CERTIFICATE OF RE-INSPECTION.pdf

A member of InflAtAble SAfety And SurvIvAl equIpment trAde ASSocIAtIon lImIted ISSettA form no 197

Certificate no.

CertifiCate of re-inspeCtion

Inflatable Liferaft Type: Serial Number: Date of Manufacture:

Fabric Type: Capacity: Length of Painter:

m/inside m/outside

Max Stowage height:

m

Identification:

Cylinders:

Equipment:

Tests:

Verification:

Flagstate of ship:

IMO No.

International call signal

Name of ship:

Ship owner:

Signature

For authorized servicing station

Serial No. Contents CO2 Contents N2 Latest hyd. test

Unit Type Serial No. Expiry date

Emergency pack:

EPIRB:

HRU test:

Radar Reflector:

First aid kit:

Nap-test Gas inflation test Floor seam test Load test davit launched Yes/No Yes/No Yes/No Yes/No

Latest Test: Latest Test: Latest Test: Latest Test:

Date of inspection: Service Station name and No. Date issued to ship:

National Marine authority ID No.

Remarks/modification:

Unit Serial No. Date of Manufacture

Humidity/CO2 Sensor:

2904776

This is to certify that the raft detailed below has been surveyed, controlled and tested in compliance with requirements from:

USCG and the manufacturer and in accordance with IMO resolution A.761 (18)

Elliot SoLaS Style Mk IV TO B02466 Lot 1175 Jun-2010

Natural Rubber 6 27 1 18

594546 3.380kg 0.140kg May-2020

Solas A Sep-2023

N/A

NONE

N/A

USCG Sep-2023

N/A

Yes No Yes No Sep-2022 May-2020 Sep-2022

16-Sep-2022 50450:

Puget Sound Inflatables Inc Head Office 21-Sep-2022

ANNUAL SERVICE AND INSPECTION - PREFORMED SB14/09 - MSO SEATTLE

According to SOLAS regulation, this inflatable liferaft requires servicing within 12 months from the date of inspection (above).

Eric Hutchison United States

NUWC VESSEL

NUWES

Survitec Group. Sharon Center Office:

1420 Wolf Creek Trail, PO Box 359, Sharon Center, OH 44274, USA, Tel: 330-239-4331

Powered by TCPDF (www.tcpdf.org)

1 / 1

Puget Sound Inflatables, Inc.

309 S. Cloverdale St., Bldg A-7 • Seattle, Washington 98108 • Phone 206-762-3877 • Toll Free 800-743-7238 • Fax 206-762-1250 www.life-raft.com Powered by TCPDF (www.tcpdf.org) http://www.tcpdf.org

SurvIvAl equIpment trAde ASSocIAtIon lImIted ISSettA form no 197

Certificate no.

CertifiCate of re-inspeCtion

Inflatable Liferaft Type: Serial Number: Date of Manufacture:

Fabric Type: Capacity: Length of Painter:

m/inside m/outside

Max Stowage height:

m

Identification:

Cylinders:

Equipment:

Tests:

Verification:

Flagstate of ship:

IMO No.

International call signal

Name of ship:

Ship owner:

Signature

For authorized servicing station

Serial No. Contents CO2 Contents N2 Latest hyd. test

Unit Type Serial No. Expiry date

Emergency pack:

EPIRB:

HRU test:

Radar Reflector:

First aid kit:

Nap-test Gas inflation test Floor seam test Load test davit launched Yes/No Yes/No Yes/No Yes/No

Latest Test: Latest Test: Latest Test: Latest Test:

Date of inspection: Service Station name and No. Date issued to ship:

National Marine authority ID No.

Remarks/modification:

Unit Serial No. Date of Manufacture

Humidity/CO2 Sensor:

2904777

This is to certify that the raft detailed below has been surveyed, controlled and tested in compliance with requirements from:

USCG and the manufacturer and in accordance with IMO resolution A.761 (18)

Elliot SoLaS Style Mk IV TO B02532 Lot 1175 Jun-2010

Natural Rubber 6 27 1 18

4101135 3.380kg 0.140kg May-2020

NONE

N/A

USCG Sep-2023

N/A

Yes No Yes No Sep-2022 Mar-2020 Sep-2022

16-Sep-2022 50450:

Puget Sound Inflatables Inc Head Office 21-Sep-2022

ANNUAL SERVICE AND INSPECTION - PREFORMED SB14/09 - MSO SEATTLE

According to SOLAS regulation, this inflatable liferaft requires servicing within 12 months from the date of inspection (above).

Survitec Group. Sharon Center Office:

1420 Wolf Creek Trail, PO Box 359, Sharon Center, OH 44274, USA, Tel: 330-239-4331

309 S. Cloverdale St., Bldg A-7 • Seattle, Washington 98108 • Phone 206-762-3877 • Toll Free 800-743-7238 • Fax 206-762-1250 www.life-raft.com Powered by TCPDF (www.tcpdf.org)

SurvIvAl equIpment trAde ASSocIAtIon lImIted ISSettA form no 197

Certificate no.

