Exhibit C-FPA-3027124.pdf

FPA/N #: 3027124

Received Date: 6/18/2024

Completed Date: 6/18/2024

WDFW Concurrence Due Date: ______ _

WDFW Concurrence Review Completed: ______ _

Comments Due Date: 7/2/2024

Decision Due Date: 7/18/2024

Forest Practices Application/Notification

Office Checklist Page 1

NORTHEAST REGION

FP Forester: DJ Greene

Shutdown Zone:_.,,.6.,,.8""'6'------

FPAJN CLASSIFICATION: D11D11101vG [Z]1vs BiomassO FFFPP□ 20-acre exemptD

Landowner Name: j Washington State Parks and Recreation Commission Project I 7 Mile FHT Name:

WRIA: Lower Spokane WAU: Deep Creek

WRIA: Lower Spokane WAU: Nine Mile Reservoir

WRIA: WAU:

Legal Description: 17,20,7,8, 18-26-42 County: Spokane

Activity Type: Harvest 341 .6

Road Construction

ALTERNATIVE PRESCRIPTIONS

Oren-Year Forest Management Plan 0Columbia River Gorge National Scenic Area

RESOURCE REVIEW

✓ Unstable Slopes[Z]a10

Rain-on-Snow

Stream Crossing(s)

Road ft Abandonment

0Habitat Conservation Plan □Alternate Plan

High Mass Wasting Potential Highly Erodible Highly Unstable

Rock Pit ac ft Spoils cy

Ocooperative Habitat Enhancement Agreement □watershed Analysis:

✓ Bull Trout Overlay HCP Bull Trout Population

✓ Wetland[Z] Forested DAD B In WMZ of O A, or O B Wetland ✓ SLPSTAB

✓ Bald Eagle nest or roost within 660 feet olume greater than 5 mbf per acre

Even-Aged Harvest greater than 120 Acres In RMZ/ELZ of Type□ S [Z] F ON Water Verification Needed In or Over Typed Water Os OF ON Group A or B Water Supply

Landsl ide Inventory Polygon Hydric Soils Potential Avalanche Area High Avalanche Hazard Area

✓ Slopes greater than 40% ( 40 )

Road Construction on Slopes greater than 65%

✓ Site Class 3

ASSOCIATED NON-SCANNED DOCUMENTS - On file with FPA/N at the Region Office

[Z] SEPA Checklist/Documents

ASSOCIATED SCANNED DOCUMENTS

Qualified Expert Report; Type: _____ _ FPBM Appendix(s) WTM Form# ________ _ Shade Documentation (Stream Shade Assessment Worksheet) Slope Stability Informational Form

✓ Small Landowner RMAP Checklist

ADDITIONAL COMMENTS:

0 Call prior to site visit

Conversion Option Harvest Plan Hardwood Conversion Form Natural Regeneration Plan DFC Printout Shorel ine Permit

✓ CMZ Assessment Form

FPHP Plans & Specifications Water Classification Worksheet Watershed Analysis Worksheet Water Protocol Surveys Wetland Mitigation Plan

EARR Tax Credit li]Yes □ No

1cN Dswo □Nrc Previous FPA -------------- Adjacent FPA-:-::----,---..,...,..,.,-------- Priority Habitat/Species White Tail Deer.Mule Deer

Form Completed by AB

EXHIBIT C

Date: 9/10/2024

Forest Practices Application/Notification: 3027124

□ Revision:

~Amendment:

Addition of new construction road Road identifier: Road B Road construction length: 1580 feet Steepest side slope: 5% Road abandonment length: 1580 feet Abandonment date: 08/2027 Abandonment specifications: slash will be left in road footprint to prevent erosion , and water bars will be constructed on slopes. as necessary. There are no water crossings associated with Road B. The gate currently barricading publ ic access will be maintained or re installed at the conclusion of the thinning Road B new construction ROW marked with blank pink ribbon .

Amended question 16.

□Transfer:

□ Notification:

□ Other:

Date: 7-9-2024

Forest Practices Application/Notification:3027124

[XI Revision:

Revisions include wetland classification changes for wetlands B, C, E, and G (B now combined with A). And an additional landform, outside of the harvest boundary, added to the slope stability form and map. Also , for q27 a ROW flagging is now identified. 3.a. of Appendix D Other Describe: Mass wasting deposits

□Amendment:

□Transfer:

□ Notification:

□ Other:

FPA/N No.:

Region :

Date of Receipt:

Forest Practices Application/Notification

Eastern Washington Project Name: _7....:.M....:.i.;..;:le_F_H_T ________ _

PLEASE READ FPA/N INSTRUCTIONS PRIOR TO COMPLETING THIS APPLICATION.

1. Landowner, Timber Owner and Operator

Legal Name of Landowner Legal Name of Timber Owner Legal Name of Operator

Washington State Parks and Recreation ~Same as Landowner ~Same as Landowner

Comission

Mailing Address Mailing Address Mailing Address

1111 Israel Road S.W

City, State, Zip City, State, Zip City, State, Zip

Olympia, WA 98504-2650

Phone: 509.863.6713 Phone: Phone:

Email: zach .stamand@parks.wa.gov Email: Email:

Contact Person: Phone: 509.863.6713

Zach St. Amand Email: zach .stamand@parks.wa.gov

2. Are you converting any portion of the land to non-forestry use within three (3) years of harvest?

~ No □ Yes If yes, include a SEPA checklist and SEPA determination (if applicable) and copies of county clearing and grad ing permits (if appl icable).

3. If you are harvesting timber, enter the Forest Tax Number of the Timber Owner.

800-888-888

Contact the Department of Revenue at 360-534-1324 to obtain a forest tax number or further information.

4. Are you eligible for the Enhanced Aquatic Resources Requirements (EARR) Tax Credit? See FPAIN instructions for further information.

~ No □ Yes

2023 July - Eastern Washington FPA/N 1 of 9

5. Are you a small forest landowner per RCW 76.09.450? See FPAIN instructions for details.

□ No~ Yes If yes, check all that apply. If no, skip to Question 6.

3027124 l&I My entire proposed harvest area is on a single contiguous ownership consisting of one or more parcels.

□ My proposed forest practices activities are within an area covered by an approved Forest Stewardship Plan or Forest Management Plan developed in cooperation with DNR.

D I received technical assistance from a DNR small forest landowner Stewardship and Technical Assistance Forester in preparing this FPA/N.

6. Are you substituting prescriptions from an approved state or federal habitat conservation plan (HCP) or Watershed Analysis?

181 No □ Yes Write "HCP" or "Using Prescriptions" in tables that apply. Attach or reference prescriptions and/or crosswalk(s) for the approved HCP or Watershed Analysis on file at the region office.

7. What is the legal description of your forest practices?

Section Township Range E/W Tax Parcel Number County

17 26 42 E 261 71.9007, 26172.9018, 26173.9020 Spokane

17 26 42 E 26174.9024, 26173.9021 , 26175.9022 Spokane

17 26 42 E 26172.9017, 26171 .9044 Spokane

20 26 42 E 26201 .9004, 26201 .9005, 26202.9012 Spokane

7 26 42 E 26074.0105, 26074 .0106 Spokane

18 26 42 E 26181 .0101 , 26181 .0102, 26181 .9001 Spokane

8. Have you reviewed this forest practices activity area to determine whether it may involve historic sites and/or Native American cultural resources? Please read FPAIN instructions prior to answering this question.

□ No ~ Yes If you made any contacts, please provide information in Question 28.

9. Do you have a DNR approved Road Maintenance and Abandonment Plan (RMAP)?

a. 181 No □ Yes If no, skip to c., if yes, enter your RMAP number: ___________ ; continue to b.

b. □ No □ Yes Is this forest practices activity for work that is included in the approved RMAP?

c. □ No 181 Yes Is a Small Forest Landowner Checklist RMAP required? See FPAIN instructions for details.

10. Are there potential unstable slopes or landforms in or around the area of your forest practices activity?

□ No 181 Yes If yes, attach Appendix D. Slope Stability Informational Form and map of areas reviewed for and locations of unstable slopes and landforms found. If applicable, attach a geotechnical letter, memo, or report , Watershed Analysis prescriptions, and/or SEPA Environmental Checklist.

2023 July - Eastern Washington FPA/N 2 of 9

30 27 124

ADDENDUM : QUESTION 7 RIVERSIDE STATE PARK FPA

Section Township Range E/W Parcel County

7 26 42 E 26074.0104 Spokane 7 26 42 E 26074.9021 Spokane 7 26 42 E 26074.9020 Spokane 8 26 42 E 26083 .9039 Spokane 8 26 42 E 26083 .9029 Spokane 8 26 42 E 26083.9028 Spokane

17 26 42 E 26171.9006 Spokane 17 26 42 E 26171.9007 Spokane 17 26 42 E 26171.9044 Spokane 17 26 42 E 26172.9014 Spokane 17 26 42 E 26172.9017 Spokane 17 26 42 E 26172.9018 Spokane 17 26 42 E 26172.9041 Spokane 17 26 42 E 26173 .9020 Spokane 17 26 42 E 26173.9021 Spokane 17 26 42 E 26174.9024 Spokane 18 26 42 E 26181.0101 Spokane 18 26 42 E 16181.0102 Spokane 18 26 42 E 26181.0106 Spokane 18 26 42 E 26181.0105 Spokane 18 26 42 E 26181.9001 Spokane

11. Is this Forest Practices Application/Notification (answer all of the following questions) 3u ~7 1 24

a. [81 No □ Yes A request for a multi-year permit? If yes , length requested: □ 4 years or □ 5 years .

See FPA/N instructions to verify you qualify for a multi-year permit.

b. ~ No □ Yes An Alternate Plan? If yes, include a template Alternate Plan Form or detailed plan . See FPAIN instructions for details.

c. ~ No □ Yes For a funded Forest Family Fish Passage Program (FFFPP) project?

d. ~ No □ Yes Within an urban growth area? If yes, review FPA/N instructions for additional required documents.

e. □ No ~ Yes Within a public park? If yes, include a SEPA Environmental Checklist or SEPA Determination , except for harvesUsalvage of less than 5,000 board feet within a developed public park.

Park Name: Riverside State Park

f. □ No [81 Yes Within 500 feet of a public park? Park Name: _R_iv_e_rs_id_e_S_t_at_e_P_a_rk ___________ _

g. ~ No □ Yes Part of an approved Conversion Option Harvest Plan (COHP) prepared by a local government entity? If yes , include a copy.

h. ~ No □ Yes Within 200 feet of the Ordinary High Water Mark (OHWM) or floodway of Type S Water? If yes , check with the county or city to determine whether a Substantial Development Permit is required under the local shoreline master plan.

i. ~ No □ Yes Within 50 miles of saltwater AND you own more than 500 acres of forestland in Washington state?

If yes, include Appendix J. Marbled Murrelet Form or attach/reference applicable HCP prescriptions.

j. □ No ~ Yes In or directly adjacent to a potential Channel Migration Zone (CMZ)? If yes, include Appendix E.

CMZ Assessment Form or attach/reference applicable HCP and/or Watershed Analysis prescriptions.

You are required to verify all waters within 200 feet of your proposed forest practices activities prior to submitting a Forest Practices Application/Notification. Use Appendix A. Water Type Classification Worksheet and/or a Water Type Modification form to explain how you verified water types. See Water Typing Requirements in the FPAIN instructions for details.

***IF NOT WORKING IN OR OVER TYPED WATER, SKIP TO QUESTION 16 * * *

Prior to answering Questions 12-15 in this section, please refer to the Forest Practices Application/Notification Instructions and Forest Practices Board Manual Section 5.

12. Are you proposing any of the following projects NOT permitted by current HPAs from WDFW?

a. □ No □ Yes Installing , replacing , or repairing a culvert at or below the bankfull width of Type S or F Water that exceeds a five percent gradient?

b. □ No □ Yes Construction, replacing , or repairing a bridge at or below the bankfull width of unconfined streams in Type S or F Water?

c. □ No □ Yes Placing fill material within the 100-year flood level of unconfined streams in Type Sor F Water?

13. Have you consulted with DNR and/or WDFW about the proposed hydraulic project(s) in or over Type S or F Water?

□ No □ Yes

2023 July - Eastern Washington FPA/N 3 of 9

3027124

14. If installing, replacing, removing, or maintaining structures in or over any typed water, complete the table below. Provide crossing locations and identifiers on your Activity Map. Provide plan details in Question 28 or attach plan to the FPA/N. Type S and F and complex Type N Waters require detailed plan information per WAC 222-24- 042(2) . See FPNN instructions for detailed plan requirements.

