Title Page
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Conducted on
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Prepared by
Barge Information
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Vessel Name
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Barge Name
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Barge Owner
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Waterway
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Location (Mile Point or Latitude & Longitude)
Inspection
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Are decks clean?
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If no, were decks cleaned?
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Is the water around the barge free of sheen?
Supplemental Inspection
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Is water in voids sheen free?
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Voids to pump?
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Sheen present in the water after pumping void?
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Hopper pumped?
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Sheen present in the water after pumping hopper?
Corrective Actions
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List any corrective actions required (insert N/A if no corrective action is necessary):
Inspector
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Inspected by