CertifiCate of re-inspeCtion

Inflatable Liferaft Type: Serial Number: Date of Manufacture:

Fabric Type: Capacity: Length of Painter:

m/inside m/outside

Max Stowage height:

m

Identification:

Cylinders:

Equipment:

Tests:

Verification:

Flagstate of ship:

IMO No.

International call signal

Name of ship:

Ship owner:

Signature

For authorized servicing station

Serial No. Contents CO2 Contents N2 Latest hyd. test

Unit Type Serial No. Expiry date

Emergency pack:

EPIRB:

HRU test:

Radar Reflector:

First aid kit:

Nap-test Gas inflation test Floor seam test Load test davit launched Yes/No Yes/No Yes/No Yes/No

Latest Test: Latest Test: Latest Test: Latest Test:

Date of inspection: Service Station name and No. Date issued to ship:

National Marine authority ID No.

Remarks/modification:

Unit Serial No. Date of Manufacture

Humidity/CO2 Sensor:

2904778

This is to certify that the raft detailed below has been surveyed, controlled and tested in compliance with requirements from:

USCG and the manufacturer and in accordance with IMO resolution A.761 (18)

Elliot SoLaS Style Mk IV TO B03546 Lot 1266 Apr-2011

Natural Rubber 20 45 1 36

M660054 8.800kg 0.440kg Aug-2021

NONE

N/A

USCG Sep-2023

N/A

Yes No Yes No Sep-2022 Aug-2021 Sep-2022

15-Sep-2022 50450:

Puget Sound Inflatables Inc Head Office 21-Sep-2022

ANNUAL SERVICE AND INSPECTION - PREFORMED SB14/09 - MSO SEATTLE

According to SOLAS regulation, this inflatable liferaft requires servicing within 12 months from the date of inspection (above).

Survitec Group. Sharon Center Office:

1420 Wolf Creek Trail, PO Box 359, Sharon Center, OH 44274, USA, Tel: 330-239-4331

309 S. Cloverdale St., Bldg A-7 • Seattle, Washington 98108 • Phone 206-762-3877 • Toll Free 800-743-7238 • Fax 206-762-1250 www.life-raft.com Powered by TCPDF (www.tcpdf.org)

SurvIvAl equIpment trAde ASSocIAtIon lImIted ISSettA form no 197

Certificate no.

CertifiCate of re-inspeCtion

Inflatable Liferaft Type: Serial Number: Date of Manufacture:

Fabric Type: Capacity: Length of Painter:

m/inside m/outside

Max Stowage height:

m

Identification:

Cylinders:

Equipment:

Tests:

Verification:

Flagstate of ship:

IMO No.

International call signal

Name of ship:

Ship owner:

Signature

For authorized servicing station

Serial No. Contents CO2 Contents N2 Latest hyd. test

Unit Type Serial No. Expiry date

Emergency pack:

EPIRB:

HRU test:

Radar Reflector:

First aid kit:

Nap-test Gas inflation test Floor seam test Load test davit launched Yes/No Yes/No Yes/No Yes/No

Latest Test: Latest Test: Latest Test: Latest Test:

Date of inspection: Service Station name and No. Date issued to ship:

National Marine authority ID No.

Remarks/modification:

Unit Serial No. Date of Manufacture

Humidity/CO2 Sensor:

2904779

This is to certify that the raft detailed below has been surveyed, controlled and tested in compliance with requirements from:

USCG and the manufacturer and in accordance with IMO resolution A.761 (18)

Elliot SoLaS Style Mk IV TO B03547 Lot 1266 Apr-2011

M658014 8.800kg 0.440kg Aug-2021

NONE

N/A

USCG Sep-2023

N/A

Yes No Yes No Sep-2022 Aug-2021 Sep-2022

06-Sep-2022 50450:

Puget Sound Inflatables Inc Head Office 21-Sep-2022

ANNUAL SERVICE AND INSPECTION - PREFORMED SB14/09 - MSO SEATTLE

According to SOLAS regulation, this inflatable liferaft requires servicing within 12 months from the date of inspection (above).

Survitec Group. Sharon Center Office:

1420 Wolf Creek Trail, PO Box 359, Sharon Center, OH 44274, USA, Tel: 330-239-4331

309 S. Cloverdale St., Bldg A-7 • Seattle, Washington 98108 • Phone 206-762-3877 • Toll Free 800-743-7238 • Fax 206-762-1250 www.life-raft.com Powered by TCPDF (www.tcpdf.org)

SurvIvAl equIpment trAde ASSocIAtIon lImIted ISSettA form no 197

Certificate no.

CertifiCate of re-inspeCtion

Inflatable Liferaft Type: Serial Number: Date of Manufacture:

Fabric Type: Capacity: Length of Painter:

m/inside m/outside

Max Stowage height:

m

Identification:

Cylinders:

Equipment:

Tests:

Verification:

Flagstate of ship:

IMO No.

