Attachment_2_-_Range_Site_Evaluation_Checklist.pdf

1 CQC Demo 2 CQC Demo 3 CQC Demo 4 CQC Demo 5 CQC Demo 6 CQC Demo 7 CQC Demo 8 CQC Demo

Fire Medical Police Name Name Name Emergency Phone No. Emergency Phone No. Emergency Phone No.

Admin Phone No. Admin Phone No. Admin Phone No.

Street Address Street Address Street Address Street Address Street Address Street Address City, State City, State City, State Distance from Range Distance from Range Distance from Range Approx. Resp. Time Approx. Resp. Time Approx. Resp. Time Lat/Long Coord. Lat/Long Coord. Lat/Long Coord.

Life Flight Ambulance Name Name Emergency Phone No. Emergency Phone No.

Admin Phone No. Admin Phone No.

Street Address Street Address Street Address Street Address City, State City, State Distance from Range Distance from Range Approx. Resp. Time Approx. Resp. Time Lat/Long Coord. Lat/Long Coord.

Static Pistol/Rifle Live‐Fire and Maneuver Static Pistol/Rifle Live‐Fire and Maneuver Static Pistol/Rifle Live‐Fire and Maneuver Static Pistol/Rifle Live‐Fire and Maneuver Static Pistol/Rifle Live‐Fire and Maneuver Static Rifle/Sniper Live‐Fire and Maneuver Static Rifle/Sniper Live‐Fire and Maneuver

List of Ranges Classification/Capability (circle one) Static Pistol/Rifle Live‐Fire and Maneuver

Range Owner Name Range Street Address (L1) Range Street Address (L2) Range City, State Zip Code

Organization

Local Emergency Services Information

Range Information

Job Title Assessment Team

Range Site Evaluation Checklist EmailPhoneAssessor Name Assessment Role

(This section will be completed by the Government Assessment Team Lead)

Backstop (Circle one, fill‐in below characteristics)

Height: Type: Type: .45/9mm 5.56mm 7.62mm .50 cal

Depth:

Install Date:

Install Date:

Concrete Slab (5kpsi) 3.94" 5.12" 6.30" 11.81"

Slope:

MFR

Caliber Rating:

MFR

Caliber Rating:

Core‐filled CMU Block 7.87" 11.81" 11.81" 23.62"

Side Containment (Circle one, fill‐in below characteristics)

Broken Stone 13.78" 13.78" 19.69" 19.69" Height: Height: Sand 23.62" 23.62" 35.43" 47.25"

Depth:

Block size: Earth 35.43" 35.43" 51.18" 66.93"

Slope:

Core filled: Yes/No

AR500 Steel 0.256" (6.5mm)

0.394" (10mm)

0.394" (10mm) none

Baffle Types: Length Backstop Types: Angled/Upright Targets: Barriers Painted Angled/Upright Width Steel: Rubber: Mobile Steel Other Steel Side Thickness Decelerator Layer‐Lamella Static Rubber Wood Overhead Escalator Formed bits Mover Wood Other Steel Brinell/AR rate Ven. Blind Chopped bits Reactive Paper Wood Gravel

Earth Berm CMU Block Wall

Characteristics

Other:

Characteristics

Other:

Caliber

Material

Earth Berm Steel Decelerator

Bullet Trap Rubber Bullet Trap

Construction Outdoor Ranges

MIL HDBK 1027/3B Table 5: Ballistic Material Thickness References Tables/Charts: