Instructions: do not email/fax this to nh lakes



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INSTRUCTIONS: DO NOT EMAIL/FAX THIS TO NH LAKES.

Inspectors: Complete one row for each boat inspection. A boat that was inspected when launched and retrieved should take up two rows.

Point Person/Mangers: Indicate what specimens were sent to DES. STAPLE all Boater Survey sheets to the corresponding daily summary sheet and mail on “payroll Monday Afternoon” to NH LAKES.



017 Lake Host Program Boater Survey


Local Group Name: _______________________________________________ Date:_____________




Lake Name: _________________________________Ramp Name:____________________________




Lake Host Name: __________­­______________________Shift Start Time:_____­­­__ Shift End Time:________



Time of Survey

(add

AM

or

PM)

Indicate if Vessel is being Launched

or

Retrieved





State

of motor boat

regis-tration


Type of Boat



For ALL vessels being launched OR retrieved –

BEFORE originally being launched into this waterbody…

Boater AIS awareness?
(H=high; M=Med. L=Low)

Speci-men

found?
Y=Yes

N=No


If ‘suspicious’ specimen found:


LAST waterbody BEFORE

ORIGINALLY launching

into this waterbody
(waterbody name, state)

Met a Lake Host before?
Y=Yes

N=No


Drained?
Y=Yes

N=No


Rinsed?
Y=Yes

N=No


Dry for at least 5 days?
Y=Yes

N=No


H

M

L




If motorboat:

Full Bow #


If non-motor boat: trailer vehicle state & license#

Sent to DES?

Y=Yes


N=No




Launched

Retrieved





 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N



 Launched

 Retrieved





 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N


 Launched

 Retrieved





 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N




Launched

 Retrieved






 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N


 Launched

 Retrieved





 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N




 Launched

 Retrieved





 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N


 Launched

 Retrieved





 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N



 Launched

 Retrieved





 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N




 Launched

 Retrieved






 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N



Y
N


 Launched

 Retrieved





 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N


SUBTOTAL

# inspect

State of Boat Registration

Type of Boat

Met Host before?

Drain?

Rinse?

Dry?

Awareness of AIS

Speci-

men ?

-

To DES?




NH

MA (MS)

ME

VT

CT

RI

NY

Other

I/O

PWC

jet


Paddle/Row/ Sail (no motor)

Y

Y

Y

Y

H

M

L

Y

-

Y


























































-




Page ____ of ______



2

INSTRUCTIONS: DO NOT EMAIL/FAX THIS TO NH LAKES.

Inspectors: Complete one row for each boat inspection. A boat that was inspected when launched and retrieved should take up two rows.

Point Person/Mangers: Indicate what specimens were sent to DES. STAPLE all Boater Survey sheets to the corresponding daily summary sheet and mail on “payroll Monday Afternoon” to NH LAKES.



017 Lake Host Program Boater Survey


Local Group Name: _______________________________________________ Date:_____________




Lake Name: _________________________________Ramp Name:____________________________




Lake Host Name: __________­­______________________Shift Start Time:_____­­­__ Shift End Time:________



Time of Survey

(add

AM

or

PM)

Indicate if Vessel is being Launched

or

Retrieved





State

of motor boat

regis-tration


Type of Boat



For ALL vessels being launched OR retrieved –

BEFORE originally being launched into this waterbody…

Boater AIS awareness?
(H=high; M=Med. L=Low)

Speci-men

found?
Y=Yes

N=No


If ‘suspicious’ specimen found:


LAST waterbody BEFORE

ORIGINALLY launching

into this waterbody
(waterbody name, state)

Met a Lake Host before?
Y=Yes

N=No


Drained?
Y=Yes

N=No


Rinsed?
Y=Yes

N=No


Dry for at least 5 days?
Y=Yes

N=No


H

M

L




If motorboat:

Full Bow #


If non-motor boat: trailer vehicle state & license#

Sent to DES?

Y=Yes


N=No




 Launched

 Retrieved





 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N



 Launched

 Retrieved





 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N


 Launched

 Retrieved





 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N




 Launched

 Retrieved






 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N


 Launched

 Retrieved





 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N




 Launched

 Retrieved





 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N


 Launched

 Retrieved





 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N



 Launched

 Retrieved





 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N




 Launched

 Retrieved






 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N



Y
N


 Launched

 Retrieved





 inboard/outboard (I/O)

 PWC/jet ski/jet boat

 paddle/row/sail (non-motor)





Y
N

Y
N

Y
N

Y
N










Y
N




Y
N


SUBTOTAL

# inspect

State of Boat Registration

Type of Boat

Met Host before?

Drain?

Rinse?

Dry?

Awareness of AIS

Speci-

men ?

-

To DES?




NH

MA (MS)

ME

VT

CT

RI

NY

Other

I/O

PWC

jet


Paddle/Row/ Sail (no motor)

Y

Y

Y

Y

H

M

L

Y

-

Y


























































-






Page ____ of ______


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