The sample/specimen background document allows a collector to note the most relevant details associated with pre- and post-sample/specimen collection conditions. Do not consider the report to be all-inclusive. The information collected should include at least the items listed in [Figure B-2]. Interviews should be conducted with individuals exposed to the CB agent as well as individuals not exposed (see [Figure B-3]).

1. ID NUMBER___________

2. COLLECTION (DATE/TIME):______________________

3. COLLECTOR/UNIT:_______________________________

4. TYPE: ENVIRONMENTAL___ BIOMEDICAL___ SINGLE___ MULTIPLE___

5. PURPOSE: ATTACK___ CHEM/BIO ALARM___ CHEM DETECT___ RECON ILLNESS/DEATH___ OTHER___

6. POSTEXPOSURE: HOURS___ DAYS___ WEEKS___ UNKNOWN___

7. LOCATION: TOWN_________________ COORDINATES____________________________

A. TERRAIN: FLAT___ HILLS___ MOUNTAIN___ DESERT___ JUNGLE___ SPARSE TREES___ GRASS___ BODY OF WATER/TYPE___

B. WEATHER: CLEAR___ CLOUDY___ RAIN___ FOG___ SNOW___ DUST___