International call signal

Name of ship:

Ship owner:

Signature

For authorized servicing station

Serial No. Contents CO2 Contents N2 Latest hyd. test

Unit Type Serial No. Expiry date

Emergency pack:

EPIRB:

HRU test:

Radar Reflector:

First aid kit:

Nap-test Gas inflation test Floor seam test Load test davit launched Yes/No Yes/No Yes/No Yes/No

Latest Test: Latest Test: Latest Test: Latest Test:

Date of inspection: Service Station name and No. Date issued to ship:

National Marine authority ID No.

Remarks/modification:

Unit Serial No. Date of Manufacture

Humidity/CO2 Sensor:

2905041

This is to certify that the raft detailed below has been surveyed, controlled and tested in compliance with requirements from:

USCG and the manufacturer and in accordance with IMO resolution A.761 (18)

Elliot SoLaS Style Mk III TO S0944 Lot 812 Feb-2006

Polyurethane 25 45 1 36

4455151 19.230lb 2.340lb Aug-2021

NONE

N/A

USCG Sep-2023

N/A

Yes No Yes No Sep-2022 Aug-2021 Sep-2022

06-Sep-2022 50450:

Puget Sound Inflatables Inc Head Office 21-Sep-2022

ANNUAL SERVICE AND INSPECTION - PREFORMED SB14/09 - MSO SEATTLE

According to SOLAS regulation, this inflatable liferaft requires servicing within 12 months from the date of inspection (above).

Brian Hough

Survitec Group. Sharon Center Office:

1420 Wolf Creek Trail, PO Box 359, Sharon Center, OH 44274, USA, Tel: 330-239-4331

309 S. Cloverdale St., Bldg A-7 • Seattle, Washington 98108 • Phone 206-762-3877 • Toll Free 800-743-7238 • Fax 206-762-1250 www.life-raft.com Powered by TCPDF (www.tcpdf.org)

SurvIvAl equIpment trAde ASSocIAtIon lImIted ISSettA form no 197

Certificate no.

CertifiCate of re-inspeCtion

Inflatable Liferaft Type: Serial Number: Date of Manufacture:

Fabric Type: Capacity: Length of Painter:

m/inside m/outside

Max Stowage height:

m

Identification:

Cylinders:

Equipment:

Tests:

Verification:

Flagstate of ship:

IMO No.

International call signal

Name of ship:

Ship owner:

Signature

For authorized servicing station

Serial No. Contents CO2 Contents N2 Latest hyd. test

Unit Type Serial No. Expiry date

Emergency pack:

EPIRB:

HRU test:

Radar Reflector:

First aid kit:

Nap-test Gas inflation test Floor seam test Load test davit launched Yes/No Yes/No Yes/No Yes/No

Latest Test: Latest Test: Latest Test: Latest Test:

Date of inspection: Service Station name and No. Date issued to ship:

National Marine authority ID No.

Remarks/modification:

Unit Serial No. Date of Manufacture

Humidity/CO2 Sensor:

2918626

This is to certify that the raft detailed below has been surveyed, controlled and tested in compliance with requirements from:

USCG and the manufacturer and in accordance with IMO resolution A.761 (18)

Elliot SoLaS Style Mk IV TO B03289 Lot 1252 Feb-2011

Special Blend 6 27 1 18

M504018 3.380kg 0.140kg Nov-2021

Solas A Nov-2023

NONE

N/A

USCG Nov-2023

N/A

Yes No Yes No Nov-2022 Nov-2021 Nov-2022

23-Nov-2022 50450:

Puget Sound Inflatables Inc Head Office 30-Nov-2022

ANNUAL SERVICE AND INSPECTION - PREFORMED SB14/09 - MSO SEATTLE

According to SOLAS regulation, this inflatable liferaft requires servicing within 12 months from the date of inspection (above).

Survitec Group. Sharon Center Office:

1420 Wolf Creek Trail, PO Box 359, Sharon Center, OH 44274, USA, Tel: 330-239-4331

309 S. Cloverdale St., Bldg A-7 • Seattle, Washington 98108 • Phone 206-762-3877 • Toll Free 800-743-7238 • Fax 206-762-1250 www.life-raft.com Powered by TCPDF (www.tcpdf.org)

SurvIvAl equIpment trAde ASSocIAtIon lImIted ISSettA form no 197

Certificate no.

CertifiCate of re-inspeCtion

Inflatable Liferaft Type: Serial Number: Date of Manufacture:

Fabric Type: Capacity: Length of Painter:

m/inside m/outside

Max Stowage height:

m

Identification:

Cylinders:

Equipment:

Tests:

Verification:

Flagstate of ship:

IMO No.

