APPENDIX E1 Open-Circuit Scuba Equipment Evaluation Forms · APPENDIX E1: OPEN-CIRCUIT SCUBA...

APPENDIX E1: OPEN-CIRCUIT SCUBA EQUIPMENT EVALUATION FORMS Recreational Diving Fatalities Workshop Proceedings • 1

APPENDIX E1

Open-Circuit Scuba Equipment Evaluation Forms

Jeffrey E. BozanicNext Generation Services

P.O. Box 3448Huntington Beach, CA 92605-3448 USA

David M. CarverEmergency Services Detail

Los Angeles County Sheriff ’s Department1060 North Eastern AvenueLos Angeles, CA 90063 USA

2 • Recreational Diving Fatalities Workshop Proceedings APPENDIX E1: OPEN-CIRCUIT SCUBA EQUIPMENT EVALUATION FORMS

Forms in Appendix E:

• Divecomputers

• Cylinders

• Valves

• Deco,ponyorbailoutcylinders

• Buoyancycompensators/alternateairsources

• Regulators

• Wetsuits

• Drysuits

• Watches,bottomtimers,SPGs,compasses,depthgauges,capillarygauges,temperaturegauges

• Masks

• Snorkels

• Fins

• Cameraandvideoequipment

• Slates

• Goodiebags

• Liftbags

• Reels

• Knives/cuttingtools

• Divelights

• Jonlines

• Speargunsandslings

• Diverpropulsionunits


DIVE COMPUTER (Complete one form per computer.)

Manufacturer:______________________________________ Model:_________________________________________

Serial#:___________________________________________ Condition:PoorFairGoodExcellent

Batterystatus:____________________Computersettothecorrecttime?YesNo

Computerstatus: Working Notworking Nobattery

Locationofthecomputer: Wristmount ConsoleonHPhose

AttachedtoBC Attachedtohose Mask

Other:_____________________________________________

Decedent’scomputer Divepartner’scomputer

Typeofdivecomputer: Basicaironly Basicnitrox Technicalgas

Airintegrated Diveprofilerecorder

Downloadable:YesNo

Programmable:YesNo

Program/modeused: Gaugemode Airmode Nitroxmode

Trimixmode Helioxmode Notworking

Opencircuit Closedcircuit

Gas(es)programmedintocomputer:%O2______%He______Inuseattime

Gas#_____%He_____%O2_____OC/CC Gas#_____%He_____%O2_____OC/CC





Listthecomputer’sstatusatthefollowingtimes:

Whenfirstlocated: On Off DiveMode ViolationModeSIMode

Atthesurface: On Off DiveMode ViolationModeSIMode

Duringevaluation: On Off DiveMode ViolationModeSIMode

Doescomputerautomaticallygointodivemodewhensubmersed?Yes No

AtwhatdepthdoescomputergointoSurfaceMode(SI)?___________________

Ifthecomputerinformationhasbeenrecorded,downloadtheinformationassoonaspossibleandprinthardcopiesofallrelevantprofilesanddivedetails.Maintainacomputerfileofthedatathatwasdownloaded.Thecomputer’smanufacturermightneedtobecontactedtoassistinthisprocess.ChamberdirectorslikeKarlHugginshavealsoproventobeavaluable


resourcewhenassistanceisneededindownloadingfromoldercomputers.Ifthecomputerdatacannotbedownloaded,takephotographsofthedifferentscreensshowinganyrelevantinformation.Afterallimportantinformationhasbeengathered,thecomputershouldbetestedtoensurethecomputerwas/isfunctioningcorrectly.

Computerinformationdownloaded? Yes No

Downloadedby:________________________ Date/time:_________________________

Computerrecordsdepth/timeevery______seconds

Computershowsgasconsumptionrates?YesNo

Depth testing of the computer

Depth Computerdepth Depth Computerdepth

0fsw ______fsw 130fsw ______fsw

10fsw ______fsw 120fsw ______fsw

20fsw ______fsw 110fsw ______fsw

30fsw ______fsw 100fsw ______fsw

40fsw ______fsw 90fsw ______fsw

50fsw ______fsw 80fsw ______fsw

60fsw ______fsw 70fsw ______fsw

70fsw ______fsw 60fsw ______fsw

80fsw ______fsw 50fsw ______fsw

90fsw ______fsw 40fsw ______fsw

100fsw ______fsw 30fsw ______fsw

110fsw ______fsw 20fsw ______fsw

120fsw ______fsw 10fsw ______fsw

130fsw ______fsw 0fsw ______fsw

Completeacopyofthisformforeachdivecomputerwornbythedecedent.Ifpossible,completethisformforeachdivecomputerwornbythedecedent’sdivepartner,includingalldownloadableinformation.

Notes: ____________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________


CYLINDER (Complete one form per cylinder.)


