Second Navy range fouler release

!Ee~ETlfI'U!L fe ~e,.", PYEY Tracking Number (Intemal Use Only) LI________...1
Please do not use th~ purple
"submit" button above_ Save and
Range Fouler Reporting Form emaillhe complete file manually
(see below).
Please complete this form to the best of your ability. If you do nal 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 ::tEe~ETIfp;:Et, and treat your inputs as you would any
other classified government information. You should receive a response within 7 bUsiness days_
Lest Name, First Name Rellil Sq!ladron SIPR EmBil Address CJfJ'W Position
(b) (6) !0-3 El (b) (1) (b) (6) ~_...J,El...
UAPTF sanitizes aU reports of Identifying Information. Your personal information will remain completely privare, and is
reqll':ste(i for po/enUM fmu(e debl!efillg "urpos~.~ only. AlIllltli!l alld Gpo; Ilddlf'~Sees llavli! signed confidelltiality 51iltl."ments to
protfCl your id~"ritie!i 1l!1(1 trw in/omlJlioll in tfles~ rep oris.
aul! !Day ElIRl (b) (1).
Dale (mmldli/yy) Time of detediQn Day I Night Side No.
(hh:mm~sZ)
~====~!~!====~!@J!~==~Goograp/iic Iocatkm COII!;Jr:( LlJlilude NIS Con/act LonDitude
8'00
-El
(n, W.721A) (OO.MM-SS) (DD:MMSS) (Ex: 22000) (al Collloct Att)
PlellsJ.i!JlIljPt!o delermil1fj II Lall LMiI for Ille cOlI/act al initial dete~/ion_ We recommend
lISl~O reference the !if!()SOf-eenved bearing alld range re/aWe 10 the bullseye yoo had
in use. If thaI m~ is fIOlllvailflble. /JlIy reasonable detivation 0/ lorelifm WIIJ 1IIfIf1!, but
ple~ be as specifIC IlS possible Ilnd malle 8 note in IhfJ commrmts ~octi<m. TheS() Jocalioos
mey be used to clie olher moons ofrroding
(b) (1 )
# of Contacts in
"Group":
Was the cOlltact moving?
DimeUM/Speed nBO/200
(Ex. 09(115) L
Please check alJ that apply:
J./ound [l] MOVIng Parts_ 0
Square: 0 Metallic- 0
BDlIooo-stIfJped. D Merlcings__ 0
WingSAh1ral1le_ D TnmslUCfJnt. 0
Otllf/f Sl!a~ D Opaque, D
Apporenl PIO(Julsioo_ [l] Refler;/;"'o D
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.
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( II ) ~ nd
(b) (1)
Thank you for
a .wmv (E:<arnple:
located at (b) (1)
Both in the global). For troubleshooting, calf
tapes are ripped for the entire time of interactJon and saved as
~UB<<ron inter personnel shall upload those files to the repository
BE8RETHREb:"'F8 W8.', rYE\,