International call signal

Name of ship:

Ship owner:

Signature

For authorized servicing station

Serial No. Contents CO2 Contents N2 Latest hyd. test

Unit Type Serial No. Expiry date

Emergency pack:

EPIRB:

HRU test:

Radar Reflector:

First aid kit:

Nap-test Gas inflation test Floor seam test Load test davit launched Yes/No Yes/No Yes/No Yes/No

Latest Test: Latest Test: Latest Test: Latest Test:

Date of inspection: Service Station name and No. Date issued to ship:

National Marine authority ID No.

Remarks/modification:

Unit Serial No. Date of Manufacture

Humidity/CO2 Sensor:

2918627

This is to certify that the raft detailed below has been surveyed, controlled and tested in compliance with requirements from:

USCG and the manufacturer and in accordance with IMO resolution A.761 (18)

Elliot SoLaS Style Mk IV TO B03676 Lot 1266 May-2011

M659175 8.800kg 0.440kg Aug-2021

NONE

N/A

USCG Nov-2023

N/A

Yes No Yes No Nov-2022 Aug-2021 Nov-2022

14-Nov-2022 50450:

Puget Sound Inflatables Inc Head Office 30-Nov-2022

ANNUAL SERVICE AND INSPECTION - PREFORMED SB14/09 - MSO SEATTLE

According to SOLAS regulation, this inflatable liferaft requires servicing within 12 months from the date of inspection (above).

Survitec Group. Sharon Center Office:

1420 Wolf Creek Trail, PO Box 359, Sharon Center, OH 44274, USA, Tel: 330-239-4331

309 S. Cloverdale St., Bldg A-7 • Seattle, Washington 98108 • Phone 206-762-3877 • Toll Free 800-743-7238 • Fax 206-762-1250 www.life-raft.com Powered by TCPDF (www.tcpdf.org)

SurvIvAl equIpment trAde ASSocIAtIon lImIted ISSettA form no 197

Certificate no.

CertifiCate of re-inspeCtion

Inflatable Liferaft Type: Serial Number: Date of Manufacture:

Fabric Type: Capacity: Length of Painter:

m/inside m/outside

Max Stowage height:

m

Identification:

Cylinders:

Equipment:

Tests:

Verification:

Flagstate of ship:

IMO No.

International call signal

Name of ship:

Ship owner:

Signature

For authorized servicing station

Serial No. Contents CO2 Contents N2 Latest hyd. test

Unit Type Serial No. Expiry date

Emergency pack:

EPIRB:

HRU test:

Radar Reflector:

First aid kit:

Nap-test Gas inflation test Floor seam test Load test davit launched Yes/No Yes/No Yes/No Yes/No

Latest Test: Latest Test: Latest Test: Latest Test:

Date of inspection: Service Station name and No. Date issued to ship:

National Marine authority ID No.

Remarks/modification:

Unit Serial No. Date of Manufacture

Humidity/CO2 Sensor:

2918628

This is to certify that the raft detailed below has been surveyed, controlled and tested in compliance with requirements from:

USCG and the manufacturer and in accordance with IMO resolution A.761 (18)

Elliot SoLaS Style Mk IV TO B04244 Lot 1316 Dec-2011

Natural Rubber 20 27 1 18

M337147 8.800kg 0.440kg Nov-2021

NONE

N/A

USCG Nov-2023

N/A

Yes No Yes No Nov-2022 Nov-2021 Nov-2022

22-Nov-2022 50450:

Puget Sound Inflatables Inc Head Office 30-Nov-2022

ANNUAL SERVICE AND INSPECTION - PREFORMED SB14/09 - MSO SEATTLE

According to SOLAS regulation, this inflatable liferaft requires servicing within 12 months from the date of inspection (above).

Survitec Group. Sharon Center Office:

1420 Wolf Creek Trail, PO Box 359, Sharon Center, OH 44274, USA, Tel: 330-239-4331

309 S. Cloverdale St., Bldg A-7 • Seattle, Washington 98108 • Phone 206-762-3877 • Toll Free 800-743-7238 • Fax 206-762-1250 www.life-raft.com Powered by TCPDF (www.tcpdf.org)

SurvIvAl equIpment trAde ASSocIAtIon lImIted ISSettA form no 197

Certificate no.

CertifiCate of re-inspeCtion

Inflatable Liferaft Type: Serial Number: Date of Manufacture:

Fabric Type: Capacity: Length of Painter:

m/inside m/outside

Max Stowage height:

m

Identification:

Cylinders:

Equipment:

Tests:

Verification:

Flagstate of ship:

IMO No.

International call signal

Name of ship:

Ship owner:

Signature

For authorized servicing station

Serial No. Contents CO2 Contents N2 Latest hyd. test

Unit Type Serial No. Expiry date

Emergency pack:

EPIRB:

HRU test:

Radar Reflector:

First aid kit:

Nap-test Gas inflation test Floor seam test Load test davit launched Yes/No Yes/No Yes/No Yes/No

Latest Test: Latest Test: Latest Test: Latest Test:

Date of inspection: Service Station name and No. Date issued to ship:

National Marine authority ID No.

Remarks/modification:

Unit Serial No. Date of Manufacture

Humidity/CO2 Sensor:

2918629

This is to certify that the raft detailed below has been surveyed, controlled and tested in compliance with requirements from:

USCG and the manufacturer and in accordance with IMO resolution A.761 (18)

Elliot SoLaS Style Mk IV TO B04324 Lot 1316 Dec-2011

M341183 8.800kg 0.440kg Nov-2021

NONE

N/A

USCG Nov-2023

N/A

Yes No Yes No Nov-2022 Nov-2021 Nov-2022

22-Nov-2022 50450:

Puget Sound Inflatables Inc Head Office 30-Nov-2022

ANNUAL SERVICE AND INSPECTION - PREFORMED SB14/09 - MSO SEATTLE

According to SOLAS regulation, this inflatable liferaft requires servicing within 12 months from the date of inspection (above).

Survitec Group. Sharon Center Office:

1420 Wolf Creek Trail, PO Box 359, Sharon Center, OH 44274, USA, Tel: 330-239-4331

309 S. Cloverdale St., Bldg A-7 • Seattle, Washington 98108 • Phone 206-762-3877 • Toll Free 800-743-7238 • Fax 206-762-1250 www.life-raft.com Powered by TCPDF (www.tcpdf.org)

SurvIvAl equIpment trAde ASSocIAtIon lImIted ISSettA form no 197

Certificate no.

CertifiCate of re-inspeCtion

Inflatable Liferaft Type: Serial Number: Date of Manufacture:

Fabric Type: Capacity: Length of Painter:

m/inside m/outside

Max Stowage height:

m

Identification:

Cylinders:

Equipment:

Tests:

Verification:

Flagstate of ship:

IMO No.

International call signal

Name of ship:

Ship owner:

Signature

For authorized servicing station

Serial No. Contents CO2 Contents N2 Latest hyd. test

Unit Type Serial No. Expiry date

Emergency pack:

EPIRB:

HRU test:

Radar Reflector:

First aid kit:

Nap-test Gas inflation test Floor seam test Load test davit launched Yes/No Yes/No Yes/No Yes/No

Latest Test: Latest Test: Latest Test: Latest Test:

Date of inspection: Service Station name and No. Date issued to ship:

National Marine authority ID No.

Remarks/modification:

Unit Serial No. Date of Manufacture

Humidity/CO2 Sensor:

2918630

This is to certify that the raft detailed below has been surveyed, controlled and tested in compliance with requirements from:

USCG and the manufacturer and in accordance with IMO resolution A.761 (18)

Elliot SoLaS Style Mk IV TO B04945 Lot 1341 Jun-2012

11d123134 8.800kg 0.440kg Nov-2022

NONE

N/A

USCG Nov-2023

N/A

Yes Yes Yes No Nov-2022 Nov-2022 Nov-2022

18-Nov-2022 50450:

Puget Sound Inflatables Inc Head Office 30-Nov-2022

ANNUAL SERVICE AND INSPECTION - PREFORMED SB14/09 - MSO SEATTLE

According to SOLAS regulation, this inflatable liferaft requires servicing within 12 months from the date of inspection (above).

Survitec Group. Sharon Center Office:

1420 Wolf Creek Trail, PO Box 359, Sharon Center, OH 44274, USA, Tel: 330-239-4331

309 S. Cloverdale St., Bldg A-7 • Seattle, Washington 98108 • Phone 206-762-3877 • Toll Free 800-743-7238 • Fax 206-762-1250 www.life-raft.com Powered by TCPDF (www.tcpdf.org)

SurvIvAl equIpment trAde ASSocIAtIon lImIted ISSettA form no 197

Certificate no.

CertifiCate of re-inspeCtion

Inflatable Liferaft Type: Serial Number: Date of Manufacture:

Fabric Type: Capacity: Length of Painter:

m/inside m/outside

Max Stowage height:

m

Identification:

Cylinders:

Equipment:

Tests:

Verification:

Flagstate of ship:

IMO No.

International call signal

Name of ship:

Ship owner:

Signature

For authorized servicing station

Serial No. Contents CO2 Contents N2 Latest hyd. test

Unit Type Serial No. Expiry date

Emergency pack:

EPIRB:

HRU test:

Radar Reflector:

First aid kit:

Nap-test Gas inflation test Floor seam test Load test davit launched Yes/No Yes/No Yes/No Yes/No

Latest Test: Latest Test: Latest Test: Latest Test:

Date of inspection: Service Station name and No. Date issued to ship:

National Marine authority ID No.

