Oregon Clean Marina Program Foam Encapsulation Certification Form

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Oregon Clean Marina Program

Department
- Boards
  - Marine Board
- Others

Foam Encapsulation Certification Form

Keep Oregon's waters clean and enjoyable for all boaters.

An Encapsulation Certification is required for all new construction projects or additions to existing structures involving polystyrene foam floatation, and certain other maintenance, alteration and repair projects as specified in the rules. These rules apply to all public and private floating structures placed on the waters of this state.

To certify foam encapsulation, use:

This page to send a report
Mail or fax a Certification Form

We will review your certification and respond by mail, usually within 10 days. Encapsulation methods must be approved by OSMB before the foam is placed in the water. Certifications are valid for 20 years, once approved. No fee is required.

Mr./ Ms./ Mrs.

Owner's First Name
Owner's Last Name
Company/Agency Name
Address
City
State
Zip Code
Phone # (Home)
Phone # (Work)
Fax#
e-mail

Date of proposed foam installation

Installer's name, address and phone

County / Waterbody
(Include Rivermile)

Description of foam location, including structure address, marina name and slip number if any

Type of floating structure (floating home, boathouse, walkway, moorage slip, fuel float)
Dimensions of Floating Structure
Type and thickness of material used to encapsulate foam

Amount of foam installed

Click below to submit your foam use information and indicate your agreement with the following statement:

I certify that, to the best of my knowledge and belief, the proposed project and activity described in this certification form complies with the Floatation Encapsulation Program Rules and will be completed and installed in a manner consistent with the program.

Your Name (Required):

Page updated: October 03, 2007

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