Sea Personal Injury Attorney ~ Seattle ~ Maritime Injury ~ Seattle Lawyer, Gary Wolfstone

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Maritime Casualty Checklist

You must insist upon full disclosure from the shipping company of all of the following details in each case.

General

Name: Date of birth:
Home address:
 
Rank or occupation:
Kind and serial number of mariner's documents or license, if any:
Issued by: Date of issue:
Mariner's school and date of graduation:
Total sea service:
Date signed on this vessel:
Duty station at time of casualty:

Particulars of Vessel

Name:
 Official No.:
Gross tonnage: Net tonnaqe:
Summer deadweight:
Flag: Port of registry:
Type (Freighter, passenger, tanker, etc.)
Name and address of owner(s):
 
 
Name and address of operator(s) or manager(s):
 
 
Name and address of agent(s):
 
 
Shipbuilders:  
Date of build: Where built:
Length overall: Breadth extreme:
Draught summer:
Propulsion (steam, diesel, etc.):
Number of engines:
Size (e.g., horse power):
Type:
Engine builders:
Where built:
Particulars of boilers:
Type of propeller(s): Direction of revolution:
 
Engine(s) Operation/Performance Envelope
Knots       RPM
Engine(s) at Full speed
Normal mode:
Maneuvering mode:
Engine(s) at Half Speed
Normal mode:
Maneuvering mode:
Engine(s) at Slow speed
Normal mode:
Engine(s) at Astern speed
Slow Astern mode:
Half Astern mode:
Full Astern mode:
Engine(s) at Emergency Full Astern
Emergency Astern mode:
 
Any troubles with the engine(s):
 
 
Navigational/Maneuvering Controls
Type       Location
Steering apparatus:
Any troubles with it:
Standard compass:
Steering compass:
Any deviation of index of error with steering compass:
Date when last checked:
Course recorder:
Whether operating at time of casualty:
Direction finder:
Whether operating at time of casualty:
Type of echo sounding apparatus:
Whether operating at time of casualty:
 
Number of gyro repeaters:
Whether operating at time of casualty: Operating on what range:
Distance from face or bridge to stem:
Height of bridge above water at time of casualty:
 
Navigation lights burning at time of casualty:
Watts of Bulb       Condition of Light
Mast head light(s):
Range light:
Side lights:
Stern light:

Particulars of Casualty

Original port of departure:
Time and date:
Port of call previous to casualty:
Time and date of departure:
Draft - Fore:
Draft - Aft:
Time and date of casualty:
Draft - Fore:
Draft - Aft:
Location of casualty:
Latitude and Longitude:
Distance and true bearing from charted object, dock, anchorage, etc.:
Body of water (geographical name):
Rules of the Road applicable:    __ Inland                __ International __ Other (specify)
Position of sunken ship:
 
Physical status at time of casualty:  
Heading of vessel:
Angle between vessels:
(show by drawing sketch of
 vessels with collision angle)
Speed over the ground:
Engine(s) working:__ Ahead               __ Astern: RPM:
Name and number of chart(s) used:
 
Weather conditions prevailing:  
__ Clear__ Partly Cloudy__ Overcast__ Fog
__ Rain__ Snow__ Moonlight__ Other (specify)
Visibility (miles, meters, yards, etc.):
Wind direction: Force in knots:
Gusty:    __ Yes               __ No
Tide or Current direction: Force:
Sea conditions when casualty occurred:
Height of sea: Height of swell:
Direction of sea: Direction of swell:
Did you observe the time of casualty by your watch or clock:
Was it fast or slow by the engine room clock:
 
Name of pilot:
Regulating Authority of pilot:
Where was the captain at the time of casualty:
When did he come to the bridge:
 
Other personnel on duty at the time of casualty:
Name and Rank       Location
1.
2.
3.
 
Who first sighted other vessel:
What was the location of the observer:
How did the observer inform you of the sighting (telephone, orally, etc.):
 
What time was the other ship first sighted:
By radar:
Visually (by eye or glasses):
On what bearing:
Estimated course and speed of the other ship:
Your vessell's compass course and speed at that time:
How would the vessels have passed if no action taken by either:
 
What lights of the other vessel were first seen:  
Type:
Distance:
Bearing:
Were they burning brightly:
Sighted by eye or glasses:
 
Response to sighting:
Event:       Time:
Helm action taken to avoid the casualty:
Engine action was taken to avoid casualty:
Signals heard from the other vessel:
 
Personnel involved:
This vessel:       Other vessel(s):
Total number of crew:
Deck department:
Engine department:
Steward department:
Total number of passengers:
Others (specify):
Total number of persons dead, injured, or missing:
 
Location of damage sustained to the vessel:
Any leakage of sea water:
Estimate cost for repairs:
Place where repairs were carried out:
Nature and amount of cargo:
Damage to cargo:


© 2004-2008. Seattle Lawyer, Gary L. Wolfstone
 
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