Title Page

  • Conducted on

  • Prepared by

Barge Information

  • Vessel Name

  • Barge Name

  • Barge Owner

  • Waterway

  • Location (Mile Point or Latitude & Longitude)


  • Are decks clean?

  • If no, were decks cleaned?

  • Is the water around the barge free of sheen?

Supplemental Inspection

  • Is water in voids sheen free?

  • Voids to pump?

  • Sheen present in the water after pumping void?

  • Hopper pumped?

  • Sheen present in the water after pumping hopper?

Corrective Actions

  • List any corrective actions required (insert N/A if no corrective action is necessary):


  • Inspected by

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