Form 89-864 Marine Mammal Stranding Report - Level A Data

Marine Mammal Stranding Report/Marine Mammal Rehabilitation Disposition Report

0178 Stranding report

Marine Mammal Stranding Report - Level A Data - Not for profits

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: _____________________________________________________
Other Findings Upon Level A:
□ 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): □ External Exam
□ Internal Exam □ Necropsy
□ Other: __________________________________________________________________________

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

□ Actual □ Estimated
How Determined: (check ONE)

□ Map

(NMFS Use)
# Animals: _______ □ Actual

Findings of Human Interaction:

Locality Details: ____________________________

□ GPS

GE# ____________________

□ Internet/Software

□ Not Able to Examine

INITIAL OBSERVATION

LEVEL A EXAMINATION

Date: Year: _______ Month: ____________ Day: _______________

Date: Year: _______ Month: ____________ Day: _______________

First Observed:

□ Beach or Land □ Floating □ Swimming

CONDITION AT EXAMINATION (Check ONE)

CONDITION AT INITIAL OBSERVATION (Check ONE)

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

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

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

INITIAL LIVE ANIMAL DISPOSITION (Check one or more)

□ 1. Left at Site
□ 2. Immediate Release at Site
□ 3. Relocated

MORPHOLOGICAL DATA

□ 6. Euthanized at Site
□ 7. Transferred to Rehabilitation:
Date: Year:______ Month:_____Day:___
Facility:___________________________

□ 8. Died during Transport
□ 4. Disentangled
□ 5. Died at Site
□ 9. Euthanized during Transport
□ 10. Other:____________________________________________________
7. Location Hazardous

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

TAG DATA Tags Were:
Present at Time of Stranding (Pre-existing):
Applied during Stranding Response:
ID#

Color

Type

Placement*

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:______________

CONDITION/DETERMINATION (Check one or more)

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

□ YES □
□ YES □
Applied

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

NO
NO
Present

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______________
SPECIMEN DISPOSITION (Check one or more)

D DF L
_________________________ LF LR RF RR

□

□

□
□

D DF L
_________________________ LF LR RF RR

□

□

Comments: __________________________________________________________
____________________________________________________________________

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

1. Scientific collection

□

2. Educational collection

3. Other:__________________________________________________________

NECROPSIED □ NO

□ Carcass Fresh

□ YES □ Limited □ Complete
□ Carcass Frozen/Thawed

NECROPSIED BY: ____________________________________________________
Date: Year: ______________Month:_______________Day:__________________

NOAA Form 89-864 (rev. 2007) OMB Control No.0648-0178; Expiration Date:10/31/2010

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; Expiration Date: 10/31/2010


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