Section 363-116-2051. Vessel certification form.

Washington State Board of Pilotage Commissioners

Date:

Vessel Name:

Flag:

MASTER'S CERTIFICATION

I, . . . . . . . . . . ., Master of this vessel, certify the following information:

I have notified the United States Coast Guard Captain of the Port of any deficiencies noted above and he has authorized the vessel to proceed. Any such deficiencies will be corrected before the time the vessel is scheduled to leave the waters of Washington state.

PILOT'S REPORT

I, . . . . . . . . . . ., a pilot licensed by the state of Washington, certify that upon boarding the above-named vessel on this date I requested to see the following certificates:

DEAD SHIP MOVEMENT

I, . . . . . . . . . . , owner, master, or agent's representative of this vessel, certify the following information:

[WSR 97-08-042, recodified as § 363-116-2051, filed 3/28/97, effective 3/28/97. Statutory Authority: RCW 88.16.155(7). WSR 92-08-052, § 296-116-2051, filed 3/26/92, effective 4/26/92. Statutory Authority: RCW 88.16.035 and 88.16.155. WSR 83-16-032 (Order 83-4, Resolution No. 83-4), § 296-116-2051, filed 7/28/83. Statutory Authority: RCW 88.16.155. WSR 79-11-097 (Order 79-6, Resolution No. 79-6), § 296-116-2051, filed 10/29/79. Statutory Authority: RCW 88.16.035 and 88.16.155. WSR 78-09-057 (Order 78-2, Resolution No. 78-2), § 296-116-2051, filed 8/23/78.]

WSR 97-08-042, recodified as § 363-116-2051, filed 3/28/97, effective 3/28/97. Statutory Authority: RCW 88.16.155(7). WSR 92-08-052, § 296-116-2051, filed 3/26/92, effective 4/26/92. Statutory Authority: RCW 88.16.035 and 88.16.155. WSR 83-16-032 (Order 83-4, Resolution No. 83-4), § 296-116-2051, filed 7/28/83. Statutory Authority: RCW 88.16.155. WSR 79-11-097 (Order 79-6, Resolution No. 79-6), § 296-116-2051, filed 10/29/79. Statutory Authority: RCW 88.16.035 and 88.16.155. WSR 78-09-057 (Order 78-2, Resolution No. 78-2), § 296-116-2051, filed 8/23/78.