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USGS Ash Sample Data Collection Form

The document is a data collection sheet for submitting ash samples to the USGS/Alaska Volcano Observatory, including fields for sample details and collector information. It also includes a section for photographers to grant permission for photo use. The paperwork reduction act statement indicates the estimated public burden for completing the form.

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RPM28XI
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5 views1 page

USGS Ash Sample Data Collection Form

The document is a data collection sheet for submitting ash samples to the USGS/Alaska Volcano Observatory, including fields for sample details and collector information. It also includes a section for photographers to grant permission for photo use. The paperwork reduction act statement indicates the estimated public burden for completing the form.

Uploaded by

RPM28XI
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

OMB Control Number: 1028-0106

Expiration Date: March 31, 2023

Data Collection Sheet (please print, fill out, and submit with your samples)

A B C D E F G
Sample Date & time of Location of Dimensions Thickness of Describe Describe
Number Collection (or collection of container ash layer surface upon weather
duration if (nearest ½ which ash has conditions
fallen
applicable) millimeter) during ash
fall, if known

Please send samples and sample datasheet to:

USGS/Alaska Volcano Observatory, 4230 University Drive, Suite 201, Anchorage, AK 99508, 907-786-7497

Collector Contact Information: Name_______________________, Phone ________________, Email_____________________

H. Photos

Please indicate if you give permission to the Alaska Volcano Observatory to use your photographs on their
Webpage __________________________ all photos ____ select photos only____ (please indicate which images).
signature

Please only send copies or digital images as they will not be returned. All photos will be credited to photographer.

PAPERWORK REDUCTION ACT STATEMENT: A Federal agency may not conduct or sponsor, and a person is not required to respond to a collection of information
unless it displays a currently valid OMB control number. Public burden for reviewing these instructions is estimated to average 3 minutes per response. Comments regarding
this collection of information should be directed to the Bureau Clearance Officer, U.S. Geological Survey, 12201 Sunrise Valley Drive, MS 807, Reston, VA 20192, or call
703-648-7174.

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