Form Ops-8 - Facility Orders Request
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1CGD11NR-AUX
FACILITY ORDERS REQUEST
**Form OPS-8**
REV. 07-08E
**
(Complete one form for each facility. Turn in with ANSC 7003 Vessel Facility Inspection and Offer for Use)) **
Vessel
PWC
Land Mobile
Aircraft
Facility Type:
Facility Name (boats only):__________________________________________________________________
Facility #: _______________________________ Land Mobile Call Sign: ____________________________
Facility Registration/Documentation #:________________________________________________________
Date of Last Inspection: _______________________ Inspected by: _________________________________
Owner: ______________________________________________Member #:___________________________
Street Address: ____________________________________________________________________________
City: _____________________________________________ State: _________ Zip_____________________
Home telephone: ________________________E-Mail: ___________________________________________
Authorization of Non-Owner Operation:
I authorize the following members to be Coxswain (or Pilot in Command) and Operator of the above
facility under authorized Coast Guard orders:
Name (Print Clearly)
Member #
Owner must be on board
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Owner’s Signature: _____________________________________________Date:_______________________
**Keep a copy of this form so you may add new coxswains throughout the year. Just fax or mail this form again if you add more coxswains.**
Mail or Fax to:
COMMANDER (dpa-N)
ELEVENTH COAST GUARD DISTRICT
COAST GUARD ISLAND, Bldg. 50-2
ALAMEDA, CA 94501-5100
Fax: (510)437-2728
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