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Clean Boater Pledge Form
Clean Boater Logo
As A Clean Boater I Pledge To:
  • Practice proper fueling techniques or ask fuel dock attendants to do so
  • Use oil absorbent materials in bilge areas when needed
  • Use sewage pumpout facilities, floating restrooms, or land based facilities
  • Use phosphate-free, biodegradable, and non-toxic cleaners
  • Recycle when containers are available
  • Dispose of fish waste properly
  • Keep Oregon waters free of trash
  • Help prevent the spread of invasive species - "Never Launch a Dirty Boat"
  • Lead by example and encourage fellow boaters to take the pledge
 
To be eligible to receive a Clean Boater Kit you must have a current and valid boat registration decal and a boater’s education card from the Oregon Marine Board.  (Only 1 Boater Kit per registered boat)
Mr./ Ms./ Mrs.
Name (Registered Owner):
Boat Registration Number:
Education Card Number:
Mailing Address:
City:
State:
Zip Code:
E-mail:
 
Environmental Questionnaire
1. What is the overall length of your boat? less than 16 ft    16 - 25 ft     26 - 39 ft
40 - 65 ft           more than 65 ft
2. What type of engine is the primary means of propulsion for your boat? carbureted two-stroke outboard
direct fuel injected two-stroke outboard
four stroke outboard
inboard
inboard/outboard
3. Where do you store or berth your boat during the boating season? at home on a trailer            berth at home (private dock)
marina during the summer   marina all year
4. Where do you most often fuel your boat? at gas station prior to launching
marina with an on-water fuel dock
bring your own gas can
5. If you use a marina with a fuel dock, does the gas attendant use an oil absorbent pad with the fuel nozzle to prevent fuel spills from entering the water? yes, all the time
no, never
only sometimes
N/A
6. Petroleum spills are required to be reported to the State of Oregon (DEQ) and the U.S. Coast Guard. What do you think is the amount of oil that is required to be reported? 1-2 drops     1/2 cup     1 cup
any amount that causes a sheen on the water
only motor oil should be reported, gas and diesel are exempt from reporting
don't know
7. While you are boating, what percent of the time do you use the following facilities?% toilet on boat
% port-a-potty on boat
% floating restroom
% on-shore restroom at marina / near boat ramp
8. If you use floating restrooms, what percent of the time were they in good working order and clean? 100%      75%      50%
25%       0%
I don't use floating restrooms
9. If you have an installed toilet on your boat, what type of marine sanitation device is connected to it ? (a port-a-potty is not an installed toilet) Type I: Macerates waste so there are no visible solids; discharges may not be clear (e.g. "Electro -san").
Type II: Macerates waste finer than Type I; discharges may not be clear.
Type III: Holding tank only; does not treat waste, instead holds waste until pumped into a facility on shore.
no toilet
don't know
10. If you use boat sewage pumpout stations, what percent of the time were they in good working order? 100%     75%      50%
25%       0%
I don't use pumpouts
11. On a scale of 1-10, how much of a threat do you think aquatic invasive species (e.g. milfoil, an aquatic weed, or zebra mussels) are to Oregon's environment?A very big threat:   10 9 8 7
A small problem:              6 5 4
Not a problem/ no issue: 3 2 1
12. Do you inspect and remove attached plants or animals from your boat upon taking it out of the water? yes, every time at the boat ramp
yes, after I get back home
no, it's not an issue
N/A
13. Marine law enforcement officers primarily focus on boating safety activities. Should they also enforce/ investigate environmental regulations? If so, rank the following activities from 1-3, with 1 being the highest environmental priority oil spills
inspect boats for proper sewage disposal
inspect boats for invasive species
no environmental enforcement, only boating safety
14. Do you know what this sign means?
 
no
yes - please describe
15. How did you hear about the Clean Boater Program? (Include bag code if you already received a bag)
 
Click below to submit your Oregon Clean Boater Pledge and indicate your agreement with the following statement:

As a participating member of the Oregon Clean Boater Program, I will/have read the "Clean Boater Guide - Protecting Oregon’s Marine Resources" and do pledge to abide by the guidelines covered therein. I will also ensure that all passengers aboard my vessel follow the guidelines and maintain a clean boating environment. When possible, I will also support Oregon’s certified Clean Marinas while boating.
 
Your Name (Required):