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Date Created: 01/03/16
Stock Collection and Release* Special Activity License Application Florida Fish and Wildlife Conservation Commission Division of Marine Fisheries Management 620 S. Meridian St., Mail Station 4B3, Tallahassee, Florida 32399-1600 Ph: 850-487-0554 • Fax: 850-487-4847 *Applicants for a Special Activity License ( SAL) involving prohibited species may also use this application form, butan application for prohibited species must be separate from an application for non-prohibited species. Complete all information that is applicable to your license request. If additional space is required other than what is provided on the form, you may provide additional attachments as long as they are clearly marked and identifiaDocuments submitted separately from an application form must be marked (or files named) with the applicant’s name and affiliation.Applications will not be evaluated until all requested information, fees, and reporting documentation required by previously held licenses has been submitted. A “release” is defined as the intentional or unintentional introduction, reintroduction, or relocation of eggs or organisms that have been held in captivity, into waters of the state, including municipal waters. A. GENERAL APPLICANT INFORMATION (Please Print or Type) Name: Date of Birth: / / Affiliation: Mailing Address: City: State: Zip: Phone Number: ( ) Fax: ( ) Alt. Phone Number: ( ) Email Address**: This application is for a(n): New License Renewal Amendment To Existing License Previous Special Activity License Number: Time period requested (may not exceed 12 months): **To provide more timely exchange of information please check this box: I authorize the Florida Fish and Wildlife Conservation Commission (FWC) to send me future correspondence regarding this application, including requests for additional information and final agency permitting actions by either e- mail or express delivery. Future agency actions will be provided henceforth by either e-mail or express delivery. Have you ever been convicted or found guilty, of any criminal or non-criminal violation, regardless of adjudication, or plea entered, of any fisheries or wildlife violation (including a violation of Chapters 370, 372, 379, F.S.; Section 597.004, F.S.; Title 5L-3.004, F.A.C.; rules of the Commission (Title 68, F.A.C.); 50 CFR Parts 622, 635, 640, 648, 654, 660, or 679; similar laws or rules in another jurisdiction)? YES NO If yes, please explain and list the type(s) of violation(s) cited and the county/state where the violation occurred: Have you ever had a fisheries or wildlife related permit suspended or revoked? YES NO If yes, please explain: Applicant Signature : Date: Certification: I hereby swear and affirm by signature that the information submitted in this application and supporting documents is complete and accurate to the best of my knowledge and belief. I understand that any false statement herein may subject me t o criminal penalties. I further state that I will abide by all applicable State, Federal, and local laws. Any false statements or misrepresentations when applying for this license may result in felony charges and will result in revocation of this license. By signing this document, I also agree to comply with the reporting and notification requirements outlined in sections “U” and “V” of this application form. Rule 68B-8.010, F.A.C. Page 1 of 13 Form DMF-SCRSAL (9/09) B. ELIGIBILITY. A Stock Collection and Release SAL may be issued only to the following: 1) Any applicant eligible to apply for a Scientific Research SAL as established by 68B-8.006(2), F.A.C. 2) An owner, director, or manager of a certified aquaculture facility that holds a valid aquaculture certificate of registration issued pursuant to 597.004, F.S., and 5L-3, F.A.C. C. INELIGIBILITY. 1) A SAL will not be issued to a third party contractor. 2) A SAL will not be issued to a person and no person may conduct activities under a SAL if, during the 36-month period prior to the application or activity, that person has been charged with a violation of a rule in Titles 68A through E, F.A.C.; Chapters 370, 372 or 379, F.S.; or 50 CFR Parts 622, 635, 640, 648, 654, 660, or 679 unless that person has received a final disposition of acquittal or dismissal of such charged violation. D. PROCESSINGFEE. The processing fee for a Stock Collection and Release SAL is $25.00, and is non-refundable. Checks or money orders should be made payable to “FWC” and must be submitted at the same time as the application form. Purchase orders and credit cards cannot be accepted as payment. Payments submitted separate from an application form (because of electronic submission) must include the payment slip available on the last page of this application form. E. SCOPE OF AUTHORITY. Special Activity Licenses do not authorize activities: 1) Outside of state waters (seaward of 3 nautical miles in the Atlantic Ocean and seaward of 9 nautical milesin the Gulf of Mexico). 2) Within a state park, unless a Research/Collecting Permit has been obtained from the Florida Department of Environmental Protection, Division of Recreation and Parks in addition to a SAL. 3) Within any federal park. 4) Within the following areas of the Florida Keys National Marine Sanctuary (FKNMS): Western Sambo and Tortugas North Ecological Reserves; Cheeca Rocks, Eastern Dry Rocks, Hen and Chickens, Newfound Harbor Key, Rock Key, and Sand Key Sanctuary Preservation Areas (SPAs); or Eastern Sambo Research Only Area. 5) Within any Manatee Limited Entry Area (No Entry or Motorboat Prohibited Zones – exemptions may be requested on this application form). 