1.0 DETAILS OF ANOMALOUS PHENOMENON CONTACT - FULL NARRATIVE
Please tell what happened in as much detail as is possible. Include only operator initials if needed.
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2.0 DETAILS OF YOUR LOCATION:
2.1 AIRPORT: ______________________ 2.2 Facility ID: ________ 2.3 TRACON: _____________________
2.5 Lat. _____ o ______' _____" 2.6 Long. _____ o ______' ______" 2.7 Altitude MSL: ____________ ft.
(optional - airport only)
2.8 Local time of radar contact: (24 hr. clock) Start: _________________
2.9 End: _________________
2.91 Total duration of radar contact: _________ (minutes) ________ (seconds)
2.92 Date of Occurrence: Month_________ Day ______ Year ________ ( ) exact ( ) +/- 2 days ( ) est. only
Rept. No. ______ - ___________
3.0 RADAR EQUIPMENT DETAILS:
3.1 Manufacturer: (if known): ______________________3.2 Model: ______________ 3.3 Yr. Installed: __________
3.4 Revolution rate: ___________ rpm 3.5 Primary Frequency: _____________ MHz.
3.6 Microwave band: ___________________ 3.7 Antenna Location: _____________________________
3.4 MTI was: ( ) off ( ) on ( ) unknown
4.0 REPORTER DETAILS: Check all that apply
4.1 In what type of facility do you work? ( ) Tower ( ) Approach ( ) Center ( )FSS Other: _________
4.2 Describe your ATC qualifications: ( ) FPL ( ) Developmental ( ) Other: ________________________
4.3 Time certified on position/sector: ___________ yrs/mo.
4.4 What is your ATC experience in years? _____ radar _____ limited radar _____ non-radar ____ military ____ supervisor
4.5 What was your control position/activity ( ) radar ( ) local ( ) arrival ( ) clrnc. delivery ( ) pre-flt. ( ) supervisor
4.6 During the occurrence? (check all that apply for combined position)
that ( ) hand-off ( ) ground ( ) departure ( ) coordinator ( ) in-flight ( ) monitor
( ) radar assoc.( ) data ( ) assistant ( ) manual ( ) flt. watch
4.7 At time of occurrence: I was ( ) instructing ( ) receiving training ( )performing normal duties
4.8 Do you have pilot experience? ( ) no ( ) yes, _________ hours ( ) instrument rated
5.0 AIRSPACE IN WHICH OCCURRENCE TOOK PLACE:
5.1 ( ) Class A (PCA) ( )Class B (TCA) ( )Class C (ARSA) ( )Class D (Control Zone/ATA)
( ) Class E (General Controlled) ( ) Class G (Uncontrolled) ( )Special Use Airspace
( ) Airway/route: _______________________ ( ) not known/other: _______________________
5.2 Was an aircraft involved in this radar contact? ( ) yes ( ) no If "no" go directly to paragraph 9.0
6.0 WEATHER/VISIBILITY/LIGHT DETAILS: in general vicinity of radar return
6.1 ( ) VMC ( ) IMC ( ) mixed ( ) marginal ( ) rain ( ) fog ( ) ice
( ) snow ( ) turbulence ( ) thunderstorm ( ) windshear
6.2 Barometer was: ( ) steady ( ) rising ( ) dropping ( ) unknown
6.3 Ceiling (if known): ___________ feet
6.4 Visibility (if known): ____________ feet
6.5 Light conditions: ( ) Dawn ( ) Full Daylight ( )Dusk ( ) Moonlit Night ( ) No Moon Night
6.6 Was weather conducive to 'ducting' or other anomalous radar propagation? ( ) yes ( ) no ( ) unknown
(Please provide as many supporting details as possible)
7.0 RADIO COMMUNICATIONS DETAILS:
7.1 Who made the first radio contact? ( ) Capt. ( )F/O ( )You ( )Other: (specify) _____________
7.2 What did this person(s) say? ____________________________________________________________________
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7.3 As far as you know was the source of the radar return also visible from cockpit? ( ) yes ( )no ( ) unknown
7.31 If "yes" to whom was the source visible? ( ) Capt. ( )F/O ( )both ( ) Others: ______________
7.4 What advisory or other information did you provide to the pilot(s)? _____________________________________
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7.5 What did the pilot say he/she saw from cockpit in same direction and range as radar return? __________________
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7.6 Did the flight crew identify themselves to you by flt. number, airline, etc.? ( ) yes ( )no
7.7 Did the flight crew want to report a "UFO?" ( ) no ( )yes ( )unknown
7.71 If "yes" who received their report? ____________________________________________________________
8.0 AIRCRAFT DETAILS AT TIME OF OCCURRENCE: (If more than one use separate sheets)
8.1 Type of Aircraft: (Make/Model) _____________________________
8.2 Operator: ( ) air carrier ( ) private ( ) commuter ( ) military ( ) corporate ( )other
8.3 Flight Type: ( ) passenger ( ) pleasure ( ) business ( ) cargo ( ) military ( )unk./other
8.4 Aircraft was flying on: ( ) VFR ( ) IFR ( ) SVFR ( ) DVFR ( ) none ( ) unknown
8.5 Aircraft phase of flight: ( ) takeoff ( ) climb ( )cruise ( ) descent ( ) approach ( ) not applic.
8.6 Control status of aircraft: ( ) controlled ( ) no radio ( ) on vector ( ) radar advisories
( ) none ( ) on SID ( ) on STAR ( ) unknown
8.7 Altitude: ____________ feet ( ) MSL ( ) AGL
8.8 Distance and radial from airport/NAVAID, or other fix: _________________________________________________
8.81 Radar return nearest to what city/state: _____________________________________________________________
8.9 Minimum separation distance between aircraft and return (use any appropriate units): __________________________
8.91 Was evasive action taken by pilot(s)? ( ) no ( ) yes ( ) unknown
8.92 If "yes" what did pilot(s) do? _____________________________________________________________________
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8.93 Was TCAS involved in any way prior to your radar contact? ( ) no ( ) yes ( ) unknown
8.94 Did Conflict Alert Activate? ( ) no ( ) yes ( ) unknown
9.0 RADAR SCREEN IMAGES/OTHER DETAILS:
9.1 Range was set to: ___________ miles.
9.2 If range was changed during occurrence how: ________________________________________
9.3 What was maximum velocity of anomalous radar return? _____________ (mph) (knots) (circle)
9.4 Did radar return ever come to full stop (zero velocity)? ( ) yes ( ) no ( )unknown
9.5 If "yes" for how long did return remain stationary? _________ (min.) _______ (sec.)
9.6 Was radar and/or voice tape saved from this occurrence? ( ) yes ( ) no ( ) unknown
9.7 If "yes" are you willing to assist NARCAP in obtaining a copy? ( ) yes ( ) no
Please provide any special phone numbers or contact information here for this purpose: _________________
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