Planned Structure Culvert Design Channel Stream Crossing Water Activity (bridge, Proposed Method

Bed Gradient Is this Identifier Type (install, replace, ford/equipment Size (no-slope, Width (ft) an (Jetter, (S, F, remove, crossing*, (width x stream-sim, (%)

RMAP

number) Np, Ns) temporary, puncheon/fill, arch, length) hydraulic, other) (F and S (F and S

Project maintenance) round culvert, other) (F and S only) only) only)

*Fords and/or equipment crossings on Type S and F Waters may result in an unauthorized incidental take of certain threatened or endangered fish species. For more information, see 'Background for the State's Incidental Take Permits for certain threatened and endangered fish species' following Question 22 of the FPA/N Instructions.

15. If conducting any of the following activities in or over typed water, complete the table below. Some activities will require identifiers on the Activity Map and/or more information in Question 28. See FPNN instructions for details.

*Activity Type S Water Type F Water Type Np Water Type Ns Water

Equipment Crossing** PROVIDE DETAILS IN QUESTION 14

Suspending Cables

Cable Yarding

LWD Placement/Removal

Beaver Dam Removal

Felling and Bucking

Other (describe in Question 28)

*Fords and/or equipment crossings on Type Sand F Waters must be identified in Question 14.

16. If constructing or abandoning forest roads, complete the table below. Show the road locations and identifiers on the Activity Map. Include abandonment plans for all temporary roads and abandonment projects. See FPNN instructions for abandonment plan requirements.

Road Identifier Road Construction Road Abandonment

(name, number) Length Steepest Side- Length Abandonment Date (feet) slope(%) (feet) (MM/YYYY)

A 3250 5 3250 08/2027

2023 July - Eastern Washington FPA/N 4 of 9

• • FPAII 3 f/3,f}1, 3 Q 2 7l 2 4

17. If depositing spoils and/or expanding or developing !Mffl:k p2 est:trse, eomplete the table below.

Show locations and identifiers on the Activity Map.

Spoil Area Amount of Identifier Spoils Deposited

(letter, number) (cubic yards)

Rock Pit Identifier Acres of New Acres of

Rock Pit Existing Rock (name, number or letter) Developed Pit Expanded

18. If operating within 200 feet of a wetland that is not associated with Type Sor F Water, complete the table below. Wetlands associated with Type Sor F Water should be listed in Question 25 .2! Question 23 if using 20-acre exempt rules. Show the boundaries of each wetland , along with its identifier, and Wetland Management Zone (WMZ) on the Activity Map. See FPA/N instructions for details.

A, D

B, C, E, G

Planned Planned Activities in

None

None

***IF NOT HARVESTING OR SALVAGING TIMBER, SKIP TO QUESTION 27 * * *

How many acres will be filled?

None

None

19. If harvesting or salvaging timber, complete the table below. Show all harvest areas and unit numbers on the Activity Map. For even-aged harvest units, show surrounding stand information on the Activity Map. See FPA/N instructions for details.

Logging System Estimated - 0 .so' Number of c ........ -Harvest C/1 (rubber tired skidder, tracked ,;:::-.

Cl) "C Cl) ~ Trees per acre ·;; ~ .. Cl) Cl) .Q Cl) Method ~ skidder, dozer, shovel, full Cl) "C .a E E a, e- Remaining Q. -.0 ca~ .0 Cl) O'- ::s - a,' ::s "C o.:t: E (Even-aged, suspension cable, leading end .s ui - "C

- C/1 0) - Cl) after Harvest -c ::c ... 0 Cl) a, o- ,,, ::> ::s

Uneven-aged, C/1 0 suspension cable, helicopter, C/1 Cl) Cl) Cl) > ~ c:: >I 15 0 z E ui --C/1).. I!~ C/1 ca c:: Cl)~ C: .c Cl) Cl)

~ Salvage, Right ca'- cable assist/tethered, animal, ::s Cl) Cl) ::c -2 IV Ll .c - .c Cl) Cl) u ca c, ca .., - Ll C of Way) E chipper, fo,warder, slash c( ::c 0~ ca G> ..._ ca ::c :5-o cii ~ -0 i~ ::> 0 > ca E .a ~ Cl)

II) • .., CT• CD ca iii bundler) ::c 0 II) 0 11) Q) 0 U) ::c iii ~.0 Q) ..... Q) ........ _.

c'5 0

1 Uneven-Aged N Rubber Tired Skidder 30.7 94 NIA NIA 150 21 15

2 Uneven-Aged N Rubber Tired Skidder 57.2 173 NIA N/A 150 21 5

3 Uneven-Aged N Handfell , RTS 22.2 26 NIA N/A 50 21 40

4 Uneven-Aged N Rubber Tired Skidder 181 633 N/A NIA 150 21 5

5 Uneven-Aged N Rubber Tired Skidder 50.5 119 NIA N/A 100 21 20

2023 July - Eastern Washington FPA/N 5 of 9

. REVISION

FPA# l o ~-, I 1. '(

17. If depositing spoils and/or expanding or developing a rock pit for forestMn:,e, compl,;te the ta e low.

Show locations and identifiers on the Activity Map. - '1 -1 __ t

Spoil Area Amount of Identifier Spoils Deposited

(letter, number) (cubic yards)

Rock Pit Identifier Acres of New Acres of

(name, number or letter) Rock Pit Existing Rock Developed Pit Expanded

18. If operating within 200 feet of a wetland that is not associated with Type Sor F Water, complete the table below. Wetlands associated with Type S or F Water should be listed in Question 25 or Question 23 if using 20-acre exempt rules. Show the boundaries of each wetland , along with its identifier, and Wetland Management Zone (WMZ) on the Activity Map. See FPAIN instructions for details.

Wetland Wetland Planned Planned Total How many How many Identifier Type

Activities in Activities in Wetland acres will acres will (letter, (A, B, Wetland Maximum Acres be drained? be filled? number) Forested) WidthWMZ

A, D,C, E, G A None None 16.9 None None

***IF NOT HARVESTING OR SALVAGING TIMBER, SKIP TO QUESTION 27 * * *

19. If harvesting or salvaging timber, complete the table below. Show all harvest areas and unit numbers on the Activity Map. For even-aged harvest units, show surrounding stand information on the Activity Map. See FPAIN instructions for details.

Estimated Logging System 0 0--.., Number of

C: -

Harvest Ill (rubber tired skidder, tracked c;:::- Cl) 't:J :~ Trees per acre ·;~ ... Cl) Cl) .Q

Cl) Method ~ skidder, dozer, shovel, full Cl) 't:J .c E: E Cl) E'- Remaining a.'- .c .c Cl) ::, ... Q)' ::, 't:J 0~ E (Even-aged, cu~ suspension cable, leading end o- o'-'- - Ill Ol - Cl) after Harvest - C: :::c "- .., Ill ... 't:J 0 Cl) Cl) o- rn::::, ::, Cl) Cl) > le z Uneven-aged, Ill 0 suspension cable, helicopter, Ill Cl)

E 1ii > ~ c:: ffi 0

Ill>- Cl)~ 1/1 CU C:: Cl)~ C: Ill Ill

~ Salvage, Right cable assisVtethered, animal, ... cu ::, Cl) Ill :::C ,8 co .c .c ..., .c Cl) Cl) cu - C) cu .c .0 ..., - .0

C: E u :::c 0~ cu Cl) - ~ :::c ..., "O <ii ~ "O g- ~ ::::, of Way) 0 chipper, forwarder, slash c( > cu E .c <fl : ..., 0- : Cl) cu in :::c 0 - Cl) tflO CO Ql 0 U) :::c bundler) ~ .c Q) ..... Q) in ....J c'.3 0

1 Uneven-Aged N Rubber Tired Skidder 30.7 94 N/A N/A 150 21 15

2 Uneven-Aged N Rubber Tired Skidder 57.2 173 N/A N/A 150 21 5

3 Uneven-Aged N Handfell, RTS 22.2 26 N/A N/A 50 21 40

4 Uneven-Aged N Rubber Tired Skidder 181 633 N/A N/A 150 21 5

5 Uneven-Aged N Rubber Tired Skidder 50.5 119 N/A N/A 100 21 20

, .. 3027124

17. If depositing spoils and/or expanding or developing a rock pit for forestry use, complete the table below.

Show locations and identifiers on the Activity Map.

Spoil Area Amount of Identifier Spoils Deposited

(letter, number) (cubic vards)

Rock Pit Identifier Acres of New Acres of

Rock Pit Existing Rock (name, number or letter) Develooed Pit Expanded

18. If operating within 200 feet of a wetland that is not associated with Type S or F Water, complete the table below. Wetlands associated with Type S or F Water should be listed in Question 25 Qr Question 23 if using 20-acre exempt rules. Show the boundaries of each wetland , along with its identifier, and Wetland Management Zone (WMZ) on the Activity Map. See FPAIN instructions for details.

Wetland Wetland Planned Planned Total How many How many

Identifier Type Activities in Activities in Wetland acres will acres will

(letter, (A, B, Wetland Maximum Acres be drained? be filled?

number) Forested) WidthWMZ

A, D A None None 2.8, 0.8 None None

B, C,E,G Forested None None 6.7, 0.8, 2.8, 3 None None

*** IF NOT HARVESTING OR SALVAGING TIMBER. SKIP TO QUESTION 27 * * *

19. If harvesting or salvaging timber, complete the table below. Show all harvest areas and unit numbers on the Activity Map. For even-aged harvest units, show surrounding stand information on the Activity Map. See FPAIN instructions for details.

Estimated Logging System ... 0 0 --._ Number of ...

C: -Harvest 1/1 (rubber tired skidder, tracked G::' ;~ ... Q) Q) .Q Q) 'C Trees per acre ·;~ Q) Method ~ skidder, dozer, shovel, full Q) 'C .c E: E a, e- 0. -.c "'z .c Q) o- :::, ... Q) :::, 'C Remaining o:t:

E (Even-aged, suspension cable, leading end 0 ... ... 'C - 1/1 0) - Q) after Harvest - C:

:::, J: ._ ... 1/1 0 Q) <ll 0 ... rn =>

Uneven-aged, 1/1 Q) Q) Q) > ~ C: > xi z 1/1 0 suspension cable, helicopter, E ui ~ 0

1/1 >- Q) ~ 1/1 "' C: Q) ~ C: 1/1 1/1

;t: Salvage, Right "' - cable assist/tethered, animal, ... "' :::, Q) 1/1 J: .8 ro .c .c - .c Q) Q) C) "' .c .0 - - .0 C:

of Way) E " J: 0 ~ "' Q) - ~ J: - ""C Q) ~ ""C g-~ :::> 0 chipper, forwarder, slash ct > "' E .c <I) = - o- , Q) "' in bundler) J: 0 - Q) <l)Q ro (I) o rii J: ~ .c (I) ..... (I) in ....J (50

1 Uneven-Aged N Rubber Tired Skidder 30.7 94 N/A N/A 150 21 15

2 Uneven-Aged N Rubber Tired Skidder 57.2 173 N/A N/A 150 21 5

3 Uneven-Aged N Handfell, RTS 22.2 26 N/A N/A 50 21 40

4 Uneven-Aged N Rubber Tired Skidder 181 633 N/A N/A 150 21 5

5 Uneven-Aged N Rubber Tired Skidder 50.5 119 N/A N/A 100 21 20

ADDENDUM: QUESTION 18 RIVERSIDE STATE PARK FPA

Wetland Planned Identifier Wetland Type Activities Planned Activities in Total How many How many (letter, (A, B, in Maximum Width Wetland acres will acres will be number) Forested) Wetland WMZ Acres be drained? filled?

G Forested None None 3.0 None None

20. Reforestation. Check all that apply:

□ Planting. Tree Species: ----------------

□ Natural. Include a Natural Regeneration Plan

~ Not required because of one of the following:

3027124

□ I am converting some or all of this land to non-forestland in the next three (3) years or lands are exempted under WAC 222-34-050.

□ Individual dead, dying, down, or wind-thrown trees will be salvaged .

igJ Trees are removed under a thinning program reasonably expected to maximize the long-term productivity of commercial timber.

□ I am leaving at least 100 vigorous, undamaged , and well distributed saplings or merchantable tress per acre.

□ An average of 150 tree seedlings per acre are established on the harvest area and my harvest will not damage them .

□ Road right-of-way or rock pit development harvest only.

* * IF YOU OWN MORE THAN 80 ACRES OF FORESTLAND IN WASHINGTON, SKIP TO QUESTION 25 * *

21. Are you using the exempt 20-acre parcel riparian management zone (RMZ) rule on Type S, F, or Np Waters?

See FPA/N instructions for details.

□ No Skip to Question 25.

□ Yes Continue to Question 22. See FPA/N instructions for qualifications and information.

22. Choose the answer below that best fits your situation. Show all RMZs on the Activity Map.

□ a. All of the following apply to me and my land: if no, answer b.

• Between June 5, 2006 and today's date I have always owned less than 80 acres of forestland in Washington .

• Between June 5, 2006 and today's date this parcel has always been 20 acres or less of contiguous ownership . See RCW 76.09.020 for definition of "contiguous".

