NORFOLK, Va. — Lax security at the gates of the Navy's largest fleet base allowed a disturbed civilian trucker to trespass deep into the base late on the night of March 24, 2014, and provoke a fatal confrontation that took the life of a heroic sentry. master at arms. Several errors by civilian police officers at Gate 5 of Naval Station Norfolk, Va., were the predominate factors leading to the March 24, 2014, shooting death of Master at Arms 2nd Class Mark Mayo, according to the Manual of the Judge Advocate General, or Jagman, provided March 17 to Navy Times.

The 35-year-old civilian trucker, Jeffrey Tyrone Savage, passed "unchecked through layers of security" according to the Navy's command investigation, released to Navy Times March 17. Savage, who appeared to be under the influence of drugs or otherwise impaired, was able to access the base without proper ID and wasn't followed until it was too late. By then he'd walked onto a pierside destroyer, where he killed Master at Arms 2nd Class Mark Mayo, who had shielded a fellow sailor from whom he had wrested a gunfrom the gunman. Savage was killed moments later.

The investigation found a host of errors and missteps that could have stopped security officials from stopping Savage before he got to the ship, and they also uncovered a culture of lax standards among the base police who guard and protect Naval Station Norfolk. The incident began at Gate 5, when a civilian police officer allowed Savage to enter without proper ID; it took nine minutes for him another police officer to pursue Savage, who by then had left his vehicle.

"Gate 5 personnel were clearly negligent in the performance of their duties, and there is a gross lack of procedural compliance, accountability and oversight of the civilian police force," according to the investigation, which was conducted by Rear Adm. Jeffrey Harley, assistant deputy chief of naval operations for operations, plans and strategy, and closed endorsed by Adm. Michelle Howard, vice chief of naval operations.

Investigators noted that the "individual failures of key individuals were matched by the heroism of a petty officer of the watch, who was prepared to engage a gunman with only a baton after numerous shotps were already fired, or that of a selfless master at arms who gave his life shielding that same petty officer of the watch and the crew of the USS Mahan."

While no one would disputeargue the heroism of that night, Adm. William Gortney took issue with investigators who, in the opening paragraph of their report, said layered security was ultimately successful in this event. Gortney, who was U.S. Fleet Forces Command bosscommander at the time, flatly disagreed. The suspect gained unauthorized access to the base, then the pier, and ultimately the ship's quarterdeck, the admiral ​ wrote in his endorsement.

"The multiple defense layers intended to protect the ship and the people on it failed to protect those people; they were not even warned until the suspect was already in the vicinity of Mahan's brow. … Lives were lost, and Navy personnel and critical assets were exposed to unnecessary risk. This was an unacceptable security failure, and improvements in our security program are required to ensure this never happens again."

A fateful night

At approximately 11 p.m., Jeffrey Tyrone Savage, 35, drove his employer's semi-tractor cab to Gate 5 for reasons that still remain unknown reasons. The gate guard neglected to ask him for He stopped but was not asked to show proper identification. Believing Savage wanted to make a U-turn and exit the base, the civilian police officer-in-charge allowed him to pass.

Savage did possessed a valid Transportation Worker Identification Credential, but this shouldn't have been would not have been sufficient by itself to gain access. When Savage failed to turn around, the officer didn't immediately respond, such as execute a U-turn, the police officer did not initiating "gate runner" procedures, or instead of deploying the hardened anti-access control system or pursuing the intruder. Instead, the security officer continued checking identification of several cars coming onto the base before informing another civilian police officer that Savage had gotten past. not shown proper ID or made a U-turn.

Approximately nine minutes later, after the initial encounter, the officer-in-charge jumped in his police car to search for the truckersuspect. departed in his police car to search for the suspect. Neither he nor his the colleague made aware of the situation radioed to report the unauthorized access.

After accessing the base, Savage parked the semi near adjacent to Pier 1 and got out of the semi, the engine still running. He walked up to the entry control point, where the exited the vehicle, which he left running. He approached the Entry Control Point on foot. The sentry was replacing traffic cones after a security vehicle drove onto entered the pier for a routine sentry and security check. That van carried MA2aster at Arms 2nd Class Mark Mayo, chief of the guard for the Waterfront Security Operations Center, and was driven by anunnamed chief of the guard traineeunder instruction, whose name, like many others, officials redacted out of privacy concerns.

