Dbw Form Bar 1 PDF Details

In the realm of recreational boating in California, the responsibility to maintain safety and report any mishap falls significantly on the vessel operator. Following the guidelines set forth by Section 656 of the Harbors and Navigation Code, the DBW BAR 1 form serves as a crucial document, detailing the procedure for reporting boating accidents. Required in circumstances that involve personal injuries needing more treatment than first aid, deaths, disappearances, substantial property damage exceeding $500, or the total loss of a vessel, this form mandates timely submission to the California Department of Boating and Waterways. Deadlines are stringent, with a 48-hour window for reporting deaths, disappearances, or serious injuries, and a 10-day period for all other reportable incidents. The form extends beyond mere documentation, providing insights on weather and water conditions, accident specifics including types of collisions, and potential contributing factors such as operator inattention or equipment failure. Additionally, it incorporates information regarding the involved vessels, operator experience, and safety gear in use at the time of the accident. Non-compliance with this reporting requirement is not taken lightly, carrying misdemeanor charges that could lead to fines up to $1000, imprisonment, or both. This document not only facilitates legal and administrative processes but also plays an integral role in boating safety research, contributing to the ongoing efforts to prevent future accidents, with a copy of the report also being forwarded to the United States Coast Guard.

QuestionAnswer
Form NameDbw Form Bar 1
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesBAR california boating accident report form

Form Preview Example

CALIFORNIA BOATING ACCIDENT REPORT

CALIFORNIA DEPARTMENT OF BOATING AND WATERWAYS

The operator of every recreational vessel is required by Section 656 of the Harbors and Navigation Code to file a written report whenever a boating accident occurs which results in death, disappearance, injury that requires medical attention beyond first aid, total property damage in excess of $500, or complete loss of a vessel. Reports must be submitted within 48 hours in case of death occurring within 24 hours of an accident, disappearance, or injury beyond first aid. All other reports must be submitted within 10 days of the accident. Reports are to be submitted to the California Department of Boating and Waterways at 2000 Evergreen Street, Suite 100, Sacramento, California 95815-3888, (916) 263-8189. Failure to submit this report as required is a misdemeanor and is punishable by a fine not to exceed $1000 or imprisonment not to exceed 6 months or both.

DATE OF ACCIDENT (M/D/Y)

 

TIME OF ACCIDENT

COUNTY

BODY OF WATER

 

LOCATION ON WATER

 

 

 

 

 

AM

 

 

 

 

 

 

 

 

 

PM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

# INJURED

# DEAD

TOTAL $$

LAW ENFORCEMENT ON ACCIDENT SCENE?

AGENCY NAME

YES NO

WEATHER (CHECK ALL THAT APPLY):

CLEAR

RAIN

CLOUDY SNOW

FOG

HAZY

WATER CONDITIONS

CALM (waves less than 6") CHOPPY (waves 6"-2') ROUGH (waves 2'-6') VERY ROUGH (waves >6')

WIND CONDITIONS

NONE

LIGHT (0-6 mph) MODERATE (7-14 mph) STRONG (15-25 mph) STORM (over 25 mph)

TEMPERATURE

 

 

WATER

AIR

 

VISIBILITY

STRONG CURRENT

 

GOOD

 

 

FAIR

YES

NO

 

 

POOR

 

 

 

 

 

TYPE OF ACCIDENT (CHECK ALL THAT APPLY):

CAPSIZING

COLLISION WITH VESSEL

COLLISION WITH FIXED OBJECT COLLISION WITH FLOATING OBJECT FALL OVERBOARD

FALL IN BOAT

OTHER

FIRE / EXPLOSION (fuel)

FIRE / EXPLOSION (other than fuel)

FLOODING / SWAMPING

SINKING

STRUCK BY BOAT / PROPELLER SKIER MISHAP

CAUSE OF ACCIDENT (CHECK ALL THAT APPLY):

IMPROPER LOOKOUT / INATTENTION OPERATOR INEXPERIENCE

EXCESSIVE SPEED

MACHINERY FAILURE

EQUIPMENT FAILURE

IMPROPER LOADING

OVERLOADING

HAZARDOUS WEATHER / WATER

RESTRICTED VISION

IGNITION OF SPILLED FUEL / VAPOR

IMPROPER ANCHORING

ALCOHOL USE

FAILURE TO VENT

OTHER

D E S C R I B E W H AT H A P P E N E D A N D W H AT YO U C O U L D H AV E D O N E TO P R E V E N T T H I S AC C I D E N T

( E x p l a i n t h e c a u s e o f d e a t h o r i n j u r y, m e d i c a l t r e a t m e n t , e t c . U s e s k e t ch i f h e l p f u l . I f n e e d e d , c o n t i nu e d e s c r i p t i o n o n a dd i t i o n a l p a p e r. )

V I C T I M O R W I T N E S S I N F O R M AT I O N

VICTIM / WITNESS

VICTIM / WITNESS

RIDING IN

AGE

INJURY DESCRIPTION

CAUSE OF DEATH

COULD

LIFE JACKET

NAME & ADDRESS

STATUS

VESSEL #

VICTIM SWIM?

WORN?

 

 

 

 

 

 

 

 

 

 

 

 

INJURED

 

 

 

DROWNING

YES

YES

 

 

 

 

 

 

 

DEAD

 

 

 

TRAUMA

NO

NO

 

 

 

 

 

 

 

WITNESS ONLY

 

 

 

OTHER

 

 

 

 

 

 

 

 

 

 

 

INJURED

 

 

 

DROWNING

YES

YES

 

 

 

 

 

 

 

DEAD

 

 

 

TRAUMA

NO

NO

 

WITNESS ONLY

 

 

 

OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INJURED

 

 

 

DROWNING

YES

YES

 

 

 

 

 

 

 

DEAD

 

 

 

TRAUMA

NO

NO

 

 

 

 

 

 

 

WITNESS ONLY

 

 

 

OTHER

 

 

 

 

 

 

 

 

 

 

 

INJURED

 

 

 

DROWNING

YES

YES

 

DEAD

 

 

 

TRAUMA

 

 

 

 

NO

NO

 

WITNESS ONLY

 

 

 

OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DBW FORM BAR-1 (1/00)

THIS CONFIDENTIAL REPORT IS USED IN RESEARCH FOR THE PREVENTION OF ACCIDENTS AND A COPY IS FORWARDED TO THE UNITED STATES COAST GUARD

CALIFORNIA BOATING ACCIDENT REPORT

 

 

 

 

 

 

 

 

CALIFORNIA DEPARTMENT OF BOATING AND WATERWAYS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I N F O R M AT I O N : O P E R ATO R # 1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OPERATOR NAME AND ADDRESS

 

 

 

 

 

 

 

 

IS OWNER DIFFERENT THAN OPERATOR?

YES

NO

 

 

OPERATOR EXPERIENCE

 

 

OPERATOR EDUCATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AMERICAN RED CROSS

 

 

 

 

 

 

 

 

 

 

 

 

 

OWNER NAME AND ADDRESS

 

 

 

 

 

 

 

 

UNDER 10 HOURS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

USCG AUXILIARY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10 TO 100 HOURS

 

 

 

 

 

US POWER SQUADRON

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OVER 100 HOURS

 

 

 

 

STATE COURSE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMAL

 

 

 

AGE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I N F O R M AT I O N : V E S S E L # 1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

( YO U R V E S S E L )

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THIS

 

# INJURED

 

 

# DEAD

 

 

ESTIMATED DAMAGE

 

 

RENTED BOAT

 

 

 

# OF PERSONS ON BOARD

 

 

# OF PERSONS TOWED

 

 

 

VESSEL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ONLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BOAT NUMBER (CF OR DOC #)

 

 

 

 

 

MFR. HULL ID #

 

 

 

 

 

BOAT NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LENGTH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BOAT MANUFACTURER

 

 

 

 

 

 

BOAT MODEL

 

 

 

 

 

YEAR BUILT

TYPE OF FUEL

 

 

 

 

 

 

# OF ENGINES

 

 

HORSEPOWER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACTIVITY

 

 

 

 

 

 

 

 

 

 

 

 

 

FIRE EXTINGUISHER ON BOARD

FIRE EXTINGUISHER USED

 

LIFE JACKETS ON BOARD

 

LIFE JACKETS ACCESSIBLE

 

LIFE JACKETS WORN

RECREATIONAL

 

