MONMOUTH COUNTY

LOCAL INTERFERENCE COMMITTEE

U.S. Post Office Box 8 – Morganville, NJ 07751

mclic@qsl.net

Malicious Interference Reporting Form

 

MASTER PLAN OPERATING GUIDELINES v1.00

9 September 2002

 

Enter your Name/Callsign:                                                         /                                              

 

Your E-mail Address:                                                                                                        

 

Home Phone Number (incl. Area Code):                                                                           

 

Work Phone Number (incl. Area Code):                                                                           

 

Interference Event Date:                /            /                      

 

Interference Event Local Time (From - To):                 :            a.m./p.m.

 

Receiving Equipment Used:(Type/Make/Model):                                                                 

                                                                                                                                               

 

Test Equipment Used :(Type/Make/Model):                                                                       

                                                                                                                                               

 

Antenna(s) Used: (Rubber-duckie, J-pole, Beam [type], etc.):                                        

                                                                                                                                               

 

Interference Actual Signal strength received in S units:              

 

Interference Signal Quality: (Circle One)

 

Full Quieting | Strong | Half Scale | Weak | Noisy

 

Repeater Station Affected: Sponsoring Group or Callsign -

 

Is this an RF linked system: YES | NO

Is this an Internet linked system: YES | NO

 

Local Frequency Input(s):                                                Mhz.

Local Frequency Output(s):                                             Mhz.

 

PL or DPL access required: YES | NO    If YES what code:                                                         

Kind(s) of Interference Heard: (Check all that apply.)

This report may be forwarded to the FCC in the future, so consider placing as much detail as possible in your reports in an effort to help them as much as possible.

 

List any background sounds heard: (alternator whine, mic clicks, birds, chimes etc.)

                                                                                                                                                                                                                                                                                               

                                                                                                                                               

                                                                                                                                               

 

Detailed Log/Comments: (Describe herein all pertinent information that you can recall regarding the incident in question. Such things as beam headings when fixed, signal strengths, directions of travel and locations of signal strength readings if you were mobile, whether what you heard was on the output of the repeater direct or through the repeater or reverse, etc.)