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NOAA Form 57-03-03 U.S

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NOAA Form 57-03-03 U.S NOAA Form 57-03-03 U.S. DEPARTMENT OF COMMERCE (1-14) Page 1 of 13 NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION DIVING UNIT SAFETY ASSESSMENT CHECKLIST DIVING UNIT NAME LINE or STAFF OFFICE DATE of LAST INSPECTION DATE of INSPECTION DIVING UNIT ADDRESS CITY STATE ZIP INSPECTOR’S NAME INSPECTOR’S E-MAIL ADDRESS INSPECTOR’S PHONE NUMBER UNIT DIVING SUPERVISOR (UDS) NAME UDS SIGNATURE DATE of SIGNATURE LINE OFFICE DIVE OFFICER (LODO) NAME LODO SIGNATURE DATE of SIGNATURE Background: The Diving Unit Safety Assessment (DUSA) checklist was developed so that each diving unit could conduct an annual self-inspection. Individual diving units are responsible for ensuring that this inspection is completed and documented. Annual inspections of each diving unit are required by the NOAA Diving Program. The DUSA Checklist is due to be turned in to your Line/Staff Office Diving Officer (LODO/SODO) by January 15th every year. Purpose: To promote safe diving operations at the unit level through a self-inspection process. Instructions: This inspection checklist provides NOAA-wide guidelines for the requirements of diving units and dive lockers to ensure unit operational readiness and safety. When completing this checklist, inspectors must be critical and thorough in identifying deficiencies. In preparation for a successful inspection, all inspectors shall complete the online training presentation "Diving Unit Safety Assessment" posted on the Commerce Learning Center. This course guides inspectors step-by-step through the inspection process in preparation for a DUSA inspection. The course 'certificates of completion' must be kept with the diving unit records and a copy sent to the Unit Diving Supervisor (UDS). Upon completion of the diving unit self-inspection, results must be forwarded to the LODO/SODO and UDS. A copy of the completed checklist must be kept by the UDS and at the unit. After careful review, the LODO/SODO shall forward the completed checklist to the NOAA Diving Safety Officer (NDSO) by January 31st. Discrepancies shall be investigated by the UDS/LODO/SODO/NDSO and corrected by the unit as soon as possible. Contact the UDS or LODO/ SODO/NDSO for any questions about this self-inspection process. There may be a certain number of new units added to the list of dive units each year. If your unit is newly assigned you will be contacted with specific instructions. Areas of Inspection: A. Administration E. Support Equipment B. Training F. Dive Briefing C. SCUBA Equipment and Storage G. Rescue D. Air Compressor and System Components H. Inspection Comments and Recommendations NOAA Form 57-03-03 U.S. DEPARTMENT OF COMMERCE (1-14) Page 2 of 13 NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION DIVING UNIT SAFETY ASSESSMENT CHECKLIST Section A – Administration YES NO ASSESSMENT ITEM N/A A1 - Has the inspector successfully completed the required DUSA training provided by the Commerce Learning Center, with proof provided by certificates of completion? Reference: DUSA Manual Comments: A2 - Has a Diving Emergency Assistance Plan, NOAA Form (NF) 57-03-21, for each known dive location been updated and filed with the NDP for the current year? Reference: NWDSSM 5.2.3 / NSDSSM 4.2.3 Comments: A3 – Is there a diver assigned to the diving unit qualified as Divemaster or Lead Diver (must have successfully completed appropriate training)? Reference: NWDSSM 2.7.1 / NSDSSM 2.7 Comments: A4 – Are the latest NOAA Diving Regulations, NOAA Working Diver Standards and Safety Manual (NWDSSM) and NOAA Scientific Diving Standards and Safety Manual (NSDSSM), on site? Reference: NWDSSM 10.1.4 A / NSDSSM 1.1.9 Comments: A5 – Is the current edition of the NOAA Diving Manual available at the diving unit? Reference: NWDSSM 1.1.7 / NSDSSM 1.1.9 Comments: A6 – Are all NOAA Diving Safety Bulletins available at the unit or easily accessible online? Reference: NWDSSM 1.1.7 / NSDSSM 1.1.9 Comments: A7 – Is there a sufficient number of qualified divers to meet manning requirements of typical dives performed by the diving unit? Reference: NWDSSM 6.1.2 / NSDSSM 4.5.1 Comments: A8 – Are all assigned divers authorized to dive? Reference: NWDSSM 1.1.3 / NSDSSM 3.4 Comments: A9 – Is access to the “Dive Safety Ship Operations Checklist” NF 57-03-22, available at the diving unit if needed? Reference: NWDSSM 2.7.2 A 11 Comments: A10 – Is a Diving Unit Logbook maintained at the diving unit (contents to include operational diving information, training accomplished, drills, equipment service/testing etc.)? Reference: 29 CFR 1910.430 / NWDSSM 3.4.8, 10.1.2 / NSDSSM 5.1 Comments: NOAA Form 57-03-03 U.S. DEPARTMENT OF COMMERCE (1-14) Page 3 of 13 NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION DIVING UNIT SAFETY ASSESSMENT CHECKLIST Section B – Training YES NO ASSESSMENT ITEM N/A B1 – Is each diver currently certified in cardio-pulmonary resuscitation (CPR), automatic external defibrillator (AED), and First-Aid, with hard copies of current certifications available at the unit? Reference: NWDSSM 3.3.4 / NSDSSM 3.1 Comments: B2 – Has each diver received refresher training in the operation of oxygen resuscitators in the past 12 months with completion dates listed in the Diving Unit Logbook? Reference: NWDSSM 3.4.8 / NSDSSM 3.4.9 Comments: B3 – Has annual classroom training been conducted in the past 12 months for all unit divers, (e.g. Recognition and treatment of diving accidents and injuries, five-minute neurological examination, rescue techniques, diving accident management, etc.) with completion dates listed in the Diving Unit Logbook? Reference: NWDSSM 3.4.8 / NSDSSM 3.4.9 Comments: B4 – Has each diver conducted an in-water Rescue and Diving Skills Checkout dive and completed a NF 57-03-41 in the past 12 months with a UDS, or designee, to assess in-water rescue and basic diving skills, with completion dates listed in the Diving Unit Logbook? Reference: NWDSSM 3.4.8 / NSDSSM 3.4.9 Comments: B5 – Has each SCUBA cylinder filling station operator been properly trained in the specific air compressor operating procedures and the training documented in the Diving Unit Logbook? Reference: NWD follow NSD requirement / NSDSSM 5.2.3 N Comments: B6 – Has each diver required to use the Reserve Air Supply System (RASS) received formal training in its use and the training documented in the Diving Unit Logbook? Reference: NWDSSM 5.3.8 / NSDSSM 4.3.7 Comments: B7 – Has each diver required to use line-tending techniques for stand-by divers received formal training in these procedures and the training documented in the Diving Unit Logbook? Reference: NWDSSM 6.1.1 D / NSDSSM 4.3 Comments: Section C – SCUBA Equipment and Storage C1 – Are all divers wearing equipment in the standard configuration, in accordance with NOAA policy? Reference: NWDSSM 7.3.1 / NSDSSM 4.2.8 Comments: C2 – Is written approval on file from the LODO/SODO to use equipment not issued through the Standardized Equipment Program (SEP)? Reference: NWDSSM 5.2.8 / NSDSSM 4.2.8 Comments: NOAA Form 57-03-03 U.S. DEPARTMENT OF COMMERCE (1-14) Page 4 of 13 NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION DIVING UNIT SAFETY ASSESSMENT CHECKLIST YES NO ASSESSMENT ITEM N/A C3 – Is all tethered SCUBA equipment inspected and maintained in accordance with manufacturer’s recommendations? Reference: NWDSSM 7.4.1 / NSDSSM 5.4 Comments: C4 – Is diving equipment stored in a secure, properly ventilated space free of noxious fumes and corrosive elements? Reference: NWDSSM 7.1.1 F / NSDSSM 5.1.1 Comments: C5 – Is there sufficient space to allow for proper maintenance and organization of equipment? Reference: NWDSSM 7.1.1 G / NSDSSM 5.1.1 Comments: C6 – Has each diver performed an annual inventory of SEP issued gear? Reference: NWDSSM 7.1.1 H / NSDSSM 5.1.1 Comments: C7 – Have all SCUBA regulators, full face masks, BCD inflators, depth/time gauges, and pressure gauges been overhauled in the past 12 months and documented in the Diving Unit Logbook? Reference: NWDSSM 7.3.6 / NSDSSM 5.3.6 Comments: C8 – Is all equipment free from corrosion and deterioration that may impede its intended use? Reference: NWD follow NSD requirement / NSDSSM 5.1.1 I Comments: C9 – Is all diving equipment that is in need of repair, inspection, or testing, properly labeled as such and kept separate from operational gear? Reference: NWDSSM 5.2.8 D / NSDSSM 5.1.1 Comments: C10 – Are all dry suits in good condition and functional? Reference: NWDSSM 5.2.8 / NSDSSM 5.1.1 Comments: C11 – Are all wet suits and related equipment (hoods, gloves, and boots) in good condition? Reference: NWDSSM 5.2.8 / NSDSSM 5.1.1 Comments: C12 – Are all SCUBA and RASS cylinders within hydrostatic test date? Reference: NWDSSM 7.3.6 E / NSDSSM 5.3.6 Comments: NOAA Form 57-03-03 U.S. DEPARTMENT OF COMMERCE (1-14) Page 5 of 13 NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION DIVING UNIT SAFETY ASSESSMENT CHECKLIST YES NO ASSESSMENT ITEM N/A C13 – Has each SCUBA and RASS cylinder been visually inspected in the past 12 months and labeled accordingly or properly tagged out and removed from service? Reference: NWDSSM 7.3.6 E / NSDSSM 5.3.6 Comments: C14 – Is each SCUBA cylinder containing a breathing media other than air (e.g. Nitrox) labeled accordingly? Reference: NWDSSM 7.7 Comments: C15 – Is the equipment used with gas mixtures containing oxygen concentrations of 40% or greater cleaned and approved for oxygen service? Reference: NWDSSM 7.1.2 / NSDSSM 7.7.2 Comments: Section D – Air Compressors and System Components D1 – Is a SCUBA cylinder fill system located at the diving unit? If “No”, skip to Section E.
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