This undated photo released the Navy on Thursday, March 27, 2014, shows Jeffrey Tyrone Savage, who, according to Navy is the civilian who shot and killed a sailor aboard a guided-missile destroyer at the Naval Station Norfolk in Norfolk, Va., earlier this week. Savage was killed by Navy security forces aboard the USS Mahan on Monday, March 24, after he disarmed the ship's petty officer of the watch and used her gun to shoot Petty Officer 2nd Class Mark Mayo. (AP Photo/Navy)
This undated photo released the Navy on Thursday, March 27, 2014, shows Jeffrey Tyrone Savage, who, according to Navy is the civilian who shot and killed a sailor aboard a guided-missile destroyer at the Naval Station Norfolk in Norfolk, Va., earlier this week. Savage was killed by Navy security forces aboard the USS Mahan on Monday, March 24, after he disarmed the ship's petty officer of the watch and used her gun to shoot Petty Officer 2nd Class Mark Mayo. (AP Photo/Navy)

Jeffrey Tyrone Savage, 35, who wrested a gun from one sailor and killed another who intervened, was gunned down during the incident.

Photo Credit: AP

Savage walked through the open pedestrian gate as the ECP sentry gave access to the security van. The fully armed ECP sentry, upon seeing Savage walking up the pier, yelled for him to stop and provide identification; Savage did not comply with her direction. According to the investigation, Savage waved his arms while talking into a cellular phone earpiece and appeared intoxicated or otherwise impaired. Investigators pointed out that the hospital ship USNS Comfort was also docked at Pier 1, which meant civilian personnel were not out of the ordinary.

Meanwhile, the Gate 5 officer-in-charge found As this event unfolded, the Gate 5 police officer-in-charge located Savage's truck idling in the nearby parking lot. He looked in the truck, did not see the driver, and contrary to procedures did not notify Naval Station Security Dispatch of the missing owner of the abandoned idling truck. He instead headed back to Gate 5.

The pier ECP sentry radioed the destroyer Mahan's quarter deck; the unnamed and unarmed officer of the deck, a chief, and an fully armed petty officer of the watch verbally demanded Savage show proper IDidentification. Savage ignored them and repeated orders and instead opened several tool boxes and storage lockers located on the pier. They didn't perceive Savage as a threat, but as a drunk civilian mariner or contractor, and didn't order a Mahan's watch standers did not order a shipboard security or force protection alert because Savage was not perceived as a threat, but thought to be an intoxicated civilian mariner or contractor. With the concurrence of the Mahan's command duty officer, who was in his stateroom, the team notified the Waterfront Security Operations Center, in which Mayo served as chief of the guard. The radio call was also received by the USNS the Comfort's watch stander, poised directly across the pier from Mahan, but was not copied by watch standers aboard the guided-missile frigate Kauffman, also moored at Pier 1, who lacked because department radios were unavailable to them.

Hearing the Upon receiving the radio call, Mayo's security van turned around and headed toward Mahan's brow. As the vehicle approached, Savage started up Mahan's brow. Mayo jumped out of the moving vehicle and raced after Savage, who was boarding the destroyer. in foot pursuit. Amid repeated orders to stop, Savage proceeded up the brow to board the destroyer. Savage said he just wanted to talk and that watch standers should just relax as he approached the quarterdeck. The ship's topside rover took position near the quarterdeck; the OODofficer of the deck stepped back so that Savage could see the presence of armed watch standers.

The POOWpetty officer of the watch drew her firearm and pointed it at the deck, rather than opting for her baton or mace, because she did not believe a person of her size (compared to the intruder) would be an adequate deterrent. Savage, who had exhibited no threatening behavior up to this point, reportedly said "give me that gun" and wrestled for her 9mm pistol. The POOW, much smaller than the male trucker, couldn't disengage the safety in time. As they struggled, the OOD also tried to gain control of the pistol. for control of the weapon. The petty officer of the watch was unable to disengage the safety in order to fire; the officer of the deck attempted to grab her side arm, but to no avail. After mere seconds, Savage "forcibly spun" the sailor, throwing her several feet onto the ship's lifelines, where he seized her pistol, the report said.