Workingpressure:___________________________________ Serial#:________________________________________

Pressurewhenrecovered: _____________________________

Type: Single Sidemount Doubles Bailout Deco Staged Pony

Gastype: Air Nitrox Trimix Heliox O2Clean

CylinderCondition: Poor Fair Good Excellent

Type: Steel HPorLP Aluminum Composite

Size:______________________________________________ Color:_________________________________________

Boot:YesNo Cylinderwrap:YesNo

VIPdate:__________________________________________ Where: ________________________________________

Hydrodate:________________________________________ Where: ________________________________________

Initialfillpressure,ifknown:___________________________________________________________________________

Wherethecylinderwaslastfilled:_______________________________________________________________________

Compressorownerandaddress:________________________________________________________________________

Currentcompressorgasanalysisonfile: Yes No (Attach copy of analysis.)

Lastcompressorfilterchange:__________________________________________________________________________

Oxygencleancompressor:YesNo

Wholastfilledthecylinder?___________________________________________________________________________

Datethecylinderwasfilled: ___________________________________________________________________________

Gaslabelsattachedtocylinder:NitroxTrimixOther:_________________

Reportedgasmixused: Air Nitrox______

Heliox/trimix O2______He______

Wasdecedenttrainedintheuseofthegas? Yes No Certification:______

Wasthecylinderanalyzedbeforethedive? Yes No Unknown

Whoanalyzedthecylinder? ___________________________________________________________________________

Investigatoranalysis

Pressureincylinderwhentested:_______________________________________________________________________

Manufacturer,modelandserial#ofanalyzer:______________________________________________________________

Testresultsofportableanalyzer:O2______He______

Nameofpersonwhotestedportableanalyzer:_____________________________________________________________

Date/timeanalyzerwastested: _________________________________________________________________________


Outside Gas Analysis Information

Cylindersentforoutsideanalysis:YesNo

Wherewascylindersent: AQMDLab PrivateLab CrimeLab

Nameofthelab: ____________________________________________________________________________________

Addresstothelab:___________________________________________________________________________________

Cylindergivento(name):_____________________________________________________________________________

Date/timecylinderwasdelivered:_______________________________________________________________________

Cylinderpressureatdelivery:__________________________________________________________________________

Date/timecylinderwasreturned:_______________________________________________________________________

Cylinderpressurewhenreturned:_______________________________________________________________________

Cylinderanalyzedby:________________________________________________________________________________

Results:MeetsGradeEScubaAir O2______He______N2______

Failedforthefollowingreason:________________________________________________________________

In-House Gas Analysis Information

Cylindergasanalyzedby:_____________________________________________________________________________

Wherecylinderwasanalyzed:__________________________________________________________________________

Date/timeofanalysis: ________________________________________________________________________________

Cylinderpressurewhenanalyzed:_______________________________________________________________________

Cylinderpressurewhendone:__________________________________________________________________________

Testinganalyzermanufacturer:_______________________Model:__________________Serial#: ___________________

Datetheanalyzerwaslasttested/calibrated:_______________________________________________________________

Gaugemanufacturer/model/serial#:_____________________________________________________________________

Gaugelastcalibrated: ________________________________________________________________________________

Results:O2_____He_____


Visual Inspection Information

VIPconductedby:___________________________________________________________________________________

Companyname/address:______________________________________________________________________________

Date/timeVIPwasconducted:_________________________________________________________________________

Results:PassFailFailReasons:_________________________________________________________________

Notes: ____________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Acompletegasanalysisofallcylindersusedduringdivingfatalitiesshouldbeconductedbyanaccreditedlabtoensurethegasmeetsscubastandards.

Usecalibratedstand-alonegaugesforcylinderpressure.

Completeacopyofthisformforeachcylinderusedbythedecedent.Thisincludesapartner’scylinderifthedecedentuseditduringthediveorifthepartnerreportedproblemsthatmaypossiblyberelatedtobadgasinthecylinder.


VALVES (Complete one form per valve.)



Serialnumberofthecylindertowhichthevalvewasattached:________________________________________________

Type: Yoke O-ringinplace:YesNo O-ringcondition:PFGE

DIN Yokeinsert: YesNo O-ringcondition:PFGE

Manifold:YokeDINN/A

Wasthevalveoxygencleaned? Yes No Unknown

Howwasregulatorattachedtothevalve?_________________________________________________________________

DidO-ringorvalveleakduringunderwatertest? Yes No

Positionofthevalveattimeoffatality:___________________________________________________________________

Positionofthevalveatstartoftesting:___________________________________________________________________

Wasvalvemanipulatedduringrescue/recovery? Yes No Unknown

Numberofturnsfromopentoclose: ____________________________________________________________________

Difficultyinturningthevalveonoroff: Easy ModerateDifficult

Notes: ____________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________


DECO, PONY OR BAILOUT CYLINDER(S) (Complete one form per cylinder.)