• Between June 5, 2006 and today's date this parcel has always been owned by me or someone else that has owned less than 80 acres of forestland in Washington.

b. ONE OR MORE of the following apply to me and/or my land (check all that apply):

If any of the statements below apply AND you use the exempt 20-acres parcel RMZ rule, you are NOT authorized under the State's Incidental Take Permits. See FPA/N instructions for details.

□ Between June 5, 2006 and today's date I have owned more than 80 acres of forestland in Washington .

□ Between June 5, 2006 and today's date this parcel has been a part of more than 20 acres of contiguous ownership . See RCW 76.09.020 for definition of "contiguous".

□ Between June 5, 2006 and today's date this parcel has been owned by someone that has owned more than 80 forested acres in Washington.

2023 July - Eastern Washington FPA/N 6 of 9

REVISION

FPA# 3 £J ;z Z I z i/ o1::r~ z/4;1~ ,~ 3 0 2 7 1 2 _4 .

23. If harvesting on an exempt 20-acre parcel and are within 345 feet of a Type S or F Water or periodically inundated areas of their associated wetlands, complete the table below. Show RMZs and stream segment identifiers on the Activity Map. If you are harvesting within 75 feet or within the maximum RMZ (whichever is less), stream shade must be assessed and met following harvest. Describe in Question 28 how stream shade was determined to be met or use Appendix F. Stream Shade Assessment Worksheet.

Are you Only complete if harvesting within 75

Stream Adjacent RMZ harvesting feet or within the maximum RMZ, Segment Water Segment Harvest Maximum within the whichever is less Type Length Type Minimum Shade met per

Identifier (S, F,) (feet) (partial cut

Width maximum Shade FPBM - Section (letter) or other) (feet) RMZ? Required 1?

(YorN) (%) {YorN)

24. Are you harvesting within 29 feet of a Type Np Water on an exempt 20-acre parcel?

□ No Skip to Question 27.

□ Yes Describe leave tree strategy in Question 28 and Skip to Question 27. See FPAIN instructions for details.

25. If harvesting within 130 feet of any Type S or F Water or periodically inundated areas of their associated wetlands, complete the table below. Include stand information for all inner zone harvests unless you have an HCP prescription . Show RMZs, CMZs, and stream segment identifiers on the Activity Map. If you are harvesting within 75 feet or within the maximum RMZ (whichever is less), stream shade must be assessed and met following harvest. Describe in Question 28 how stream shade was determined to be met or use Append ix F. Stream Shade Assessment Worksheet.

Only complete if harvesting RMZ within 75 feet or within the

Stream Water Site Stream Is there Harvest

Total maximum RMZ, whichever is Segment

Type Class Width aCMZ? Code(s) DFC Run width less

Identifier Number ofRMZ Minimum Shade met (letter) (S, F,) (I - V) (feet) (YorN) (see

(feet) Shade per FPBM-instructions) Required Section 1?

(%) (YorN) A s Ill 300' y B,L 200'

B F Ill J.0" /5-I N B, L 100'

26. If harvesting within 50 feet of Type Np Water, complete the table below. Show RMZs and stream segment identifiers on the Activity Map.

Stream Stream Segment Selected Strategy Identifier (partial cut or clearcut)

(letter)

Segment Selected Strategy Identifier (partial cut or clearcut)

(letter)

2023 July - Eastern Washington FPA/N 7 of 9

302712 4

23. If harvesting on an exempt 20-acre parcel and are within 345 feet of a Type Sor F Water or periodically inundated areas of their associated wetlands, complete the table below. Show RMZs and stream segment identifiers on the Activity Map. If you are harvesting within 75 feet or within the maximum RMZ (whichever is less) , stream shade must be assessed and met following harvest. Describe in Question 28 how stream shade was determined to be met or use Appendix F. Stream Shade Assessment Worksheet.

Are you Only complete if harvesting within 75

Stream Adjacent RMZ harvesting feet or within the maximum RMZ, Segment Water Segment Harvest Maximum within the whichever is less Type Length Type Minimum Shade met per

Identifier (S, F,) (feet) (partial cut

Width maximum Shade FPBM - Section (letter) or other)

(feet) RMZ? Required 1?

(Yor NJ (% ) {YorN)

24. Are you harvesting within 29 feet of a Type Np Water on an exempt 20-acre parcel?

□ No Skip to Question 27.

□ Yes Describe leave tree strategy in Question 28 and Skip to Question 27. See FPAIN instructions for details.

25. If harvesting within 130 feet of any Type S or F Water or periodically inundated areas of their associated wetlands, complete the table below. Include stand information for all inner zone harvests unless you have an HCP prescription. Show RMZs, CMZs, and stream segment identifiers on the Activity Map. If you are harvesting within 75 feet or within the maximum RMZ (wh ichever is less), stream shade must be assessed and met following harvest. Describe in Question 28 how stream shade was determined to be met or use Appendix F. Stream Shade Assessment Worksheet.

Only complete if harvesting

RMZ within 75 feet or within the Stream Water Site Stream Is there Harvest

Total maximum RMZ, whichever is Segment

Type Class Width aCMZ? Code(s) DFC Run width less

Identifier Number ofRMZ Minimum Shade met (letter)

(S, F,) (I - VJ (feet) (Yor NJ (see (feet) Shade per FPBM-instructions) Required Section 1?

(% ) (Yor NJ

A s Ill 300' y B, L 200'

B F Ill 10' N B, L 100'

26. If harvesting within 50 feet of Type Np Water, complete the table below. Show RMZs and stream segment identifiers on the Activity Map.

Stream Stream Segment Selected Strategy Segment Selected Strategy Identifier (partial cut or clearcut) Identifier (partial cut or clearcut)

(letter) (letter)

2023 July - Eastern Washington FPA/N 7 of 9

REVJSJON

FPA# ~oz z ; c. £/ JATE 7//v / e 1/'

I /

27. How are the following currently marked on the ground? (Flagging color, paint color, road, fence, etc.)

H tis I B d . Pink "Timber Harvest Boundary" Ribbon; Unit 2 is flagged in purple ribbon . arves a vage oun anes: _____________________________ _

Clumped Wildlife Reserve Trees I Green Recruitment Trees: _N __ IA _________________ _

Right-of-Way Limits I Road Centerlines: Unmarked light pink ribbon . Flagging follows single-track recreation trail

Stream Crossing Work: _N_I_A ______________________________ _

Orange "Riparian Management Zone" Ribbon Riparian Management Zone Boundaries and Leave/Take Trees: _________________ _

Channel Migration zone: Orange "Riparian Management Zone" Ribbon

Wetland Management Zone Boundaries and Leave/Take Trees: Orange "Riparian Management Zone"

28. Additional information (attach additional pages if necessary):

• See FPA/N instructions for required plan information for hydraulic projects in or over Type S, F, or complex N

Water.

• If applicable, include mitigation measures from a geotechnical memo, letter, or report.

WA State Parks is completing a forest health thinning on approximately 341 .6 acres in portions of Riverside State Park. The primary objective of this thinning is to reduce wildfire fuels while improving forest health and stand vigor. The harvest will be completed using the Individuals, Clumps, and Openings ("ICO") marking strategy and is designed to increase spatial heterogeneity within the stand after harvesting is complete.

Stream A - Spokane River, 200' buffer established.

Stream B - Deep Creek, 100'+ buffer established protecting potentially unstable slopes, see attached Appendix D.

Stream C - Does not exist - walking and biking trail.

Wetland A - Floodplain of Spokane River, 200' buffer established.

Wetland C - Type A along bank of Spokane River, more than 200' from unit.

Wetland D - Type A along bank of Spokane River, more than 200' from unit.

Wetland E - Type A along bank of Spokane River, more than 200' from unit.

Wetland G - Type A along bank of Spokane River, more than 200' from unit.

There will be some reconstruction of the road that encompasses the western-most edge of unit 4.

07. The harvest boundary also extends into Parcels 26083.9029 and 26083.9039 of T26 R42E S8, as well as Parcel 26074.0101 ofT26 R42E S18.

016. All of Road A new construction will be abandoned following the conclusion of the thinning, approximately 3,150'. From the existing county road approach on 7-mile Rd. approximately 100' of rough two-track road already exist for utility ROW access. Currently, there is a gate blocking public vehicle access from the 100' of existing two-track.

For abandonment of Road A new construction, slash will be left in road footprint to prevent erosion, and water bars will be constructed on slopes, as necessary. There are no water crossings associated with Road A. The gate currently barricading public access will be maintained or re installed at the conclusion of the thinning.

In unit 4, a 170' section of existing gravel road , which will be used for hauling, lies within the RMZ (200') of the Spokane River.

2023 July - Eastern Washington FPA/N 8 of 9

FPA#_1.....;;.0 ,.!:l.;..7£.LI .S.l .::J'iL..._

DATE __ ..L..2 _- ...J.~..::.- ~<- J..Y _

27. How are the following currently marked on the ground? (Flagging color, paint color, road, fence, etc.)

HarvesUSalvage Boundaries: Pink "Timber Harvest Boundary" Ribbon; Unit 2 is flagged in purple ribbon .

Clumped Wildlife Reserve Trees I Green Recruitment Trees: N/A ------------------- Right -of -Way Limits I Road Centerlines: Unmarked light pink ribbon . Flagging follows single-track recreation trail

Stream Crossing Work: N/A -------------------------------- Rip aria n Management Zone Boundaries and Leave/Take Trees: Orange "Riparian Management Zone" Ribbon

Channel Migration zone: Orange "Riparian Management Zone" Ribbon

Wetland Management Zone Boundaries and Leave/Take Trees: Orange "Riparian Management Zone"

28. Additional information (attach additional pages if necessary):

• See FPA/N instructions for required plan information for hydraulic projects in or over Type S, F, or complex N

Water.

• If applicable, include mitigation measures from a geotechnical memo, letter, or report.

WA State Parks is completing a forest health thinning on approximately 341 .6 acres in portions of Riverside State Park. The primary objective of this thinning is to reduce wildfire fuels while improving forest health and stand vigor. The harvest will be completed using the Individuals, Clumps, and Openings ("ICO") marking strategy and is designed to increase spatial heterogeneity within the stand after harvesting is complete.

Stream A - Spokane River, 200' buffer established.

Stream B - Deep Creek, 100'+ buffer established protecting potentially unstable slopes, see attached Appendix D.

Stream C - Does not exist - walking and biking trail.

Wetland A - Floodplain of Spokane River, 200' buffer established.

Wetland C - Type A along bank of Spokane River, more than 200' from unit.

Wetland D - Type A along bank of Spokane River, more than 200' from unit.

Wetland E - Type A along bank of Spokane River, more than 200' from unit.

Wetland G - Type A along bank of Spokane River, more than 200' from unit.

There will be some reconstruction of the road that encompasses the western-most edge of unit 4.

07. The harvest boundary also extends into Parcels 26083.9029 and 26083.9039 of T26 R42E S8, as well as Parcel 26074.0101 ofT26 R42E S18.

016. All of Road A new construction will be abandoned following the conclusion of the thinning , approximately 3,150'. From the existing county road approach on 7-mile Rd . approximately 100' of rough two-track road already exist for utility ROW access. Currently, there is a gate blocking public vehicle access from the 100' of existing two-track.

For abandonment of Road A new construction, slash will be left in road footprint to prevent erosion, and water bars will be constructed on slopes, as necessary. There are no water crossings associated with Road A. The gate currently barricading public access will be maintained or re installed at the conclusion of the thinning .

302712 4

27. How are the following currently marked on the ground? (Flagging color, paint color, road, fence, etc.)

Harvest/Salvage Boundaries: Pink "Timber Harvest Boundary" Ribbon; Unit 2 is flagged in purple ribbon.

N/A Clumped Wildlife Reserve Trees I Green Recruitment Trees: -------------------- Right -of -Way Limits I Road Centerlines: N/A ---------------------------- Stream Crossing Work: N/A ---------------------------------- Rip aria n Management Zone Boundaries and Leave/Take Trees: Orange "Riparian Management Zone" Ribbon

Channel Migration zone: Orange "Riparian Management Zone" Ribbon

Wetland Management Zone Boundaries and Leave/Take Trees : Orange "Riparian Management Zone"

28. Additional information (attach additional pages if necessary):

• See FPA/N instructions for required plan information for hydraulic projects in or over Type S, F, or complex N

Water.

• If applicable, include mitigation measures from a geotechnical memo, letter, or report.

WA State Parks is completing a forest health thinning on approximately 341 .6 acres in portions of Riverside State Park. The primary objective of this thinning is to reduce wildfire fuels while improving forest health and stand vigor. The harvest will be completed using the Individuals, Clumps, and Openings ("ICO") marking strategy and is designed to increase spatial heterogeneity within the stand after harvesting is complete.