COMMERCIAL

OTHER

 

 

 

 

YES

NO

YES

NO

 

YES

NO

 

YES

 

 

NO

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPE OF BOAT

 

 

 

 

HULL MATERIAL

 

PROPULSION

 

 

 

 

OPERATION AT TIME OF ACCIDENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OPEN MOTORBOAT

 

 

 

WOOD

 

 

OUTBOARD

 

 

 

CRUISING

 

 

 

 

 

 

 

 

 

DRIFTING

 

 

 

 

CABIN MOTORBOAT

 

 

 

ALUMINUM

 

 

INBOARD

 

 

 

CHANGING DIRECTION

 

 

 

 

AT ANCHOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERSONAL WATERCRAFT

 

 

 

FIBERGLASS

 

 

INBOARD / OUTBOARD

 

CHANGING SPEED

 

 

 

 

 

 

 

 

 

TIED TO DOCK

 

 

 

HOUSEBOAT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAILBOAT (aux. engine)

 

 

 

PLASTIC

 

 

JET

 

 

 

 

 

TOWING SKIER / TUBER

 

 

 

 

LAUNCHING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAILBOAT (sail only)

 

 

 

RUBBER / VINYL

 

 

SAIL ONLY

 

 

 

TOWING SKIER- SKIER DOWN

 

 

 

 

DOCKING / LEAVING DOCK

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CANOE / KAYAK

 

 

 

OTHER (specify)

 

 

PADDLE / OARS

 

 

 

TOWING ANOTHER VESSEL

 

 

 

 

SAILING

 

 

 

 

RAFT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER (specify)

 

 

 

BEING TOWED BY ANOTHER VESSEL

 

 

OTHER (specify)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ROWBOAT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER (specify)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SPEED

 

 

 

 

 

MPH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I N F O R M AT I O N : O P E R ATO R # 2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OPERATOR NAME AND ADDRESS

 

 

 

 

 

 

 

 

IS OWNER DIFFERENT THAN OPERATOR?

YES

NO

 

OPERATOR EXPERIENCE

 

 

OPERATOR EDUCATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AMERICAN RED CROSS

 

 

 

 

 

 

 

 

 

 

 

 

 

OWNER NAME AND ADDRESS

 

 

 

 

 

 

 

 

UNDER 10 HOURS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

USCG AUXILIARY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10 TO 100 HOURS

 

 

 

 

 

US POWER SQUADRON

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OVER 100 HOURS

 

 

 

 

STATE COURSE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMAL

 

 

 

AGE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I N F O R M AT I O N : V E S S E L # 2

 

 

 

 

 

 

 

 

( OT H E R V E S S E L I N VO LV E D )

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THIS

 

# INJURED

 

 

# DEAD

 

 

ESTIMATED DAMAGE $$

 

 

RENTED BOAT

 

 

 

# OF PERSONS ON BOARD

 

 

# OF PERSONS TOWED

 

 

 

VESSEL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ONLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BOAT NUMBER (CF OR DOC #)

 

 

 

 

 

MFR. HULL ID#

 

 

 

 

 

BOAT NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LENGTH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BOAT MANUFACTURER

 

 

 

 

 

 

BOAT MODEL

 

 

 

 

 

YEAR BUILT

TYPE OF FUEL

 

 

 

 

 

 

# OF ENGINES

 

 

HORSEPOWER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACTIVITY

 

 

 

 

 

 

 

 

 

 

 

 

 

FIRE EXTINGUISHER ON BOARD

FIRE EXTINGUISHER USED

 

LIFE JACKETS ON BOARD

 

LIFE JACKETS ACCESSIBLE

 

LIFE JACKETS WORN

RECREATIONAL

 

COMMERCIAL

OTHER

 

 

 

 

YES

NO

YES

NO

 

YES

NO

 

YES

 

 

NO

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPE OF BOAT

 

 

 

 

HULL MATERIAL

 

PROPULSION

 

 

 

 

OPERATION AT TIME OF ACCIDENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OPEN MOTORBOAT

 

 

 

WOOD

 

 

OUTBOARD

 

 

 

CRUISING

 

 

 

 

 

 

 

 

 

DRIFTING

 

 

 

 

CABIN MOTORBOAT

 

 

 

