AD-941 Biological Shipment Record - Foreign/Overseas Source

~

~f4
._:".,.'e~"-

0"-'.'.__'0_""'""

"';:;;:-;:';'-;;;7°0;;;,,",--,~

;:, c;o,
-,

CODES "...

Nlk.12)

I

15. FOOD
PLA'NT1.ANrMAL
A. Field
(at collection)

LYe!)

SPECIMENS
RETAINED

DATE

OF RECEIPT

(m,d,)')

bOther

Beneficlals

)TALS -

.,

"""

iiI

IIEstl

Received

P~IV
I ~t 9r t

Dead

Alive

and Stages
-Host/Prey

,..

OF

Of

I

HOST/PREY
I B. Lab (when

cultured)

23. SCREENED

22.SHIPPEDVIA

DR PACKAGED

tNQUARAN~fQrinfacility
outside contiguous U.S.)
27. RECEIVER'S
fe. Contents
'IA.contalner

(block 2)
or Parasitized

Dead...

n ac

BY

FILE

NO.

(use codes)
B. No. 50 ~tages Of InOIVloualS Of eacn ~pecles
Emerged Enroute and in Quarantine
(alille and dead)

Hosts

Pal:aslte$
'.,1.,(
or.
Emeraed

-Hosts/Prey.

Beneficia's.

Other .E!1.a~e~RJe
.Notes
e 9

--C"

111;5]

Section III -FINAL

(code)

(expl/!!~jr~!k. 18)

RECEJVEP
28. RECEIPT AND EMERGENC~RECORD

Number

Stage/part

host/prey attacked

18. REMARKS

from blk. 12)

21: PACKING/HANDLING
,
'i~pu~ua}

Section II -REPOR~mRIALRECEIVED
25. DATE OPENED
26.
(m,d.y)
ICONOl.T.J.ON
A.

@~

E.

II

TARGETHDST!PREY

Gen., sp. (if different

j -zo:-REPRESENTATIVE

!Y@

.-

HOST/PREY.Gen~

t;r\""';;!"jl:1;1~~it'"
,
,'"
-'J:.:,l~;~...:

SHIPPED

I

.retained,

IE~::::I :'" 4'0
",,~.!J
"'..-' ("I

:t~~i.'

-~~---

30. REPORTED

RECORD OF RECEIPT. EMERGENCE.

AND DETERMINATION

IN QUARANTINE

OR EXAM

'NED

BY

(Or in facility outside contfauous U.S.)

D.

A.
Genus. Specles.Subspec;!es,Author

Number

E.
I Specimens

r.taKe -use code.) I Reta~
numbers

31. BENEF'ICIAL~PECIES
H

IL-?~

~]~]

[y~

~]
orner oene(iciou)

.,"

~5"

i~~i
't]IJd!

."

'!~]

I~]

i:;",

I lYe~

1Es"tl

cc

.REMARKS

33. ORIGINAL

HOST/PREY

rYe"$!

(final determination)

l:Ye~

I fEs""i1

~

ccO:

3S:RELEASED,
c(enterfile

$HII'PEO;Co-NSTGNED

numbers)

36. FINAL

Name

REPORT

BYA.

a[Ye~
b [Ye~

ic IYfi]
arm AD-941

(5{90)

Date (m,d,)')

Part 4 -SHIPPERS (F'ENDING) COpy

i.l
118.
123.
.'~8~

t

U. S. Department of Agricu Iture
Biological Shipment
Recor~ ~ Foreigp/ONetsea
0

'"

urce

or!

:" ~("Ci; c",

,cr,9ntlg\1ous U,S.

$ection I -REPORT
ROM (Faci/it;Y or Ex:p./Q~r)c
c
c

OF MATERIAL

:i. TYPE

i

r
6. DA1:ESTRANSFORMEO

TO STAGES

(month, day...yecr)

TOTAL'
O. LOCATION

ORIGI~,~,",~YFIEiLP

(m;d,y)

0

Shipped
directly"

I..AB CULTURED

-CouRtry&

1.1:2.
'O~...~INAl.

PrOVfRce/State

& RearestTown

or physical

(FI'+J

B. Culture Faclll~y(~

tctOST/PREY (or other food sources):!M'!C, Oe~e.rlijrried(by (name and
&(~;1
affiliation)

1'C:'LA II HOSTjpREY-Gerl.,sp...(ffdf"ereiiffl'Ombllt:T2)n5.

JI

.;;;",.c)
FOOO

0 WEedfeeder10
D POllinator
D OTher

"

-

to.Speclmensl E. Stage/part (code) of
'I ret~~d
I
host/prey attacked

[t:IQI~-I

PLANT/.ANIMAL

OF HOST/PREY

IA. Field (at collection)

I B. Lab (when cultured)

I

iHIPPED

TO

17. INTENDED

TARGET

REMARKS

HOST/PREY'

Gen., sp. (if differen t (rom blk. 12)

JATE

I
D PArasite
PRedator
c MI,crobial

feature

~.~orde.r;E~.jju'~- ~J:.;'..~~:"i~~~~~I~~tlr.~(
I

",

blk.l0

OF ORGANISM-explain

SHIPPED

lAc Gen".~p...subsp..auth.
Em~rg~dIQ,
L;a:b '

,Gcronym)-explalilln

~

MI&OTlnblk.18,

o

Det'lf'I'i1Tried1!jy:i~ifih:i;
af"fi"liaHo~!-

OLLECTED

c

Gen..$p'..$U~$p"aU~ l@

Order:Famlly

'ATES

b

SHIPPED (To be completed by Shipper)

-ORGANI~M~HIP~ED-A.

05:"&STAGES sl:!'PEf~p(~~~coii~T

0
0
0

a .'

or
or

To Quarantine Facilities In",,",',',:!,;
[~ ,"" 'G:,i~"c,LQCatlon ,u,tside
Contiguous U.S.

j(;qe "ft;';.}

SHIPPED

(m,d,y)

;,
20.

REPRESENTATIVE

SPECIMENS
RETAINED

Section III -FINAL

'.',',
.c

~~t,Jii~~~~~c~,7f~~~LI,N;
..
,L..J ,l./~~uaJ,,' hUqt",r:
~,xp/aII\I(ll!l.k.

RECORD OF RECEIPT, EMERGENCE.

AND DETERMINATION

zz.

5HIPPED

VIA

SCREENED

IN QUARANTINE
"e.

Genus. SpecleS,~~bspeC!eS~
p,uth9r

D.

Number

Q,~erm!J)e9by

(t1l1tne.affiliqtiO1\.&4qteJ

31. BENEFICIAL

1m
jMJ

i'i

SPECIES

c""

(.tage

IF'1~J

~]
~s]

~]
I lEst!

~

,LJ

I

fEs"tl

33.0RIGINAL

m AD-941

(5/90)

BY

-use

code.)

!
I

E.
Specimens
Retained

numbers

c

"';'1;":";"
(;

~;~:;';j(..\;;(
,'.'Ots!

Ii!

PACKAGED

fOr in facilitv outside contiauous U.S.l

C.

A.

OR

18)

IIY~
-

I~~
lYe~lIVeS!

I~:~
lYe~

HOST'/PREY (final'determination)

Part 3 -RECEIVER/QUARANTINE COpy

~7.r!NAL

u.s. Department of Agriculture

138.v,s.

I>I;:YE:RMTHAT.f:QN -~8n...Sp.;SUbsp:;.iit.fj:

j(ne

Biological Shipment Record-foreign/OverseasSource
0

To Quarantine Facilities In
Contiguousu.s.

-REPORT
"ROM

OF M~~IAL

(Facility QrE~plorer)

4. TYPE OF ORGANISM-explainMI & OT In blk. 18

[I
-..,..
--'.i-""..,..
Determined
by
i

(names

&

"""",,-,,--,;;";"'-'-',-'-i
affiliations)

,

PArasite

c

I i Ml.cr:o~ja!
6, DAT~STRANSFORM~T

~

;

t'IP~~3~'

-~:>ATES
ORIGIN~LLY
:OLLECTED
(m,d,y)

TOTAl,
:10. LOCA TJON~ry

c

1'(2.D?A:fGtHAL~OS71PR

C. Determined by (nartle-and
affiliation),

,\I

directly

POllinator
OTher

i&Provlnce/State&nearest'l'owri;orph';;;slcalfeatiire

0 EI11~~P!~~..~en,.sp..SL)bsp..ayth.

Shipped

WEed feeder'~PReda

0
0

;"

FIELD

---

0

AGESSH1PPED

(month.. day, year)

il

or
3. SHIPPER'S FILE NO.

~\

order:Fam-;iy

~

aD
bO
..
~O

SHIPPED (To be completed b~;eperl

ORGANISMSHIPPEP-A:Gen...sp.,Subsp:.auth

~OS. 8cSTAGES SHIPPEO (see codes)

D~\
.

or

OTOLocatlons Outside
""," cContlgllousU.S.

file,)

HOST/PREY-Gen.,sp,

(if different

ID.Speclmensi~eJpart
I

I ,.

order:FamJlv
t4.~AB

.,

,i;

{rom lilk. 12) It5. FOOD PLANT/.ANIMAL
IA. Field (at collection)

retained

I

(code)of

hostlpreyattacked

lYe~
;. !"~9J
I
OF HOST/PREY
I B. Lab (when cultured)

REMARKS

DATE

SHIPPED

OR

(m,d,y)

DATE

Section II ~REPORTOFMATER1AL RECE1VED1N;QUARANnNE(Oiiil facili1youtti!!ec:ontiguous U.S.)
25. DATEOPENSO
C~ntents
27. RECEIVER'S
26.
1A...GOntalhef
(m,d",)
ICONDITION

OF RECEIPT

(m,d,y)

Beneficials
Alive

FILE

BY

NO.

RECEIVED
28. RECEIPT AND EMERGENCE RECORD (use codes)
A. Number and Stages Received (block 2)
B. No. & Stages of Individuals of each Species
!-;lost/Prey or Parasitized Hosts
Emerged Enroute and In Quarantine (alive and dead)
t"ltv~ gr
Dead
it
I?arasite~"
'-'Hosts/Prey.
"Beneficials
.Other.
Dead
E e
a es
0
.Notes
PH lntact
or
Emerged
gence

---""'-"""

TALS -

Ilgs]

I~]

~

~!~nl
rz.
lB.
1
118.
i23-:-SCREENED
"B.

PACKAGED

""

1[g5:!1'

MEstl

; ~?!
30. REPORTED

Section III -FINAL

RECORD OF RECEIPT. EMERGE~~~DETERMINATION

IN QUARANTINE

(Or in facility outside conti!luous

D.

A.
Genus,Species,Subspecles,Authqr

,.tage.

31. BENEFICIAL

Number
use code.}

SPECIES

I~]

~]

c

j;J."",..

OR EXAMINED

.i~mJj

'8§

"',"' ,,'"

j' !\

1/Est!

I~]

1Es"il

33. ORIGINAL

HOST/PR~Y

(fino/detennination)

BY

U.S.)

I

E.

J Specimens
I Retained

numbers

LYe~
IIYe~

~~
IlYelj

SECTION I -MATERIAL
SHIPPED -Continued
Block Number
9. Datesoriginally field collected -May refer to collection of parasitized host material and thus may differ from Datestransformed to stagesshipped
(block 6). "Shipped directly" meansshipped in stagecollected. "Emerged in lab" means that the stageshipped emerged from hosts or other stages
originally collected.
10. Location -Give as precisecollectipn data, including oo~pcoordinates (UTM,MGCror~titude and longitude), as may be possible. If more than 2
collection sites; useblock 18and/qr AD",94tA. If .fabcuJturel;i,recordnameand a-ddressoffacility; and date the culture was started. If known,
g:iveoriginal collectio~ da~o~_t~ec.ultured qI~t~(e!g.,Lab
culture,CIBC, Delemont, Switzerland (Origin: Austria, 1982); or Lab culture, Tex.
J\gt. Expt.Sta., Weslaco(Origmz,Vn~oiWn,J.97;$,~),;
,
1\.
"

.Collectors-If fto~c{)c~\t~rth/in'sl1ipp~gfaciU);y,gi-ve'theirarr1liation(useacronym).

12. Origina~'h~p~ey -13JQck~AtWQ\l~~
':

"

"'.

'

.,

-::,C<;;?;~p,~etIQ~9f
the~ b\pC~~m~y,potqe:possl11~~a,t
th.etl;m~ QJ;s~pqlent. When apprQpr~te, pro~de:
food SQ,urceQtbeneficialspeeiesattime of collection. For'" 12JJ"j,only
the family name is needed for plants. Refer to instruction "2C" for completion of" 12C".

19. &.abculture~ :!Gheck'V,.i~y!j!'~ultured
oIcultuteirt block 10i'"
"f

inthelaboratbryfot-'one
" '-

ot more complete generation (s). Give acronytRofce1:flture"facility and detailS

15. FoOd.plaht/~nimal
use~e~4sn8:n1e,If InQi'etbarttWQtood sources,r~col:d num~ror"multiple:"
note if food ISother than pIantQJ'~W~~ '("~"f,du~g,4e:qayedmatenal,~t9..),
16. Shipped to -Full

~e

Also

and addressof receivingU.S. or foreign/overseasfacility. Include agency designation (e.g.,USDA-ARS, DOA-CE, etc.).

18. Remarks- Include remarks on intended:destination and any instructions for receiver.
22. Shipped via -Air

;UPPLEMENTA:L

frei"ht,
hand-canied, etc. Give naooeof
(individual or company) when applicable.
c9:' airmail,
'"
,. carrier iI'

NOTE:

DATA

8 Do not fold this sheet over form when writing -carbons
will distort entries.
.If additional copies are needed, photocopy and staple to form.

Section I -Additional

Shipper Notes.

(.~XP"O4/30/93)

IS_hipper's
File Number
(From AD-941)

.

(Ide!!t{f~ co!!!!!!~n~ b~ blo£k n!!mber)
8 Additional

Collections

(Numbers and stages collected -Dates

'm AD-941A

8 Emergence

-Site

and host/prey details)

Records

.Other