Marine Mammal Interaction & Specimen Form

Permit

Resubmission
(Circle All Changes)

sec

min

sec

E/
W

Sex

Longitude
Deg

Value

min

Specimen
type

Latitude (N)
Deg

Animal
number

Location during Trip

Specimen
number

Food
species

Specimen Data
Deterrence
successful?

Deterrence
code

Condition
Code

Day

Number of
animals in
interaction

Month

Species Common
Name

Did you
observe
mammal?

(circle one)

Interaction
Date

Total number
of animals
observed

Trip
Haul
Offload

Page _______ of _______

Vessel name
Mammal
code

Observer name

Interaction
code

Cruise

Comments: (see manual for list of required information)

For condition code 3 was animal injured? Y

N

U

sec

min

sec

E/
W

Sex

Longitude
Deg

Value

min

Specimen
type

Latitude (N)
Deg

Animal
number

Location during Trip

Specimen
number

Food
species

Deterrence
successful?

Deterrence
code

Condition
Code

Interaction
code

Did you
observe
mammal?

Day

Number of
animals in
interaction

Month

Species Common
Name

Total number
of animals
observed

(circle one)

Interaction
Date

Mammal
code

Specimen Data
Trip
Haul
Offload

Comments: (see manual for list of required information)

For condition code 3 was animal injured? Y
National Marine Fisheries Service/Fisheries Monitoring and Analysis Division

N

U
Page _________ of _________ for transmission

Cr.

08

Permit

Resubmission
(Circle All Changes)

sec

min

sec

E/
W

Sex

Longitude
Deg

Value

min

Specimen
type

Latitude (N)
Deg

Animal
number

Location during Trip

Specimen
number

Food
species

Specimen Data
Deterrence
successful?

Deterrence
code

Condition
Code

Day

Number of
animals in
interaction

Month

Species Common
Name

Did you
observe
mammal?

(circle one)

Interaction
Date

Total number
of animals
observed

Trip
Haul
Offload

Page _______ of _______

Vessel name
Mammal
code

Observer name

Interaction
code

Cruise

Comments: (see manual for list of required information)

For condition code 3 was animal injured? Y

N

U

sec

min

sec

E/
W

Sex

Longitude
Deg

Value

min

Specimen
type

Latitude (N)
Deg

Animal
number

Location during Trip

Specimen
number

Food
species

Deterrence
successful?

Deterrence
code

Condition
Code

Interaction
code

Did you
observe
mammal?

Day

Number of
animals in
interaction

Month

Species Common
Name

Total number
of animals
observed

(circle one)

Interaction
Date

Mammal
code

Specimen Data
Trip
Haul
Offload

Comments: (see manual for list of required information)

For condition code 3 was animal injured? Y
National Marine Fisheries Service/Fisheries Monitoring and Analysis Division

N

U
Page _________ of _________ for transmission

Cr.

08