SPUT Form Template Excel_2017
SPUTFormTemplateExcel_2017.xlsx
Federal Fish and Wildlife Permit Applications and Reports--Migratory Birds and Eagles; 50 CFR 10, 13, 21, 22
SPUT Form Template Excel_2017
OMB: 1018-0022
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1018-0022 can be found here:
Document [xlsx]
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2. ENTER CORE INFORMATION
3. ENTER MORT-INJ DATA
PERMIT OFFICES
GLOSSARY OF TERMS
PRIVACY ACT PAPERWORK REDUCTION
Overview
1. READ BEFORE DATA ENTRY2. ENTER CORE INFORMATION
3. ENTER MORT-INJ DATA
PERMIT OFFICES
GLOSSARY OF TERMS
PRIVACY ACT PAPERWORK REDUCTION
Sheet 1: 1. READ BEFORE DATA ENTRY
| USFWS Bird and Bat Injury and Mortality Reporting System (Excel Version) | |
| Data Sheet Instructions and Information | |
| *Please e-mail or call your regional Migratory Bird Permit Office (see Tab 4) with any questions about this report. | OMB Control No. 1018-0022, Expires 5/31/2017 Form 3-202-17, Rev. 4/2017 |
| ABOUT THIS SPREADSHEET: | IF YOU DISCOVER AN EAGLE OR A THREATENED OR ENDANGERED (T&E) SPECIES |
| 1. REQUIRED FIELDS are indicated by orange column headers. These are fields that should be filled in at a minimum for each record. 2. REQUESTED FIELDS (fields with information we would like if you have it) are indicated by light grey column headers. At the very least, please try to populate all these fields, and any other applicable fields where possible, if that information is available. |
Please complete the following steps: If the animal is alive, step 1 is call your local migratory bird rehabilitation facility or a licensed veterinarian for instructions before handling the animal. Then follow steps 1-3 below. 1. If you have a permit, please follow the instructions in your permit conditions on how to proceed before collecting or moving the carcass or its parts. If you do not have a permit, please call the USFWS employee who is working with you on your monitoring process. If you do not know the appropriate USFWS contact, please call the OLE Office in your USFWS Region (see contact information at: http://www.fws.gov/le/regional-law-enforcement-offices.html) for instructions. You must contact OLE immediately, if possible, but not later than 48 hours after discovery, or at the beginning of the next business day to notify them of the mortality. |
| IMPORTANT NOTE ABOUT REQUIRED AND REQUESTED FIELDS: If you have a permit with the USFWS, your permit conditions may require you to fill in more than just the required and requested fields, or the fields that are required and requested may differ slightly than indicated in this spreadsheet. Please check your permit conditions to make sure you are providing all the information required for compliance with your permit. -DROP DOWN BOXES are provided with several of the fields for your convenience, and to support greater consistency of data for these fields. Please try to use one of the options provided within the drop down boxes for these fields. However, if you can not find the appropriate match in the drop down (or your selection is "Other - describe", you may enter your own text in the field as well. To enter your own text, click on the cell once and start to type your own text. To clear a field, click on the cell once and hit the Delete button. |
2. Fill out as many of the fields as possible on tab 3 of this workbook regarding the incident, have an official representative sign the signature block and enter the signature date in tab 2 (signatory does not have to be the Principal Officer, can also be the Primary Contact or other official company representative), and e-mail a copy of this entire workbook (all tabs included) to the individuals specified in your permit conditions (which may be a Migratory Bird Permit Office, and Ecological Services Field Office, or both). You must report eagle mortalities and injuries no later than 48 hours after discovery, or at the beginning of the next business day. T&E mortalities should be reported no later than 24 hourse after discovery, or at the beginning of the next business day. IN THE SUBJECT LINE OF THE E-MAIL, if you are reporting an eagle write "EAGLE REPORT - [Permittee Name]". If you are reporting a T&E species write "T&E REPORT - [Permittee Name]" e.g. Eagle Report - Windy Hill Wind Farm (if eagle) or T&E Report - Wind Hill Wind Farm (if T&E). If you do not have a permit, reports should be e-mailed to the USFWS contact who is working with you on your monitoring process. Please ALSO COPY the following e-mail address: [email protected]. |
| 3. IF YOU SELECT THE OPTION "OTHER" or contains the word "OTHER" or you have additional details about your choice: please try to provide additional details with your selection in the other details column provided next to it. 4. ON TAB 3, PLEASE SCROLL RIGHT TO VIEW ADDITIONAL DATA ENTRY FIELDS. There are more fields than are immediately viewable in tab 3. Please use the scroll bar at the bottom right hand side of the spreadsheet to view all fields. 5. TO SUBMIT YOUR INTERIM (ANNUAL) REPORT: Please e-mail this entire workbook (including all tabs) as an e-mail attachment to your Regional Migratory Bird Permit Office using the Directory on tab 4 of this workbook, AND copy the following e-mail addresss: [email protected]. Your interim (annual )report should include all injuries/mortalities logged at your facility site during the reporting period (including any eagle or T&E reports). IN THE SUBJECT LINE OF THE E-MAIL write "ANNUAL REPORT - [Permittee Name]". e.g. ANNUAL REPORT - Windy Hill Wind Farm. |
