Dd Form 2993 - Environmental Baseline Survey (Ebs) Checklist

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Classification:

ENVIRONMENTAL BASELINE SURVEY (EBS) CHECKLIST

For use of this form, see ATP 3-34.5/MCRP 4-11B; the proponent agency is TRADOC.

Note: Do not leave any blanks empty. If they do not apply to the current site, enter not applicable (NA) or nothing significant to report (NSTR) to show the

section has been investigated. The section numbers in the checklist correspond to the section numbers in the report format.

*Items that are completed in DD Form 2994, Environmental Baseline Survey (EBS) Report. These items are shown in the EBS Checklist to ensure that item

numbers are matched between the checklist and the report.

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1. ADMINISTRATIVE DATA

(Official name and legal address of the location being assessed. Name of country, city,

township, or area of operation for the site location.)

a. LOCATION NAME

(Other names the base is currently or was previously known as.)

b. LOCATION ALIASES

c. START DATE AND TIME

d. END DATE

(Name of the unit or activity conducting the assessment.)

e. ORGANIZATION CONDUCTING SURVEY

f. SURVEYOR’S NAME, RANK, GRADE, AND TITLE

g. SURVEYOR’S TELEPHONE

h. SURVEYOR’S E-MAIL

i. GEOGRAPHIC LOCATION

Note: If this information is classified, enter it in Section 14 of this checklist. The 8-digit military grid coordinates are mandatory for the site using the center of the

camp for reference. Coordinates may also be taken from the outside corners of the site to provide site boundaries. A global positioning system may be used in

addition to the grid coordinates. The 8-digit military grid coordinates will always include the 3-character zone designator and the 2-character grid square

identifier.

Coordinate 2

Coordinate 1

Coordinate 3

Coordinate 4

NOTES

(Enter notes associated with the geographic location; for example, the datum associated with the location, map type, map number, global

positioning system used, and so forth.)

2. EXECUTIVE SUMMARY *

(Completed after information gathered is analyzed and recommendations developed. This is a synopsis of significant findings, conclusions, and

recommendations based on the data analysis with the ultimate recommendation being to use or not use the site.)

3. INTRODUCTION

a. LIMITATIONS OF ASSESSMENT

(Enter the physical obstructions, limiting conditions (such as weather), mission restrictions, and the lack of equipment and supplies encountered during the

assessment.)

DD FORM 2993, AUG 2015

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Classification:

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