2022 FHP Cooperative Form .pdf

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Attached to
USDA Forest Service - GLRI Forest Restoration 2022
Opportunity number
USDA-FS-GLRI-FR22
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Forest Pest Treatment Form

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Eastern Region | State and Private Forestry | June 2022

FOREST HEALTH PROTECTION

COOPERATIVE (Non-Federal) LANDS FOREST PEST TREATMENT FUNDING REQUEST

1.S&PF

Eastern Region

2. Agency (if applicable): 3. Organization Name: 4. State: 5. Fiscal Year:

:6. Project Name

7.

Primary Project Goal (check only one)

Protect Threatened/Endangered Species Habitat 8. Proposed Project Is In:

(check only one)

Critical Wildlife Habitat

Eradicate Exotic Insect/Disease/Weed Infestation Wildland/Urban Interface

Protect Developed Sites/High Value Trees General Forest Area

Protect Adjacent Private Land Other (specify):

Protect Native Vegetation (forests and trees) 9. Project Is:

(check only one)

Urgent (treatment must be done this year to be effective)

Other (specify): Not Urgent

11. Primary Pest(s):

12. Primary Host(s):

13. No. Acres Proposed:

14. Treatment Method(s):

15. Treatment Material(s) (if applicable):

16. Treatment Rate(s) (if applicable):

17. Project Activities:

Fiscal Year Targets and Costs

b. Funding Requested ($)a. Proposed Acres

(1). Treatment

(2). Total Funding Requested

18. Project Lead1: Title: Date:

1Please provide the name of the individual who will be the primary point of contact for coordination and communication with U.S. Forest Service, Forest Health Protection staff.

→ Continue onto page 2 to complete, 19. Brief Project Description & Remarks.

→ Save your form and attach as instructed in the Request for Applications.

Updated June 2022 Coop

10. Primary Strategy: Prevention Eradication Suppression Restoration initiator:FS-GLRI@fs.fed.us;wfState:distributed;wfType:email;workflowId:78d9820ea25fbb40be4e41340e433c63

19. Brief Project Description & Remarks: Provide a concise but detailed project description that includes the following: 1) Project goals, strategies, objectives, and tactics; 2) Treatment area(s); 3) Timing of treatment(s); 4) Pesticides, delivery method, and application rate(s), if applicable; and 5) Budget.

Updated June 2022 Coop

19. (cont. from page 2) Brief Project Description & Remarks

Updated June 2022 Coop

USDA is an equal opportunity provider, employer, and lender.

FOREST HEALTH PROTECTION COOPERATIVE (Non-Federal) LANDS FOREST PEST TREATMENT FUNDING REQUEST
Brief Description of Project & Remarks
(cont. from page 2) Brief Description of Project & Remarks
Back to the beginning
Group1: Choice6
Group2: Choice7
Group3: Off
4 State:
5 Fiscal Year:
7 Project Name:
12 Primary Pests:
13 Primary Hosts:
14 No Acres Proposed:
15 Treatment Methods:
16 Treatment Materials if applicable:
17 Treatment Rates if applicable:
No acres to be protected2 Treatment:
20 Submitted By:
T t e_2:
Date_2:
whole dollars2 Treatment:
Brief Description of Project & Remarks Part 1:
Brief Description of Project & Remarks Part 2:
2 Agency:
Group 8: Off
3 Organization name:
FOREST HEALTH PROTECTION COOPERATIVE NonFederal LANDS FOREST PEST TREATMENT FUNDING REQUEST:
Other specify group 1:
Other specify group2:
17 Project Activities:
Treatment dollars:
d:

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