3. Please assign a Local Specimen Number in Column B of Tab 3 to ANY birds you hand off to a responding OLE agent or any other party that might receive the bird once it is transferred (rehabber, vet, lab, etc.). Make sure to give this Local Specimen Number to individual you hand the bird off to. If you can not assign your own unique specimen ID, please use the Source Record ID in Column A as your Local Specimen ID. If you do this, make sure you also put the Source Record ID in Column B to indicate to us you have used this as your local specimen number. |
Sheet 2: 2. ENTER CORE INFORMATION
| CORE INFORMATION | Required Fields | |
| Report Year (yyyy) | ||
| Permittee Name | ||
| FWS Permit Number (MB followed by up to 6 numbers and an optional upper case character [e.g., MB13456B]) | ||
| Project Type | ||
| If Project Type selected is "Other", please enter more details | ||
| Principal Officer Name, Phone, and E-mail Address | ||
| Primary Contact Name | ||
| Primary Contact Title | ||
| Primary Contact Business Phone Number (xxx-xxx-xxxx) | ||
| Form 3-202-17, Rev. 4/2017 | ||
| OMB Control No. 1018-0022, Expires 5/31/2018 | ||
| If you do not have any mortality/injury information to report for the current reporting cycle, please indicate this by checking the box in the cell to the right. | 
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| I certify that the information in this report is true and correct to the best of my knowledge. I understand that any false statement herein may subject me to the criminal penalties of 18 U.S. C. 1001. | ||
| Official Representative Signature : X | ||
| Please type name in box above | ||
| Date of Signature: | ||
| Please type date (mm/dd/yyyy) of signature in box above | ||
Sheet 3: 3. ENTER MORT-INJ DATA
Sheet 4: PERMIT OFFICES
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Sheet 5: GLOSSARY OF TERMS
| GLOSSARY OF TERMS |
| Brine Pond: A type of non-focusing solar collector consisting of a pool of salt water heated by the sun. |
| De-Oiled: A breakdown of the fine structure of a bird's feathers that makes them waterproof. This waterproof system works like a winter coat whose outer layer covers a thicker layer of material that traps air, keeping the wearer warm and dry. When this structure is disrupted, as can commonly occur when birds are oiled during an oil spill, the bird is no longer properly insulated from the cold air and water and can die from exposure to the elements. |
| Incidental Finding: is used to describe a bird was found any way other than a structured survey process (either a Mortality survey, Routine infrastructure survey, or Structured Research). Examples of incidental findings are: (1) the finding occurred as a result of a power outage; (2) an individual just happened upon a bird in the course of another activity; (3) an individual was out looking for birds, but not using any structure survey protocol or recording search time and effort (e.g. they may go out every day, but walk a different route and search for different periods of time and do not record either) |
| Mortality Survey: Refers to a structured survey designed to find dead/injured birds within a defined area and time. It includes a consistent and clearly defined search area, search times and intervals, and standardized search protocols. |
| Project Proponent: An entity with overall responsibility for the implementation and registration of projects. This is as opposed to the operating company who simply owns and finances these projects. For instance, project proponent Western Wind is a developer that is owned by the Terra-Gen Power LLC operating company. |
| Routine Infrastructure Survey: Refers to a routine and systematic facility or infrastructure survey (e.g., monitoring of buildings, electric utility lines, wind turbine pads, towers, oil pits, pipes, fences) that includes a consistent and clearly defined search area, search times and search intervals. For example, if maintenance staff goes out every week day (Mon-Fri) for 4 hours and walks the same route to systematically inspect each turbine pad in a wind energy facility, that qualifies as a Routine infrastructure survey. If consistent search areas, times and intervals such as these cannot be applied to the monitoring being conducted at the time of the finding, then the option Incidental finding should be used. |
| Structured Research: Refers to research activities such as field work, bird re-release and use of telemetry (satellite, VHF, PTT). |
| Sub-Adult: A bird that has some adult characteristics but is not yet sexually mature. The term Sub-Adult usually refers to larger birds such as gulls and raptors that may take several years to reach full maturity and recognizable adult plumage. |
Sheet 6: PRIVACY ACT PAPERWORK REDUCTION
| Paperwork Reduction Act and Privacy Act Notice: |
| In accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. 3501, et seq.) and the Privacy Act of 1974 (5 U.S.C. 552a), please be advised: 1. The gathering of information on fish and wildlife is authorized by: (Authorizing statutes can be found at: http://www.gpoaccess.gov/cfr/index.html and http://www.fws.gov/permits/ltr/ltr.html.) a. Bald and Golden Eagle Protection Act (16 U.S.C. 668), 50 CFR 22; b . Migratory Bird Treaty Act (16 U.S.C. 703-712), 50 CFR 21; c. General Provisions, 50 CFR 10; d . General Permit Procedures, 50 CFR 13; and e . Wildlife Provisions (Import/export/transport), 50 CFR 14. 2. Information requested in this form is purely voluntary. However, submission of requested information is a condition of your permit under the above laws. Failure to provide all requested information may be sufficient cause for the U.S. Fish and Wildlife Service to revoke your permit. Response is not required unless a currently valid Office of Management and Budget (OMB) control number is displayed on form. |
| 3. Disclosures outside the Department of the Interior may be made without the consent of an individual under the routine uses listed below, if the disclosure is compatible with the purposes for which the record was collected. (Ref. 68 FR 52611, September 4, 2003) a. Routine disclosure to subject matter experts and Federal, Tribal, State, local, and foreign agencies, for the purpose of obtaining advice relevant to making a decision on an application for a permit or when necessary to accomplish an FWS function related to this system of records. |
| b. Routine disclosure to Federal, Tribal, State, local, or foreign wildlife and plant agencies for the exchange of information on permits granted or denied to assure compliance with all applicable permitting requirements. |
| c. Routine disclosure to Federal, Tribal, State, and local authorities who need to know who is permitted to receive and rehabilitate sick, orphaned, and injured birds under the Migratory Bird Treaty Act and the Bald and Golden Eagle Protection Act; federally permitted rehabilitators; individuals seeking a permitted rehabilitator with whom to place a bird in need of care; and licensed veterinarians who receive, treat, or diagnose sick, orphaned, and injured birds. d. Routine disclosure to the Department of Justice, or a court, adjudicative, or other administrative body or to a party in litigation before a court or adjudicative or administrative body, under certain circumstances. e. Routine disclosure to the appropriate Federal, Tribal, State, local, or foreign governmental agency responsible for investigating, prosecuting, enforcing, or implementing statutes, rules, or licenses, when we become aware of a violation or potential violation of such statutes, rules, or licenses, or when we need to monitor activities associated with a permit or regulated use. |
| f. Routine disclosure to a congressional office in response to an inquiry to the office by the individual to whom the record pertains. g. Routine disclosure to the Government Accountability Office or Congress when the information is required for the evaluation of the permit programs. h. Routine disclosure to provide addresses obtained from the Internal Revenue Service to debt collection agencies for purposes of locating a debtor to collect or compromise a Federal claim against the debtor or to consumer reporting agencies to prepare a commercial credit report for use by the FWS. 4. For individuals, personal information such as home address and telephone number, financial data, and personal identifiers (social security number, birth date, etc.) will be removed prior to any release of the application. |
| 5. The public reporting burden for information collection varies depending on the type of permit held. The relevant annual burden for Special Purpose – Utility Permit reporting is 6 hours. This burden estimate includes time for reviewing instructions, gathering and maintaining data, recordkeeping, and completing and reviewing the form. You may direct comments regarding the burden estimate or any other aspect of the form to the Service Information Clearance Officer, U.S. Fish and Wildlife Service, Mail Stop 222, Arlington Square, U.S. Department of the Interior, 1849 C Street, NW, Washington D.C. 20240. |
| Freedom of Information Act Notice: |
| For organizations, businesses, or individuals operating as a business (i.e., permittees not covered by the Privacy Act), we request that you identify any information that should be considered privileged and confidential business information to allow the Service to meet its responsibilities under FOIA. Confidential business information must be clearly marked "Business Confidential" at the top of the letter or page and each succeeding page and must be accompanied by a non-confidential summary of the confidential information. The non-confidential summary and remaining documents may be made available to the public under FOIA [43 CFR 2.26 – 2.33]. |
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |
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