Appendix F - SAR Sample.pdf

PACAF REGIONAL SUPPORT CENTER SITE ARRIVAL REQUEST

Please read Privacy Act Statement on reverse before completing this document

SECTION I: REQUESTOR INFORMATION

1. FIRST AND LAST NAME: 6. BILLING:

Name:

Address:

Phone:

Email:

Org:

MEALS LODGING MAN DAYS

2. PHONE: 3. EMAIL:

4. SITE POC:

5. MIPR/FUNDING DOCUMENT NUMBER (if applicable):

SECTION II: TRAVEL INFORMATION

7. LOCATION: 10. NEED BASE PASS: YES NO

8. DATE ARRIVE: 11. FOREIGN NATIONAL(S): YES NO

Note: Foreign Nationals require a 45 day lead time. Image of passport(s) must be submitted with the SAR.

9. DATE DEPART: 12: HAVE EMERGENCY EVAC PLAN: YES NO

Note: The BOS contractor is not responsible for coordinating Medical Evacuation, it is the responsibility of all Contractors to have their own Emergency Medical Evacuation plan prior to visiting any PRSC site.

13. PURPOSE OF TRAVEL:

14. MEANS OF TRAVEL: C-12 AMC CHARTER: MIL-AIR OTHER:

SECTION III: AIRCRAFT PPR INFORMATION (only for charters/mil-air/other)

15. AIRCRAFT TYPE: 18. DEPARTING LOCATION/DATE/TIME:

16. CALL SIGN: 19. ARRIVING LOCATION/DATE/TIME:

17. TAIL NUMBER: 20. HANGAR TOWBAR HAZ TYPE:

21. GPU 22. FUEL AMOUNT: 23. A/C MEALS QUANTITY: SPECIAL:

SECTION IV: ADDITIONAL REQUIREMENTS

24. SUPPORT REQUIRED:

HOURS: TYPE:

DOD CTR QTY: TYPE:

a. 3RD PARTY SUPPORT

b. DET SUPPORT

c. EQUIPMENT TYPE: d. SUPPLIES TYPE:

e. TRANSPORTATION TO/FROM PORT:

g. NON-AIRCRAFT FUEL Type: Amount:

f. RADAR DOWN TIME HOURS:

h. PERMIT:

i. OTHER SUPPORT:

QUANTITY: ATTACH DD FORM 2760 & AF FORM 1314. ADDITIONAL FIREARMS ADD TO SECTION V 25. FIREARMS

MAKE: TYPE: SERIAL# CALIBER: # OF ROUNDS:

DEVICE SERIAL#

REMOVABLE SERIAL#

26. INSTALLATION PHOTOGRAPHY

DEVICE MAKE AND MODEL:

REMOVABLE MEDIA

REMOVABLE MAKE AND MODEL:

CONTENT:

LOCATIONS:

27. SPECIAL ACCESS REQUIREMENT

MET IDT COBRA DANE POWER PLANT TER MAR TOWER OTHER ACCESS:

SECTION V: COMMENTS

Note: For unnacompanied access to secure locations, contact the 611ASUS/AFM office or submit a DISC request

MAY 2025 - previous versions obsolete

SECTION VI: TRAVELER INFORMATION

# LAST, FIRST, M.I. ORG DOB SEX RANK DODID DL

STATE

DL NUMBER ACCESS CLEARANCE

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

Approved By: 611th Air Support Squadron Approval Authority:

Mission Support Flight, Site Arrival Operations ARS.SAN@us.af.mil 611ASUS.KS.Org@us.af.mil 611ASUS.EAS@us.af.mil 611ASUS.WI.SAR@us.af.mil

SECTION VII: TRAVELER INFORMATIONAL CHECKLIST

3 copies of LOA/Orders IN HAND REAL ID or Passport IN HAND Baggage For EAS: Baggage is limited to 2 check-in bags total, 50 lbs each max.