Workingpressure:___________________________________ Serial#:________________________________________

Pressurewhenrecovered: _____________________________

Type: Bailout Deco Staged Spareair

Gastype: Air Nitrox Trimix Heliox O2clean

Cylindercondition: Poor Fair Good Excellent

Type: Steel HPorLP Aluminum Composite

Size:______________________________________________ Color:_________________________________________

VIPdate:__________________________________________ Where:________________________________________

Hydrodate:________________________________________ Where:________________________________________

Howwasthecylindercarried? _________________________________________________________________________

Howwasregulatorsecuredtothecylinder?BandClipOther:_________________________________________

Coulddecedentreach2ndstage? Yes No Unknown

Coulddecedentreachvalve? Yes No Unknown

Initialfillpressure,ifknown:___________________________________________________________________________

Wherethecylinderwaslastfilled:_______________________________________________________________________

Compressorownerandaddress:________________________________________________________________________

Currentcompressorgasanalysisonfile? Yes No (Attach copy of analysis.)

Lastcompressorfilterchange:__________________________________________________________________________

Oxygencleancompressor? Yes No

Wholastfilledthecylinder?___________________________________________________________________________

Datethecylinderwasfilled:___________________________________________________________________________

Gaslabelsattachedtocylinder: Nitrox Trimix Other:________

Reportedgasmixused: Air Nitrox________

TrimixO2_______He_______

HelioxO2_______He_______

Wasdecedenttrainedintheuseofthegas:?YesNoCertification:______________________________________

Wasthecylinderanalyzedbeforethedive?YesNoUnknown

Whoanalyzedthecylinder? ___________________________________________________________________________


Investigator Analysis

Manufacturer,modelandserial#ofanalyzer:______________________________________________________________

Pressureincylinderattimeoftesting: ___________________________________________________________________

Testresultsofportableanalyzer:O2______He______

Nameofpersonwhotestedportableanalyzer:_____________________________________________________________

Date/timeanalyzerwastested: _________________________________________________________________________

Outside Gas Analysis Information

Cylindersentforoutsideanalysis?YesNo

Wherewascylindersent: AQMDLab PrivateLab CrimeLab

Nameofthelab: ____________________________________________________________________________________

Addresstothelab:___________________________________________________________________________________

Cylindergivento(name):_____________________________________________________________________________

Date/timecylinderwasdelivered:_______________________________________________________________________

Cylinderpressureatdelivery:__________________________________________________________________________

Date/timecylinderwasreturned:_______________________________________________________________________

Cylinderpressurewhenreturned:_______________________________________________________________________

Cylinderanalyzedby:________________________________________________________________________________

Results:MeetsGradeEScubaAir O2______He______N2______

Failedforthefollowingreason:________________________________________________________________

In-House Gas Analysis Information

Cylindergasanalyzedby:_____________________________________________________________________________

Wherecylinderwasanalyzed:__________________________________________________________________________

Date/timeofanalysis: ________________________________________________________________________________

Cylinderpressurewhenanalyzed:_______________________________________________________________________

Cylinderpressurewhendone:__________________________________________________________________________

Testinganalyzermanufacturer:_______________________Model:__________________Serial#: ___________________

Datetheanalyzerwaslasttested/calibrated:_______________________________________________________________

Gaugemanufacturer/model/serial#:_____________________________________________________________________

Gaugelastcalibrated: ________________________________________________________________________________

Results:O2_____He_____


Visual Inspection Information

VIPconductedby:___________________________________________________________________________________

Companyname/address:______________________________________________________________________________

Date/timeVIPwasconducted:_________________________________________________________________________

Results:PassFailFailReasons:_________________________________________________________________

Notes: ____________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Completeacopyofthisformforeachcylinderusedbythedecedent.Thisincludesapartner’scylinderifthedecedentuseditduringthediveorifthepartnerreportedproblemsthatmaypossiblyberelatedtobadgasinthecylinder.


BUOYANCY COMPENSATOR



Size:XSSMLXLXXL Volume:________________ Color:________________

Type: JacketStyle HorseCollar Jacket/Wing

BackPlate: Steel Composite Aluminum Plastic Other:________________

Wing: Banded Non-Banded

WingVolume:_________

BCsizeappropriateforthediver? Yes No

BCattachedtocylinder(s)properly? Yes No

Crotchstrap? Yes No

Crotchstrapinterferewithweightditching? Yes No Unknown

WeightintegratedBC? Yes No

Weightintegrationtype:VelcroSnapbuckleRipcordpullOther:___________________________________

Weightperintegratedpocket: Left:___________ Right:___________

Trimpockets? Yes No

Trimpocketlocations:________________________________________________________________________________

