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Use to send periodic information (interim snapshots) of the environmental status of specific sites (assembly areas, base camps, logistical support areas, and medical facilities) where hazards are likely to occur, which can result in significant, immediate and/or long-term effects on the natural environment and/or health of friendly forces and noncombatants. Send IAW unit SOPs and commander’s direction.

LINE 1 — DATE AND TIME______________________________(DTG)

LINE 2 — UNIT________________________________________(Unit Making Report)

LINE 3 — LOCATION___________________________________(UTM or Six-Digit Grid Coordinate With MGRS Grid Zone Designator) of Site/Incident)

LINE 4 — DESCRIPTION________________________________(Description of Site/Incident)

LINE 5 — CHANGES ___________________________________(Changes From Last ECR or Environmental Baseline Survey EBS)

LINE 6 — HAZARDS____________________________________(Hazards to Natural Environment, Friendly Forces and/or Civilian Personnel)

LINE 7 — ACTIONS____________________________________(Summary of Actions to Minimize Hazards/Remedial Effects)

LINE 8 — UNIT POC____________________________________(Reporting Unit Point of Contact)

LINE 9 — ASSISTANCE_________________________________(Assistance Required/ Requested)

LINE 10 — REFERENCE_________________________________(Site-Specific EBS (if required))

LINE 11 — NARRATIVE_________________________________(Free Text for Additional Information Required for Clarification of Report

LINE 12 — AUTHENTICATION___________________________(Report Authentication)

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