Size is limited to 62 linear inches (length + width + height) – soft sided preferred Only 1 carry on item allowed, and must fit into your lap – no overhead or under seat storage available

For Wake Island: Baggage is limited to 2 check-in bags total, 70 lbs each max.

Size is limited to 62 linear inches (length + width + height) Only 1 carry on item allowed, must be able to fit in lap, overhead or below seat storage

Show time:

EAS: 0630

Wake Island: 0600 Med evac plan (see item 13) For EAS: Breakfast or a snack. Limited food available on flight

MAY 2025 - previous versions obsolete

Privacy Act Statement:

Authority: 5 USC § 57, Travel, Transportation, and Subsistence; 10 USC § 135, Under Secretary of Defense (Comptroller); and 10 USC § 136 Under Secretary of Defense for Personnel and Readiness. Information is collected to verify and book seats to and from sites managed by the 611th Air Support Squadron Routine Use: Information is only used within 611th Air Support Squadron, Mission Support Flight to book seats through government sites Disclosure: Voluntary, however failure to provide information may result in our inability to reserve and book seats mailto:ARS.SAN@us.af.mil mailto:611ASUS.KS.Org@us.af.mil mailto:611ASUS.EAS@us.af.mil mailto:611ASUS.WI.SAR@us.af.mil

All Site Arrival Request (SAR) forms must be filled out in their entirety and sent to the 611 ASUS SAR office via email or DoD SAFE website https://safe.apps.mil/ to one of the following: ARS.SAN@us.af.mil (ARS sites), 611ASUS.EAS@us.af.mil (Eareckson Air Station), 611ASUS.WI.SAR@us.af.mil (Wake Island Airfield), or 611ASUS.KS.Org@us.af.mil (King Salmon, Johnston Atoll, Koke’e, Ka’ala, Wheeler) depending on the requested destination; a minimum of 14 calendar days prior to travel. (U.S. Citizens)/45 calendar days (Foreign National) prior to date of travel from the port of embarkation (POE) (i.e., Joint Base Pearl Harbor Hickam (JBPHH), or Joint Base Elmendorf-Richardson (JBER), etc.). FAILURE TO MEET TIMELINES

WILL AFFECT ENTRY APPROVAL.

SECTION I: REQUESTOR INFORMATION

Block 1: Enter the requestor’s name (this is the person submitting the form to the PACAF Regional Support Center (PRSC).

Block 2: Enter the requestor’s phone number. No dashes, spaces or parenthesis

Block 3: Enter the requestor’s email.

Block 4: Enter the POC currently on location or at HQ “Project Manager” that is aware of the traveler’s scheduled visit.

Block 5: Enter the MIPR/FUNDING document number, if applicable. This is not required, but may assist the billing department.

Block 6: Enter the information for the office or person who will receive the bill.

1. Name: Name of office or person

2. Address: Mailing address of office or person

3. Phone: Phone of office or person

4. Email: Email of office or person

5. Org: Organization of office or person

6. Meals/Lodging/Man Days: Check all that is applicable and add number of man days being utilized

SECTION II: TRAVEL INFORMATION

Block 7: Utilize drop-down to select location traveling to.

Block 8: Enter date arriving to the traveling location

Block 9: Enter date departing the traveling location

Block 10: Yes or No. If traveler(s) require base access, they must receive it the day before traveling. If the traveler(s) arrival date is changed for any reason, please ensure the SAR office is aware that they require a base pass.

Block 11: Yes or No. SARs with foreign nationals must be sent 45 days in advance, with passport image(s).

Block 12: Yes or No. It is the responsibility of all contractors to have their own Emergency Medical Evacuation Plan prior to visiting any PRSC site. It is not the responsibility of the SAR office, nor any site office to provide a plan.

mailto:ARS.SAN@us.af.mil mailto:611ASUS.EAS@us.af.mil mailto:611ASUS.WI.SAR@us.af.mil mailto:611ASUS.KS.Org@us.af.mil

Block 13: Enter specific purpose of travel.

