PMNM Research Permit Application and Cover Sheet

Papahānaumokuākea Marine National Monument

Permit Application - Research

OMB Control # 0648-0548

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Papahānaumokuākea Marine National Monument

RESEARCH Permit Application

NOTE: This Permit Application (and associated Instructions) are to propose activities to be conducted in the Papahānaumokuākea Marine National Monument. The Co-Trustees are required to determine that issuing the requested permit is compatible with the findings of Presidential Proclamation 8031. Within this Application, provide all information that you believe will assist the Co-Trustees in determining how your proposed activities are compatible with the conservation and management of the natural, historic, and cultural resources of the Papahānaumokuākea Marine National Monument (Monument).

Public Reporting Burden

Submittal of the information requested in these guidelines is required to obtain a permit pursuant to Monument regulations (50 CFR Part 404). This data is to evaluate the potential benefits of the activity, determine whether the proposed methods will achieve the proposed results, evaluate any possible detrimental environmental impacts, and determine if issuance of a permit is appropriate. It is through this evaluation that the Co-trustees are able to use permitting as one of the management tools to protect Monument resources and qualities.

Public reporting burden for this collection of information, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information is estimated at five (5) hours per response for General (Research, Conservation and Management, and Education) permits.

Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to NOAA/Inouye Regional Center, NOS/ONMS/PMNM/Attn: Permit Coordinator, 1845 Wasp Blvd, Building 176, Honolulu, HI 96818.

Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject 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.

ADDITIONAL IMPORTANT INFORMATION:

• Any or all of the information within this application may be posted to the Monument website informing the public on projects proposed to occur in the Monument.

• In addition to the permit application, the Applicant must either download the Monument Compliance Information Sheet from the Monument website OR request a hard copy from the Monument Permit Coordinator (contact information below). The Monument Compliance Information Sheet must be submitted to the Monument Permit Coordinator after initial application consultation.

• Issuance of a Monument permit is dependent upon the completion and review of the application and Compliance Information Sheet.

INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED

Send Permit Applications to:

NOAA/Inouye Regional Center

NOS/ONMS/PMNM/Attn: Permit Coordinator

1845 Wasp Blvd, Building 176

Honolulu, HI 96818

nwhipermit@noaa.gov

PHONE: (808) 725-5800 FAX: (808) 455-3093

SUBMITTAL VIA ELECTRONIC MAIL IS PREFERRED BUT NOT REQUIRED. FOR ADDITIONAL SUBMITTAL INSTRUCTIONS, SEE THE LAST PAGE.

Papahānaumokuākea Marine National Monument

Permit Application Cover Sheet

This Permit Application Cover Sheet is intended to provide summary information and status to the public on permit applications for activities proposed to be conducted in the Papahānaumokuākea Marine National Monument. While a permit application has been received, it has not been fully reviewed nor approved by the Monument Management Board to date. The Monument permit process also ensures that all environmental reviews are conducted prior to the issuance of a Monument permit.

Summary Information

Applicant Name:  FORMTEXT      

Affiliation:  FORMTEXT      

Permit Category: Research

Proposed Activity Dates:  FORMTEXT      

Proposed Method of Entry (Vessel/Plane):  FORMTEXT      

Proposed Locations:  FORMTEXT      

Estimated number of individuals (including Applicant) to be covered under this permit:  FORMTEXT      

Estimated number of days in the Monument:  FORMTEXT      

Description of proposed activities: (complete these sentences):

1. The proposed activity would…

 FORMTEXT      

2. To accomplish this activity we would ….

 FORMTEXT      

3. This activity would help the Monument by …

 FORMTEXT      

Other information or background:

 FORMTEXT      

Section A - Applicant Information

1. Applicant

Name (last, first, middle initial):  FORMTEXT      

Title:  FORMTEXT      

1a. Intended field Principal Investigator (See instructions for more information):

