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pdfMARINE MAMMAL STRANDING REPORT - LEVEL A DATA
FIELD #:
NMFS REGIONAL #:
NATIONAL DATABASE#:
(NMFS USE)
COMMON NAME:
(NMFS USE)
GENUS:
SPECIES:
EXAMINER Name:
Affiliation:
Address:
Phone:
Stranding Agreement or Authority:
Report Type: □ Stranded
□ Live entangled, in-water
□ Same Information for Level A Examination
INITIAL OBSERVATION
DATE: Year:
Month:
LOCATION: State:
Body of Water:
Locality Details:
Lat (DD):
Long (DD):
Actual
Day:
County:
City:
.
DATE: Year:
□ Estimated
First Examined:
□
How Determined: (check ONE)
□ GPS
□
□ Confirmed Public Report □ Confirmed by Network
□ Restrand
Month:
Actual
Examined?
Day:
□ Floating □
OnBeach/Land/Ice
LOCATION: State:
Body of Water:
Locality Details:
Lat (DD):
Long (DD):
N
W
.
□ Unconfirmed Public Report
LEVEL A EXAMINATION
□ OnBeach/Land/Ice □ Floating □ Swimming □ Anchored
First Observed:
□
CONFIDENCE CODE (Check ONE):
Swimming
County:
□ YES □ NO
□ Anchored
City:
.
N
W
.
□ Estimated
How Determined: (check ONE)
□ Map □ Internet/Software □Other___________________________
□ GPS
□ Map □ Internet/Software □Other_______________________________
CONDITION AT INITIAL OBSERVATION (Check ONE)
□
□
□
□ 4. Advanced Decomposition
□ 5. Mummified/Skeletal
□ 6. Condition Unknown
1. Alive
2. Fresh Dead
3. Moderate Decomposition
CONDITION AT EXAMINATION (Check ONE)
□
□
□
LIVE ANIMAL INFORMATION
1. Left at Site
2. Immediate Release at Site
3. Relocated and Released
4. Disentangled
□ a. Partially
□ b. Completely
□
□
□
□
□
CARCASS STATUS (Check one or more)
6. Died during Transport
Lat__________Long___________
7. Euthanized
8. Transferred to Rehabilitation:
Date: Year: ______Month: _______Day:______
Facility:_______________________________
9. Other:_________________________________________________________
1. Sick
7. Location Hazardous
□ a. To animal
□ b. To public
2. Injured
3. Out of Habitat
□ 8. Unknown/CBD
□ 9. No Rehabilitation Options
□ 10. Other: ____________________
4. Deemed Releasable
5. Abandoned/Orphaned
6. Inaccessible
MORPHOLOGICAL INFORMATION
SEX (Check ONE)
□
□
□
1. Male
2. Female
3. Unknown
□ Whole Animal
3. Moderate Decomposition
□ 1. Frozen for Later Examination/Necropsy Pending
□ 2. Left at Site □ 5. Landfill
□ 8. Towed:
5. Died at Site
CONDITION/DETERMINATION (Check one or more)
□
□
□
□
□
□
2. Fresh Dead
DEAD ANIMAL INFORMATION
INITIAL LIVE ANIMAL DISPOSITION (Check one or more)
□
□
□
□ 1. Adult
□ 2. Subadult
□ 3. Yearling
□ 3. Buried
□ 4. Rendered
EXAMINED BY:
Date: Year:
Code 2
□
Code 3
Month:
PHOTOS/VIDEOS TAKEN:
Photo/Video Disposition:
□ YES
□ 4. Pup/Calf
□ 5. Unknown
□ kg □ lb
□ Actual □ Estimated □ Not Weighed
SAMPLES COLLECTED (Check one or more)
□ 1. Histology □ 2. Other Diagnostics □ 3. Life History
□ 4. Skeletal □ 5. Other ______________________________
PARTS TRACKING (Check one or more)
2. Educational Collection
□ Code 4
Day:
□ NO
Was the Marine Mammal Human Interaction Report completed? □ YES
□ NO
□ YES □ NO □ Could Not Be Determined (CBD)
□ YES □ NO □ CBD
2. Shot □ YES □ NO □ CBD
3. Fishery Interaction □ YES □ NO □ CBD
4. Entangled □ YES □ NO □ CBD
5. Ingestion □ GEAR □ DEBRIS □ NO □ CBD
Findings of Human Interaction:
Evidence of:
1. Vessel Interaction
□ in
□ Actual □ Estimated □ Not Measured
□
□
CARCASS CODE AT EXAM
□ Partial Animal
1. Scientific Collection
□ 9. Sunk: Lat__________Long___________
□ 10. Unknown/Other______________________
DEAD ANIMAL EXAM □ YES □ NO
□ Photos Only □ External Exam □ Partial Internal Exam □ Complete Internal Exam
□ Carcass Fresh
□ Carcass Frozen/Thawed
Straight Length:______________ □ cm
□
□
□ 6. Incinerated
□ 7. Composted
OCCURRENCE DETAILS
ESTIMATED AGE CLASS (Check ONE)
Weight:___________________
□ 4. Advanced Decomposition
□ 5. Mummified/Skeletal
1. Alive
6. Other Human Interaction: ________________________________________
If YES, what was the likelihood that the human interaction contributed to the stranding event?
□ Uncertain (CBD)
□ Improbable
□ Suspect
□ Probable
□ YES □ NO Gear Disposition: ___________________________________
□ 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): □ Photos Only
□ External Exam □ Partial Internal Exam
□ Complete Internal Exam (Necropsy) □ Other: ________________________________________
Gear/HI Items Collected?
Other Findings Upon Level A:
3. Other:_________________________________________
NOAA Form 89-864; OMB Control No.0648-0178; Expiration Date 6/30/2024
GROUP EVENT (NMFS Use)
GE# ___________________________________________
□ YES
□ NO
□ Cow/Calf Pair □ Mass Stranding □ UME
Group Event:
If Yes, Type:
# Animals:________□ Actual
TAG DATA
Tags Were:
Present at Time of Stranding (Pre-existing):
Applied during Stranding Response/Release:
Applied during Rehabilitation/Release:
Absent but Suspect Prior Tag:
ID#
□ Estimated
Color
Type
Placement*
(Circle ONE)
□ YES
□ YES
□ YES
□ YES
□ NO
□ NO
□ NO
□ NO
D DF L R
_________________________LF LR RF RR V
D DF L R
__________________LF
Present
Removed
□
□
□
□
□
□
□
□
□
LR RF RR V
D DF L R
__________________LF
Applied
LR RF RR V
* 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; V= Ventrum
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
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.
NOAA Form 89-864; OMB Control 0648-0178, Expiration Date 6/30/2024
File Type | application/pdf |
File Title | Microsoft Word - Level A 2010-11 |
Author | Stephen.Manley |
File Modified | 2024-04-10 |
File Created | 2020-03-06 |