Block 14: Utilize the check marks for means of travel C-12 = C-12 AMC = G-IV (EAS) or Wake Island Rotator Charter = Third party flight – Must give carrier’s name and fill in Section III MIL-AIR = Military aircraft – Must fill in Section III Other = Any other type of travel (commercial flight, barge, etc) – Must define and fill in Section III

SECTION III: AIRCRAFT PPR INFORMATION – Only used for charters, mil-air, or other.

Block 15: Define aircraft type (i.e., C-130, C-12)

Block 16: Enter call sign of aircraft

Block 17: Enter tail number of aircraft

Block 18: Enter original departure location, date and time (where aircraft is coming from)

Block 19: Enter arrival location (same as block 8), date and time

Block 20: Utilize check boxes if needing hangar, towbar or have hazmat (if hazmat, define type)

Block 21: Utilize check box if needing GPU and define

Block 22: Utilize check box if needing aircraft fuel and define amount

Block 23: Utilize check box if needing meals (box lunches) and define quantity and if any special are needed (i.e.,vegetarian)

SECTION IV: ADDITIONAL REQUIREMENTS

Block 24: Utilize the check boxes to select whether any of the following support is required 3rd Party Support: Check if Base Operations Support (BOS) Contractor labor will be used. Define number of hours and type needed.

DET Support: Check if DET Support is required (place vehicle request here) Equipment: Check if equipment is required and define type of equipment Supplies: Check if additional supplies are required while on installation and define type(s) Transportation to and/or from port: Check if transportation to/from port needed on site Radar Down Time: Check if radar down time is needed and define how many hours needed Non-aircraft fuel: Check for non-aircraft fuel, select fuel type and define amount needed Permit: Define permit type(s) needed (if applicable). Dig permits must be reviewed and signed by AFCEC/CZOP (Environmental Restoration Section) prior to issuance.

Other Support: Define any other support required that is not defined in previous blocks.

Block 25: Check if traveler(s) have firearm(s) and how many. Place the main firearm’s information in the blocks provided. All additional firearm information will be placed in Section V Comments. DD Form 2760 and AF Form 1314 will be filled out and attached to the SAR.

Block 26: Check if traveler(s) will be taking any devices for the purpose of photography, and define in the blocks provided. Removable media must also be checked and defined if applicable. All devices and removable media devices must be included, if additionals utilize Section V or provide word document with list of media. Content of photography and locations being photographed must be included utilizing the blocks provided. NO CELL PHONES, IPADS, TABLETS OR ANY OTHER DEVICE THAT IS BLUETOOTH

CAPABLE CAN BE USED IN RESTRICTED OR CLASSIFIED AREAS.

Block 27: Utilize the check boxes to select all applicable special access. Unaccompanied access to the secured locations listed will require additional information sent to the 611 ASUS/AFM office. The information required and the method of provision is listed on the 611 ASUS/SFM Secured Area Instructions.

SECTION V: COMMENTS

Add any additional comments that may be useful, or could not fit in blocks provided elsewhere. Required for additional firearms.

SECTION VI: TRAVELER INFORMATION

Up to 20 travelers can be placed on the same SAR. The travelers must all be under the same billing.

# = Provided Last, First, M.I. = If no middle name, put NMN DOB = Required, calendar block provided SEX = Required for lodging RANK = Default CTR, utilize drop-down for all others DODID = Only use if applicable. When used, Us issued DL must still be provided DL State = Required DL Number = Required Access = Utilize drop-down if traveler needs to have an escort Clearance = Utilize drop-down if traveler has a clearance

Approval provided by 611 ASUS, travelers and requestors do not sign.

COPA # and COPA Instructions provided by airfield manager.

SECTION VII: TRAVELER INFORMATIONAL CHECKLIST.

Not required, but is encouraged for all travelers to use. Space provided for companies to add any additional information for their traveler(s).

Requesting escort and access support from ArcTec during site visit.

We will require access to secured PRC radio safe.