 16-25 [ ] 26-39 [ ] 40-65 [ ] > 65 [ ]
Area of Operations: Inland [ ] Coastal [ ]
Powered by: Gas [ ] Diesel [ ] Sail [ ] Other [ ]
Type: PWC [ ] Open [ ] Cabin [ ] Other [ ]
VESSEL SAFETY CHECK DECAL REQUIREMENTS | RECOMMENDED AND DISCUSSION ITEMS
Item


Yes No NA Item Yes No NA
1. Display of Numbers




(While encouraged, items below are not VSC
requirements)
2. Registration / Documentation




I. Marine Radio



3. Personal Flotation Devices (PFD)




II. Dewatering Device & Backup



4. Visual Distress Signals (VDS)




III. Mounted Fire Extinguishers



5. Fire Extinguishers




IV. Anchor & Line for Area



6. Ventilation




V. First Aid and PIW Kits (**over)



7. Backfire Flame Control




VI. Inland Visual Distress Signals



8. Sound Producing Devices / Bell




VII. Capacity / Cert. of Compliance



9. Navigation Lights




VIII. Discussion Items: as applies



10. Pollution Placard




a. Accident Reporting / Owner Responsibility
11. MARPOL Trash Placard




b. Offshore Operations
12. Marine Sanitation Devices




c. Nautical Charts / Navigation Aids
13. Navigation Rules




d. Survival Tips / First Aid
14. State and/ or Local Requirements




e. Fueling / Fuel Management
15. Overall Vessel Condition: as applies



f. Float Plan / Weather & Sea Conditions
a. Deck free of hazards / clean Bilge

g. Insurance Considerations
b. Safe Electrical / Fuel Systems

h. Boating Check List
c. Safe Galley / Heating Systems

i. Safe Boating Classes

I certify that I have personally examined this vessel and find it meets the above requirements at the time of this Vessel Safety
Check. I am a qualified Vessel Examiner of the: CGAUX [ ], USPS [ ], State of __________[ ], or ____________________ [
]Printed Name of the Examiner ______________________________
Examiner Number ____________________

Examiner Signature: ______________________________________
Telephone Number ____________________


Additional Comments: This is not an official boarding for law enforcement purposes. It is recommended that you correct any deficiencies noted.
This checklist is furnished for your information. There is no assumption of liability of any kind for advice given or opinions expressed in connection
to this examination. By accepting the Vessel Safety Check decal you are pledging to maintain your boat and equipment to the standard of safety
exhibited during this examination. Please remove the Vessel Safety Check decal if the boat is sold or no longer meets these requirements.

I am consenting to this Vessel Safety Check of my watercraft with full knowledge that it is being provided to me as a public
service on a volunteer basis without cost, and I understand and agree that my receipt of a Vessel Safety Check decal shall
not constitute or be construed as a warranty or guarantee as to either the qualification, knowledge, or skills of the operator;
the seaworthiness of the vessel; or the serviceability or adequacy of any equipment on board.

Owner/Operator Signature:




Date:
U.S.C.G. AUX FORM 204 (6-2000) PREVIOUS EDITIONS ARE OBSOLETE




Brief Explanation of VSC Required Items:

1. NUMBERING
:
The boats registration number must
be permanently attached to each side of the forward half of the boat
They must be plain, vertical, block characters, not less than three (3)
inches high, and in a color contrasting with the background. A space or
hyphen must separate the letters from the numbers. Place State tax
sticker according to State policy.
(e.g.
FL 1234 AB
or
FL-1234-AB
)

2. REGISTRATION / DOCUMENTATION
:

Registration or Documentation papers must be on board and available.
Documentation numbers must be permanently marked on a visible part
of the interior structure. The documented boats name and hailing port
must be displayed on the exterior hull in letters not less than 4 inches in
height. To be documented a boat must be 5 net tons or greater.

3.
PERSONAL FLOTATION DEVICES (PFDs)
:
Acceptable PFDs (also known as Life Jackets) must be U.S. Coast
Guard approved, in good serviceable condition, and of suitable size for
the each person on the boat. Children must have properly fitted PFDs
designed for children. Wearable PFDs shall be readily accessible.
Throwable devices shall be immediately available. PFDs shall NOT
be stored in unopened plastic packaging. For Personal Watercraft
riders, the PFD must be worn and indicate an impact rating. Boats 16
Feet or longer, must also have one Type IV.

4. VISUAL DISTRESS SIGNALS
:
All
recreational boats used on coastal waters or the Great Lakes are
required to carry a minimum of three Coast Guard approved (current
dated) day and night visual distress signals. Some signals (e.g. red
flares) can serve for both day and night.

Boats operating on inland waters should have some means of making a
suitable day and night distress signal. The number and type of Visual
Distress Signals is best judged by considering conditions under which
the boat will be operating. Alternatives to pyrotechnic devices (flares)
include:

Night
Day

Strobe light
Signal mirror

Flashlight
Red or orange flags
Lantern
Hand
signals

5. FIRE EXTINGUISHERS
:
Fire extinguishers are
required if one of the following conditions exists: (1) Inboard
engine(s); (2) Closed compartments that store portable fuel tanks; (3)
Double bottom hulls not completely sealed or not completely filled
with flotation materials (4) Closed living space (5) Closed stowage
compartments that contain flammable materials or (6) Permanently
installed fuel tanks NOTE: Fire extinguishers must be readily
accessible and verified as serviceable.

Minimum number of extinguishers required

Boat
No Fixed With Fixed
Length
System System
___________________________________________________________________
Less than 26 one B-1 0
26 to less than 40 two B-1 or one B-2 one B-1
40 to 65
three B-1 or two B-1 or


one B-1 & one B-2 one B-2


6. VENTILATION
:
Boats with gasoline engines in
closed compartments, built after 1 August 1980 must have a powered
ventilation system. Those built prior to that date must have natural or
powered ventilation.


Boats with closed fuel tank compartments built after 1 August 1978
must meet requirements by displaying a certificate of
compliance. Boats built before that date must have either
natural or powered ventilation in the fuel tank compartment.

7. BACKFIRE FLAME ARRESTER
:

All gasoline powered inboard/outboard or inboard motor boats must
be equipped with an approved backfire flame control device.

8. SOUND PRODUCING DEVICES
:
To
comply with Navigation Rules and for distress signaling purposes all
boats must carry a sound producing device (whistle, horn, siren, etc.)
capable of a 4-second blast audible for � mile. Boats larger than 39.4
ft. are also required to have a bell (see Navigation Rules.)

9. NAVIGATION LIGHTS
:
All boats must be able to
display navigation lights between sunset and sunrise and in conditions
of reduced visibility. Boats 16 feet or more in length must have
properly installed, working navigation lights and an all-around anchor
light capable of being lit independently from the red/green/white
running lights.

10. POLLUTION PLACARD
:
Boats 26 feet and over
with a machinery compartment must display an oily waste pollution
placard.

11. MARPOL TRASH PLACARD
:
Boats 26 feet and
over in length must display a MARPOL trash placard. Boats 40 feet
and over must also display a written trash disposal plan.

12. MARINE SANITATION DEVICE:
Any
installed toilet must be a Coast Guard approve