Stream A - Spokane River, 200' buffer established.

Stream B - Deep Creek, 100'+ buffer established protecting potentially unstable slopes, see attached Appendix D.

Stream C - Does not exist - walking and biking trail.

Wetland A - Floodplain of Spokane River, 200' buffer established.

Wetland B - Forested wetland, within 200' buffer of Spokane River.

Wetland C - Forested Wetland along banks of river. Middle wetland beneath power lines should be considered a forested wetland because if not for the spray application, trees would be present in same capacity as two neighboring forested wetlands .

Wetland D - Type A along bank of Spokane river, more than 200' from unit.

Wetland E - Forested Wetland along banks of river, more than 200' from unit.

Wetland G - Forested Wetland along banks of river, more than 200' from unit.

There will be some reconstruction of the road that encompasses the western-most edge of unit 4.

07. The harvest boundary also extends into Parcels 26083.9029 and 26083.9039 of T26 R42E S8, as well as Parcel 26074.0101 ofT26 R42E S18.

016. All of Road A new construction will be abandoned following the conclusion of the thinning, approximately 3,150' . From the existing county road approach on 7-mile Rd . approximately 100' of rough two-track road already exist for utility ROW access. Currently, there is a gate blocking public vehicle access from the 100' of existing two-track.

For abandonment of Road A new construction , slash will be left in road footprint to prevent erosion , and water bars will be constructed on slopes, as necessary. There are no water crossings associated with Road A. The gate currently barricading public access will be maintained or re installed at the conclusion of the thinning .

t,;

29. We acknowledge the following: 3027124

• The information on this application/notification is true.

• We understand this proposed forest practice is subject to:

o The Forest Practices Act and Rules, AND o All other federal , state or local regulations.

• Compliance with the Forest Practices Act and Rules does not ensure compliance with the Endangered Species Act or other federal , state or local laws.

• If we said that we would not convert the land to non-forestry use, the county or city may deny development permits on this parcel for the next six (6) years.

• The following may result in an unauthorized incidental take of certain endangered or threatened fish species:

o Conversion of land to non-forestry use.

o Harvesting within the maximum RMZ on a 20-acre exempt parcel that was acquired after June 5, 2006.

o Equipment crossings or fords that are in or over Type S and F Waters .

• Inadvertent Discovery - Chapter 27.44, 27.53, 68.50 and 68.60 RCW o If you find or suspect you have found an archeological object or Native American cairn , grave, or glyptic record , immediately cease disturbance activity, protect the area and promptly contact the Department of Archaeology and Historic Preservation at 360-586-3077.

o If you find or suspect you have found human skeletal remains, immediately cease disturbance activity, protect the area, and contact the County Coroner or Medical Examiner and local law enforcement as soon as possible. Failure to report human remains is a misdemeanor.

The landowner understands that by signing and submitting this FPA/N they are authorizing the Department of Natural Resources to enter the property in order to review the proposal, inspect harvest operations, and monitor compliance for up to three years after its expiration date. RCW 76.09.150 d';J Landowner

Print Name:

~ Sf_ Awie(VI J Date:

G/ti I i.02.1-Jt

Signature of Legal of Timber Owner* (if different than landowner)

Print Name:

Date:

Signature of Legal Operator (if different than landowner)

Print Name:

Date:

*N OTE: if you are a "Perpetual Timber Rights Owner," and are submitting this without the landowner's signature, provide written evidence the landowner has been notified.

• Please make a copy of this FPA/N for your records .

• If this FPA/N contains a hydraulic project requiring WDFW concurrence review, it will not be available online for public review until after the WDFW concurrence review period .

2023 July - Eastern Washington FPA/N 9 of 9

Small Forest Landowner Checklist Road Maintenance and Abandonment Plan

3027124

Use the following questions to determine if a SFL Checklist RMAP is required.

A) Does your FPA/N include timber harvest or salvage?

~ Yes. Continue to B. D No. Stop, a checklist is not required .

B) Are you hauling timber on existing forest roads on your property? Not including: residential driveways; skid trails; haul roads on neighboring property;

~ Yes. Continue to C. D No. Stop, a checklist is not required .

C) Do you own more than 80 acres of forest land in Washington?

~ Yes. A checklist is required . D No. Continue to D.

D) Is this FPA/N on a block of forest land that contains more than 20 contiguous acres?

~ Yes. A checklist is required D No. Stop, a checklist is not required .

1. This checklist applies to: Select one.

~ The existing forest roads on my forestland that I will use for this FPA/N . (minimum required)

D I assessed all existing forest roads on my forestland . Assessing all your forest roads is optional. If you choose this, you will not be required to submit additional checklists with future FPNNs.

If you check this box, include a Forest Practices Activity Map that shows all your forest roads .

2. What is the approximate total number of miles of existing forest road assessed: _4_.5 ________ _

3. Forest Road Assessment. Complete this question after you have assessed your existing forest roads.

Select all sediment and road issues that are known to be associated with your existing forest roads.

D I would like DNR to contact me for help with this section. (If you check this box, you may leave the rest of the boxes in this question blank. DNR will contact you.)

D Water from the road or ditch runs directly into typed water.

D Water flows under, over, or around the culvert.

D The culvert keeps filling with dirt.

D The road has large cracks or ruts.

D The road has sinkholes. (not a pothole, but a hole that you can 't drive over)

D Dirt from the uphill side of the road keeps falling into the ditch-line before regularly scheduled maintenance.

D Dirt from the cut-slope keeps falling downhill into or near a stream, pond, or wetland .

D There are indications of past surface erosion.

D The road crosses typed water (a culvert, bridge, or ford exist)

~ I have assessed my existing forest roads and they do not have any of the above issues.

2023 July - Small Forest Landowner Checklist RMAP Page 1 of 2

3021.12 4

4. Family Forest Fish Passage Program

The Family Forest Fish Passage Program (FFFPP) is a program to fix fish passage barriers , such as culverts. Not all culverts are fish passage barriers. For an evaluation of your potential fish passage barrier please contact DNRs Small Forest Landowners Office at 360-902-1404 or visit www.dnr.wa.gov\fffpp for more information.

Check the box that applies:

~ Not applicable.

D I choose to enroll in the FFFPP and would like to have my potential barrier evaluated for eligibility. I understand by checking this box, I may be required to provide cost-share associated with the barrier removal or replacement.

D I choose not to enroll in the FFFPP and accept responsibility for removing or repa iring any artificial fish barriers on my forest roads at my own expense.