 FORMTEXT      

2. Mailing address (street/P.O. box, city, state, country, zip):  FORMTEXT      

Phone:  FORMTEXT      

Fax:  FORMTEXT      

Email:  FORMTEXT      

For students, major professor’s name, telephone and email address:  FORMTEXT      

3. Affiliation (institution/agency/organization directly related to the proposed project):

 FORMTEXT      

4. Additional persons to be covered by permit. List all personnel roles and names (if known at time of application) here (e.g. John Doe, Research Diver; Jane Doe, Field Technician):

 FORMTEXT      

Section B: Project Information

5a. Project location(s): Ocean Based

Nihoa Island Land-based Shallow water Deep water

Necker Island (Mokumanamana) Land-based Shallow water Deep water

French Frigate Shoals Land-based Shallow water Deep water

Gardner Pinnacles Land-based Shallow water Deep water Maro Reef

Laysan Island Land-based Shallow water Deep water

Lisianski Island, Neva Shoal Land-based Shallow water Deep water

Pearl and Hermes Atoll Land-based Shallow water Deep water

Midway Atoll Land-based Shallow water Deep water

Kure Atoll Land-based Shallow water Deep water

Monument Expansion Area

Other

NOTE: Shallow water is defined by water less than 100 meters in depth.

Remaining ashore on any island or atoll (with the exception of Sand Island,at Midway Atoll and field camp staff on other islands/atolls) between sunset and sunrise.

NOTE: There is a fee schedule for people visiting Midway Atoll National Wildlife Refuge via vessel and aircraft.

Location Description:

 FORMTEXT      

5b. Check all applicable regulated activities proposed to be conducted in the Monument:

Removing, moving, taking, harvesting, possessing, injuring, disturbing, or damaging any living or nonliving Monument resource

Drilling into, dredging, or otherwise altering the submerged lands other than by anchoring a vessel; or constructing, placing, or abandoning any structure, material, or other matter on the submerged lands

Anchoring a vessel

Deserting a vessel aground, at anchor, or adrift

Discharging or depositing any material or matter into the Monument

Touching coral, living or dead

Possessing fishing gear except when stowed and not available for immediate use during passage without interruption through the Monument

Attracting any living Monument resource

Sustenance fishing (Federal waters only, outside of Special Preservation Areas, Ecological Reserves and Special Management Areas)

Subsistence fishing (State waters only)

Swimming, snorkeling, or closed or open circuit SCUBA diving within any Special Preservation Area or Midway Atoll Special Management Area

6. Purpose/Need/Scope State purpose of proposed activities:

 FORMTEXT      

*Considering the purpose of the proposed activities, do you intend to film / photograph federally protected species beyond the protocols provided in PMNM Best Management Practices (https://www.papahanaumokuakea.gov/permit/bestmanagement.html)? Yes No

If so, please list the species you specifically intend to target.

 FORMTEXT      

For a list of terrestrial species protected under the Endangered Species Act visit:

http://www.fws.gov/endangered/

For a list of marine species protected under the Endangered Species Act visit:

http://www.nmfs.noaa.gov/pr/species/esa/

For information about species protected under the Marine Mammal Protection Act visit:

http://www.nmfs.noaa.gov/pr/laws/mmpa/

7. Answer the Findings below by providing information that you believe will assist the Co-Trustees in determining how your proposed activities are compatible with the conservation and management of the natural, historic, and cultural resources of the Monument:

The Findings are as follows:

a. How can the activity be conducted with adequate safeguards for the cultural, natural and historic resources and ecological integrity of the Monument?

 FORMTEXT      

b. How will the activity be conducted in a manner compatible with the management direction of this proclamation, considering the extent to which the conduct of the activity may diminish or enhance Monument cultural, natural and historic resources, qualities, and ecological integrity, any indirect, secondary, or cumulative effects of the activity, and the duration of such effects?

