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pdfNATIONAL CLANDESTINE LABORATORY SEIZURE REPORT!INSTRUCTIONS
PURPOSE: The National Clandestine Laboratory Seizure Report!(EPIC Form 143) and the Clandestine Laboratory Seizure
System (CLSS) include data pertaining to clandestine laboratories seized in the United States by local, State and Federal law
enforcement agencies. (The entered data must meet Department of Justice 28 CFR Part 23 guidelines.) The CLSS is a
Privacy Act System of Records. The records contained in the system are under the control and custody of the Drug
Enforcement Administration (DEA), and are maintained in accordance of Federal laws and regulations. Use of the information
is limited to law enforcement agencies in connection with activities pertaining to the enforcement of criminal laws.
Accordingly, disclosure, release or dissemination of information obtained through accessing the CLSS is strictly prohibited
without the express written consent of the DEA. The El Paso Intelligence Center (EPIC) is the central repository for these
data. The data will be useful in determining, among other criteria, the types, numbers, and locations of laboratories seized;
manufacturing trends; precursor and chemical sources; the number of children and law enforcement officers affected; and
investigative leads. The data may also be useful to agencies in justifying and allocating current or future resources. Further
information can be obtained on RISS.NET at URL http://clanlab.riss.net.
TYPE OF REPORT: (top right corner) Check only one box to indicate the type of seizure being reported.
LAB SEIZURE: CLANDESTINE LABORATORY DEFINED: “An illicit operation consisting of a sufficient
combination of apparatus and chemicals that either has been or could be used in the manufacture or
synthesis of controlled substances.” Check this box only if the seizure meets this definition.
CHEM/GLASSWARE/EQUIPMENT SEIZURE: A seizure of only chemicals, glassware, and/or equipment normally
associated with the manufacturing of a controlled/illicit substance, but there is insufficient evidence that the items were used
in the manufacture of a controlled/illicit substance.
DUMPSITE SEIZURE: A location where discarded laboratory equipment, empty chemical containers, waste by products,
pseudoephedrine containers, etc., were abandoned/dumped. There was no lab found with this seizure.
I.
REPORTING OFFICE: Indicate the date of seizure (MMDDYYYY). Identify the seizing agency, ORI number,
agency location (city and state), case or file number, reporting officer (first and last name) and telephone number.
These are mandatory fields. The file title is not a mandatory field, but it can be queried. The primary subject’s name
is often times used as the file title. Under “Reporting Officer/Agent” provide the full name and telephone number of
the person submitting the information and any other person that can be contacted for further information or
investigative referrals. Place additional phone numbers in the Remarks Section. The COPS number (‘S’ number) is
assigned by DEA to agencies requesting DEA funding for lab clean up and should be provided if applicable. If more
than one agency was involved in the seizure, the same identifying information can be placed in the database with each
participating agency. Place additional agency information in the Remarks Section.
II.
SEIZURE LOCATION: Check the box that most closely describes the location of the seizure. Vehicle is used for
anything on wheels, to include cars, trucks, tractor-trailer, recreational vehicles, etc. Family dwelling includes
residences or mobile homes. Use Remarks Section for additional information.
III.
SEIZURE NEIGHBORHOOD: Check the box that most closely describes the surrounding area. An urban area is a
city or town, suburban is the outskirts of a city or town, and rural is the countryside or an agricultural area. If the
seizure occurs on public land, indicate the official name of the land.
IV.
ESTIMATED LAB CAPACITY: Estimate the amount the seized lab could have produced, per cooking cycle, based
on the amount of precursors, chemicals, and equipment at the lab site. This should be a best estimate, based on on-site
observations or intelligence. This field is mandatory if the Type of Report!has been checked as a Lab Seizure.
V.
LABORATORY STATUS: A laboratory is considered operational if all the necessary chemicals and apparatus are
present, and it is set up so that a chemical synthesis can begin within a short period of time. Anything not considered
an operational laboratory should be reported as non-operational.
