2. Registration Information

   Please fill out the following Pumpout Registration Form to request mobile vessel pumpout services provided by the City of Key West in partnership with Monroe County. Services will be available to anchored vessels in the following anchorages: Wisteria, Fleming, Seaplane Basin, Cow Key Channel and Boca Chica Basin. Once an application is received, your vessel will be registered for pumpout service. Service is anticipated to start in mid-August 2020.

   
   

   Upon first service, you will be provided an orange pumpout flag to be flown when service is requested. This flag shall be flown from a visible location aboard the vessel. Service will be provided only when the pumpout flag is properly displayed. A monthly endorsement sticker will be placed on the bow of your vessel adjacent to the state vessel registration decal. For each new month of service thereafter, a new endorsement sticker will be placed in the same location. This sticker shall serve as documentation for compliance with the Monroe County Proof of Pumpout Ordinance 015-2017.

   
   

   A weekly service schedule for your vessel's location will be made available on the City of Key West’s website HERE. Every effort will be made to provide your vessel with a routine, weekly pumpout service if requested. However, weather, safety or other scheduling considerations cannot guarantee that you will be provided service on a routine schedule. Shoreside pumpout stations are also available throughout Monroe County. A list of available shoreside facilities can be found HERE.

   
   

   For more information, please call the Key West Bight Marina at 305-809-3981 or by email or the Monroe County Marine Resources Office at 305-289-2505 or by email.

4. First Name*
5. Last Name*
7. Mailing Address*
9. City*
10. State*
11. Zip*
13. Email Address
14. Phone*
16. Contact Name (if different from above)
17. Contact Phone (if different from above)
19. Monroe County Resident?*
    -- Select One --YesNo
20. Vessel Registration Number (or USCG Documentation Number)*
21. In-State or Out-of-State Registration*
    -- Select One --In-StateOut-of-State
23. Vessel Type*
    -- Select One --SailPower
24. Vessel Length*
25. Vessel Make/Model*
27. Vessel Name*
    If none, type 'No Name'
28. Holding Tank Capacity (Gallons)*
29. Waste Outlet Location*
    -- Select One --StarboardPort
31. Vessel Location/Anchorage*
    -- Select One --WisteriaFlemingCow Key Channel (North)Cow Key Channel (South)Boca Chica BasinSeaplane Basin

    NOTE: only vessels anchored in the locations above will be considered for pumpout services
32. GPS Latitude (if known)
    Format: Degrees, Minutes, Seconds (e.g. 24 34' 18.07"N)
33. GPS Longitude (if known)
    Format: Degrees, Minutes, Seconds (e.g. 81 48' 38.75"W)
35. Detailed Location Description
37. I anticipate needing service:*
    -- Select One --Only OnceMonthlyBi-WeeklyWeekly
38. Vessel Use*
    -- Select One --Year-Round Local LiveaboardSeasonal Local LiveaboardTransient CruiserRecreational Use/Non LiveaboardCommercial UseOther (Please specify below)
40. Special Notes / Additional Information
42. I understand that it is my responsibility to ensure this vessel and all waste valves are in the proper position for waste collection. I understand that I will not receive mobile pumpout service unless I display the orange pumpout flag indicating a request for pumpout services. I understand that weather and other scheduling and health or safety considerations may impact receiving pumpout services. I understand that Monroe County and the City of Key West will not for any reason in connection with or in relation to the provision of the service be responsible or liable for any damages including but not limited to vessel defects or improper installation of holding tank systems. I understand the above terms, and authorize Monroe County and/or the City of Key West personnel to perform pumpout services aboard my vessel. I understand that Monroe County and/or City of Key West personnel may need to board this vessel, if necessary, to perform the service. Service will not be provided to a vessel that does not have sewage to be pumped, and I will not receive a monthly endorsement sticker if services have not been provided. Service may be denied for any reason including but not limited to if the vessel is not properly equipped to provide for a safe, secure pumpout as determined by the pumpout vessel operator. By executing this Registration Form, I attest that I am legally authorized to authorize provision of the service by Monroe County and/or the City of Key West, and that I assume all liability, and shall indemnify and hold harmless the County and City for the provision of the service pursuant to their reliance upon the truth and accuracy of this executed Registration Form.
44. Electronic Signature*
45. Date*
    Date
Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit

* indicates a required field