Sea Turtle Entanglement Report Form (nonfillable)

	SEA TURTLE ENTANGLEMENT REPORT FORM OMB Control No. 0648-0496; Exp Date: XX/XX/XXXX			FIELD #: ______________________________
Shaded area for NOAA Fisheries Service (NMFS) use only NMFS #:_______________ EVENT CONFIRMATION: Confirmed Probable Not confirmed Reasoning: ________________________________________________
INITIAL OBSERVATION: Observer name: ________________________________________________ Phone: __________________________________ Observer address / affiliation: ____________________________________________________________________________________________________ Observation date: _________________________ (mm / dd / yyyy) Time: _________________________ am pm Turtle condition: Alive Fresh dead Moderately decomposed Severely decomposed Dried carcass Skeleton Unknown
EXAMINATION / RESPONSE: Responder name: ___________________________________________ Phone: _________________________________ Responder address / affiliation: ___________________________________________________________________________________________________ Response date: _________________________ (mm / dd / yyyy) Time responder arrived on scene: _________________________ am pm Turtle condition: Alive Fresh dead Moderately decomposed Severely decomposed Dried carcass Skeleton Unknown
PHOTO DOCUMENTATION: Photos / video taken: Yes No If Yes, disposition: Initial observer STDN member NMFS Documentation of: Turtle in gear Injuries / entanglement site Buoy colors, numbers and any other identifiable feature(s)
LOCATION: State: __________ County: ______________________ Nearest port / town: ___________________________________________________ Locality details: ___________________________________________________________________________________­__ Stranded ashore: Yes No Latitude: _________________________________________ N Longitude: _______________________________________ W
TURTLE DATA: Species or description: ___________________________________________________________________________________________ Straight carapace length:** ____________________ cm in actual est. Sex: Male Female Not examined CBD Curved carapace length:** ____________________ cm in actual est. Does tail extend beyond carapace? Yes No **Carapace length is measured from nuchal notch to posterior tip (see diagram on back) If Yes, how far? ____________ cm in actual est. Weight: ____________________ kg lb actual est. Sex determined by: Necropsy Tail length (adults only) N/A Was turtle: Anchored Free-swimming Unknown Describe behavior in gear: ______________________________________________________________________________________________________
GEAR TYPE: Indicate the primary (in contact with turtle) entangling gear with a “P” and secondary gear with an “S”. Fill out all applicable details. ____ Vertical Line with Surface Buoy Gear anchored / weighted: Yes No If Yes, anchored by: Pot(s) Net Unknown Other: ­­­­­­­­­­___­_____________________________ Length of line between turtle and surface buoy: ____________________ cm in actual est. ____ Line Only (no buoy) Type: Monofilament Multifilament (e.g. nylon or poly rope) Unknown Hook(s) present: Yes No If Yes, where attached to turtle: Not attached Mouth Ingested (past mouth) Soft tissue (not mouth) Gear anchored / weighted: Yes No If Yes, anchored by: Pot(s) Net Unknown Other: ___­­­­­­­­­­­­_____________________________ ____ Net Type: Monofilament Multifilament (e.g. nylon) Unknown Estimated stretched mesh size: ____________________ cm in Net ID number(s): ____________________ ____ Fish Trap (pound net / weir) Location: Free-swimming in trap Entangled in leader Entangled in trap Other (describe in Additional Remarks) ____ Other Describe: _________________________________________________________________________________________________________
GEAR DETAILS: Number of pots: _______________ Pot ID Number(s): ____________________ Number of buoys: ______________ Buoy ID number(s): Buoy 1: _______________________ Buoy 2: _______________­­­____________ Buoy 3: ___________________________ Buoy color(s): Buoy 1: ___________________________ Buoy 2: ___________________________ Buoy 3: ____________________________
Line color(s): Line 1: _______________________________ Line 2: _______________________________ Line 3: _______________________________ Biofouling present on gear: Yes No If Yes, % of visible gear covered by biofouling: __________ % (describe type of biofouling in Additional Remarks) Gear retrieved: Yes- all Yes- partially No If Yes, disposition: Initial observer STDN member State agency NMFS Gear Team
DISENTANGLEMENT OUTCOME: (Check one)
Disentangled and released Partially disentangled and released Release behavior:________________________________________ Collected for treatment at: _______________________________			Entangled / no action taken Entangled / not relocated Lost during disentanglement Died during disentanglement	Relocated to: _________________________ Euthanized Other: _______________________________
CARCASS / SAMPLE DISPOSITION: (Check all that apply)
Left at site Towed ashore Buried off beach Buried on beach		Necropsied Scientific collection Educational collection Biopsied	Other: ______________________________ Unknown

TAG / MARK DATA: Checked for flipper tags: Yes No Scanned for PIT tags: Yes No

Tag / mark type Number Location on animal Applied Present

_____________________________ _____________________________ _____________________________

_____________________________ _____________________________ _____________________________

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ENTANGLEMENT / WOUND DESCRIPTION: Use table below to describe the entanglement configuration and any wounds associated with the entanglement site.

Body area involved	Description (Specific location, # wraps, partial or complete circumference, tight vs. loose, etc.)	Wound description at entanglement site (mark all that apply)
		Indentation	Abrasion	Laceration	Swelling	Bleeding	None
Head / neck
Front flippers
Carapace / plastron
Rear flippers

ENTANGLEMENT / WOUND DIAGRAM: Below, please provide a diagram of entangling gear, new or healed wounds, abnormalities and / or tag locations.

EVENT SUMMARY AND 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.

The collection of information on sea turtle entanglement is necessary to ensure sea turtles are being conserved and protected, as mandated by the Endangered Species Act of 1973, as amended. Your voluntary collection and submission of this information will help achieve this objective. The public reporting burden for this collection of information is estimated to average one hour 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. Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject 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. Personal identifiers and any commercial information will be kept confidential to the extent permitted under the Freedom of Information Act (FOIA) (5 U.S.C. 552), the Department of Commerce FOIA regulations (15 CFR Part 4, Subpart A), the Trade Secrets Act (18 U.S.C. 1905), and NOAA Administrative Order 216-100. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to (NMFS, Greater Atlantic Regional Fisheries Office Protected Resources Division, 55 Great Republic Drive, Gloucester, MA 01930).