Weightcontainedinthetrimpockets: Left:___________ Right:___________

Integratedweightsabletobeditchedeasily: Yes No

AmountofgasintheBC:__________cc’s

AmountofwaterintheBC:__________cc’s Fresh Salt

Powerinflatorattachedcorrectly? Yes No

Doespowerinflatorworkcorrectly? Yes No

Doesmanualinflationworkcorrectly? Yes No

Locationofthedumpvalves: Upperright Upperleft

Lowerright Lowerleft

Doallthedumpvalveswork? Yes No Notes:________________________________________

DoestheBCholdair? Yes No Notes:________________________________________

Anyleaksdetected? Yes No

Ifyes,whereweretheleaks?___________________________________________________________________________


In-watertestingofpowerinflator/dumpvalves:Workedasdesigned Didnotworkasdesigned

Anytypeofin-watermalfunction?______________________________________________________________________

AnydivermodificationstotheBCorweightsystem? Yes No

Describeindetail:___________________________________________________________________________________

(Isthereanythingthatpreventsweightpocketsfrombeingdumpedasdesigned?)

DotheregulatorhosesinterferewithBCoperation? Yes No

AuxiliarygearattachedtoBC: Knife Light GoodieBag

Reel LiftBag Camera

AudibleSignalDevice Other:____________________________________

Alternate air source connected to the BC


Serial#:___________________________________________ Color:_________________________________________

Condition: Poor Fair Good Excellent

LPhoseconnectedproperlytoairsource? Yes No

Airsourcesecondstageworksasdesigned? Yes No

In-watertestingworkedasdesigned? Yes No

Inhalationeffort:____________________________________ Exhalationeffort: ________________________________

Cylinderpressurewhentested(shouldmatchcylinderpressureattimeoffatality):________________________________

IPpressure:________________________________________ Crackingpressure: _______________________________

Magnahelicpressure:_________________________________

Notes: ____________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________


REGULATORS (Complete one form per regulator.)


Serial#:___________________________________________ IPpressure:_____________________________________

Type: Piston Diaphragm Yoke DIN

Conditionoffirststage: Poor Fair Good Excellent

SinterScreencondition: Poor Fair Good Excellent

Howmanyhigh-pressureports?________________________ Howmanylow-pressureports?_____________________

Howmanyhigh-pressurehosesareattachedtothefirststage?_________________________________________________

HP#1: Brand:___________________Color:_____________Length:_______Use:___________________________

HP#2:Brand:___________________Color:_____________Length:_______Use:___________________________

Howmanylow-pressurehosesareattachedtothefirststage? _________________________________________________

LP#1: Brand:___________________Color:_____________Length:_______Use:___________________________





Wasfirststageattachedcorrectlytovalve? Yes No Unknown

ConditionoftheO-ringconnectingaDINfirststagetothecylindervalve?

Poor Fair Good Excellent Missing

Second Stage of the Regulator


Serial#:___________________________________________ Color:_________________________________________

Conditionof2ndstage: Poor Fair Good Excellent

Conditionofthemouthpiece: Poor Fair Good Excellent Missing

Anyholesorbitemarksnotedonthemouthpiece? No Yes Where?______________________

Typeofmouthpiece: Standard Orthodontic Heatmolded

Brand,type,lengthandcolorofthehose:_________________________________________________________________

Positionofdivercontrolknob(noteifnone):______________________________________________________________

Positionofventureknob(noteifnone):__________________________________________________________________

Inhalationeffort:______________________ Exhalationeffort: _____________________ PSItested:________________

Crackingpressure:_____________________ Magnahelicpressure: __________________ PSItested:________________


ANSTItestresults: Workedasdesigned FailedtheANSTItest

Workedunderwaterasdesigned? Yes No

Regulator (Alternate 2nd Stage)


Serial#:___________________________________________ Color:_________________________________________

Conditionofalternate2ndstage: Poor Fair Good Excellent

Conditionofthemouthpiece: Poor Fair Good Excellent Missing

Anyholesorbitemarksnotedonthemouthpiece: No Yes Where?______________________

Typeofmouthpiece: Standard Orthodontic Heatmolded

Brand,type,lengthandcolorofthehose:_________________________________________________________________

Positionofdivercontrolknob(noteifnone):______________________________________________________________

Positionofventureknob(noteifnone):__________________________________________________________________

Howwasthedecedentwearingthealternate2ndstage?______________________________________________________

Inhalationeffort:______________________ Exhalationeffort: _____________________ PSItested:________________

Crackingpressure:_____________________ Magnahelicpressure: __________________ PSItested:________________

ANSTItestresults: Workedasdesigned FailedtheANSTItest

Workedunderwaterasdesigned? Yes No

Notes: ____________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________


WETSUITS


Serial#:___________________________________________ Color:_________________________________________