Remarks/modification:

Unit Serial No. Date of Manufacture

Humidity/CO2 Sensor:

2918631

This is to certify that the raft detailed below has been surveyed, controlled and tested in compliance with requirements from:

USCG and the manufacturer and in accordance with IMO resolution A.761 (18)

Elliot SoLaS Style Mk IV TO B06710 Lot 1463 Aug-2013

Natural Rubber 10 27 1 18

12d025054 11.860lb 0.590lb Nov-2018

NONE

N/A

USCG Nov-2023

N/A

No No No No Nov-2018

14-Nov-2022 50450:

Puget Sound Inflatables Inc Head Office 30-Nov-2022

ANNUAL SERVICE AND INSPECTION - PREFORMED SB14/09 - MSO SEATTLE

According to SOLAS regulation, this inflatable liferaft requires servicing within 12 months from the date of inspection (above).

Survitec Group. Sharon Center Office:

1420 Wolf Creek Trail, PO Box 359, Sharon Center, OH 44274, USA, Tel: 330-239-4331

309 S. Cloverdale St., Bldg A-7 • Seattle, Washington 98108 • Phone 206-762-3877 • Toll Free 800-743-7238 • Fax 206-762-1250 www.life-raft.com Powered by TCPDF (www.tcpdf.org)

SurvIvAl equIpment trAde ASSocIAtIon lImIted ISSettA form no 197

Certificate no.

CertifiCate of re-inspeCtion

Inflatable Liferaft Type: Serial Number: Date of Manufacture:

Fabric Type: Capacity: Length of Painter:

m/inside m/outside

Max Stowage height:

m

Identification:

Cylinders:

Equipment:

Tests:

Verification:

Flagstate of ship:

IMO No.

International call signal

Name of ship:

Ship owner:

Signature

For authorized servicing station

Serial No. Contents CO2 Contents N2 Latest hyd. test

Unit Type Serial No. Expiry date

Emergency pack:

EPIRB:

HRU test:

Radar Reflector:

First aid kit:

Nap-test Gas inflation test Floor seam test Load test davit launched Yes/No Yes/No Yes/No Yes/No

Latest Test: Latest Test: Latest Test: Latest Test:

Date of inspection: Service Station name and No. Date issued to ship:

National Marine authority ID No.

Remarks/modification:

Unit Serial No. Date of Manufacture

Humidity/CO2 Sensor:

2918637

This is to certify that the raft detailed below has been surveyed, controlled and tested in compliance with requirements from:

USCG and the manufacturer and in accordance with IMO resolution A.761 (18)

Elliot SoLaS Style Mk IV TO B03290 Lot 1252 Feb-2011

Special Blend 6 27 1 18

M504090 3.380kg 0.140kg Nov-2021

NONE

N/A

USCG Nov-2023

N/A

Yes No Yes No Nov-2022 Nov-2021 Nov-2022

23-Nov-2022 50450:

Puget Sound Inflatables Inc Head Office 30-Nov-2022

ANNUAL SERVICE AND INSPECTION - PREFORMED SB14/09 - MSO SEATTLE

According to SOLAS regulation, this inflatable liferaft requires servicing within 12 months from the date of inspection (above).

Survitec Group. Sharon Center Office:

1420 Wolf Creek Trail, PO Box 359, Sharon Center, OH 44274, USA, Tel: 330-239-4331

309 S. Cloverdale St., Bldg A-7 • Seattle, Washington 98108 • Phone 206-762-3877 • Toll Free 800-743-7238 • Fax 206-762-1250 www.life-raft.com Powered by TCPDF (www.tcpdf.org)

INFLATABLE SAFETY AND

SURVIVAL EQUIPMENT

TRADE ASSOCIATION LIMITED

ISSETTA FORM NU 197

iELLIDi Certlfkate 2757148 No

CERTIFICATE OF RE-INSPECTION

This is to certify thar the rar1 detailed below has been surveyed, controlled and tested in compliance with requirements frum:

USCG and the manufacturer and in ac1.-ord:mce willl IMO resolution A,761 {18)

Inflatable Liferaft hlenti!icatiun: Tyre: ~eri•l Number: Date nf :'>13nufacturc:

Elliot SuLaS Style Mk IV TO B04315 Lot 1315 Dtc-2011

F•bri• rype: I Capacily: l•nNlh ur P.Jinlcr: Max ~tow.ii,: he,~ht:

Nalural Rubber 20 27111/lnslJc 1 mfout11Jc 18m

Cylinders: So!ri3l No. Contents CO2 Cont,·11ts !\2 1.31.st hytl l<st

M338026 19,4001b 6.9701b Dtt•2016

Equipment: Unit Type

En1~rgen.y po.:k: Solas A Nov-2021

EPIRB: NIA

HRUtest: NONE

Radar Refic,tor: NIA

First aid kit· USCG No,·•2021 l,mt Date of:1,1.inuta.turc

1 HumiJityiCOZ Sensor:

Tests: Gas inflation tc,,l J:lnor seam t..'~t lo,1<J t,•st J1vit laur>cneJ

Yes/No No Yes/No No I Yes/No No I Yes/No No J,..1tcU 1,1L: L.1tc:s1 f 1!1-t: Dec-2016 I L;,t~bl T\!it. I Ltlt\!,it T1.:fi.l:

Verification: Date or inspection: Service Station naml! and Nu. I Date issued to shiv:

25-Nov-2020 50450: P1111et Souad lntlatables Ille Had Office 03-Dec-2020

National Marine llcmark,;/m0Jilirnlio11:

.iuthority II) Nn. ANNUAL SERVICE AND INSPECTION •PERFORMED S014/09. MSO SEArrLE

According to SOLAS regulation, this in0atable lil"eraft requires servici11g within 12 months fmm the date or m,pection (obo,e>.