 FORMTEXT      

c. Is there a practicable alternative to conducting the activity within the Monument? If not, explain why your activities must be conducted in the Monument.

 FORMTEXT      

d. How does the end value of the activity outweigh its adverse impacts on Monument cultural, natural and historic resources, qualities, and ecological integrity?

 FORMTEXT      

e. Explain how the duration of the activity is no longer than necessary to achieve its stated purpose.

 FORMTEXT      

f. Provide information demonstrating that you are qualified to conduct and complete the activity and mitigate any potential impacts resulting from its conduct.

 FORMTEXT      

g. Provide information demonstrating that you have adequate financial resources available to conduct and complete the activity and mitigate any potential impacts resulting from its conduct.

 FORMTEXT      

h. Explain how your methods and procedures are appropriate to achieve the proposed activity's goals in relation to their impacts to Monument cultural, natural and historic resources, qualities, and ecological integrity.

 FORMTEXT      

i. Has your vessel been outfitted with a mobile transceiver unit approved by OLE and complies with the requirements of Presidential Proclamation 8031?

 FORMTEXT      

j. Demonstrate that there are no other factors that would make the issuance of a permit for the activity inappropriate.

 FORMTEXT      

8. Procedures/Methods:

 FORMTEXT      

NOTE: If land or marine archeological activities are involved, contact the Monument Permit Coordinator at the address on the general application form before proceeding.

9a. Collection of specimens - collecting activities (would apply to any activity): organisms or objects (List of species, if applicable, attach additional sheets if necessary):

Common name:

 FORMTEXT      

Scientific name:

 FORMTEXT      

# & size of specimens:

 FORMTEXT      

Collection location:

 FORMTEXT      

Whole Organism Partial Organism

9b. What will be done with the specimens after the project has ended?

 FORMTEXT      

9c. Will the organisms be kept alive after collection? Yes No

 FORMTEXT      

• General site/location for collections:

 FORMTEXT      

• Is it an open or closed system? Open Closed

 FORMTEXT      

• Is there an outfall? Yes No

 FORMTEXT      

• Will these organisms be housed with other organisms? If so, what are the other organisms?

 FORMTEXT      

• Will organisms be released?

 FORMTEXT      

10. If applicable, how will the collected samples or specimens be transported out of the Monument?

 FORMTEXT      

11. Describe collaborative activities to share samples, reduce duplicative sampling, or duplicative research:

 FORMTEXT      

12a. List all specialized gear and materials to be used in this activity:

 FORMTEXT      

12b. List all Hazardous Materials you propose to take to and use within the Monument:

 FORMTEXT      

13. Describe any fixed installations and instrumentation proposed to be set in the Monument:

 FORMTEXT      

14. Provide a time line for sample analysis, data analysis, write-up and publication of information:

 FORMTEXT      

15. List all Applicants’ publications directly related to the proposed project:

 FORMTEXT      

With knowledge of the penalties for false or incomplete statements, as provided by 18 U.S.C. 1001, and for perjury, as provided by 18 U.S.C. 1621, I hereby certify to the best of my abilities under penalty of perjury of that the information I have provided on this application form is true and correct. I agree that the Co-Trustees may post this application in its entirety on the Internet. I understand that the Co-Trustees will consider deleting all information that I have identified as “confidential” prior to posting the application.

_________________________________________________________________

Signature Date

SEND ONE SIGNED APPLICATION VIA MAIL TO THE MONUMENT OFFICE BELOW:

NOAA/Inouye Regional Center

NOS/ONMS/PMNM/Attn: Permit Coordinator

1845 Wasp Blvd, Building 176

Honolulu, HI 96818

FAX: (808) 455-3093

DID YOU INCLUDE THESE?

Applicant CV/Resume/Biography

Intended field Principal Investigator CV/Resume/Biography

Electronic and Hard Copy of Application with Signature

Statement of information you wish to be kept confidential

Material Safety Data Sheets for Hazardous Materials

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RESEARCH