Form 89-864 Marine Mammal Stranding Report - Level A

Marine Mammal Stranding Report/Marine Mammal Rehabilitation Disposition Report

0178 marine mammal stranding report_level A

Marine Mammal Stranding Report - Level A - State, Local or Tribal Government

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: ________________________________________________________________________________________________

□ Restrand
□ YES
□ NO
□ Cow/Calf Pair □ Mass Stranding

LOCATION OF INITIAL OBSERVATION

OCURRENCE DETAILS

State: _______ County: _____________________

Group Event:

City: _____________________________________

If Yes, Type:

Body of Water: ____________________________
If Yes, Choose one or more:

_________________________________________

□ Estimated

□ YES □ NO □ Could Not Be Determined (CBD)
□ 1. Boat Collision
□ 2. Shot
□ 3. Fishery Interaction

□ 4. Other Human Interaction: ____________________________________________________________________
How Determined (Check one or more): □ External Exam □ Internal Exam □ Necropsy □ Other
Gear Collected? □ YES □ NO Gear Disposition: _____________________________________________________

Lat (DD): ________ . _____________________ N
Long (DD): ________ . ___________________ W

□ Actual or □ Estimated

□ YES □ NO □ Could Not Be Determined (CBD)
□ 1. Illness □ 2. Injury □ 3. Other:_________________________________________
How Determined (Check one or more): □ External Exam □ Internal Exam □ Necropsy □ Other: ____________

How Determined: (check ONE)

□ Map

(NMFS Use)
# Animals: _______ □ Actual

Findings of Human Interaction:

Locality Details: ____________________________

□ GPS

GE# ____________________

Other Findings Upon Level A:

□ Internet/Software

If Yes, Choose one or more:

_________________________________________________________________________________
INITIAL OBSERVATION
Date: Year: _______ Month: ____________ Day: _______________
First Observed:

□ Beach or Land □ Floating □ Swimming

Date: Year: _______ Month: ____________ Day: _______________
CONDITION AT EXAMINATION (Check ONE)

CONDITION AT INITIAL OBSERVATION (Check ONE)

□ 1. Alive
□ 2. Fresh dead
□ 3. Moderate decomposition

□ Not Able to Examine

LEVEL A EXAMINATION

□ 1. Alive
□ 2. Fresh dead
□ 3. Moderate decomposition

□ 4. Advanced Decomposition
□ 5. Mummified/Skeletal
□ 6. Condition Unknown

□ 4. Advanced Decomposition
□ 5. Mummified/Skeletal
□ 6. Unknown

INITIAL LIVE ANIMAL DISPOSITION (Check one or more)

□ 1. Left at Site
□ 6. Euthanized at Site
□ 2. Immediate Release at Site
□ 7. Transferred to Rehabilitation:
□ 3. Relocated
Date:________Facility:_____________
□ 8. Died during Transport
□ 4. Disentangled
□ 5. Died at Site
□ 9. Euthanized during Transport
□ 10. Other:____________________________________________________
CONDITION/DETERMINATION (Check one or more)

□ 1. Sick
□ 2. Injured
□ 3. Out of Habitat
□ 4. Deemed Releasable
□ 5. Abandoned/Orphaned
□ 6. Inaccessible

7. Location Hazardous

□ a. To animal
□ b. To public
□ 8. Unknown/CBD
□ 9.Other__________________
__________________________

Applied during Stranding Response:

□ YES □
□ YES □

SEX (Check ONE)

AGE CLASS (Check ONE)

□ 1. Male
□ 2. Female
□ 3. Unknown

□ 1. Adult
□ 2. Subadult
□ 3. Yearling

□ Whole Carcass

□ Partial Carcass

Straight length:______________
Weight:____________________

□ 4. Pup/Calf
□ 5. Unknown

□ cm □ in □ actual □ estimated
□ kg □ lb □ actual □ estimated

□ YES □ NO
PHOTOS/VIDEOS TAKEN:
Photo/Video Disposition: ________________________________________________
____________________________________________________________________
CARCASS STATUS (Check one or more)

□ 1. Left at Site □ 4. Towed: Lat__________Long__________ □ 7. Landfill
□ 2. Buried
□ 5. Sunk: Lat__________Long__________ □ 8. Unknown
□ 3. Rendered □ 6. Frozen for Later Examination
□ 9. Other________

TAG DATA Tags Were:
Present at Time of Stranding (Pre-existing):

MORPHOLOGICAL DATA

NO
NO

____________________________________________________________________
ID#

Color

Type

Placement*

Applied

Present

D DF L
_________________________ LF LR RF RR

□

□

D DF L
_________________________ LF LR RF RR

□

□

D DF L
_________________________ LF LR RF RR

□

□

(Circle ONE)

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

NOAA Form 89-864 (rev. 2007) OMB Control No.: ________; Expires: _________

SPECIMEN DISPOSITION (Check one or more)

□
□

1. Scientific collection

□

2. Educational collection

3. Other:__________________________________________________________
Comments: __________________________________________________________
____________________________________________________________________
NECROPSIED □ NO

□ YES □ Limited □ Complete
□Carcass Fresh
□ Carcass Frozen/Thawed

NECROPSIED BY: ______________________________ Date ______________
PLEASE USE THE BACK SIDE OF THIS FORM FOR ADDITIONAL REMARKS.

ADDITIONAL REMARKS
ADDITIONAL IDENTIFIER: _________________________________________________ (If animal is restranded, please indicate any previous field numbers here)
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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 (rev. 2007) OMB Control No.: 0648-0178; Expires: xx/xx/xxxx


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