Broodstock Post-Harvest Report

Southeast Region Aquaculture Program

5 - Broodstock Post-Harvest Report (12-4-2015)

Broodstock Post-Harvest Report

OMB: 0648-0703

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OMB Control No. 0648-0703

Expiration Date:


BROODSTOCK POST-HARVEST REPORT

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This form must be received by NOAA Fisheries no later than 15 days following the date of broodstock harvest.


For questions, contact the Regional Aquaculture Coordinator at (727) 551-5755 or email nmfs.ser.aquaculture@noaa.gov.



FOR OFFICE USE ONLY


Date Received


Gulf Aquaculture Permit Number


Reviewer Initials and Date











Part 1 – Permit Holder Information


LAST NAME FIRST NAME MIDDLE NAME Suffix (Sr., II, etc.)

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Shape6 Shape7 MAILING ADDRESS Apt/Suite #




Shape9 Shape10 Shape11 Shape8 CITY STATE COUNTY ZIP CODE



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HOME TELEPHONE NUMBER CELL PHONE NUMBER GULF AQUACULTURE PERMIT NUMBER



BUSINESS NAME BUSINESS PHONE NUMBER

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Part 2 – Broodstock Harvest Information


List the following information for each individual brood animal harvested. Report coordinates as Degree Minutes to at least the third decimal place (e.g., DD MM.MMM). Attach additional sheets as necessary.

Genus and Date Total Fork Whole Sex Latitude Longitude

Species Harvested Length Length Weight

(MM/DD/YY) (inches) (inches) (lbs)


#1 ________________________________________________________________________­­_

#2 _________________________________________________________________________

#3 _________________________________________________________________________

#4 _________________________________________________________________________

#5 _________________________________________________________________________

#6 _________________________________________________________________________

#7 _________________________________________________________________________

#8 _________________________________________________________________________

#9 ________________________________________________________________________­­_

#10 ________________________________________________________________________

#11 ________________________________________________________________________

#12 ________________________________________________________________________

#13 ________________________________________________________________________

#14 ________________________________________________________________________

#15 ________________________________________________________________________

#16 ________________________________________________________________________

#17 ________________________________________________________________________

#18 ________________________________________________________________________

#19 ________________________________________________________________________

#20 ________________________________________________________________________

#21 ________________________________________________________________________

#22 ________________________________________________________________________


Part 3 – Submission of Fin Clips


Permittees are required to submit fin clip samples for each broodstock used to produce juveniles for stocking in offshore systems under their Gulf Aquaculture Permit. Fin clip samples must be received at least 30 days prior to stocking juveniles in offshore aquaculture systems. Instructions on submitting fin clips can be found at http://sero.nmfs.noaa.gov/sustainable_fisheries/gulf_fisheries/aquaculture/.






Part 4 – Signature


I hereby declare under penalty of perjury that the foregoing information is true and correct (28 U.S.C. section 1746; 18 U.S.C. section 1621; 18 U.S.C. section 1001).


PERMIT OWNER SIGNATURE DATE SIGNED (MM/DD/YYYY)

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PRINTED NAME POSITION IN COMPANY (if applicable)

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Mail the completed form to:

NMFS Permits Office (F/SER14), Attn: Regional Aquaculture Coordinator,

263 13th Avenue South, St. Petersburg, FL 33701.


Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or other suggestions for reducing this burden to PRA Officer, National Marine Fisheries Service. F/SER26, 263 13th Avenue South, St. Petersburg, FL 33701.


The National Marine Fisheries Service requires this information for the conservation and management of marine fishery resources. The data reported will be used to develop, implement, and monitor fishery management activities for a variety of other uses. Responses to this collection are required to obtain or retain a fisheries permit under the Magnuson - Stevens Act. Non-confidential information may be released via a NOAA Fisheries website. Non-confidential information means: Name, Street Address, City, State, Zip Code, Effective Date of Permit, Permit Types, Vessel Name, Vessel Identification Number, and in the case of a “for hire” vessel the Passenger Capacity, or individual, corporate and lease holders of permits. All other data submitted will be handled as confidential material in accordance with NOAA Administrative Order 216-100, Protection of Confidential Fishery Statistics. Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any person be subjected to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act, unless that collection of information displays a currently valid OMB Control Number.


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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleOMB 0648-XXXX Form
Authorjess.beck
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File Created2021-01-24

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