Hawaii Administrative Rules › Title 13 - DEPARTMENT OF LAND AND NATURAL RESOURCES › Subtitle 11 - OCEAN RECREATION AND COASTAL AREAS › Part 1 - SMALL BOAT FACILITIES AND PROVISIONS GENERALLY APPLICABLE TO ALL STATE NAVIGABLE WATERS › Chapter 231 - OPERATION OF BOATS, SMALL BOAT HARBORS, AND USE PERMITS FOR ALL NAVIGABLE WATERS › Subchapter 5 - ALLOCATION OF BERTHS AND OFFSHORE MOORING › Exhibit B

Current through June, 2024
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Each item shall meet applicable U.S. COAST GUARD,
						AMERICAN BOAT & YACHT COUNCIL STANDARDS AND DEPARTMENT OF LAND AND NATURAL
						RESOURCES ADMINSTRATIVE RULES.
INSPECTION ITEM
PASSED
NOT PASSED
N/A
REMARKS
CERTIFICATE/DOCUMENT ABOARD
REG/DOC NO. PROPERTY DISPLAYED
MFC S SER. NO. DISPLAYED
SAFETY EQUIPMENT
PFD' S
VISUAL DISTRESS SIGNAL(S)
HORN, WHISTLE AND/OR BELL
PLACARDS: TRASH, OIL
FIRE EXTINGUISHER(S)
PROPER LIGHTS
BILGE PUMPING DEVICE
OIL IN BILGE
OIL ABSORBENT PADS OPERATIVE
OTHER FUELS PROPERLY VENTED
PROPULSION
ENGINE ABOARD
ENGINE OPERATIVE/APPROP. SIZE
BACKFIRE FLAME ARRESTER
ENGINE COMPARTMENT VENTILATED
FUEL COMPARTMENT VENTILATED
EXHAUST SYSTEM
SPARS OPERATIVE
RIGGING OPERATIVE
APPROPRIATE SAILS ABOARD
MARINE SANITATION DEVICE ABOARD
HOLDING TANK - TYPE
FLOW THROUGH
PROPERLY INSTALLED
ADEQUATE STEERING/RUDDER OPER.
HULL/PROP/RUDDER CLEAN FOR USE
ADEQUATE EXITS
UNSECURED OPEN' GS/HULL/DECK/CAB
RECONSTRUCTION/SURVEY/INSURA NCE
CHAFE GEAR
GROUND TACKLE
GENERAL APPEARANCE
REASONABLE CLEANLINESS
ANIMAL ABOARD
HOW MANY LIVING ABOARD?
COMMENTS:
						________________________________________________
___________________________________________________________
___________________________________________________________
_____________________________
I inspected the vessel described on the front of this
						form on _______ 20_____ at ____ (AM)
(PM) at ________________________. I have observed the
						vessel described on the front of this form move by its own propulsion
						(POWER/SAIL), at an adequate speed indicating that the vessel was in good
						operating condition, from _______________ to _________________, the route
						designated by the harbor agent for this vessel. I have personally inspected
						every item on the checklist on the front and reverse side of this form for the
						vessel described therein and (CONSIDER / DO NOT CONSIDER) it to be in good
						material and operating condition in accordance with the requirements contained
						in the Hawaii Administrative Rules, Department of Land and Natural Resources,
						State of Hawaii. I further certify that the vessel's length (end to end over
						deck: LOD) is _____ feet _____ inches; and length overall (including extension
						such as bowsprit: LOA) is ____ feet _____ inches.
Date signed: __________ Signature: ____________
Name typed or printed:
						________________________________________
Company Name:
						_____________________________________________
Address:
						________________________________________________
City: _________________________ State:
						___________________
Zip: _____________
Contact Phone No:
						_______________________________________
PERMIT NO. ______________________PERMIT
						EXPIRATION
DATE: ___________