IMONo.

l 11lmmlional call signal

Name of ship:

Ship uwner:

Eric Hutchison United States

US NAVY

NAVAL UNDERSEA WARFARE !:>ignaturc

Survit~ Group. Sharon Cenl<r Offi ce.

1420 Wolf Creek Trail, PO BOJ< 359. Shoron Center. OH 44274. USA. Tel 330-239-1331

Puget Sound Inflatables, Inc.

309 s. Cloverdale St., Bldg A·7 • Seattle, Washington 98108 • Phone 206-762·3877 • Toll Free 800-743-7238 • Fax 206-762-1250 www.life-raft.com

SURVIVAL EQUIPMENT i:LLIDi C,:nilkale 2757149

No. TRADE ASSOCIATION LIMllED ISSETTA FOlU,I NO 197

CERTIFICATE OF RE-INSPECTION

This is to cenify 1ha1 the raft de1ailed below ha. been surveyed, controlled and lested in ~-urnpliance with requiremenls from:

USCG and lhe manufacturer and in :u:conlance wuh IMO resululion A.761 (18)

Inflatable Liferaft ltkntifii.:at iun· 1'ype: ~eriJI :,. umhcr Date of /lfanulJclure:

Elliot SuLaS Stylt Mk IV TO B04326 Lot 1316 Dec-2011 l·abri, l'ype: I ~;va'•lY, LenHth of l'Jmkr· Max ~low,*~ lm~hl:

Nntural Rubbtr 27m/insidc I m1,,u1s,J, 18111

Cylinders: S.:ri.il No. Contents CO? ContL·nls S 2 l.att sl Ii) d. k .C

M337007 19.4001b 0,!170lb Dff-2016

Equipment: Unit

F.1n~rJ!em:y pa-:~ Solas A Nov-2021

EPIRB: NIA

HRUtcst: NONE

Radar Rctlc.:tor: NIA

First aid k11 : USCG Nov-2021

Unit ScriJI ~ O. Date ot Manulacto rc I Humidity/CO~ Seruor:

Nap -test I o.ul 1c1:1 ,.l,1v11 luu ni:hcd

No I Yes/ No No I Yes/No No No Ll<ICSI Test Dec-2016 I t .iul Tc,1

Verilkation: Date of inspection: Service Slalion name and No I Dale is.,;uc<l 10 ~h,p:

25-Nov-2020 50450: Pugtt Souod lnflalables In~ H•ad Offl« 03-Dec-2020

National Marin.• Rcmarl..,/muJilicatiun:

authority m No. ANNUAL SER VICE AND INSPECTION -PERFORMED SD 14109. MSO SEA TILE

According lo SOLAS rcgulution, 1h1s ,nllatable hfer.ift requircs serv,cinp w11l11n 12 months from the dale of inspcct,on (alxivc).

l'l,,gstato: of ship: United States Eric Hutchison

!'or authorized servicing stJtiun

I I

IMO No.

lnt.,·rnational ull sign~I

Name of ship: US NAVY ~ ~'n--- Shir uwner: NAVAL UNDERSEA WARFARE

Surv,te~ Group. Sharon Center Office:

1410 Wolf Creek Trail, PO Box 359, Sharon Center. OH 44274. USA. Tel: J30-239-433 I

Puget Sound Inflatables, Inc.

309 s. Cloverdale St., Bldg A-7 • Seattle, Washington 98108 • Phone 206-762-3877 • Toll Free 800-743-7238 • Fax 206·762-12S0

SURVIVAL EQUIPMENT

TRADE ASSOC IA T1ON LIMITED

JSSETTA f'ORM NO 197 i:LLIDi Certificate 2757132 No

CERTIFICATE OF RE-INSPECTION

This is to cenif y thar the raJt detailed below has been surveyed, controlled and tested in comph:mce " ith requirement, from:

USCG and the manufacturer and in accordance with IMO resolution A.761 ( lll)

Inflatable Liferaft ldcnli!icalion: Tyrt•: Seri.ii Xumhcr: llatc nf Manuf.tctur~:

Elliot SoLaS Style Mk JV TO B07060 Lot 1484 Dtt,2.013 hlirk Typ,:: I t;apa,·ity· Length uf l'amler. M;u ~luw•~• hei~il:

Nalural Rubber 10 4Sm/mstJe l m.touts1llc 36m

Cylindt:rs: Serial No. Contents CO2 Cont,uts :-2 l.201251!/0 11.8601b 0.9701b Nov•2018

Equipment: Lnit Expiry dJtr

Emergen,-y pa.:k: Solas A Nov-2021

EPIRB: NIA

HRUtcst: NONE

Radar Reflector: NIA First ai<I kit: USCG Nov-2021 t:uit Scrnll ]'.;o, Dale of Manuta,turc I Humidity/CO2 Sensor: I NIA

Tests: N ap -tcs1 Gas inlla11un test Floor st am test I odd t~•t J Jvit laun,h~d

I Yes/No No I Yes/No No Yrs/No No YcsfNo No f Lares, T~tt: I t..u.., r,,1. Nov-2018 l.01<,1 Tc;I· Late~1 'Jbt.:

Verification: Date of inspection: Service Station name and No. I nate in ueJ to ship:

24-Nov-2020 $04S0: Puget So1111d lnllalabln Inc !load Ollltt 03-Dec-2020

National Marine Rcmarks/moJ ilicallun:

authority In No. ANNUAL SERVICE AND INSPECTION •PERFORMED S814/09. MSO SEA TILE

Aa:urding to SOLAS regulation, this inflatable lifernft require~ scrvi,ing within 12 months from the date of inspec1mn tubuve) l'lagstatc of ship:

IMO No.

I nt~rnalional call s11tnal

Name of ship:

Ship owner:

United States

USNAVY

NAVAL UNDERSEA WARFARE

Survitcc Group. Sharon Center Office:

Brian Hough for authoriu·d servicing statwn

,., 2. <t,t,11

Signature t J

1420 Wulf Creek Trail, PO B<n 359, Sharon Cemer. OH 44274. USA. Tel. 330-239-4331

Puget Sound Inflatables, Inc.

I I

309 s. Cloverdale St., Bldg A-7 • Seattle, Washington 98108 • Phone 206-762-3877 • Toll Free 800·743-7238 •

Fax 206-762·1250

SURVIVAL EQUIPMENT

TR/\DE ASSOCIATION LIMITED

ISSE'ffA FORM NO 197 i:LLIDi Ccrtifkate 2757153 No

CERTIFICATE OF RE-INSPECTION

Tius is lo certify that the raft detailed below hll5 bc•n surveye<l. controlled and tested in wmplo:uicc w,th requirement~ from:

USCG and the manufaclUJ'er and m acconlance with IMO reso)ut,on A.761 (18)

Inflatable Liferaft lyre: Serial i'-nmhcr: Date of Manufacture :

Elliot SoLaS Style Mk m TO S 1298 Lut 833 Apr-20ll(j l·ahrK fn1c: l~P:l\"ll) .. Longlh uf l'dtnkr, Ma."( MuwJ~t' he1~hl:

Polyul'l!thane 45 rn/lnslJc 1 mfllutsiJc 36m

Cylinders: Contenls CO? Cont,·nts N ? l.arc,t hytl test

3200346 19.2301b 2J40lb Dec•2016

Equipment: Unit Expiry J•tc

F ll\l' rc<.·n.:y pack.: Solas A Nov-2021

EPIRB, N/A

IIRU l,'SI: NONE

Radar Reflc.:tor: N/A

First a,J kit:

USCG Nov-2021

Unit Serial No. D.llc of Manufacture I Humidity/CO2 Sensor:

Tests: Nap-test Gas inflat ion test l.o.iJ test J,.vit lau n.:hcJ

Yes/No Yes Yes/No No Yes/No Yes Yes/ No No Nov-2020 Dec-2016 LitcJl Test Nov-2020 1,1c,1 fo1, Verification: Date of inspection: Scrvrce Station oam~ anJ No. I Date issued to ship:

17-Nov-2020 S0450: PuRol Sound lnllolahles Inc H•od omco 03-Dec-2020

National Manne Remarks/moJificallon:

authority II) No. ANNUAL SERVICE AND INSPE(.'TlON •PERFORMED S814/09 · \\ISO SEATTLE

According to SOLAS rcgul:itton. this inflamblc lifcmft requiru ser,icing wilhin 12 months from the date of inspcc1ion Cabove)

Flagslatc of ship:

IMO No.

International call signal

Name of ihip:

Ship owner:

United States Brian Hough

USNAVY

NAVAL UNDERSEA WARFARE

,~) ."7 F0< a,<h0<iuJ •e,·••"• s<•hoo

~ .)v't>~,,_ '-c~ , dA,, l 5ignaturc 1

Survitcc Group. Sharon Center Office:

1420 Wolf Creek Trail. PO Box 359. Sharon Center. OH 44274, USA. Tel 330-231}-4331

Puget Sound Inflatables, Inc.

309 s. Cloverdale st., Bldg A-7 • Seattle, Washington 98108 • Phone 206-762-3877 • Toll Free 800-743-7238 • Fax 206-762-1250 www .life-raft.com