Conditionofthesuit: Poor Fair Good Excellent Cutoff

Wetsuit: Bodysize:_____________ Thickness:_________mm

Bodytype: Frontzip Sidezip Rearzip Hoodedvest

Attachedhood Onepiece Twopiece

Other:______________________________________________________________

Gloves: Handsize:_________ Thickness:_________mm Type:_____________

Vest: Vestsize:_________ Thickness:_________mm Type:_____________

Hood: Headsize:_________ Thickness:_________mm Type:_____________

Booties: Bootsize:__________ Thickness:_________mm Type:_____________

Lycrasuit: Size:______________ Thickness:_________mm Type:_____________

Doesthesuithaveanyholes? Yes No Location:_______________________

Dothegloveshaveanyholes? Yes No Location:_______________________

Doesthevesthaveanyholes? Yes No Location:_______________________

Doesthehoodhaveanyholes? Yes No Location:_______________________

Dothebootieshaveanyholes? Yes No Location:_______________________

Doesthewetsuithaveanydamagethatisconsistentwithtrauma? Yes No

Wasthediverexperiencedinthewetsuit? Yes No

Wasthediverusedtodivingincoldwater? Yes No

Notes: ____________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________


DRYSUITS


Serial#:___________________________________________ Color:_________________________________________

Conditionofthesuit: Poor Fair Good Excellent Cut

Conditionoftheseals: Poor Fair Good ExcellentCut

Conditionofthezipper: Poor Fair Good ExcellentCut

Conditionofreliefzipper: Poor Fair Good ExcellentCut

Drysuit: BodySize:_________ Type:_________________

Bodytype: Frontzip Sidezip Rearzip Latexseals

Attachedhood Drygloves Attachedboots Neopreneseals

Gloves: Handsize:_________ Thickness:_________mm Type:_____________

Hood: Headsize:_________ Thickness:_________mm Type:_____________

Pocketlocations:____________________________________________________________________________________

Pockettype: Velcro Zipper Neoprene

Contentsofthepockets: ______________________________________________________________________________

LPhoseconnectedtothedrysuitvalve? Yes No Unknown

BrandandconditionoftheLPhose:_____________________________________________________________________

Doesthedrysuitvalvefunction? Yes No Unknown

Locationoftheexhaustvalveonthesuit:_________________________________________________________________

Doestheexhaustvalvefunctionproperly?________________________________________________________________

Anydebrislocatedintheexhaustvalve? Yes No

Didundergarmentgetstuckinexhaustvalve? Yes No Unknown

Inwhatpositionwastheexhaustvalvedial?_______________________________________________________________

Didthedrysuitflood? Yes No Unknown

Typeofinsulationwornunderthedrysuit:________________________________________________________________

Wasvictimcertifiedortrainedindrysuituse? Yes No

Levelofexperienceinadrysuit:NoneNovice(1-10dives)Intermediate(11-50dives)Experienced(>50dives)

Notes: ____________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________


WATCH, BOTTOM TIMER, SPG, COMPASS, DEPTH GAUGE, CAPILLARY GAUGE, TEMPERATURE GAUGE (Complete one form per instrument.)


Serial#:___________________________________________ Color:_________________________________________

Typeofgauge:______________________________________________________________________________________

Conditionofthegauge: Poor Fair Good Excellent

Isthetimecorrectontimingdevices? Yes No

Istemperaturecorrectonallthermometerdevices? Yes No

Depth Testing of the Depth Gauge (Descent/Ascent)

TestGaugeDepth ComputerDepth TestGaugeDepth ComputerDepth

0fsw ______fsw 130fsw ______fsw

10fsw ______fsw 120fsw ______fsw

20fsw ______fsw 110fsw ______fsw

30fsw ______fsw 100fsw ______fsw

40fsw ______fsw 90fsw ______fsw

50fsw ______fsw 80fsw ______fsw

60fsw ______fsw 70fsw ______fsw

70fsw ______fsw 60fsw ______fsw

80fsw ______fsw 50fsw ______fsw

90fsw ______fsw 40fsw ______fsw

100fsw ______fsw 30fsw ______fsw

110fsw ______fsw 20fsw ______fsw

120fsw ______fsw 10fsw ______fsw

130fsw ______fsw 0fsw ______fsw


Testing of the SPG (Pressurization/Depressurization Cycle)

TestGaugePressure SPGPressure TestGaugePressure SPGPressure

0psi ______psi 3500psi ______psi

500psi ______psi 3000psi ______psi

1000psi ______psi 2500psi ______psi

1500psi ______psi 2000psi ______psi

2000psi ______psi 1500psi ______psi

2500psi ______psi 1000psi ______psi

3000psi ______psi 500psi ______psi

3500psi ______psi 0psi ______psi


MASKS (Complete one form per mask.)


