Form 77-5a Chart Update Report

NOAA Chart Update Report NS-CU03
77-5a

District

USCG AUX - NOAA COOPERATIVE CHART UPDATE OMB Control No. 0648- 0022 Expires
08/31/2010
Type of update

1

use only
Rev 4-21-2010

Division Flotilla

4

For DSO

CU Report Number

CU - CHART UPDATE
CP - COAST PILOT

1

AUX

REPORT NUMBER

District

Number

1. CHART UPDATER DATA
CU Qualified

Trans Code

NO

Chart Updater's Last Name, First Name and Initial

Phone Number

Date of Investigation

06E

Street Address, City or Town, State and Zip Code.

Time Observed

E-Mail address
Distance traveled and time expended for NOAA

2. CHART / COAST PILOT INFORMATION

Chart/CP Number Chart or Coast Pilot Name

Hor. Datum Chart/CP Date

Chart/CP Edition

Updated to LNM reference.

Total Distance Traveled

Total Time Expended (hrs)

3. LOCATION DATA

Latitude:

DD-MM-SS.SS N

Longitude:

DDD-MM-SS.SS W

Method Used

EPE / HDOP QC Reading GPS Manufacturer's Name and Model Number
Observed Depth:

4. CORRECTED DEPTH AT CHARTED DATUM (Sounding UOM)

Units
FEET

Trnsdcr Correction

Ht. of Tide

Cor Depth Time Taken

Method Used

Manufacturer's Name and Model No.

Operating Frequency

FEET
Area of Coverage

5. STATEMENT ABOUT THE SCOPE OF THE TASK(S) BEING REPORTED:

6. OBSERVATIONS AND COMMENTS:

ADDITIONAL OBSERVATIONS AND COMMENTS ATTACHED TO THIS REPORT
7. ADDITIONAL OBSERVERS NOTIFICATION LIST

If more than 6
Auxiliarists
participated,
attach a separate
list.

Last Name

First Name and Initial

Phone Number

District
(3 digits)

E-Mail address

8. RECOMMENDATION

9. NOAA Chart Order

Quantity

1

Chart Number

Division Flotilla
(2 digits) (2 digits)

Chart Name

10. FURTHER EVIDENCE ATTACHED TO THIS REPORT:

Date report submitted

Sign your name here as the preparer of the report.

Page 1

a. Chart Updating Worksheet(s)
b. Chartlet(s)
c. Drawing(s).
d. Other e. Photograph(s)
f. Other evidence.

Points
Share (%)

Public reporting burden for this collection of information is estimated to average 3 hours 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
suggestions for reducing this burden to Ken Forster, NOAA's Ocean Service, Nautical Data Branch, 1315 East West
Highway, Room 7317, Silver Spring MD 20910 . Notwithstanding any other provisions of the law, no person is
required to respond to, 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 that collection of information displays
a currently valid OMB Control Number.