Eastern Diamondback Rattlesnake Observation Form

Please answer these questions about your encounter with an eastern diamondback rattlesnake. The primary objective of this survey is to document the range of forest conditions occupied by the species. NCASI will collect data, analyze results and provide a report to the U.S. Fish & Wildlife Service.

Required questions are marked with asterisks.

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* 1. Contact Information

Observer Name:

Affiliation:

Email Address:

Phone Number:

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* 2. State

State:

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* 3. County

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* 4. GPS coordinates (if available)

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* 5. Property owned or managed by (optional)

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* 6. Date & Time

Observation occurred

Date

Time

AM/PM

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* 7. Temperature

< 40 F

41-50 F

51-60 F

61-70 F

71-80 F

81-90 F

> 90 F

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* 8. Snake alive?

Yes

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* 9. Estimated length (check one)

< 1 ft

1-2 ft

2-3 ft

3-4 ft

4-5 ft

> 5 ft

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* 10. Habitat where snake was observed

Dirt Road (also check surrounding habitat if known)

Paved Road (also check surrounding habitat if known)

Open Field - few or no trees (non-forest)

Pine Forest

Mixed Pine/Hardwood Forest

Hardwood Forest

Non-Forest Wetland

Other (describe in comments box below)

Comments:

If the snake was observed in forest habitat, please answer the following questions about the stand characteristics.

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* 11. Stand age

< 10 yrs

11-20 yrs

21-30 yrs

31-40 yrs

41-50 yrs

> 50 yrs

Uneven-aged

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* 12. Basal area

< 40 sq. ft.

41-60 sq. ft.

61-80 sq. ft.

> 80 sq. ft.

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* 13. Stand origin

Planted

Natural

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* 14. Canopy closure

Open (abundant light reaches ground)

Closed (little or no light reaches ground)

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* 15. If pine forest, dominant overstory species

Longleaf pine

Loblolly pine

Slash pine

Pond pine

Other (please specify)

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* 1. Contact Information

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* 2. State

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* 3. County

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* 4. GPS coordinates (if available)

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* 5. Property owned or managed by (optional)

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* 6. Date & Time

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* 7. Temperature

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* 8. Snake alive?

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* 9. Estimated length (check one)

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* 10. Habitat where snake was observed

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* 11. Stand age

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* 12. Basal area

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* 13. Stand origin

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* 14. Canopy closure

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* 15. If pine forest, dominant overstory species

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* 16. Comments