Form 89-864 Marine Mammal Stranding Report - Level A Data

Marine Mammal Stranding Reports/Marine Mammal Rehabilitation Disposition Report/Human Interaction Data Sheet

Revised Level A form_Revised

Marine Mammal Stranding Report - Level A

OMB: 0648-0178

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MARINE MAMMAL STRANDING REPORT - LEVEL A DATA


FIELD #:

NMFS REGIONAL #: NATIONAL DATABASE#: (NMFS USE) (NMFS USE)


COMMON NAME: GENUS: SPECIES:


EXAMINER Name: Affiliation:


Address: Phone:


Stranding Agreement or Authority:

CONFIDENCE CODE (Check ONE): Unconfirmed - Low Confirmed - Minimum Confirmed - Medium Confirmed – High

INITIAL OBSERVATIONSame Information for Level A Examination


DATE: Year: Month: Day:

First Observed: Beach/Land/Ice Floating Swimming


LOCATION: State: County: City: Body of Water: Locality Details: Lat (DD): . N

Long (DD): . W

  • Actual Estimated


How Determined: (check ONE)

GPS Map Internet/Software Other___________________________

CONDITION AT INITIAL OBSERVATION (Check ONE)

  • 1. Alive 4. Advanced Decomposition

2. Fresh Dead 5. Mummified/Skeletal

3. Moderate Decomposition 6. Condition Unknown



LEVEL A EXAMINATION Examined? YES NO


DATE: Year: Month: Day:

First Examined: Beach/Land/Ice Floating Swimming


LOCATION: State: County: City: Body of Water: Locality Details: Lat (DD): . N

Long (DD): . W

  • Actual Estimated


How Determined: (check ONE)

GPS Map Internet/Software Other_______________________________

CONDITION AT EXAMINATION (Check ONE)

  • 1. Alive 4. Advanced Decomposition

2. Fresh Dead 5. Mummified/Skeletal

3. Moderate Decomposition


LIVE ANIMAL INFORMATION


INITIAL LIVE ANIMAL DISPOSITION (Check one or more)

  • 1. Left at Site

  • 5. Died at Site

  • 2. Immediate Release at Site

  • 6. Died during Transport

  • 3. Relocated and Released

  • 7. Euthanized

4. Disentangled

  • 8. Transferred to Rehabilitation:

a. Partially b. Completely

Date: Year: ______Month: _______Day:______

Facility:_______________________________

9. Other:_________________________________________________________


CONDITION/DETERMINATION (Check one or more)

  • 1. Sick 7. Location Hazardous

  • 2. Injured a. To animal

  • 3. Out of Habitat b. To public

  • 4. Deemed Releasable 8. Unknown/CBD

  • 5. Abandoned/Orphaned 9. No Rehabilitation Options

  • 6. Inaccessible 10. Other: ____________________

DEAD ANIMAL INFORMATION


CARCASS STATUS (Check one or more)

1. Frozen for Later Examination/Necropsy Pending

2. Left at Site 5. Landfill 8. Towed: Lat__________Long___________

3. Buried 6. Incinerated 9. Sunk: Lat__________Long___________

4. Rendered 7. Composted 10. Unknown/Other______________________


NECROPSIED YES NO Limited Complete

  • Carcass Fresh Carcass Frozen/Thawed


CARCASS CODE AT NECROPSY Code 2 Code 3 Code 4


NECROPSIED BY:

Date: Year: Month: Day:


PHOTOS/VIDEOS TAKEN: YES NO

Photo/Video Disposition: ______


MORPHOLOGICAL INFORMATION


SEX (Check ONE) ESTIMATED AGE CLASS (Check ONE)

  • 1. Male 1. Adult 4. Pup/Calf

  • 2. Female 2. Subadult 5. Unknown

  • 3. Unknown 3. Yearling


Whole Animal Partial Animal

Straight Length:______________ cm in

Actual Estimated Not Measured


Weight:___________________ kg lb

Actual Estimated Not Weighed


SAMPLES COLLECTED (Check one or more)

1. Histology 2. Other Diagnostics 3. Life History

4. Skeletal 4. Other ______________________________


PARTS TRACKING (Check one or more)

  • 1. Scientific Collection 2. Educational Collection

  • 3. Other:

_________________________________________________



OCCURRENCE DETAILS Restrand GE# _______________________

(NMFS Use)

Group Event: YES NO

If Yes, Type: Cow/Calf Pair Mass Stranding UME # Animals:­­­­­­­­­________ Actual Estimated


Was the Marine Mammal Human Interaction Report completed? YES NO


Findings of Human Interaction: YES NO Could Not Be Determined (CBD)

If YES evidence of: 1. Vessel Interaction YES NO CBD

2. Shot YES NO CBD

3. Fishery Interaction YES NO CBD

4. Other Human Interaction: ________________________________________

______________________________________________________________

If YES, what was the likelihood that the human interaction contributed to the stranding event?

