template_coop_lands_forest_pest_treatment_funding_request_0.pdf

FOREST HEALTH PROTECTION

COOPERATIVE LANDS FOREST PEST TREATMENT FUNDING REQUEST

Eastern Region

SPF

2. Agency 3. Agency Name (ex. Department of Agriculture) 4. State 5. Fiscal Year

6. Region/ Agency Priority

7. Project Name:

9.

Primary Project Objective:

(check only one)

Protect Threatened/Endangered Species Habitat 10. Proposed Project Is In:

(check only one)

Critical Wildlife Habitat

Eradicate New Exotic Insect/Disease Infestation Urban/Wildland Interface

Protect Developed Sites/High Value Trees General Forest Area

Protect Adjacent Private Land Other (specify):

Protect Native Vegetation (forests and trees) 11. Project Is:

(check only one)

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

Other (specify): N/A Not Urgent Fire Condition Class:

CC

CC

CC

3 N/A Fire Regime: I II III IV V N/A

12. Primary Pest(s):

13. Primary Host(s):

14. No. Acres Proposed:

15. Treatment Method(s):

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

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

18. Project Activities:

Fiscal Year Targets and Costs

b. Funding Requested ($)a. Proposed Acres

(1). Pre-Treatment Surveys (2). Treatment (3). Post-Treatment Evaluation/Monitoring (4). Other (provide details) (5). Total Funding Requested

19. Submitted By: Title: Date:

Save and send as per instructions in the call letter and remember to complete the detailed project description on page 2, which can be continued onto page 3 if needed. You will need to manually cut and paste the continuation on page 3 since this doesn't happen automatically.

initiator:FS-GLRI@fs.fed.us;wfState:distributed;wfType:email;workflowId:78d9820ea25fbb40be4e41340e433c63

20. Brief Description of Project & Remarks: Provide a concise but detailed project description and include the following (continue on p. 3 if needed): 1) Project objective(s); 2) Treatment area(s); 3) Timing of treatment(s); 4) Pesticides, delivery method, and application rate(s); and 5) Budget breakout of the funding request.

20. (cont. from page 2) Brief Description of Project & Remarks: (Provide a description of the project and details on “other” costs directly related to the project.)