Serial#:___________________________________________ Color:_________________________________________

Data-typemask? Yes No

Conditionofthemask: Poor Fair Good Excellent Missing

Skirtintact? Yes No Strapintact? Yes No

Maskfoundondecedent? Yes No Maskonface Maskonforehead

Didthedecedenthaveanyproblemsequalizingorclearingthemask? Yes No Unknown

Wasthemaskfloodedorpartiallyfloodedbeforefatalityoccurred? Yes No Unknown

Correctivelenses? Yes No

Decedent’svisionwithoutcorrectivelenses:_______________________________________________________________

Wasdecedentwearingcontactsduringthedive? Yes No Unknown

Magnifyinginserts: Yes No

LCDdisplay: Yes No Functioningproperly? Yes No

Didthemaskhaveapurgevalve? Yes No Functioningproperly? Yes No

Anybloodorforeignobjectsinsidethemask? Yes No

Detail: ____________________________________________________________________________________________

DataMaskFunctionTest

Diddatamaskfunctionproperly? Yes No

Notes: ____________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________


SNORKELS

Manufacturer:________________________ Model:_____________________________ Color: ___________________

Conditionofthesnorkel: Poor Fair Good Excellent Missing

Mouthpiececondition: Poor Fair Good Excellent Missing

Bitetabsintact? Yes No

Notes: ____________________________________________________________________________________________

Doesthesnorkelhaveapurgevalve? Yes No Functioningproperly? Yes No

Anybloodorforeignobjectsinsidethesnorkel? Yes No

Detail: ____________________________________________________________________________________________

Wherewasthesnorkelattached? Rightside Leftside

Other(describe):____________________________________________________________________________________

Notes: ____________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________


FINS

Manufacturer:________________________ Model:_____________________________ Color: ___________________

Conditionofthefins: Poor Fair Good Excellent Missing

Finsizes: XS S M L XL XXL

Other:______________

Typeoffins: Openheel Fullfoot

Splitfins Freedivingfins

Werethefinsfoundonthedecedent? Yes No Unknown

Typeofstrapsusedwiththefins: Straps Springs

Didthefinstrapshaveaquick-disconnectfeature? Yes No

Werethefinstrapquick-disconnectsattached? Yes No Unknown

Didthefinsfitthedecedent? Yes No

Notes: ____________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________


CAMERA OR VIDEO EQUIPMENT (Complete one form per camera.)


Serial#:___________________________________________ Color:_________________________________________

Cameratype: Digital Still/video Mediatype:_____________________________

Film Still/movie Filmtype:______________________________

Lensmanufacturer:__________________________________ Type:__________________________________________

Serial#:___________________________________________ Filter: _________________________________________

Housingmanufacturer:_______________________________ Model:_________________________________________

Serial#:____________________________________________ Color:_________________________________________

Lensporttype:______________________________________

Camerafunctional? Yes No Housingflooded? Yes No

Decedent’scamera? Yes No Partner’scamera? Yes No

Strobe#1manufacturer:______________________________ Model:_________________________________________

Serial#:___________________________________________ Color:_________________________________________

Strobefunctional? Yes No Batteryflooded? Yes No

Strobe#2manufacturer:______________________________ Model:_________________________________________

Serial#:___________________________________________ Color:_________________________________________

Strobefunctional? Yes No Batteryflooded? Yes No

Lightmanufacturer: _________________________________ Model:_________________________________________

Serial#:____________________________________________ Color:_________________________________________

Lightfunctional? Yes No Flooded? Yes No

Typeofcliporattachmentusedtosecureequipmenttothediver:______________________________________________

Howwasequipmentconnectedtothediver?______________________________________________________________

Didlocationofequipmentaffectincident? Yes No

Didtheclip,lineorattachmentbecomeentangled? Yes No

Wastheequipmentnegativeorpositivelybuoyant? Negative Positive

Hownegativeorpositivelybuoyant?_____________________________________________________________________


Didthebuoyancyorlackofbuoyancyaffectincident? ______________________________________________________

Howexperiencedwasthedecedentwiththeequipment?_____________________________________________________

Nameofpersonwhodownloadedphotographs/video: ______________________________________________________

Date/timephotographs/videodownloaded:_______________________________________________________________

Name/dateofpersonwhomadeduplicateofvideotape:______________________________________________________

Downloaddigitalphotographsandvideotoatleasttwodifferentdrivesorstoragedevices,andmaintainhardcopiesofallrelevantphotographsforthecasefile.Ifvideotapewasusedinthecamera,aduplicatecopyofthetapeshouldbemade.

Doesfilmorslidesneedtobedeveloped? Yes No

Nameofthelabhiredtodevelopfilm/slides: ______________________________________________________________

Date/timefilm/slidessenttothelab:_____________________________________________________________________

Datethenegatives,printsorslideswerereceived:___________________________________________________________

Maintainnegatives,copyofprintsorslidesinthecasefile.

