Second Navy range fouler release

eEeRf1H~EL Te MeA, rYEV Tracking Number (Internal Use Only) LI________J
Pl"!lse do not use the purple
"submit" button abol/e. Sal/e and
Range Fouler Reporting Form email the comple!efile manually
(See below).
Please complete this form to the best of your ability. If you do not have the requested information. please leave
the field blank. If there was more than one "group.· please report each on a separate form for data collection
purposes. Please recognize that this form is classified eEeR:E1"f/Fl:EL, and treat your inputs as you would any
other classified government information. You should receive a response within 7 business days,
Last NIIme, Fils! NIJI1l8 /-IlIIlk SquarJron S1PI-I f:iI1ail AddrfNl~ Crew Position
"--____-'1 LI----,I LI_----'I 1"--___---'1 LI_----'
UAPTF sanitizes all reports Of !dentl!'ylng Information, Your personal information will remain completely prlvafe, and Is
requested for polenl/al fufur~ debriefing purposes only. All Intel ;lnd Ops addressees have signed conridenUality statements tn
protect yOU! identities and the information in these repons.
(b)(1) I II 101Dal9 (mmldri'yy) ~T~m.::-:"~d~""":::::ti~,"J DIJ'I I M'J/II Side No L_-;;:::::-_-l
{hh:mm:ss Z)
(b) (1)
Mission Description (CAS. BF"{ elc)
-~~~JILI~~~I[]N!,~I==~I[JLI~=I~I~~IIL~~~~Geograpf1ic loc8tiorl Conlactl.aliwoo LI Coot~c/longitade FIW Pia/form AlJitude Obiect Ailitude Wind air / Wind Speed
(C~ W-721AJ (DD:MM:SS) ({)D.MMSS) (1::~. 22(00) (at Con/ad All)
PleaS.Pllo delfmnine a Let/Long fort/Ie cooled e/ initial rlfIteclioo. We rflCOO7m9nrJ
using to re{ererlce the S81)sor..derived b98rinll ~!ld range relalive to the bullse~e you had
in USfJ. I{ thai ma/liorJ is nol nveilable. fI!IY reaoorwbla derivation of IocfIlion will tIIOr~. but
please be DS specific es possible find m<J~e ~ 1I0ie In Ihtl comments section TII9SIII0I.'iJlions
may be US9rJ /0 CU9 ofher !1Ifl8llS of tracking.
(b) (1 )
# of Contacts In
"Group":
(b) (1 )
Check all that apply):
(b) (1)
Was the contact mOvlng7~1===::;
Direc/ion/Speed I(Ex. Q9011~J L____-'
Please check a/l that apl,ly:
BalJoon..sl!lJPfId.
WlnI]s/Airfrem9.
ApPtJrenl Propulsion.
Please use the field below to describe the contact and what happened in your own words with as much detail as
possible. Please be sure to include any detail not included in questions above.
-------------------------------,
filename "Date_Locatlon_Squadron_RF.pdf" and
the at
(Bclthin -the~""IiF. For troubleshooting, call (b) (1)
Thank yau for your time. Please ensure all display tapes are ripped for the entire time of interaction and saved as
a .wmv (Example: . Squadron intel personnel shall upload those files to the repository
located at this link. (b) (1)