Step 1 of 2 50% County:*AtlanticBurlingtonCamdenCape MaryCumberlandEssexGloucesterHudsonMercerMiddlesexMorrisNJ State PolicePassaicSalemSomersetSussexWarrenType of Activity* Arrest Knock & Talk Surveillance Detail Community Event Training/Presentation Outreach Mobile Van Outreach Coordination Meeting Location Type Address Area (Radius) Municipality/City Start Date* MM slash DD slash YYYY Start Time* : Hours Minutes End Date* MM slash DD slash YYYY End Time* : Hours Minutes Activity Funder* FFY20 SFY21 FFY21 SFY22 Names of Law Enforcement/OHH Staff*Names of Recovery Support Staff*# of Contacts MadePlease enter a number greater than or equal to 0.Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Municipality/City Radius Arrest DetailsAgency Type* State County Local Agency Specifics Case #'sMaterial DistributionMaterials Distributed Select All Narcan Test Strips Written Materials Give Aways (branded items) Other If Other, please provide detail Count of Narcan*Please enter a number greater than or equal to 0.Count of Test Strips*Please enter a number greater than or equal to 0.Count of Written Materials*Please enter a number greater than or equal to 0.Count of Give Aways*Please enter a number greater than or equal to 0.Count of Other*Please enter a number greater than or equal to 0.
