[name not read] · casualty
Report of Casualty, 2 pages · T925-0005, pp. 47–48 · No. 876
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Reader’s notes on the scan
- Rubber stamps 'RIVERS', 'TOTAL LOSS', 'OTHER CAUSES' across form
- Handwritten 'Copy' at top of form.
- Signature area has '(Signed)' handwritten before the name.
Form header
- Running number
- 876
- Filed at
- Collection District No. 43, Port of Clarksville Tenn
- Received
- U.S. COAST GUARD REC'D NOV 3 1919 ANS'D · 3 Nov 1919
- Vessel name written at top
- —
- Other numbers
- —
- Stamps on the form
- —
Vessel
- 2 · Name, rig, nationality
- [name not read] · Am.
- 6 · Official number
- 216025
- 3 · Tonnage
- 21 gross + 14 net
- 4 · Age or year built
- About Five (5) months
- 5 · Port registered
- Nashville, Tenn - 216025
- 7 · Master and residence
- Jessie H. Hayes - Montgomery County, Tenn.
- 8 · Owner and residence
- Montgomery County, Tenn.
Casualty
- 1 · Date
- Aug 21, 1918 at 4 o'clock P.M
- 24 · Locality
- Caught fire from gasoline engine
- 9–10 · Voyage
- Ferry across river → Ferrying across river
- 27 · Weather
- —
- 11–13 · Passengers / crew / lost
- 8 passengers, One crew, no persons lost
- 14 · Value of vessel
- $3,000
25 · Nature of casualty, as written
—
26 · Cause, as written
—
Signature
- Signed by
- Jessie H. Hayes · Master
- Company or by
- —
- Date signed
- Oct. 14, 1918.
- Place
- —
Show all 30 items
Verbatim from the form. Item labels are approximate; the printed wording varies by year.
- 1 · Date of casualty
- Aug 21, 1918 at 4 o'clock P.M
- 2 · Vessel, rig, nationality
- Am. Gas. steam - st'm wh'l - wood
- 3 · Tonnage
- 21 gross + 14 net
- 4 · Age or year built
- About Five (5) months
- 5 · Port registered
- Nashville, Tenn - 216025
- 6 · Official number
- 216025
- 7 · Master and residence
- Jessie H. Hayes - Montgomery County, Tenn.
- 8 · Owner and residence
- Montgomery County, Tenn.
- 9 · Sailed from
- Ferry across river
- 10 · Bound for
- Ferrying across river
- 11 · Passengers
- 8
- 12 · Crew
- One
- 13 · Persons lost
- None
- 14 · Value of vessel
- $3,000
- 15 · Value of cargo
- Unknown
- 16 · Cargo
- Mixed - wagons, etc.
- 17 · Deck load
- Yes
- 18 · Overladen
- No
- 19 · Cargo weight
- Unknown - light
- 20 · Loss or insurance (20)
- total
- 21 · Loss or insurance (21)
- none
- 22 · Loss or insurance (22)
- none
- 23 · Loss or insurance (23)
- at 7 mi Ferry near Clarksville Tenn
- 24 · Locality
- Caught fire from gasoline engine
- 25 · Nature of casualty
- —
- 26 · Cause
- —
- 27 · Weather
- —
- 28 · Measures taken
- —
- 29 · Assistance
- —
- 30 · Remarks
- —