Proponent Info Prepared By Date Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20192020202120222023 Email UAS Incident Campus Campus UC ANR UC Berkeley UC Davis UC Irvine UC Los Angeles UC Merced UC Riverside UC San Diego UC San Francisco UC Santa Barbara UC Santa Cruz Other... Campus Other... Date Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20192020202120222023 Time Hour Hour123456789101112 : Minute Minute00153045 am pm Where was the drone flying How high was the drone flying? How high was the drone flying? Close to the ground (<20 ft) At the treeline (30-50 ft) High but clearly visible (50 - 200 ft) Very high (> 200 ft) Other... How high was the drone flying? Other... Drone Information Make/Model Type Helicopter Multi-rotor Plane Other What type of drone was it? How big was the drone? How big was the drone? Very Small - Softball-sized (~ 5") Small - Basketball-sized (~1 ft) Medium - Umbrella-sized (~3 ft) Large - Person-sized (~6 ft) Very Large - Car-size (~15 ft) Other... How big was the drone? Other... Color Other Notes Unsafe or Illegal Activity Did any of the following occur Did any of the following occur Crashed into a person Crashed into a building, tree or the ground Intentionally harassing or disturbing people or wildlife Invaded someone's privacy Nuisance or disturbance of peace Flew over people Flew over roads Flew over parking lot Flew over buildings or structures Disturbed wildlife Disturbed staff or other workers None of the Above Other... Did any of the following occur Other... Select all applicable situations Other Comments Attach any files or images If you have video, please email it to UASsafety@ucmerced.eduFiles must be less than 15 MB.Allowed file types: gif jpg png bmp eps tif pict psd txt rtf html odf pdf doc docx ppt pptx xls xlsx xml bz2 dmg gz jar rar sit tar zip.
