# Commission Delegated Regulation (EU) 2020/124 of 15 October 2019 supplementing Regulation (EU) 2019/833 of the European Parliament and of the Council laying down conservation and enforcement measures applicable in the Regulatory Area of the Northwest Atlantic Fisheries Organisation, Division 9: FORMAT PRESCRIBED IN ANNEX IV.C OF THE CEM, AS REFERRED TO IN ARTICLE 10(1)(E), ARTICLE 27(3)(C) AND ARTICLE 39(16) OF REGULATION (EU) 2019/833

Extent: E+W+S+N.I.

Report on port State control inspection (PSC-3)
(please use black ink)
A. INSPECTION REFERENCE.
Inspection report number:
Landing
Yes
No
Transhipment
Yes
No
Other reason for port entry
Port State
Port of landing or transhipment
Vessel name
Flag State
IMO Number 1
International Radio call sign
Landing/transhipment Start Date
Landing/transhipment Start Time (UTC)
Landing/transhipment End Date
Landing/transhipment End Time (UTC)
Vessel master’s name:
Vessel master’s nationality:
Vessel’s owner/operator:
Certificate of Registry ID:
VMS:
Port of registry:
Fishing master's name:
Fishing master's nationality:
Vessel’s beneficial owner 2:
Vessel’s agent:
Vessel Type:
Last port of call:
Date:
B. INSPECTION DETAILS
Name of donor vessel 3
IMO Number 1
Radio call sign
Flag State
B1. CATCH RECORDED IN THE LOGBOOK
Species 4
Area of catch
Declared live weight kg
Conversion factor used
B2. FISH LANDED OR TRANSHIPPED*
* In case where a vessel has engaged in transhipment operations a separate form shall be used for each donor vessel.
Species4
Product5
Area of catch
Product weight landed in kg
Conversion factor
Equivalent live weight kg
Diff (kg) between live weight declared in the logbook and the live weight landed
Diff (%) between live weight declared in the logbook and the live weight landed
Diff (kg) between Product weight landed and PSC 1/2
Diff (%) between Product weight landed and PSC 1/2
Relevant transhipment authorization:
B3. INFORMATION ABOUT LANDINGS AUTHORIzED WITHOUT CONFIRMATION FROM THE FLAG STATE
Ref. NEAFC art. 23.2/NAFO art. 43.7
Name of Storage:
Name of Competent Authorities:
Deadline for receiving Confirmation:
B4. FISH RETAINED ON BOARD
Species4
Product5
Area of catch
Product weight in kg
Conversion factor
Live weight kg
Diff. (kg) between product weight on board and PSC 1/2
Diff. (%) between product weight on board and PSC 1/2
C. RESULTS OF INSPECTION
C1. GENERAL
Inspection Start Date:
Inspection Start Time (UTC):
Inspection End Date:
Inspection End Time (UTC):
Status in other RFMO areas where fishing activities have been undertaken, including any IUU vessel listing
RFMO
Vessel identifier
Flag State status
Vessel on authorized vessel list
Vessel on IUU vessel list
Observations:
C2. GEAR INSPECTION IN PORT
A. General data
Number of gear inspected
Date gear inspection
Has the vessel been cited?
Yes
No
If yes, complete the full ‘verification of inspection in port form.
If no, complete the form with the exception of the NAFO seal details
B. Otter Trawl details
NAFO Seal number
Is seal undamaged?
Yes
No
Gear type
Attachments
Grate Bar Spacing (mm).
Mesh type
Average mesh sizes (mm)
Trawl part
Wings
Body
Lengthening Piece
Codend
D. OBSERVATIONS BY THE MASTER:
I, … the undersigned, Master of the vessel … hereby confirm that a copy of this report have been delivered to me on this date. My signature does not constitute acceptance of any part of the contents of this report, except my own observations, if any.
Signature: ______________________________________ Date : ____________
E. INFRINGEMENTS AND FOLLOW-UP
E.1 NAFO
E.1 At-Sea Inspection
Infringements resulting from Inspections inside NAFO R.A.
Inspection Party
Date of inspection
Division
NAFO CEM infringement legal reference
E.1 B Port Inspection Infringements results
(a) - Confirmation of Infringements found at-sea inspection
NAFO CEM infringement legal reference
National Infringement legal reference
(b) - Infringements found at-sea inspection and not possible to be confirmed during the Port Inspection.
Comments :
(c) - Additional infringements found during the Port Inspection
NAFO CEM infringement legal reference
National Infringement legal reference
E2. NEAFC INFRIGEMENT NOTED
Article
NEAFC provision(s) violated and summary of pertinent facts
Inspector’s observations:
Action taken:
Inspecting authority/agency:
Inspectors Name
Inspectors signature
Date and place
F. DISTRIBUTION
Copy to flag State
Copy to NEAFC Secretary
Copy to NAFO Executive Secretary
1.
Fishing vessels not assigned an IMO number shall provide their external registration number.
2.
If known and if different from vessel’s owner.
3.
In case where a vessel has engaged in transhipment operations, a separate form shall be used for each donor vessel.
4.
FAO Species Codes —NEAFC Annex V — NAFO Annex I.C.
5.
Product presentations —NEAFC Appendix 1 to Annex IV — NAFO Annex II.K.

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Source: https://www.legislation.gov.uk/eur/2020/124/annex/division/9 (the official version)
Page: https://openlegislation.uk/eu-regulation-2020-124/annex/division-9
Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives.