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Phone 803-532-6783 • Fax 803-604-0162 • e-mail: info@lakesidehull.com

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Vessel Information Checklist

    To schedule service on your vessel, please complete this checklist and return it by fax or e-mail. For a PDF version click here. You will be contacted with a quote, and to schedule a time and date for service.

Name: ___________________________________________________________________

Address: _________________________________________________________________

Phone: Daytime _________ Evening __________ Fax __________ Mobile __________

e-mail ___________________________________________________________________

Vessel name or side number:_________________________
_________________________

Make & type: _______________________________ Length overall: __________________

Vessel location ____________________________________________________________

Date of last haulout and paint: _________________________________________________

Type/brand of hull paint: _____________________________________________________

Number of anodes: _________________________________________________________

• • • SHORE POWER MUST BE DISCONNECTED FROM • • •
THE VESSEL AT TIME OF SERVICE.

Additional comments/info: