Appendix D
Boating Accident Report
D-2
For each question below, please provide answers IF APPLICABLE AND IF KNOWN, otherwise leave blank.
YOUR
BOAT
BOAT IDENTIFICATION
Your Boat Name:
Manufacturer:
Model Name:
Model Year:
Registration #:
Documentation #:
Hull Identification #
(HIN)
:
Rented:
Yes
No
SIZE ESTIMATES
Length:
ft.
Depth from transom
(stern)
to keel
(bottommost point)
:
ft.
in.
Beam width at widest point:
ft.
HULL MATERIAL
Type of Hull Material
(select one)
Fiberglass
Wood
Rubber/vinyl/canvas
Other
(describe):
Aluminum
Steel
Plastic
BOAT TYPE
Boat Type
(select one)
Available Propulsion
(select all that apply)
Cabin motorboat
Inflatable boat
Personal watercraft
(PWC) (e.g., Wave
Runner
TM
, Jet Ski
TM
, Sea-Doo
TM
)
Paddlecraft:
Propeller
Air thrust
Open motorboat
Houseboat
Canoe
Sail
Other
(describe):
Kayak
Auxiliary sail
Sail
(only)
Air boat
Standup Paddleboard
Manual
Pontoon boat
Rowboat
Other (
describe
)
:
Water jet
ENGINE
# Engines
:
Engine type and horsepower
(select one)
Fuel type
(select all that apply)
Manufacturer
Outboard
Sterndrive
Inboard
Pod drive
Gas
Electric
Total horsepower:
hp
No engine
Other:
Diesel
Other:
SAFETY MEASURES
Organizations that have conducted a vessel safety check
(VSC)
on board your boat within the past year
(including carriage of safety
equipment, e.g., lifejackets, anchor and line, fire extinguishers):
US Coast Guard Auxiliary: VSC Decal?
Yes
No
US Power Squadrons:
VSC Decal?
Yes
No
Federal Agency
(Name)
:
State Agency (
Name)
:
Other Agency
(Name)
:
# Life jackets on board:
# Fire extinguishers on board:
Type of fire extinguishers
(e.g., ABC)
:
# Fire extinguishers used:
ACCIDENT DETAILS
–
EXTERNAL CONDITIONS
WEATHER
Overall weather was
(select one)
It was
(select one)
Visibility was
(select one)
Wind was
(select one)
Clear
Raining
Day
Good
0 mph
(none)
Cloudy
Snowing
Night
Fair
Over 0, up to 12 mph
(light)
Foggy
Hazy
Poor
Over 12, up to 25 mph (
moderate)
Other
(describe):
Approximate air temperature:
ºF
Over 25, up to 55 mph
(strong)
Over 55 mph (stormy)
WATER
Overall water conditions
(select one)
:
Other water conditions:
Up to 6 in. waves
(calm)
Approximate water temperature:
ºF
Over 6 in., up to 2 ft. waves
(choppy)
Strong current?
Yes
No
Over 2 ft., up to 6 ft. waves
(rough)
Hazardous waters?
(e.g., rapid tidal flow, currents)
Yes
No
Over 6 ft. waves
(very rough)
Congested waters?
Yes
No
CG-3865 (9/18)
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Summary of Contents for C49
Page 1: ...2022 STANDARDS OPTIONS 2022 OWNERS MANUAL ...
Page 4: ...This page intentionally left blank ...
Page 8: ...Safety Information ii 43 LS Operator Notes ...
Page 13: ...Safety Labels 3 43 LS 10 19 18 17 11 37 7 12 12 27 28 2 2 22 12 15 14 13 6 23 4 5 ...
Page 28: ...Section 1 Propulsion Systems 1 4 43 LS Operator Notes ...
Page 42: ...Section 3 Fuel Systems 3 8 43 LS Operator Notes ...
Page 66: ...Section 5 Plumbing Systems 5 12 43 LS Operator Notes ...
Page 78: ...Section 7 Exterior Equipment 7 10 43 LS Operator Notes ...
Page 98: ...Section 10 Operation 10 10 43 LS ...
Page 106: ...Section 11 Routine Maintenance 11 8 43 LS Operator Notes ...
Page 112: ...Section 12 Seasonal Maintenance 12 6 43 LS Operator Notes ...
Page 118: ...Appendix A Glossary of Terms A 6 Operator Notes ...
Page 120: ...Appendix B Maintenance Guides B 2 Operator Notes ...
Page 122: ...Appendix C Maintenance Schedule C 2 Date Hours Dealer Service Repairs ...
Page 123: ...Maintenance Schedule Appendix C C 3 Date Hours Dealer Service Repairs ...
Page 124: ...Appendix C Maintenance Schedule C 4 Date Hours Dealer Service Repairs ...
Page 131: ...Float Plan Appendix E E 1 Float Plan ...
Page 132: ...Appendix E Float Plan E 2 ...
Page 134: ...Appendix E Float Plan E 4 Operator Notes ...
Page 138: ...Appendix F Troubleshooting Guide F 4 Operator Notes ...
Page 139: ...Schematics Appendix G G 1 Schematics ...
Page 140: ...Appendix G Schematics G 2 ...
Page 141: ...Schematics Appendix G G 3 ...
Page 142: ...Appendix G Schematics G 4 ...
Page 143: ...Schematics Appendix G G 5 ...
Page 144: ...Appendix G Schematics G 6 ...
Page 145: ...Schematics Appendix G G 7 ...
Page 146: ...Appendix G Schematics G 8 ...
Page 147: ...Schematics Appendix G G 9 ...
Page 148: ...Appendix G Schematics G 10 ...
Page 149: ...Schematics Appendix G G 11 ...
Page 150: ...Appendix G Schematics G 12 ...
Page 151: ...Operator Notes ...
Page 152: ...725 E 40th Street Holland MI 49423 616 392 7163 tiarayachts com ...