DHS CG-5401C 2004 free printable template

OMB No. Approved 1625-0045 Burden hours. 75 per response U.S. DEPARTMENT OF HOMELAND SECURITY U.S. COAST GUARD CG-5401C 6-04 Application for a Reception Facility Certificate of Adequacy for Garbage FORM C The Act to Prevent Pollution From Ships 33 USC 1901 authorizes the Department of Homeland Security to issue certificates to Terminals and Ports verifying their adequacy to receive operational garbage from ships. Port Section will be members of t...

How to fill out DHS CG-5401C

How to fill out DHS CG-5401C

1. Start by gathering all required documents you will need to reference when filling out the form.
2. Download the DHS CG-5401C form from the official website.
3. Fill in the applicant's details at the top, including name, address, and contact information.
4. Provide your Social Security Number (if applicable) in the designated field.
5. Complete the sections concerning the purpose of the request and the type of request being made.
6. Carefully read the instructions for each section to ensure proper completion.
7. Review all inputted information for accuracy and completeness.
8. Sign and date the form at the bottom where indicated.
9. Submit the form as instructed, whether electronically or via mail.

Who needs DHS CG-5401C?

1. Individuals applying for specific benefits or services from the Department of Homeland Security.
2. Organizations or entities needing to request information or services relevant to national security.
3. Those conducting official business with DHS that requires the submission of information documented in the CG-5401C.

Instructions and Help about DHS CG-5401C

The d-o-t USCG periodic drug testing form is pretty straightforward section one is just applicant consent, and you have to fill in your last name first name middle name reference number if applicable so those getting an original license will not have a reference number, so you'll just put your social security number in here they want it in this format three numbers two numbers four numbers, and then you'll end up signing and dating it and then as we continue down to section two this is the Samoa accredited laboratory and then section three is completed by the Medical Review officer, so you won't have to do any of that and as we come down to the second page of the form there are certain programs which will disqualify you from meeting this form or to say it another way there are certain programs that will work in lieu of using this form you can get a letter from these programs, and you will include those in your application packet you won't need this form so a periodic drug testing program, and it's described here on the right random drug testing program described here on the right and pre-employment testing program described here on the right and this is a loophole I've slipped through with my last renewal I was in a random drug testing program because I was working on a pair of sailboats and I got a letter from my random drug testing program and submitted that with my packet and that took the place of this form now this form is very easy the hardest part for people is actually finding lab with the Medical Review officer and I want to point you in the right direction, so you can get a good start if you need to use this form because you don't qualify with any of the options below to use instead of this form we can go to the Coast Guard's website at USC GPL you let the sea cheetah mill we'll go here on the right side says Mariners click on Mariners, and then you'll see up top it says drug testing you can click on drug test, and then it has right here a PDF drug testing directory users guide click on that click OK and now what it'll do it'll give you helpful links to locate one of these facilities, and it will give you instructions and then there are more resources down here it'll point you in the right direction I just wanted to show you that that's available, so you can use it as a resource if you're having trouble, so we're going to go back to the forum, so that's about that's about it that will give you a perfect head start on this drug test form you just fill out the top read the bottoms below just read the options below to see if you qualify is one of these options pertain to you and if they don't, and you are having trouble finding this location go to the Coast Guard's website click on this drug testing link, and then you'll be brought to this PDF and you can review this PDF and use the resources in here to find a location

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What is DHS CG-5401C?

DHS CG-5401C is a form used by the U.S. Coast Guard to capture and report information related to a vessel's compliance with safety and environmental regulations.

Who is required to file DHS CG-5401C?

Owners, operators, or individuals responsible for the management of vessels operating in U.S. waters are required to file DHS CG-5401C.

How to fill out DHS CG-5401C?

To fill out DHS CG-5401C, provide the requested information accurately, including vessel details and compliance data, ensuring to review for completeness and correctness before submission.

What is the purpose of DHS CG-5401C?

The purpose of DHS CG-5401C is to ensure that vessels adhere to safety regulations and environmental standards, facilitating accountability and compliance within maritime operations.

What information must be reported on DHS CG-5401C?

Information that must be reported on DHS CG-5401C includes the vessel's name, registration number, operator information, safety equipment details, and compliance results with applicable regulations.