Uncertain (CBD) Improbable Suspect Probable


Gear/HI Items Collected? YES NO Gear Disposition: ___________________________________

Other Findings Upon Level A: YES NO Could Not Be Determined (CBD)

If Yes, Choose one or more: 1. Illness 2. Injury 3. Pregnant 4.Other: ________________ How Determined (Check one or more): External Exam Internal Exam Necropsy

Other: ______________________________________________________________

Shape1 NOAA Form 89-864; OMB Control No.0648-0178; Expiration Date 03/31/2020

TAG DATA


Tags Were:

Present at Time of Stranding (Pre-existing): YES NO

Applied during Stranding Response/Release: YES NO

Applied during Rehabilitation/Release: YES NO

Absent but Suspect Prior Tag: YES NO


ID# Color Type Placement* Applied Present Removed

(Circle ONE)

D DF L R □ □ □ _________________________LF LR RF RR

D DF L R □ □ □ __________________LF LR RF RR


D DF L R □ □ □

__________________LF LR RF RR

* D= Dorsal; DF= Dorsal Fin; L= Left Lateral Body R= Right Lateral Body LF= Left Front; LR= Left Rear; RF= Right Front; RR= Right Rear


ADDITIONAL IDENTIFIER: _________________________________________________ (If animal is restranded, please indicate any previous field numbers here)


ADDITIONAL REMARKS: ____________________________________________________________________________________________________________________________________

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DISCLAIMER


THESE DATA SHOULD NOT BE USED OUT OF CONTEXT OR WITHOUT VERIFICATION. THIS SHOULD BE STRICTLY ENFORCED WHEN REPORTING SIGNS OF HUMAN INTERACTION DATA.


DATA ACCESS FOR LEVEL A DATA


UPON WRITTEN REQUEST, CERTAIN FIELDS OF THE LEVEL A DATA SHEET WILL BE RELEASED TO THE REQUESTOR PROVIDED THAT THE REQUESTOR CREDIT THE STRANDING NETWORK AND THE NATIONAL MARINE FISHERIES SERVICE. THE NATIONAL MARINE FISHERIES SERVICE WILL NOTIFY THE CONTRIBUTING STRANDING NETWORK MEMBERS THAT THESE DATA HAVE BEEN REQUESTED AND THE INTENT OF USE. ALL OTHER DATA WILL BE RELEASED TO THE REQUESTOR PROVIDED THAT THE REQUESTOR OBTAIN PERMISSION FROM THE CONTRIBUTING STRANDING NETWORK AND THE NATIONAL MARINE FISHERIES SERVICE.


PAPERWORK REDUCTION ACT INFORMATION


Shape4 Shape3 Shape2

NOAA Form 89-864; OMB Control No.0648-0178; Expiration Date 03/31/2020


NOAA Form 89-864 (rev. 2007)

OMB No. ________; Expires _________

PUBLIC REPORTING BURDEN FOR THE COLLECTION OF INFORMATION IS ESTIMATED TO AVERAGE 30 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 ANY OTHER ASPECT OF THE COLLECTION INFORMATION, INCLUDING SUGGESTIONS FOR REDUCING THE BURDEN TO: CHIEF, MARINE MAMMAL AND SEA TURTLE CONSERVATION DIVISION, OFFICE OF PROTECTED RESOURCES, NOAA FISHERIES, 1315 EAST-WEST HIGHWAY, SILVER SPRING, MARYLAND 20910. NOT WITHSTANDING ANY OTHER PROVISION OF THE LAW, NO PERSON IS REQUIRED TO RESPOND, 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 THE COLLECTION OF INFORMATION DISPLAYS A CURRENTLY VALID OFFICE OF MANAGEMENT AND BUDGET (OMB) CONTROL NUMBER.


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleMicrosoft Word - Level A 2010-11
AuthorStephen.Manley
File Modified0000-00-00
File Created2021-01-22

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