10_-TOW_TICKET.pdf

Form USM-623V Rev. 02/14

Contractor's Name Responsible for Relocation:

Date and Time of Pickup:Location of Pickup:

Date and Time of Delivery:Location of Delivery:

Asset ID # (CATS ID):District Office:

Year: Color:Vessel Name: Make:

Material:Hull ID:

Operable?: Yes No

LOA: Model:

U.S. Department of Justice United States Marshals Service Vessel Tug/Tow Ticket

INSTRUCTIONS: This form is to be utilized by the contractor or District Office only when a vessel is towed to the contractor facility. A copy of this form should be placed in the case file.

Registration/USCG Number:

VESSEL

Stored: Land Water

HULL

Overall Hull Condition:

Hull Condition Starboard:

Deck Condition:

Hull Condition Port:

Bottom Condition:

Excellent Average Below Average Salvage

Excellent Average Below Average Salvage

Excellent Average Below Average Salvage

Excellent Average Below Average Salvage

Excellent Average Below Average Salvage

Comments on Overall Condition of Hull:

ENGINE(S)

Port Engine Model:Make: Serial No: HP: Hours:

Excellent Average Below Average SalvageEngine Condition:

SternDrive: Condition:

Propeller:

Model: Type: Excellent Average Below Average Salvage

Excellent Average Below Average SalvageType: Condition:

Starboard

Excellent Average Below Average SalvageCondition:Type:Propeller:

Excellent Average Below Average SalvageCondition:Type:Model:SternDrive:

Excellent Average Below Average SalvageEngine Condition:

Hours:HP:Serial No:Model:Make:

Single: Twin: Triple: Gas: Diesel:

Type: Inboard: I/O: Outboard:

Generator

Excellent Average Below Average SalvageCondition:

Second Generator

Excellent Average Below Average SalvageCondition:

Serial No:Model:Make: Hours:

Hours:Serial No:Model:Make:

Third Engine

Excellent Average Below Average SalvageCondition:Type:Propeller:

Excellent Average Below Average SalvageCondition:Type:Model:SternDrive:

AverageExcellent Below Average SalvageEngine Condition:

Hours:HP:Serial No:Model:Make:

Excellent Average Below Average SalvageCondition:Type:Propeller:

Excellent Average Below Average SalvageCondition:Type:Model:SternDrive:

Engine Condition: SalvageBelow AverageAverageExcellent

Hours:HP:Serial No:Model:Make:Fourth Engine

Tilt:Foot Control:Manufacturer:Trolling Motor

Excellent Average Below Average SalvageCondition:

Serial No:

Comments on Overall Condition of Engines and Generators:

Key?: Yes No

Excellent Average Below Average SalvageInterior Flooring Material Condition:

CABIN

Comments:

Cabin Upholstery Condition:

Canvas Condition:

Dinghy/Outboard Condition:

Comments:

Comments:

Comments:

Excellent Average Below Average Salvage

Excellent Average Below Average Salvage

Excellent Average Below Average Salvage

Excellent Average Below Average Salvage

COCKPIT

Exterior Flooring Material Condition:

Exterior Upholstery Condition: Excellent Average Below Average Salvage

Rigging/Sails Condition: Excellent Average Below Average Salvage

Comments:

Comments:

Comments:

TRAILER

VIN: Year: Make: Model:Yes No

# of Axles: Gross Weight: Length: Type:

Yes NoPower Winch:

License Plate:

Excellent Average Below Average SalvageCondition:

Comments:

EQUIPMENT (P - Present; N - Not Present; I - Inoperable)

Canvas vessel cover: NP I NP IAir conditioning:

NP IAuto pilot:

NP IDepth sounder:

NP IDual battery switch:

Electric anchor winch:

Outboard power trim:

CB radio:

Marine radio:

Remote spotlight:

Bimini:

Hard top/canopy:

AM/FM radio:

Cassette:

CD:

Swim step:

Folder-down ladder:

Water injected headers:

Fire extinguisher:

Radar:

Radar arch:

Trim tabs:

Water temperature gauge:

Oil pressure gauge:

Fuel gauge:

Tachometer:

Speedometer:

Trash compactor:

Pressure water system:

Microwave:

Hot water system:

Ice maker:

Freezer:

Refrigerator AC/DC:

Bar:

Live bait well:

Depth finder:

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

NP I

Comments:

ELECTRONICS

Yes NoAll switched on:

Comments:

BATTERIES

Water Voltages Condition Bank #1 Bank #2 Bank #3

Battery selector switch setting:

Battery charger setting:

Comments:

GENERAL CHECK (C - Checked and Good; I - Issue)

P. Main S. Main Gen-1 Gen-2 Lube Oil

Fresh water Trans oil

Belt hose/clamps Sea strainer Zinc pencils

Raw water pump Oil leaks

Fuel system Raw water flow

Comments:

BILGE PUMPS (C - Checked and Good; I - Issue) LIGHTING (C - Checked and Good; I - Issue)

Engine room: IC Forward bilge:

Aft bilge:

Other bilges:

IC

IC

IC

IC

IC

IC

ICOther lights:

Navigation lights:

Exterior lights:

House lights:

Comments: Comments:

OTHER EQUIPMENT (C - Checked and Good; I - Issue)

Engine alarms:

Engine alternators-output:

Engine gauges upper/lower:

Engine shifts upper/lower:

Engine throttles upper/lower:

Steering (helm) upper/lower:

Horns:

Compass upper/lower:

Trim tabs:

Steering quadrant:

Rudder packing:

Water maker:

Fresh water pump & filter:

Fire system (engine room):

Fuel system (Leaks, etc.):

Thru-Hulls:

Strainers (ALL):

Stabilizers:

Shaft Packing:

Engine exhaust: Bilge Blower:

Paint condition:

Gel coat condition/wax:

Wood condition/oil:

Varnish condition:

Fenders:

Power cord:

Dock lines:

Bait system:

Shore boat:

Shore boat davit/motor:

Antennae:

Windlass:

Shower pumps:

Heads:

Fire extinguishers:

Reading:

Electrolysis control:

Air conditioning/heating:

General exhaust:

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

IC

Comments:

VESSEL DIAGRAM

Page of Operable?:

U.S. Department of Justice United States Marshals Service Vessel Tug/Tow Ticket INSTRUCTIONS: This form is to be utilized by the contractor or District Office only when a vessel is towed to the contractor facility. A copy of this form should be placed in the case file.

VESSEL

Stored:

HULL

Overall Hull Condition:

Hull Condition Starboard:

Deck Condition:

Hull Condition Port:

Bottom Condition:

ENGINE(S)

Port Engine Engine Condition:

SternDrive:

Condition:

Propeller:

Condition:

Starboard Condition:

Propeller:

Condition:

SternDrive:

Engine Condition:

Generator Condition:

Second Generator Condition:

Third Engine Condition:

Propeller:

Condition:

SternDrive:

Engine Condition:

Condition:

Propeller:

Condition:

SternDrive:

Engine Condition:

Fourth Engine Trolling Motor Condition:

Key?:

Interior Flooring Material Condition:

CABIN

Cabin Upholstery Condition:

Canvas Condition:

Dinghy/Outboard Condition:

COCKPIT

Exterior Flooring Material Condition:

Exterior Upholstery Condition:

Rigging/Sails Condition:

TRAILER

Power Winch:

Condition:

EQUIPMENT (P - Present; N - Not Present; I - Inoperable) Canvas vessel cover:

Air conditioning:

Auto pilot:

Depth sounder:

Dual battery switch:

Electric anchor winch:

Outboard power trim:

CB radio:

Marine radio:

Remote spotlight:

Bimini:

Hard top/canopy:

AM/FM radio:

Cassette:

CD:

Swim step:

Folder-down ladder:

Water injected headers:

Fire extinguisher:

Radar:

Radar arch:

Trim tabs:

Water temperature gauge:

Oil pressure gauge:

Fuel gauge:

Tachometer:

Speedometer:

Trash compactor:

Pressure water system:

Microwave:

Hot water system:

Ice maker:

Freezer:

Refrigerator AC/DC:

Bar:

Live bait well:

Depth finder:

ELECTRONICS

All switched on:

BATTERIES

Water Voltages Condition Bank #1 Bank #2 Bank #3 GENERAL CHECK (C - Checked and Good; I - Issue) P. Main S. Main Gen-1 Gen-2 Lube Oil Fresh water Trans oil Belt hose/clamps Sea strainer Zinc pencils Raw water pump Oil leaks Fuel system Raw water flow BILGE PUMPS (C - Checked and Good; I - Issue) LIGHTING (C - Checked and Good; I - Issue) Engine room:

Forward bilge:

Aft bilge:

Other bilges:

Other lights:

Navigation lights:

Exterior lights:

House lights:

OTHER EQUIPMENT (C - Checked and Good; I - Issue) Engine alarms:

Engine alternators-output:

Engine gauges upper/lower:

Engine shifts upper/lower:

Engine throttles upper/lower:

Steering (helm) upper/lower:

Horns:

Compass upper/lower:

Trim tabs:

Steering quadrant:

Rudder packing:

Water maker:

Fresh water pump & filter:

Fire system (engine room):

Fuel system (Leaks, etc.):

Thru-Hulls:

Strainers (ALL):

Stabilizers:

Shaft Packing:

Engine exhaust:

Bilge Blower:

Paint condition:

Gel coat condition/wax:

Wood condition/oil:

Varnish condition:

Fenders:

Power cord:

Dock lines:

Bait system:

Shore boat:

Shore boat davit/motor:

Antennae:

Windlass:

Shower pumps:

Heads:

Fire extinguishers:

Reading:

Electrolysis control:

Air conditioning/heating:

General exhaust:

VESSEL DIAGRAM

C:\Users\mprempooti\Pictures\vessel-diagram.jpg C:\Users\mprempooti\Pictures\vessel-diagram2.jpg