Other choices include Abandoned,
Boxed/Dismantled, or Explosion/Fire. Check all that apply. This field is mandatory if the Type of Report!has been
checked as a Lab Seizure.
VI.
LAB MANUFACTURING PROCESS: Check one. Choose the primary manufacturing process. Check Hydriodic
Acid manufacturing or Ephedrine or Pseudoephedrine tablet extraction ONLY if the lab was operated solely for this
purpose (i.e., the lab being reported was NOT manufacturing methamphetamine). In the OTHER block, indicate any
substitute chemicals used.
Page 1 of 3
EPIC Form 143 Instructions (Rev. 06/04)
VII.
LABORATORY EQUIPMENT: Check the box that most closely describes the type of glassware and apparatus
seized. Professional/retail indicates chemistry/research-type equipment. If available, provide information on the
manufacturer, seller, etc. Remember, purchaser information is available on some equipment; therefore, the recording
of brand name, model number, and serial number is encouraged for possible investigative follow-up.
VIII.
LABORATORY TYPE: Check the type of drug being manufactured or produced. The tablet extraction box
indicates the seizure of an extraction-type laboratory only (e.g. pseudoephedrine tablets). Check all boxes that apply.
IX.
SEIZURE/LABORATORY ADDRESS: List the laboratory’s complete address, including county, state, and zip
code. (County and state are mandatory fields.) In the case of a traffic stop, indicate the location of the stop. If a
seizure takes place in a rural area where there are no numbered addresses, put in the closest reference point (i.e., (2
miles West of County Road 220). Latitude/longitude for rural labs with no address are the best alternative.
X.
CHEMIST AND CLEAN-UP PERSONNEL: This is a mandatory field. Check the appropriate box and provide
the name of the HAZMAT contractor. Evaluation of Hazmat Contractor is mandatory for all DEA reported seizures.
XI.
PERSONS AFFECTED: Check all boxes that apply. The number of children affected is a mandatory field. Total
children affected would include children residing (not necessarily present) and any children visiting. (If anyone was
injured or killed at the lab site, provide additional details in the Remarks Section.)
XII.
WEAPONS/EXPLOSIVES SEIZED: Type of weapon is considered a handgun, shotgun, rifle, assault rifle, etc.
The number indicates how many of the same make and model were seized. Under Description, indicate Make, Model
and Caliber of the weapon. If a Booby Trap was encountered, indicate whether it was explosive, chemical or
mechanical and any other identifying information.
XIII.
QUANTITY OF ALL DRUGS SEIZED AT LAB SITE: Check all boxes that apply and provide quantity and unit
of measurement. This category includes finished drugs, unfinished drugs, as well as manufactured drugs in solution
(e.g. 22 grams of meth; 200 milliliters of meth in solution) and other types of drugs found, but not necessarily
manufactured, at the lab site.
XIV.
PRECURSOR/CHEMICAL SOURCE: Specify precursor and check the box that indicates the source.
Manufacturer and distributor information, including lot or identification numbers, should be reported. Additional
precursor information should be continued in the Remarks Section.
XV.
PRECURSOR AGENTS/ CATALYSTS/ SOLVENTS/ REAGENTS SEIZED: Check all known precursors/chemicals
used and provide applicable amounts (as indicated by seized containers and chemical analysis). If ephedrine or
pseudoephedrine is seized, ‘packaging’ is a mandatory field. For bulk amounts, use weight amount. For tablets, use
pill counts and dosage units (i.e., Pseudoephedrine – “250 Tablets/60 mg”). For blister packs, indicate number of
blister packs, tablet count per pack, dosage unit size, and any brand name and lot number information (i.e.,
“Pseudoephedrine – 20 blister packs, 48 tabs each, 120 mg”). If known, select the source of the ephedrine or
pseudoephedrine. Provide manufacturer, brand and lot number information where available. Include amounts of
empty containers that are found (e.g., 2 ea empty 11oz Ether cans, etc.) When reporting cans or containers of an item,
indicate the capacity/size of the containers. (Use Remarks Section for additional space.)
XVI.
CRIMINAL AFFILIATION: Check the box for any known affiliation that applies to the subjects of the
investigation. If the name of the organization is not known, put ‘unknown’ in the Organizational Name field.
XVII.
SUSPECT/CRIMINAL BUSINESS/CRIMINAL VEHICLE INFORMATION: Provide the suspect’s full name,
DOB and address, including county and zip code. Include any other available identifying information. Provide
business name and address and vehicle information if criminally associated. (Use additional sheets as necessary.)
XVIII. DEA REPORTING ONLY: Provide the GDEP Identifier, DEA office and case number (if other than reporting
office), Special Agent’s name and telephone number.
XIX.
REMARKS SECTION: Please use this section to expand on any answers or for any additional relevant information.
If additional assistance is needed, contact the CLSS Help Desk 1-888-USE-EPIC (Option 7), EPIC Watch at (915) 760-2200 or
toll free inside Texas 1-800-351-6047; outside Texas 1-800-527-4062. Completed National Clandestine Laboratory Seizure
Reports should be e-mailed to CLSS@EPICMAIL.RISS.NET or faxed to UNCLASSIFIED (915) 760-2913 or CLASSIFIED
(915) 760-2538 or mailed to:
Page 2 of 3
EPIC Form 143 Instructions (Rev. 06/04)
El Paso Intelligence Center
ATTN: Clan Lab
11339 SSG Sims Street
El Paso, Texas 79908-8098
XX. PAPERWORK REDUCTION ACT NOTICE: See Title 44 United States Code, Chapter 35. This form enables law
enforcement agencies to report!information concerning the seizure of clandestine laboratories that manufacture illicit
substances. This information will be used by law enforcement agencies to assist in developing effective interdiction strategies
and to allocate resources, and to provide valuable information to policy makers concerning the scope and breadth of illicit drug
manufacturing operations. Under the Paperwork Reduction Act, a person is not required to respond to a collection of
information unless it displays a valid OMB control number. We try to create forms and instructions that are accurate, can be
easily understood, and which impose the least possible burden on you to provide us with information. The specific
circumstances surrounding the seizure of a clandestine laboratory may make this a bit more difficult at times. The estimated
average time to complete and file this form is as follows: (1) 15 minutes for the user to become familiar with the form; (2) 30
minutes to complete the form; and (3) 15 minutes to file the form electronically or to prepare the form for mailing, for a total
estimated time of 60 minutes per form. If you have comments regarding the accuracy of this estimate, or suggestions for
making this form simpler, you can write to: Drug Enforcement Administration, El Paso Intelligence Center, 11339 SSG Sims
Street, El Paso, TX 79908-8098. Any agency of the United States government may not conduct or sponsor, and a person is
not required to respond to a request for collection of information unless it contains an OMB control number.
OMB No. 1117-0042
Page 3 of 3
EPIC Form 143 Instructions (Rev. 06/04)
OMB NO. 1117-0042
EXP. DATE: 04/30/2007
NATIONAL CLANDESTINE
LABORATORY SEIZURE REPORT
TYPE OF REPORT*
Lab Seizure
Chem/Glassware/Equip Seizure (Only)
Dumpsite Seizure (Only)
Entered data must meet 28 CFR Part 23 guidelines.
I
Reporting Office (An asterisk symbol (*) indicates a mandatory field)
Seizure Date* (MMDDYYYY)
Agency State*
Agency*
ORI*
Case or File Number*
File Title
Reporting Officer/Agent Name* (First, Last)
II
Agency City*
Telephone Number*
(
)
COPS Number (DEA ‘S’ Number)
Seizure Location* (Check one – put additional information in Remarks Section)
Apartment/Condo
Hotel/Motel
Family Dwelling
Storage Locker
Business
Outbuilding
Vehicle
Dumpster
Open – No Structure
Other – Describe:
III
Seizure Neighborhood (Check most appropriate)
Commercial/Industrial
Rural
Suburban
Public Land – Name:
IV
Urban
Other – Describe:
Estimated Lab Capacity (Based on seized chemicals, glassware, and equipment on site) (Mandatory if lab seizure is checked)
Under 2 Oz.
V
2 – 8 Oz.
9 Oz. – 1 Lb.
2 – 9 Lbs.
10 – 19 Lbs.
20 Lbs. or Greater
Laboratory Status (Check all that apply) (Mandatory if lab seizure is checked)
Operational – Not in Production
Abandoned
Explosion/Fire
Operational – In Production
Boxed/Dismantled
Other – Describe:
VI
Lab Manufacturing Process (Check ONLY one)
Ephedrine/Red “P”/Hydriodic Acid Reduction
and/or Iodine Reduction
Pseudoephedrine/Red “P”/Hydriodic Acid
and/or Iodine Reduction
Ephedrine/Lithium, Sodium or Potassium/
Anhydrous Ammonia (Nazi/Birch)
Pseudoephedrine/Lithium, Sodium or Potassium/
Anhydrous Ammonia (Nazi/Birch)
P2P/Methylamine
Hydriodic Acid Manufacturing
Hydrogenation
Anhydrous Ammonia Manufacturing
VII
Laboratory Equipment (Continue in Remarks)
Homemade/Improvised
Professional/Retail
VIII
Ephedrine Tablet Extraction
Pseudoephedrine Tablet Extraction
Ice Conversion
Other – Describe:
Store Name:
City:
Laboratory Type (Check all that apply)
Amphetamine
Tablet Extraction
Anhydrous Ammonia
Methamphetamine
Ice Conversion
Hydriodic Acid
GHB
MDMA
Methcathinone
PCP
Other – Describe:
IX
Seizure/Laboratory Address
Street #
Dir (E,S, etc.)
City
X
Street Name
County*
Suffix (St. Ave., etc.)
State*
Zip Code
Unit # (Apt) Box #
Latitude/Longitude
Chemist and Cleanup Personnel*
Hazmat Contractor
Utilized
Yes
No
Chemist on Site
None
State/Local
DEA
Name of Hazmat Contractor
Evaluation of Hazmat Contractor
Excellent
Satisfactory
Poor **
**(Provide details in Remarks Section)
XI
Persons Affected (Children are mandatory – indicate 0 when none were affected) (Check all that apply and indicate number)
Total Children Affected
(#
)
Child Injured
(#
)
Child Killed
(#
)
Law Enforcement Killed
(#
)
Suspect Injured
(#
)
Suspect Killed
(#
)
Law Enforcement Injured
(#
)
Other – Describe:
FORM EPIC 143 (06-2004)
Previous Editions Obsolete
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NATIONAL CLANDESTINE LABORATORY SEIZURE REPORT!- CONTINUED
XII
Weapons/Explosives Seized (Check all that apply and continue in Remarks Section)
Type (Handgun, Rifle, etc.)
Number
Serial No.
Description (Make, Model, & Caliber)
Booby Trap – Describe:
XIII
Quantity of All Drugs Seized at Lab Site (Check all that apply/Specify amount & unit of measure)
Amphetamine
Amt
LSD
Amt
Methcathinone
Amt
Cocaine
Amt
MDMA
Amt
PCP
Amt
GHB/GBL
Amt
Methamphetamine
Amt
Other – Describe:
Amt
XIV
Precursor/Chemical Source (If more than one precursor, continue in Remarks Section)
Specify Precursor:
Source:
Chemical Company
Store Name:
XV
Convenience Store
City:
State:
Retail Outlet
Internet
Country: Other – Describe:
Precursor Agents/Catalysts/Solvents/Reagents Seized (Check all that apply/Specify unit of measure)
Precursor Agents (If Ephedrine or Pseudoephedrine is selected, Packaging category is mandatory)
Amt
Ephedrine
Amt
Pseudoephedrine
Packaging:*
Unknown
Powder
Tablets
Source:
Domestic
Canada
Mexico
Blister Packs Packaging:*
Source:
Unknown
Powder
Tablets
Domestic
Canada
Mexico
Brand Name(s):
Blister Packs
NOTE: Brand Names and Lot Numbers for
chemicals other than ephedrine and pseudoephedrine
should be entered in the Remarks Section.
Lot Number(s):
Benzaldehyde
Amt
GBL
Amt
Piperdine
Amt
Benzylchloride
Amt
Methylamine
Amt
P2P
Amt
Benzylcyanide
Amt
Phenylpropanolamine
Amt
Other
Amt
Catalysts/Solvents/Reagents
Acetone
Amt
Hydriodic Acid (HI)
Amt
PCC
Amt
Alcohol
Amt
Hydrochloric Acid (Muriatic)
Amt
Phenylacetic Acid
Amt
Aluminum
Amt
Hydrogen Chloride Gas
Amt
Potassium Metal
Amt
Anhydrous Ammonia
Amt
Hydrogen Gas
Amt
Potassium Permanganate
Amt
Benzene
Amt
Hydrogen Peroxide
Amt
Red Phosphorus
Amt
Bromobenzene
Amt
Hypophosphorous Acid
Amt
Sodium Chloride (Salt)
Amt
Caustic Soda
Amt
Iodine (Crystals)
Amt
Sodium Cyanide
Amt
Charcoal Lighter Fluid
Amt
Iodine (Tincture)
Amt
Sodium Dichromate
Amt
Chloroform
Amt
Lithium Metal
Amt
Sodium Hydroxide (Lye)
Amt
Chromium Trioxide
Amt
Magnesium
Amt
Sodium Metal
Amt
Coleman/Camping Fuel
Amt
Mercuric Chloride
Amt
Sulfuric Acid
Amt
Cyclohexanone
Amt
Methanol
Amt
Thionyl Chloride
Amt
Ether
Amt
Methyl Ethyl Ketone (MEK)
Amt
Toluene
Amt
Freon
Amt
Methylsulfonylmethane
(MSM)
Amt
Other
Amt
Grignard
Amt
Naptha
Amt
XVI
Criminal Affiliation (If applicable)
Asian Org
Mexican Org
Other – Describe:
Militia Group
Outlaw Motorcycle Gang
Traditional Organized Crime
Middle Eastern Group
Organization/Gang/Group Name:
USE ADDITIONAL PAGES AS NECESSARY – LOCAL REPRODUCTION AUTHORIZED
FORM EPIC 143 (06-2004)
Previous Editions Obsolete
Page 2 of 4
NATIONAL CLANDESTINE LABORATORY SEIZURE REPORT!- CONTINUED
XVII
Suspect/Criminal Business/Criminal Vehicle Information
Suspect #1 Information
Last Name (Paternal)
Last Name (Maternal)
Alias/Moniker
Generation
(Jr, Sr, etc.)
DOB (MMDDYYYY)
Phone Type
First Name
Regular
Alt DOB (MMDDYYYY)
Cell
Suspect Residence Information
Street Number
Dir. (E,S, etc.)
City
Height
Pager
Middle Name
Race
Male
Weight (Lbs)
Phone Number
Nationality (US, MX, etc.)
Female
Hair Color Eye Color
(
Yes
No
)
Street Name
Unit # (Apt)
County
Arrested
State
Box #
Country
Zip Code
Involvement (Role) and Identification Numbers
Cook/Chemist
Enforcer
Smuggler
Chemical Courier
Distributor
Financier
Broker
Other – Describe:
Social Security Number
Driver License Number/State
FBI Number
Alien Registration Number
NADDIS Number
Other Numbers
Suspect #2 Information
Last Name (Paternal)
Last Name (Maternal)
Alias/Moniker
Phone Type
First Name
Generation
(Jr, Sr, etc.)
DOB (MMDDYYYY)
Regular
Alt DOB (MMDDYYYY)
Cell
Suspect Residence Information
Street Number
Dir. (E,S, etc.)
City
Criminal Associate
Height
Pager
Middle Name
Race
Male
Weight (Lbs)
Phone Number
Hair Color Eye Color
(
Arrested
Yes
No
)
Street Name
Unit # (Apt)
County
Nationality (US, MX, etc.)
Female
State
Box #
Country
Zip Code
Involvement (Role) and Identification Numbers
Cook/Chemist
Enforcer
Smuggler
Distributor
Financier
Broker
Chemical Courier
Other – Describe:
Social Security Number
Driver License Number/State
FBI Number
Alien Registration Number
NADDIS Number
Other Numbers
Suspect #3 Information
Last Name (Paternal)
Last Name (Maternal)
Alias/Moniker
Phone Type
First Name
Generation
(Jr, Sr, etc.)
DOB (MMDDYYYY)
Regular
Alt DOB (MMDDYYYY)
Cell
Suspect Residence Information
Street Number
Dir. (E,S, etc.)
City
Pager
Criminal Associate
Height
Middle Name
Race
Male
Weight (Lbs)
Phone Number
(
Hair Color Eye Color
Arrested
Yes
No
)
Street Name
Unit # (Apt)
County
Nationality (US, MX, etc.)
Female
State
Country
Box #
Zip Code
USE ADDITIONAL PAGES AS NECESSARY – LOCAL REPRODUCTION AUTHORIZED
FORM EPIC 143 (06-2004)
Previous Editions Obsolete
Page 3 of 4
NATIONAL CLANDESTINE LABORATORY SEIZURE REPORT!- CONTINUED
Involvement (Role) and Identification Numbers
Cook/Chemist
Enforcer
Smuggler
Chemical Courier
Distributor
Financier
Broker
Other – Describe:
Social Security Number
Driver License Number/State
FBI Number
Alien Registration Number
NADDIS Number
Other Numbers
Criminal Associate
Criminal Business Information (Include all a.k.a.’s)
Business Name:
Street Number
Dir. (E, S, etc.)
City
Street Name
Unit # (Apt)
County
Phone Type
Regular
Cell
State
Fax
NADDIS Number
Phone Number
(
Country
Box #
Zip Code
)
Other Numbers (TECS, Case, etc.)
Criminal Vehicle Information (If applicable)
License Plate Number
Temporary License Plate #
VIN Number
State
Type (Car, SUV, Pickup, etc.)
Model
Year
Owner Type
Country
Seized
Yes
No
Make
Privately Owned
Rental
Other
XVIII DEA Reporting Only
GDEP Identifier
DEA Office Identifier and Case Number
if other than Reporting Office
Special Operations Division Supported Case
Special Agent’s Name* (First, Last)
Yes
XIX
Phone #* (
No
)
Acknowledgement that the Clan Lab Seizure has been reported to CCF via a standard seizure form and submitted to the
Division Asset Removal Group for processing and input into the Consolidated Asset Tracking System.
Remarks Section
CLSS Help Desk
UNCLASSIFIED FAX:
1-888-USE-EPIC
873-3742 (Option 7)
(915) 760-2913
CLASSIFIED FAX:
(915) 760-2538
E-mail Address
MAILING ADDRESS
clss@epicmail.riss.net
El Paso Intelligence Center
ATTN: Clan Lab
11339 SSG Sims Street
El Paso, Texas 79908-8098
USE ADDITIONAL PAGES AS NECESSARY – LOCAL REPRODUCTION AUTHORIZED
FORM EPIC 143 (06-2004)
Previous Editions Obsolete
Page 4 of 4
File Type | application/pdf |
File Title | untitled |
Author | DEA |
File Modified | 2004-09-15 |
File Created | 2004-09-07 |