At that moment, Mayo landed on the quarterdeck and placed himself between the POOW and Savage, who was aiming the gun at her. ained control of her M9 service pistol. At this moment, Mayo arrived at the quarterdeck. Savage was poised to shoot the petty officer of the wat,ch when Mayo engaged, effectively placing himself between the two. Mayo was shot once in the front, then spun to cover the sailor and was shot three times in the back. He was not wearing his ballistic vest, which was in the van. Mayo was posthumously awarded the Navy and Marine Corps Medal, the highest non-combat heroism award.

Mayo's partner, armed with a pistol, and the Mahan's roving patrol, armed with an M16, opened fire. The POOW petty officer of the watch pulled moved herself from under Mayo and the ship's 25 mm gun mount, drewpulled her baton and prepared to take onengage Savage, but he fell to the ground, mortally wounded from the fatal gunshot wounds. The POOWpetty officer of the watch sounded a security alert aboard the ship and notified waterfront security that shots had been fired and assistance was needed.

Though the WSOCaterfront Security Operations Center had radio contact with Naval Station Norfolk Security Dispatch, operators inexplicably tried to notify dispatch via telephone, which was unsuccessful because the line was busy. As a result, a watch stander had to run across the street to the police precinct to notify dispatch to send response units and medical assistance.

Notification of "shots fired" was sent to security and medical personnel across the base, a call heard by the Gate 5 police officer-in-charge heard copied the notification as he returned to Gate 5.

It is not clear how many times Savage was shot, or what shot killed him. Though "the bulk of the investigation has been completed for some time [Naval Criminal Investigative Service is] still working on a couple of outstanding data points," said NCIS spokesman Ed Buice. That means Savage's autopsy and toxicology reports wereremain unavailable as of March 20.

A Navy official familiar with the investigation said Savage's toxicology report revealed cannaboids in his system, said a Navy official familiar with the investigation. A Navy official with close knowledge of the investigation said . The official was not authorized to discuss the issue and spoke on deep background.

Lax security

Naval Station Norfolk had security issues well before Mayo's fatal shooting, and many were cited as contributors to the tragicfateful evening.

Though not directly responsible, investigators faulted took to task the security department's unnamed precinct commander — the second-highest ranking civilian security officer, whose name was redacted — for "possible time and attendance violations." He did not come to work for six months in 2013 and missed 172.5 hours in the first three months of 2014, supposedly ondue to alleged medical leave. He only returned when the base's commanding officer personally intervened, but took an unexpected early retirement two weeks after the shooting. His absence contributed to the lack of supervision and laxity of standards, according to investigators. In addition, the assistant precinct commander position was vacated in August 2012 and remained unfilled for more than one year, though authorized and funded. An assistant precinct commander was hired in November 2014, and a new precinct commander was hired in February 2015.

Discipline and vigilance were lax among many government service security guards, the report found. were lax in the performance of duties. For example, several police officers at Gate 5, to include the OICofficer-in-charge, were not wearing ballistic vests the night of the shooting, and every Gate 5 watch stander said they had not read post orders or pre-planned responses in more than seven months.

Pay was cited as a problem. The Navy pays its civilian police less than its sister services, and this "contributed to a lack of capability and professionalism," according to investigators. Though staffed above the Navy Installations Command average, the event was "exacerbated by a significant decline in funding and manning," as sequestration, furloughs, a hiring freeze and attrition rates left the force understaffed and dispirited. Howard recommended Navy leaders assess a Navywide pay increase "to alleviate gapped billets and mitigate recruiting and retention concerns."

On the military side, investigators identified a "notable lack" of mid-level supervisors working past normal business hours, despite naval station guidance that specifies the chief of the guard be a first class petty officer or, preferably, a chief petty officer. On the night of the shooting, a second class petty officer was the duty section leader and the Waterfront Security Operations Center operator. The report recommended an "infusion of motivated mid-level personnel and proper oversight" by civilian and military supervisors.

Howard directed the CNIC boss commander of Navy Installations Command to assess "whether a culture of entitlement exists in shore establishment security departments," and to ensure a balance of skill and experience across all shifts. "At Naval Station Norfolk, there was an apparent culture where senior personnel avoided after-hours watch standing," she wrote. "Balancing experience and seniority across the watch bills is the responsibility of leadership."