6) Involving the use of entangling gear within any Manatee Entangling Gear Zone (exemptions may be requested on this application form). F. AUTHORIZED PERSONNEL. List legal name and dates of birth for all personnel who are requested for authorization to conduct activities pursuant to this license in alphabetical order by last name. If more than 10 personnel are requested, please provide justification. All authorized personnel must meet the eligibility requirements in 68B-8.003, Florida Administrative Code (F.A.C.). LEGAL NAME First M.I. Last Date of Birth (mm/dd/yyyy) If requesting more than 10 authorized personnel, please provide justification: G. THIRD PARTY CONTRACTORS. A third party contractor is an entity that is paid for services rendered to collect or transport marine organisms on behalf of a SAL holder, or paid to provide expertise as an agent or consultant for the collection or transport of marine organisms on behalf of a SAL holder. Salaried staff or faculty, non-salaried volunteers, students, interns, or visiting principle investigators who do not receive monetary compensation for their collection assistance are not third party contractors. A third party contractor may not serve as an agent for a SAL Rule 68B-8.010, F.A.C. Page 2 of 13 Form DMF-SCRSAL (9/09) applicant during the application process. In order for a third party contractor to conduct activities pursuant to a SAL, the following requirements must be met: 1) A third party contractor must be identified as such on the SAL application. 2) The SAL applicant must submit with the application a copy of the signed contractual agreement between the third party contractor and the applicant that outlines the services to be rendered. The agreement must denote payment for services rendered during the specific time period requested on the SAL application. Contractual agreements referencing payment schedules for individual marine organisms will not be accepted. List legal name, date of birth, and company name for all third party contractors, and submit a copy of the contract for services with this application form. All third party contractors must meet the eligibility requirements in 68B -8.003, F.A.C. LEGAL NAME First M.I. Last Date of Birth Name of Company (mm/dd/yyyy) H. HATCHERY GENETIC MANAGEMENT PLAN (HGMP). A separate HGMP must be completed for each species being requested. Complete only the sections or the items within sections that are applicable to your request. Section 1. General Program Description 1.1. Indicate name of facility and program. 1.2. Identify responsible organization and individuals: 1.2.1. Name (and title):____________________________________________________________ 1.2.2. Organization: ______________________________________________________________ 1.2.3. Address: __________________________________________________________________ 1.2.4. Telephone: (_____) _________________ 1.2.5. Fax: (______) ___________________ 1.2.6. EmailAddress: _____________________________________________________________ 1.2.7. List other agencies, collaborators, or organizations involved, and describe their extent of involvement in the program: __________________________________________________ __________________________________________________________________________ 1.3. List funding sources and staffing level: _________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 1.4. Identify location(s) of hatchery and associated facilities: ___________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 1.5. List the common and scientific names for all species subject to propagation (note: a separate HGMP shall be completed for each species under consideration): __________________________________ ________________________________________________________________________________ 1.5.1. Specify Endangered Species Act-listing status, if applicable, of each species (available from www.nmfs.noaa.gov/pr/species/fish/): ___________________________________________ __________________________________________________________________________ 1.6. Indicate the type of program (e.g., stock enhancement, restoration, put-and-take, mitigation, commercial aquaculture): ______________________________________________________________________ 1.7. Identify specific performance goals and quantitative success criteria of the program: _____________ _________________________________________________________________________________ _________________________________________________________________________________ 1.8. Describe current program performance if the program is ongoing (indicate the source of these data): _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 1.9. Provide the date release activities started or are expected to start: ____________________________ _________________________________________________________________________________ Rule 68B-8.010, F.A.C. Page 3 of 13 Form DMF-SCRSAL (9/09) 1.10. State the expected duration of program: ________________________________________________ _________________________________________________________________________________ Section 2. Relationship of Program to Other Management Objectives 2.1. Describe the alignment of the program with any management or recovery plan or other regionally accepted policy. Explain any proposed deviations from the plan or policy. ____________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 2.2. Identify existing cooperative agreements, memoranda of understanding, memoranda of agreement, mitigation requirements or other management plans or court orders under which program operates. _________________________________________________________________________________ _________________________________________________________________________________ 2.3. Describe the relationship of the program to harvest objectives: 2.3.1. Identify fisheries that will benefit from the program. ________________________________________________________________________________ ________________________________________________________________________________ 2.3.2 Provide harvest levels of those fisheries for the last ten years, if available. ________________________________________________________________________________ ________________________________________________________________________________ Section 3. Facilities 3.1. Provide detailed descriptions, supplemented with diagrams, of the following: 3.1.1. Broodstock holding and spawning facilities. ________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 3.1.2. Incubation facilities. ___________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 3.1.3. Rearing facilities. _____________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 3.1.4. Acclimation/release facilities, if applicable. _________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Section 4. Broodstock and Grow-out Stock Source 4.1. Provide the common name, scientific name, sex, size, number and life-history stage of broodstock/grow-out stock to be collected, or broodstock/grow-out stock currently on hand. If broodstock or grow-out stock is already on hand, also provide year collected and age. Broodstock/Grow-out Stock to be collected Broodstock/Grow-out Stock On-hand Sex Size Life-history Qty. Qty. in Year Common Name Scientific Name (M/F) (in.) Stage Requested Inventory Collected Age If the species list is extensive, please include this as an addendum to the application form. If submitting this application electronically, MS Excel format is preferred. 4.2. Provide confirmation that the broodstock/grow-out stock is native to Florida waters. _________________________________________________________________________________ Rule 68B-8.010, F.A.C. Page 4 of 13 Form DMF-SCRSAL (9/09) 4.3. Provide confirmation that the broodstock/grow-out stock is not transgenic. _________________________________________________________________________________ 4.4. Proposed location(s) for the collection of each individual broodstock/grow-out stock organism or the location(s) where each individual broodstock/grow-out stock organism on hand were collected. Indicate whether your response refers to proposed collections or to locations where organisms currently on hand were collected. The location(s) should be described as follows: 4.4.1 Approximate Global Positioning System (GPS) latitude/longitude coordinates for the boundaries of the location. ______________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 4.4.2 County/counties and coast encompassed by the location. ______________________________ ____________________________________________________________________________ ____________________________________________________________________________ 4.4.3 For marine/estuarine locations, include the name of estuary or description of coastal region. For freshwater locations, include the name of stream, river, or waterbody. ___________________ ____________________________________________________________________________ ____________________________________________________________________________ 4.5. Provide supporting information (and indicate source of information) for the validation of natural stock boundaries, including: 4.5.1 Accepted geographic boundaries for natural stocks of target species. ____________________ ____________________________________________________________________________ ____________________________________________________________________________ 4.5.2. Genetic and/or biological information relevant to natural stock structure of the proposed recipient population. ___________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 4.5.3 Estimated current adult abundance or spawning stock biomass of each natural stock of the proposed recipient population. ___________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 4.5.4 Estimated generation interval (average age of female breeders) for the natural stock. ________ ____________________________________________________________________________ ____________________________________________________________________________ Section 5. Broodstock and Grow-out Stock Collection 5.1. Describe the collection methods and sampling design for broodstock/grow-out stock. Include any justification for gear use if required by section “I” of this application. ________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 5.2. Describe methods to make individual broodstock/grow-out stock identifiable and/or to segregate discrete spawning groups of broodstock/grow-out stock. ___________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 5.3. Describe the intended disposition of organisms collected in surplus of broodstock/grow-out stock needs. _________________________________________________________________________________ _________________________________________________________________________________ 5.4. Describe broodstock/grow-out stock transportation and holding methods. ______________________ _________________________________________________________________________________ _________________________________________________________________________________ Section 6. Mating Procedures 6.1 To address concerns related to propagation-related genetic changes, provide confirmation that no transgenic modifications will be performed to any organism and that no such organism on the premises will be involved in the proposed program. _______________________________________________ Rule 68B-8.010, F.A.C. Page 5 of 13 Form DMF-SCRSAL (9/09) _________________________________________________________________________________ _________________________________________________________________________________ 6.2. Provide confirmation that there will be no attempt at genetic improvement or other intentional trait- specific selection during production. ___________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 6.3 Describe the timing of production in comparison to natural production and recruitment. _________________________________________________________________________________ _________________________________________________________________________________ 6.4 Provide a detailed mating scheme, including: 6.4.1 If broodstock are not wild, the number of generations they are removed from the wild (F1, F2, etc.). _______________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 6.4.2. Description of controlled fertilization procedures (e.g., paired mating, strip-spawning), if applicable. __________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 6.4.3. Description of uncontrolled fertilization procedures (e.g., pond- or tank-spawning), if applicable. ___________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 6.5. With supporting information, provide an estimate of variance in family size and effective number of breeders, or provide the following: 6.5.1. Minimum number of male and female breeders to be used to produce each progeny group. ____________________________________________________________________________ ____________________________________________________________________________ 6.5.2. Expected number of progeny groups to be released. __________________________________ ____________________________________________________________________________ 6.5.3. Estimated average progeny group size and variance in progeny group size (at the time of release). _____________________________________________________________________ ____________________________________________________________________________ Section 7. Incubation and Rearing 7.1. Describe incubation procedures, including: 7.1.1. Incubation conditions. _________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 7.1.2. Number of eggs taken and survival rates to eye-up and/or ponding, if known. _____________ ____________________________________________________________________________ ____________________________________________________________________________ 7.1.3. Causes for, and disposition of surplus eggs, if any. ___________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 7.2. Describe your plan for tracking information in 7.1.3 during operation of program. ________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 7.3. Describe rearing procedures, including: 7.3.1. Rearing conditions. ____________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 7.3.2. Provide expected survival rate data by hatchery life stage (e.g. fry to fingerling; fingerling to advanced size) for the most recent five years, or for years that dependable data are available. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Rule 68B-8.010, F.A.C. Page 6 of 13 Form DMF-SCRSAL (9/09) 7.3.3. Indicate expected weekly or monthly growth information, including length, weight, and condition factor data collected during rearing, if available. _____________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 7.3.4. Expected rates of cannibalism, if applicable. ________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 7.4 Describe your plan for tracking information in 7.3.2 – 7.3.4 during operation of program. _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Section 8. Broodstock Release Procedures 8.1. For programs that involve the reintroduction of broodstock originally harvested from the wild, broodstock must be returned to the original point of collection. Please indicate if the program will involve the reintroduction of broodstock into the wild, and provide confirmation that the broodstock will be released at the original point of collection. ____________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Section 9. Captive-bred or Captive-reared Organism Release Procedures 9.1. Indicate proposed numbers and average sizes of organisms to be released for the program, by age class, release year, and natural stock (size data not required for eggs, larvae, and unfed fry). _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 9.2. Provide proposed release location(s). Release location(s) should be described as follows: 9.2.1. Approximate Global Positioning System (GPS) latitude/longitude coordinates for each release point. _______________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 9.2.2. County/counties and coast encompassed by the location (if releasing in more than one county, please provide the information requested in 9.1 by each county). ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 9.2.3. For marine/estuarine locations, include the name of estuary or description of coastal region. For freshwater locations, include the name of stream, river, or waterbody. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 9.3. For any organisms released to date, list actual numbers and average sizes of fish released, by age class, Rule 68B-8.010, F.A.C. Page 7 of 13 Form DMF-SCRSAL (9/09) release year, and natural stock (size data not required for eggs, larvae, and unfed fry). _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 9.4. Organisms produced or reared in captivity must be distinguishable from wild organisms so that estimates of project success may be obtained through monitoring. Describe tags or marks applied, if any, and the proportions of the total hatchery cohort marked, to identify released individuals in subsequent captures. The method used to identify released organisms is at the discretion of the SAL holder conducting the release. Potential distinguishing methods include but are not limited to : internal or external mechanical tags, chemical tags, or genetic tags. All costs incurred in the fulfillment of this provision or any other provision of Rule 68B-8.010, F.A.C., will be the responsibility of the SAL holder. ___________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 9.5. Describe the disposition of captive-bred or captive-reared organisms that may be produced in excess of approved release levels. _____________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 9.6. Describe emergency release procedures in response to flooding or other failure that may result in unintended release. _________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Section 10. Relocation Procedures *Note – Relocation does not include fragmentation. Fragmentation is considered to be a release of a captive- reared organism. 10.1. Provide common name, scientific name, life-history stage, numbers, sex, and size of individuals you plan to relocate. Common Name Scientific Name Life-history # to be Sex Size (in.) Stage Relocated (M/F) 10.2. Proposed collection and relocation point(s). Collection Point(s) ID County GPS coordinates Name of Waterbody* CP1 CP2 CP3 Relocation Point(s) ID County GPS coordinates Name of Waterbody* RP1 RP2 RP3 * For marine/estuarine locations, include the name of estuary or description of coastal region. For freshwater locations, include the name of stream, river, or waterbody. 10.3. Describe the marking method that will be used to distinguish relocated organisms from wild organisms. Relocated organisms must be distinguishable from wild organisms so that estimates of project success Rule 68B-8.010, F.A.C. Page 8 of 13 Form DMF-SCRSAL (9/09) may be obtained through monitoring. The method used to identify relocated organisms is at the discretion of the SAL holder conducting the release. Potential distinguishing methods include but are not limited to internal or external mechanical tags, chemical tags, or genetic tags. All costs incurred in the fulfillment of this provision or any other provision of Rule 68B-8.010, F.A.C., will be the responsibility of the SAL holder. ____________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ Section 11. Management Plan 11.1. Provide a description of all precautionary approaches, procedures, and management practices that will be implemented to mitigate each of the following genetic concerns: 11.1.1. Impacts from translocation of non-native organisms. ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 11.1.2. Propagation-related genetic changes. Estimate the relative abundance of cultured organisms in the admixed (target) stock following the proposed activity. ____________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 11.1.3. Genetic swamping. ____________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 11.1.4. Indirect genetic impacts. ________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Section 12. Attachments and Literature Citations 12.1. Please include all supplemental material and literature citations to support statements provided in sections 1-9 above. I. HARVESTING GEAR SPECIFICATIONSFOR BROODSTOCK AND GROW OUT STOCK. Measurements must be stated in standard measurement form, inches, feet, etc. – NOT metric units! I. TRAPS - All traps and buoys must be marked if specified in the SAL. Trap Type # of Trap Dimensions Throat or Entrance traps Length (in) Width (in) Height (in) Width (in) Height (in) Baitfish trap Sea bass trap Lobster trap Stone crab trap Blue crab trap Shrimp trap Fish trap* Other Traps** (list below) *Fish trap tending period: Include statement of justification in Section H.5.1. if the tending period will exceed 12 hrs. Rule 68B-8.010, F.A.C. Page 9 of 13 Form DMF-SCRSAL (9/09) **Description of use for “other traps” and targeted species: II. NETS - Nets must be tended at all times. Please include a statement of justification in section H.5.1. if this requirement cannot be met. Hand held nets (Includes dip or landing net) Plankton nets. Provide the number of nets to be used, dimensions of opening diameter and length, and mesh size for each: Cast nets, up to 14’ stretched length. Stretched length is defined as the distance from the horn at the center of the net with the net gathered and pulled taut, to the lead line. Drop net: Diameter of opening: (ft) Stretched mesh size: (in) Rectangular Nets: Stretched Mesh List Net Type Below Net Material Length (ft) Net Depth (ft) Size (in) Soak Time 1. 2. 3. 4. III. LONGLINES. Longlines must be buoyed at both ends and marked, and may not exceed a twelve-hour deployment period. Please include a statement of justification in the section H.5.1. if any of these requirements cannot be met, and provide an alternate suggestion for marking and/or tending requirements. Bottom longline: Length (ft): Number of Hooks: Hooks at intervals (ft) Surface longline: Length (ft): Number of Hooks: Hooks at intervals (ft) IV. TRAWLS. Trawls may not be used in hard bottom or grass bed areas and tow times are limited to 20 minutes or less. Please include a statement of justification in section H.5.1. if these requirements cannot be met. The perimeterof a trawl is the measurement around the mouth or entrance of the trawl. For otter and skimmer trawls, it would be the measurement around the mouth including the head rope, foot rope, and wings. The stretched length of a trawl is the measurement between the head rope and the end of the bag (stretched, not relaxed) for all trawl types. All measurements are required in order to process any request for the use of this type of gear. Stretched Stretched Trawl Type Perimeter (ft) Length (ft) mesh size (in) Single Otter Double Otter (each) (each) (each) Skimmer Roller Frame Beam width (ft): Beam Beam width (ft): Trawls are required to have Turtle Excluder Devices (TEDs) installed. Exemption from state TED requirements may be granted under this license, but federal TED requirements still apply in state waters. We will contact you if it is determined that you will need to obtain a federal letter of TED exemption. i. State TED exemption requested? Yes* No Rule 68B-8.010, F.A.C. Page 10 of 13 Form DMF-SCRSAL (9/09) ii. Trawl will be fished at the: Surface Bottom iii. Will the vessel towing the trawl have a mechanical retrieval device onboard? Yes No iv. All otter trawls are required to have Bycatch Reduction Devices (BRDs) installed. BRD exemption requested? Yes* No v. All trawls are prohibited for use in hard bottom or grass bed areas. Exemption requested to use trawl in grass bed areas? Yes* No *Include statement of justification in section H.5.1. V. OTHER GEAR (Please check): Hook and line Quinaldine Bottom Grab** Settlement Tiles or Plates** Hand Collection Transect Lines** Wood Borer** Hammer/Chisel** Tongs Sediment Corer** Quadrats** Dredge** (Provide type and specifications): Other (provide type, specifications, describe of gear use, and what species/size will be targeted.): ** In waters of the Florida Keys National Marine Sanctuary (FKNMS), the use of these gear types in addition to any type of gear that may alter the sea floor (cinder blocks, rods, etc.) must be permitted by the FKNMS and cannot be licensed for use by the FWC. NOTE TO APPLICANT: THE FOLLOWING SECTIONS “J” THROUGH “O” ARE INFORMATIONAL ONLY, AND DO NOT REQUIRE ANY INFORMATION TO BE SUBMITTED. J. CAPTIVITY REQUIREMENTS.All marine organisms that are targeted for release (broodstock, captive bred and captive reared) must be maintained according to the following requirements: • Containment System Preparation - Prior to the introduction of marine organisms that are targeted for release into a containment system, the system must be thoroughly cleaned (including filter change) to prevent the spread of disease. When adding new organisms to a closed containment system, cleaning is not required if the system previously held, or currently holds, organisms originating from the same natural stock (or same county and coast if the natural stock is not known), in Florida. When adding new organisms to a flow-through containment system, cleaning is not required if the system previously held or currently holds organisms originating from the same natural stock (or same county and coast if the natural stock is not known), in Florida where the water is being discharged. • Containment System Inhabitants – All marine organisms targeted for release must be maintained with species originating from the same natural stock (or same county and coast if the natural stock is not known), in Florida. • Food Source – Fresh-caught food that is given to all marine organisms held in the same containment system as the organisms targeted for release must originate from Florida and from the same coast where the organisms were harvested. Frozen food or commercially processed dry food such as pellets, flakes, wafers, etc., are acceptable food sources regardless of their origin. • Treatment Chemicals – Marine organisms targeted for release may not be treated with chemicals such as malachite green, marine ich treatment chemicals, copper sulfate, antibiotics, formalin or anesthetics (MS-222, clove oil, quinaldine, etc), unless use of such chemicals is in compliance with established Food and Drug Administration (FDA) guidelines or are veterinarian-prescribed. This does not include chemicals used to maintain water chemistry (to control pH, ammonia, or nitrite levels) and does not include vitamins or other nutritional supplements. Chemicals that are not approved by the FDA or prescribed by a veterinarian may not be used on any organisms targeted for release. Any organisms treated with veterinarian-prescribed chemicals may not be released until the withdrawal period specified by the veterinarian has expired. K. HEALTH EXAMINATION.Prior to release, all organisms or a representative sample of organisms must be submitted for a health examination. Standards for this examination will be species-specific, developed in conjunction with the applicant and established as a condition of any SAL issued to include release activities. A health examination Rule 68B-8.010, F.A.C. Page 11 of 13 Form DMF-SCRSAL (9/09) may not be required when organisms are requested for released in an early life stage. This determination will be made when the Release Authorization is requested, and will be based upon the health history of the species during culture and health history of the culture facility. L. RELEASE AUTHORIZATION. Stock Collection and Release SAL holders shall coordinate all release activities with the Commission, and obtain written authorization prior to conducting any release. Releases may not be conducted without written authorization from the Commission. Additional information will be requested on the SAL to determine if the release is consistent with SAL authorized activities. M. REPORTING REQUIREMENTS. A Stock Collection and Release SAL holder must submit the following documentation to fulfill reporting requirements: 1) Reporting documentation as required by any Release Authorization that may be issued. 2) An activity report detailing all SAL-related harvest and release activities. The activity report is a report other than any publications or technical, monitoring, or final reports. The activity report must include common and scientific names of the marine organisms harvested and released (both targeted and incidental), numbers and sizes harvested and released, locations of harvest and release by county, and disposition of all marine organisms harvested. The activity report for a Stock Collection and Release SAL involving prohibited species must also include the specific harvesting gear used. If mortality of a prohibited species occurred during harvest or subsequent possession, the report must indicate the cause of death if known. 3) A copy of any publications, technical, monitoring, or final reports that were generated as a result of work conducted pursuant to the SAL. These reports must include the notation that research was conducted pursuant to the specific Commission Special Activity License. 4) A post-release genetic monitoring program shall be required if there was insufficient information to determine the genetic impact of activities under the SAL, or if evaluation of the proposed activity determines that the genetic risks have not been minimized. N. NOTIFICATION REQUIREMENTS. All SAL holders must notify the nearest Commission Law Enforcement Dispatch Center not later than 24 hours prior to conducting activities under a SAL. Notification may consist of a float plan detailing locations, dates, and times of activities. Deviations from the float plan are permitted only after 24-hour advance notification to the nearest Commission Law Enforcement Dispatch Center. Float plans are valid for the duration of the SAL unless rescinded by the SAL holder. O. LICENSE COPIES. Please be aware that all authorized personnel or third party contractors must have a copy of the SAL signed by both FWC and the license holder (applicant) in his or her possession while conducting SAL authorized activities. P. APPLICATION SUBMISSION. Applications may be submitted electronically to the Special Activity License Program (email to SAL@MyFWC.com), faxed to (850) 487-4847, or mailed to the following address: FWC – Special Activity License Program 620 S. Meridian St., Mailbox 4B3 Tallahassee, FL 32399-1600 Documents submitted separately from an application form must be marked (or files named) with the applicant’s name and affiliation. Payments submitted separately from an application form(because of omission or electronic submission) must attach the slip on the next page to the payment in order for it to be processed. Rule 68B-8.010, F.A.C. Page 12 of 13 Form DMF-SCRSAL (9/09) SPECIAL ACTIVITY LICENSE APPLICATION PROCESSING FEE PAYMENT The processing fee for a Stock Collection and Release SAL is $25.00, and is non-refundable. Checks or money orders should be made payable to “FWC” and must be submitted at the same time as the application form. Purchase orders and credit cards cannot be accepted as payment. Payments submitted separate from an application form (because of electronic submission) must includethis payment slip to ensure that your payment is credited to your application, and may be mailed to: FWC – Special Activity License Program 620 S. Meridian St., Mailbox 4B3 Tallahassee, FL 32399-1600 Please do not staple your payment to this page. Applicant name: Affiliation: Check amount: $ . Check number: FWC Accounting EO/Object Code02-002040 Rule 68B-8.010, F.A.C. Page 13 of 13 Form DMF-SCRSAL (9/09) SECURITY ASSISTANT TRAINING – SPRING 2016 (Updated 12/30/15) DAY 0: SUNDAY, JANUARY 3, 2016 (RETURNING SAs ONLY) TIME EVENT LOCATION 8:00 AM – 5:45 PM SAs Allowed To Arrive & Move In (Returners OnlResidential Areas 6:00 PM SAs Meet Up PRC Classrooms 101–104 6:00 PM – 6:45 PM Dinner PRC Classrooms 101–104 6:45 PM – 7:00 PM Shift Selection Explanation & Contracts PRC Classrooms 101–104 SC Natalia Ramirez 7:00 PM – 9:00 PM New Policies Overview & Returner Staff MeetingPRC Classrooms 101–104 RLSSM Brandon Douglas 9:00 PM – 9:30 PM SS Training Debrief Session (SSs/SCs Only) PRC Classroom 101 (we will continue the meeting until we have finished) 9:45 PM Spring 2016 SA Shifts Begin WhenIWork (Schedule is LOCKED DOWN starting January 3, 2016) DAY 0: TUESDAY, JANUARY 5, 2016 (NEW SAs ONLY) TIME EVENT LOCATION 8:00 AM SAs Allowed To Arrive & Move In (New SAs Only)Residential Areas Spring 2016 Security Assistant Training Schedule 1 DAY 1: WEDNESDAY, JANUARY 6, 2016 (NEW SAs ONLY) TIME EVENT LOCATION 9:00 AM – 10:00 AM Pre–Training SA Diagnostic Test SRC Lobby Couches (OA/SC Facilitated) (9:00 AM – 10:00 AM) (Group A) HRC Computer Lab (9:00 AM – 10:00 AM) (Group B) SRC Computer Lab 5:45 PM New SAs Meet Up PRC Classrooms 101–104 5:45 PM – 6:15 PM Dinner PRC Classrooms 101–104 6:15 PM – 6:45 PM Departmental Overview & Job Description PRC Classrooms 101–104 ADRLSS Adam T. Lynch & RLSSM Brandon Douglas 6:45 PM – 7:15 PM Defining Our Partnership & The Four Core Values PRC Classrooms 101–104 ADRLSS Adam T. Lynch & RLSSM Brandon Douglas 7:15 PM – 7:30 PM Training Theme Explanation PRC Classrooms 101–104 RLSSM Brandon Douglas 7:30 PM – 7:45 PM BREAK 7:45 PM – 8:15 PM Payroll Presentation PRC Classrooms 101–104 SC Herschel Hester 8:15 PM – 8:45 PM Scheduling Presentation PRC Classrooms 101–104 SC Natalia Ramirez 8:45 PM – 9:00 PM SA Training Schedule Overview PRC Classrooms 101–104 ADRLSS Adam T. Lynch & RLSSM Brandon Douglas 9:00 PM – 9:30 PM SS Training Debrief Session (SSs/SCs Only) PRC Classroom 101 (we will continue the meeting until we have finished) Spring 2016 Security Assistant Training Schedule 2 DAY 2: THURSDAY, JANUARY 7, 2016 TIME EVENT LOCATION 8:45 AM SSs Meet Up PRC Classrooms 101–104 9:00 AM – 9:45 AM Standard Procedures I + II Presentations PRC Classrooms 101–104 Security 101 & Basic Shift Responsibilities SC Natalia Ramirez 9:45 AM – 10:00 AM Shift Selection Explanation & SA Contracts PRC Classrooms 101–104 Review work requirement, Sign, & Return Contract SC Natalia Ramirez & SC Herschel Hester 10:00 AM – 10:45 AM Standard Procedures III + IV Presentations PRC Classrooms 101–104 Principles of Communication & People You May Encounter SC Herschel Hester 10:45 AM – 11:15 AM Mini Team Builder PRC Classrooms 101–104 11:15 AM – 12:00 PM Lunch Mahoney Dining Hall 12:00 PM – 1:00 PM Radio Workshop PRC Classrooms 101–104 SC Herschel Hester, SC Natalia Ramire, & SSs 1:00 PM – 1:15 PM BREAK 1:15 PM – 2:15 PM Documentation & Discipline Presentations PRC Classrooms 101–104 SSs Eric, Muniphe, Peter, & Lok 2:15 PM – 3:15 PM Professional Conduct & Customer Satisfaction PRC Classrooms 101–104 RLSSM Brandon Douglas & SC Herschel Hester 3:15 PM – 4:15 PM Eaton Front and Post–Specific Presentations PRC Classrooms 101–104 SSs Grace, Steven, Taylor, & Sarah 4:15 PM – 5:15 PM Non–Alcohol Violations Presentations PRC Classrooms 101–104 SSs Kate, Jacob, Sabrina, & Evan 5:15 PM – 9:00 PM Dinner & SA Shift Selection Draft (All SAs) PRC Classrooms 101–104 (5:15 PM – 6:00 PM) Dinner (6:00 PM – 7:30 PM) Round 1 – SAs (1 hour 30 minutes) (7:30 PM – 9:00 PM) Round 2 – SAs (1 hour 30 minutes) 9:00 PM – 9:30 PM SS Training Debrief Session (SSs/SCs Only) PRC Classroom 101 (we will continue the meeting until we have finished) Spring 2016 Security Assistant Training Schedule 3 DAY 3: FRIDAY, JANUARY 8, 2016 (NEW SAs ONLY) TIME EVENT LOCATION 8:45 AM SSs Meet Up PRC Classrooms 101–104 9:00 AM – 10:00 AM Alcohol Violations Presentations PRC Classrooms 101–104 SSs Peter, Lok, Eric, & Muniphe 10:00 AM – 11:00 AM Emergency Policies & Procedures Presentations PRC Classrooms 101–104 SSs Sabrina, Evan, Kate, & Jacob 11:00 AM – 12:00 PM Fire Alarm Systems Presentations PRC Classrooms 101–104 SSs Taylor, Sarah, Grace, & Steven 12:00 PM – 12:45 PM Lunch PRC Classrooms 101–104 12:45 PM – 1:15 PM Mini Team Builder PRC Classrooms 101–104 1:15 PM – 4:45 PM Documentation Workshop PRC Classrooms 101–104 Security Supervisors (1:15 PM – 2:15 PM) A) Eaton Front Activity Log, AD-On-Duty Memorandum, PRC Classroom 101 Activity Log, & Activity Log – Additional Page (2:30 PM – 3:30 PM) B) FYI Form, Incident Report Form, PRC Classroom 102 Incident Report Form – Additional Page, Fire Alarm Report Log, Mobility Impaired Students List, Theatre Arts Department Log, & Recreation Room Equipment Rental Log (3:45 PM – 4:45 PM) C) Guest Log, Failure To Show ID Log, PRC Classroom 103 Failure To Show ID Palm Card, Room Access Consent Form, Guest Access Card Form, Cane Card Replacement Form, Cane Card Replacement Request Log, & Quality Control Report Form 4:45 PM – 5:30 PM Dinner PRC Classrooms 101–104 5:30 PM – 9:00 PM SA Building & Post Tours Residential Areas Four Simultaneous Group Tours Led by SSs 9:00 PM – 9:30 PM SS Training Debrief Session (SSs/SCs Only) PRC Classroom 101 (we will continue the meeting until we have finished) Spring 2016 Security Assistant Training Schedule 4 DAY 4: SATURDAY, JANUARY 9, 2016 TIME EVENT LOCATION 8:45 AM SSs Meet Up PRC Classrooms 101–104 9:00 AM – 10:00 AM Dangerous Situations PRC Classrooms 101–104 Office of Emergency Management – Scott Burnotes 10:00 AM – 11:30 AM Counseling Services PRC Classrooms 101–104 Counseling Center 11:30 AM – 12:15 PM Lunch PRC Classrooms 101–104 12:15 PM – 12:45 PM Mini Team Builder (All SAs) PRC Classrooms 101–104 12:45 PM – 2:00 PM Night Work & Life Balance (All SAs) PRC Classrooms 101–104 ADRLSS Adam T. Lunch 2:00 PM – 2:45 PM How to Call 911 (UMPD) (All SAs) PRC Classrooms 101–104 UMPD – Cpt. Bill Gerlach 2:45 PM – 3:00 PM BREAK 3:00 PM – 5:00 PM Dealing with Difficult People in 3D (All SAs) PRC Classrooms 101–104 SUNY Courtland, NY – Lt. Chauncey Bennett III 5:00 PM – 6:00 PM Dinner w/ UMPD (All SAs) PRC Classrooms 101–104 6:00 PM – 9:00 PM A Night in the Life of an SA PRC Classrooms 101–104 (New SAs Required; Returner SAs Optional) (Two Simultaneous Presentations) Group A - w/ Six Supervisors ADRLSS Adam T. L
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