2017Lake Host Program Boater Survey
Local Group Name: ______Date:______
LakeName: ______Ramp Name:______
LakeHost Name: ______Shift Start Time:______Shift End Time:______
Time of Survey
(add
AM
or
PM)
/Indicate if Vessel is being Launched
or
Retrieved
/ Stateof motor boat
regis-tration / Type of Boat / For ALL vessels being launched OR retrieved –
BEFOREoriginally 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 waterbodyBEFORE
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
-
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2017 Lake Host Program Boater Survey
Local Group Name: ______Date:______
LakeName: ______Ramp Name:______
LakeHost Name: ______Shift Start Time:______Shift End Time:______
Time of Survey
(add
AM
or
PM)
/Indicate if Vessel is being Launched
or
Retrieved
/ Stateof motor boat
regis-tration / Type of Boat / For ALL vessels being launched OR retrieved –
BEFOREoriginally 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 waterbodyBEFORE
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
-
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