Investigators also took issue with the fact that the Naval Station Norfolk security officer is a lieutenant who had no facility experience prior to assuming his duties at the world's largest fleet base. The naval station "large and complex" naval station. The base is billeted and funded for a lieutenant commander. Howard noted that base security officers are limited duty officers with "significant technical experience," but affirmed a shortfall of necessary supervisory experience. She recommended a career progression model be developed in which limited duty officers can first gain experience at smaller installations before filling jobs at larger bases. or as deputy security officers at larger installations.

"Have we created a professional career path for [security officers], so that they get the right experience sets, so that they go from a small base to a large base and are equipped to make sure they understand all of their responsibilities, but also equipped with the skill sets to execute all of those responsibilities?" Howard said in a March 18 interview. "We're looking at that both, what we're doing in terms of training and then the professional career development of both the civilian and military security."

Some gear was useless; half of NSN's pier cameras and entry control point duress buttons were inoperable the day of the incident. While sailors were issued the full complement of personal protective gear, many — to include Mayo — failed to wear ballistic vests.

Boosted security

The five sentries at Gate 5 who were involved in the incident were immediately "red-tagged," — removed from law enforcement duties and were not authorized to carry a weapon. The unnamed police OIC officer-in-charge who watched Savage pass through the gate without proper ID showing proper identification remains red-tagged and was not working in any law enforcement capacity as of March 19, according to public affairs officials. One police officer was red-tagged for four months, two for two months, and one for one week. All resumed normal duties after completion of refresher training.Investigators recommended "appropriate administrative or disciplinary action," for the civilian police officers.

The investigation recommended a number of other changes to installation security procedures.

Chief among them is that the National Crime Information Center database is now checked for any criminal history or outstanding warrants that are grounds for denial, which is a stronger standard than Transportation Worker Identification Credential guidelines. The grounds for denial include includes felony convictions within the lpast 10 years; misdemeanor convictions within the last five years for crimes of violence; larceny; drugs; habitual offenders; and conviction for sex offenses. These rules would have denied Savage base access, as he had Savage had been convicted of voluntary manslaughter in North Carolina in 2008 and spent time in prison a decade earlier for possession of crack cocaine with intent to distribute.

The Navy, within days of the shooting, increased the number of required watch standers at all pier entry control points. The base also began rotating active-duty night and daytime watch standers to ensure all receive the same level of oversight and training.

The two duress buttons that were inoperable at the time of the incident have been repaired and are fully operational, said Beth Baker, Navy Region Mid-Atlantic spokeswoman.There also has been significant improvement in the repair or replacement of cameras at Naval Station Norfolk and some of the repairs are ongoing, but she could not discuss specific numbers or locations due to operational security.

The Naval Station Norfolk security officer is now filled by an LDO lieutenant commander.Upon transfer, the position will be filled with a commander or officer with comparable shore installation experience, such as having served as a security officer at another installation, Baker said.

Communication between ship, waterside and civilian security forces was poor, at best. The first ashore landside Naval Security Force police units to arrive after the shooting post-incident were unable to communicate with the ECP sentry or ship's quarterdeck, "creating potential for a blue-on-blue or friendly fire incident," according to the report. In addition, integrated training is limited or non-existent between Naval Station security forces and ships at the watch stander level. All ECP sentries, chiefs of the guard, the Waterfront Security Operations Center, and ship quarterdecks are now on the same frequency, officials said.

Investigators also recommended:

  • All security force watch standers carrying sidearms should be equipped with a lanyard to ensure the weapon does not fall overboard and is not taken away. Navy officials said the use of lanyards "has been reinforced."
  • A physical barrier be designed and installed on all Navy brows or quarterdeck entrances that "would allow the watch team more time to clearly define a threat." This is under review.
  • The OOD and POOW That both members of the quarterdeck watch team be armed, which is under review. An armed OOD "Had the officer of the deck been armed with lethal and/or nonlethal capabilities, "he may have been able to assist the petty officer of the watch during the brief struggle over control of the weapon," according to the report.
  • That Fleet Forces Command, like its Pacific Fleet counterpart, re-implement "anti-terrorism officer" billets in destroyer and amphibious squadrons.
  • That ECPs be manned with active duty masters-at-arms to improve standardization and communications integration.

"This event underscores the importance of watch teams' compliance with processes that were created to keep our bases secure," Howard wrote in her endorsement. "I am satisfied that the corrective actions underway are sufficient to improve our physical security posture. However, security is guaranteed only when resources are coupled with leadership oversight and diligent watch-standers."

Staff writer Sam Fellman contributed to this report.