Notes: ____________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________


SLATE (Complete one form per slate.)

Manufacturer:______________________________________ Sizeofslate:_____________________________________

Typeofslate: Whiteboard Sketchtype Other:____________________________________

Howslatecarried: Onarm Onleg OnBC Onconsole

Clippedtodiver/where:___________________________________

Inapocket/where:_______________________________________

Slateattachedtoliftbag:__________________________________

Waspencilattached? Yes No Howwaspencilattached?_________________________________

Didpencilorslatelinecreateentanglementissue? Yes No Unknown

Didthediveplanontheslatematchdiveprofilefromthecomputer? Yes No

Whattypeofdeviationfromtheplanwasmade?___________________________________________________________

Makeaphotocopyofanyslatesusedbythedecedentordivepartner.Trytogetslatetranslationfrompartnerifslateinformationisinshorthand.

Transcribeallnotesfromslateontothisform.

Notes: ____________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Drawingsorsketchesfromslate:


GOODIE BAG (Complete one form per bag.)


Size: XS S M L XL Color:_________________________________________

Type:_____________________________________________ Numberofbags:_________________________________

Anyitemsattachedtothebag?GamemeasuringdevicesOther:_________________________________________

Listcontents:Empty____________________________________________________________________________

Weightofcontents:None ________________________________________________________________________

Didtheextraweightordragcauseanyissues? Yes No Unknown

Howwasthebagacarried?____________________________________________________________________________

Didthemannerinwhichthebagwasattachedcauseanyissues? Yes No Unknown

Wasthebagditched? Yes No

Whoditched? Victim Partner Rescuer

Wastheditchedbagrecovered? Yes No

Whereandwhorecovered?____________________________________________________________________________

Notes: ____________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________


LIFT BAG OR SURFACE MARKER BUOY (SMB) (Complete one form per lift bag/SMB.)


Typeofbag:________________________________________ Color:_________________________________________

Liftbagcapacity:____________poundsLiftbagmarkings:______________________________________________

Wherewastheliftbagcarried?_________________________________________________________________________

Wastheliftbagusedduringthedive? Yes No

Whywastheliftbagused? PartofPlan EmergencyUse LiftingObject

Howwasthebaginflated? Orally Regulator LPHose Other_______________________

Howwasthebagdeflated? Openbottom Manualdump Other_______________________

Duringtesting,anyleaksfoundinliftbag? Yes No Where:______________________

Afteruse,wasthebagstowed,foundinthewaterorlocatedonthesurface?

Stowed IntheWater Foundonthesurface

Diverexperiencelevelwiththebag: None Novice Intermediate Experienced

Notes: ____________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________


REEL (Complete one form per reel.)


Typeofreel: Open Closed Other:__________________ Color:_______________________

Typeofline:Material________________________ Twisted/BraidedSize___________Color:_______________

Howmuchlineonthereel?____________________________________________________________________________

Waslinemarkedinincrements? Yes No Howmarked:______________________________

Handletype: Standard Goodwin Other:____________________________________

Wherewasreellocated? Inpocket BCD-ring Harness Crotchstrap

Weightbelt Other:_________________________________________________

Didthewayinwhichthereelwascarriedcontributetothefatality? Yes No Unknown

Wasreelusedduringthedive? Yes No

Whywasthereelusedduringthedive? __________________________________________________________________

Ifused,didthereeleverjamordidthelinebecomeentangled? _______________________________________________

Typeofdrag/lockingmechanismonreel:_________________________________________________________________

Duringtesting,anyproblemsnoted?No Yes Describe:_________________________________

Cuttingdeviceonreel? Yes No

Diverexperiencelevelwithreel: None NoviceIntermediate Experienced

Notes: ____________________________________________________________________________________________

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__________________________________________________________________________________________________

__________________________________________________________________________________________________

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KNIVES OR CUTTING DEVICES (Complete one form per knife/cutting device.)


Typeoftool: Knife(fixedorfolding) Paramedicshears

Linecutters Other:_____________________________________________________

Notypeoftoolcarriedbydecedent

Toolmaterial: Titanium Stainless Non-stainlesssteel Other:___________________________

Sheath: Open Locking Other_______________________________ None

Wherewasthetoolcarried? Calf: Right Left Inner Outer

Thigh: Right Left Inner Outer

Arm: Right Left Inner Outer

Waist: Right Left Front Side

Harness: Right Left Front Side

Pocket: Right Left Front Side

Wetsuitsheath(describewhere):_________________________________________

Other:______________________________________________________________

Wasthetoolinapositionitcouldbeused? Yes No Unknown

Duringtestingcouldtoolberemovedeasily? Yes No

Ifno,notewhythetoolcouldnotberemoved: Rust Sand Other:______________________

Wastoolremovedduringthedive? Yes No Unknown

Whywastoolremoved: Emergency Non-Emergency

Wasthetoolplacedbackintocarryingdevice? Yes No Unknown

Notes: ____________________________________________________________________________________________

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DIVE LIGHTS (Complete additional forms as needed.)

Primary Light


Serial#:___________________________________________ Color:_________________________________________

Batterytype: _______________________________________ Numberofbatteries:______________________________

Bulbtype: IncandescentHID LED Xenon Other:______________________


Howwasthelightcarriedorattachedtothediver? _________________________________________________________

Detachedlighthead(canisterlight)? Yes No

Ifyes,describehowlightheadcablestowed: ______________________________________________________________

Didlightcontributetotheaccident?: Yes No Unknown

Duringtesting,didlightandswitchfunctionproperly? Yes No Describe:____________________

Second Light


Serial#:___________________________________________ Color:_________________________________________






Third Light


Serial#:___________________________________________ Color:_________________________________________







Fourth Light


Serial#:___________________________________________ Color:_________________________________________






Fifth Light


Serial#:___________________________________________ Color:_________________________________________






Notes: ____________________________________________________________________________________________

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JON LINE (Complete one form per jon line.)


Type:_______________________________ Length:_____________________________ Color: ___________________

Wherewasthelinecarried? Waist: Right Left Front Side

Harness: Right Left Front Side

Pocket: Right Left Front Side

Other(describe):_____________________________________________________

Wasthejonlineinapositionitcouldbeused? Yes No Unknown

Duringtestingcouldthelineberemovedeasily? Yes No

Ifno,notewhythejonlinecouldnotberemoved: Rust Sand Other:______________________

Wasjonlineremovedduringthedive? Yes No Unknown

Whywasjonlineremoved? Non-emergency Emergency

Wasthejonlineplacedbackintocarryingdevice? Yes No Unknown

Jonlinelength:___________________feet/inches

Whattypeofclipwasattachedtothediver’ssideofthejonline?_______________________________________________

Whattypeofclipwasattachedtothenondiverendofthejonline? ____________________________________________

Ifdeployed,didthejonlinebecomeentangled? Yes No Unknown

Didthejonlinecontributetothefatality? Yes No Unknown

Notes: ____________________________________________________________________________________________

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SPEAR GUN AND SLINGS (Complete one form per spear gun.)


Type: Pneumatic Banded Polespear HawaiianslingOther:____________________

Lengthofgun:______________________________________ Color:_________________________________________

Howmanybands? 1234

Materialmadefrom: Wood Metal Other:_________________________________________________

Doesthegunhaveanattachedreel? Yes No Unknown

Doesthegunhaveanattachedbuoyancydevice? Yes No Unknown

Howmuchlineisonthereel? _________________feet

Istherea“safety”onthegun? Yes No

Ifyes,doesitfunctionproperly? Yes No Describe:____________________

Buoyancyofgun: Negative Positive Buoyantforce:_____________lbs

Wasthegunusedduringthedive? Yes No Unknown

Wastheuseofthegunafactorintheincident? Yes No Unknown

Wasthegunattachedtothediver? Yes No Unknown

Howwasthegunattachedtothediver?__________________________________________________________________

Didtheguncontributetothefatality? Yes No Unknown

Wasanygameattachedtothediver? Yes No Unknown

Ifyes,describetypes,number,sizes,andhowattached:______________________________________________________

__________________________________________________________________________________________________

Notes: ____________________________________________________________________________________________

__________________________________________________________________________________________________

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DIVER PROPULSION VEHICLES (DPV)


Type:_____________________________________________ Color:_________________________________________

DPVactivationmechanism:___________________________________________________________________________

Wasthedivertrainedtousetheunit? Yes No Unknown

Howexperiencedwasthediverwiththeunit? Novice Intermediate Experienced

Howwastheunitattachedtothediver?__________________________________________________________________

NumberofdiversusingtheDPVatthetimeoftheincident:__________________________________________________

NumberofdiverswithDPVsindiveteam:________________________________________________________________

Wasthediverusingtheunitwhentheincidentoccurred? Yes No Unknown

WastheDPVfunctionalattimeoftheincident? Yes No Unknown

Wastheunitnegativelyorpositivelybuoyant? Negative Positive

Hownegativeorpositivelybuoyantwastheunit? _____________pounds

TrimweightsaddedtoDPV? Yes No Unknown _____________pounds

DPVflooded? Yes No Unknown

AnymodificationsmadetoDPV?_______________________________________________________________________

DidtheDPVcontributetotheaccident? Yes No Unknown

Notetestresultsbelow.

Notes: ____________________________________________________________________________________________

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APPENDIX E1 Open-Circuit Scuba Equipment Evaluation Forms · APPENDIX E1: OPEN-CIRCUIT SCUBA...

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