ALUMINUM

 

 

INBOARD

 

 

 

CHANGING DIRECTION

 

 

 

 

AT ANCHOR

 

 

 

PERSONAL WATERCRAFT

 

 

 

FIBERGLASS

 

 

INBOARD / OUTBOARD

 

CHANGING SPEED

 

 

 

 

 

 

 

 

 

TIED TO DOCK

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOUSEBOAT

 

 

 

 

 

 

PLASTIC

 

 

JET

 

 

 

 

 

TOWING SKIER / TUBER

 

 

 

 

LAUNCHING

 

 

 

SAILBOAT (aux. engine)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAILBOAT (sail only)

 

 

 

RUBBER / VINYL

 

 

SAIL ONLY

 

 

 

TOWING SKIER- SKIER DOWN

 

 

 

 

DOCKING / LEAVING DOCK

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CANOE / KAYAK

 

 

 

OTHER (specify)

 

 

PADDLE / OARS

 

 

 

TOWING ANOTHER VESSEL

 

 

 

 

SAILING

 

 

 

 

RAFT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER (specify)

 

 

 

BEING TOWED BY ANOTHER VESSEL

 

 

OTHER (specify)

 

 

 

ROWBOAT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SPEED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER (specify)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MPH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

QUALIFICATION OF PERSON COMPLETING REPORT

 

 

 

NAME OF PERSON COMPLETING THE REPORT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OPERATOR

 

OWNER

OTHER (specify)

SIGNATURE OF PERSON COMPLETING THE REPORT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DBW FORM BAR-1 (1/00)

THIS CONFIDENTIAL REPORT IS USED IN RESEARCH FOR THE PREVENTION OF ACCIDENTS AND A COPY IS FORWARDED TO THE UNITED STATES COAST GUARD

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This form will need some specific details; in order to guarantee correctness, you need to take into account the recommendations further down:

1. The Dbw Form Bar 1 involves particular information to be inserted. Be sure the following blanks are completed:

Part no. 1 in filling in Dbw Form Bar 1

2. Once your current task is complete, take the next step – fill out all of these fields - D E S C R I B E W H AT H A P P E N, VICTIM WITNESS NAME ADDRESS, VICTIM WITNESS, STATUS, RIDING IN VESSEL, AGE, INJURY DESCRIPTION, CAUSE OF DEATH, COULD, LIFE JACKET, VICTIM SWIM, WORN, V I C T I M O R W I T N E S S I N, INJURED, and DEAD WITNESS ONLY with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Stage number 2 in completing Dbw Form Bar 1

People generally make some errors when filling in CAUSE OF DEATH in this part. Make sure you reread what you type in right here.

3. This subsequent part is typically pretty easy, INJURED, DEAD WITNESS ONLY, INJURED, DEAD WITNESS ONLY, INJURED, DEAD WITNESS ONLY, DROWNING, TRAUMA OTHER, DROWNING, TRAUMA OTHER, DROWNING, TRAUMA OTHER, YES, YES, and YES - all these blanks will need to be completed here.

DROWNING, YES, and YES of Dbw Form Bar 1

4. This next section requires some additional information. Ensure you complete all the necessary fields - I N F O R M AT I O N O P E R ATO, OPERATOR NAME AND ADDRESS, IS OWNER DIFFERENT THAN OPERATOR, YES, OPERATOR EXPERIENCE, OPERATOR EDUCATION, OWNER NAME AND ADDRESS, I N F O R M AT I O N V E S S E L, UNDER HOURS, TO HOURS, OVER HOURS, AMERICAN RED CROSS USCG AUXILIARY, YO U R V E S S E L, INJURED, and DEAD - to proceed further in your process!

Stage no. 4 in filling in Dbw Form Bar 1

5. And finally, this last portion is what you'll want to wrap up prior to closing the document. The blanks here are the following: SAILBOAT sail only, CANOE KAYAK, RAFT, ROWBOAT, OTHER specify, OTHER specify, PADDLE OARS, OTHER specify, TOWING ANOTHER VESSEL, SAILING, BEING TOWED BY ANOTHER VESSEL, OTHER specify, SPEED, MPH, and OPERATOR NAME AND ADDRESS.

Dbw Form Bar 1 conclusion process detailed (stage 5)

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