D This barrier is already enrolled in the FFFPP.

5. Orphaned Roads

State law requires DNR to keep an inventory of orphaned roads that pose a risk to public safety or to the public resources. Your help with this inventory is requested .

Orphaned roads are roads on your forestland that have not been used for forest activities since 197 4. Forest Practices activities include timber cutting , timber hauling , tree planting , brush control , pre-commercial thinning , timber salvage, etc.

Check the box that applies:

~ I do not have orphaned roads that I think pose a risk to public resources or public safety; e.g. houses, highways, county roads, streams, ponds, or wetlands.

D I have orphaned roads that I think may pose a risk to public resources or public safety; e.g. houses, highways, county roads, streams, ponds, or wetlands. Please show locations of all orphaned roads on a separate Forest Practices Activity Map. (This is not the same map that shows your harvest.)

D I need help identifying orphaned roads.

6. Road Maintenance Obligations

All forest landowners have a legal obligation to maintain all their forest roads on their forestland to the extent necessary to prevent damage to public resources . This includes forest roads not shown on this assessment. See WAC 222-24-052 . Best Management Practices (BMPs) for road maintenance are located in Section 3 of the Forest Practices Board Manual. Both are available on the DNR website at: www.dnr.wa.gov.

Road maintenance includes:

• Inspecting forest roads and fixing damage before, during and after hauling timber and/or rock.

• Keeping drainage structures (relief culverts, ditches, water bars, dips, etc.) and water crossings functional.

• Making sure water from roads and ditches do not flow directly into streams, ponds, or wetlands.

~ My existing roads are maintained to Forest Practices standards.

2023 July - Small Forest Landowner Checklist RMAP Page 2 of 2

Appendix A. Water Type Classification Worksheet

Eastern Washington

Stream/Segment ID Stream/Segment ID Stream/Segment ID

Stream A Stream B Stream C

Date(s) Observed Date(s) Observed Date(s) Observed

1/30/2024 1/30/2024 1/30/2024

1. Did you determine fish use as described in the Forest Practices Board Manual Section 13? Or, does the stream have waiver characteristics? See WAC 222-16-031(3)(b)(ii).

□ No. Continue to 2. 181 No. Continue to 2. 181 No. Continue to 2.

□ Yes . Meets waiver criteria . Skip to 6. □ Yes. Meets waiver criteria. Skip to 6. □ Yes . Meets waiver criteria . Skip to 6.

□ Yes . Attach documentation or □ Yes. Attach documentation or □ Yes . Attach documentation or provide approved WTMF number: provide approved WTMF number: provide approved WTMF number:

~ Fish found . Stop: Type F water. □ Fish found . Stop: Type F water. □ Fish found . Stop: Type F water.

□ No fish . Skip to 6. □ No fish . Skip to 6. □ No fish. Skip to 6.

2. Were fish observed, or are fish known to use the stream any time of the year?

□ No. Continue to 3. □ No. Continue to 3. 181 No. Continue to 3.

□ Yes . Stop : Type F water. 181 Yes. Stop: Type F water. □ Yes. Stop: Type F water.

3. Is there an impoundment (ponded water) upstream of the assessed segment that is greater than 0.5 acres?

□ No. Continue to 4. □ No. Continue to 4. 181 No. Continue to 4.

□ Yes . Stop : Type F water. □ Yes. Stop: Type F water. □ Yes. Stop: Type F water.

4. Are there segments within or upstream of the assessed portion of the stream where the average bankfull width is three feet or greater? AND, is the average stream gradient less than or equal to 16%?

□ No. Continue to 5. □ No. Continue to 5. l&l No. Continue to 5.

□ Yes. Stop: Type F water. □ Yes. Stop: Type F water. □ Yes. Stop: Type F water.

5. Are there segments within or upstream of the assessed portion of the stream where the average bankfull width is three feet or greater? AND, is the average stream gradient between 16 and 20%? AND, is the contributing basin to the stream greater than 175 acres?

□ No. Continue to 6. □ No. Continue to 6. l&l No. Continue to 6.

□ Yes . Stop: Type F water. □ Yes . Stop: Type F water. □ Yes. Stop: Type F water.

6. Does the stream segment contain water at all times during a normal rainfall year?

□ No. Continue to 7. □ No. Continue to 7. 181 No. Continue to 7.

□ Yes. Type Np water. Skip to 9 □ Yes. Type Np water. Skip to 9 □ Yes. Type Np water. Skip to 9

7. Is the stream segment downstream of a perennial source of water?

□ No. Continue to 8. □ No. Continue to 8. 181 No. Continue to 8.

□ Yes . Type Np water. Skip to 9 □ Yes. Type Np water. Skip to 9 □ Yes . Type Np water. Skip to 9

8. Is the stream physically connected by an above-ground channel to Type S, F or Np water?

□ No. Non-typed water. □ No. Non-typed water. 181 No. Non-typed water.

□ Yes . Type Ns water. □ Yes . Type Ns water. □ Yes . Type Ns water.

9. Describe how you determined the uppermost point of perennial flow. Include a description of its location and show the point on a map. Use a separate piece of paper if necessary.

Spokane River Deep Creek Does not exist - walking/biking trail.

2023 July - Appendix A. Water Type Classification Worksheet, Eastern Washington Page 1 of 1

FPA# ·so,-~ ti y

DATE 7 - / o - Z '.( Appendix D. Slope Stability Informational Form

Complete and submit this form with your FPA/N if you indicated you are working io. or around potentially unstable slopes or landforms.

• Instructions for Appendix D. Slope Stability Informational Form is located in the Forest Practices Application/Notification Instructions document.

• Refer to WAC 222-16-050(1 )(d) and Forest Practices Board Manual Section 16 - Guidelines for Evaluating Potentially Unstable Slopes for definitions and descriptions of potentially unstable slopes or landforms.

1.a. What preliminary screening tools were used to identify unstable slopes or landform features in and/or around your proposal?

□ Aerial Photo IZI LiDAR □ Landslide Inventory □ GIS IZI Field Review

□ Forest Practices Application Mapping Tool (FPAMT) Resource Map □ Other. Describe:

b. Did any of the features identified during the preliminary screening not exist when you performed a field review?

181 No. □ Yes . Describe :

2.a. Are you conducting forest practices activities in or over potentially unstable slopes or landforms?

IZl No. Skip to Question 3.a □ Inner Gorge □ Bedrock Hollow □ Convergent Headwall

□ Groundwater recharge area of glacial deep-seated landslides □ Outer edges of meander bends

□ Toe of deep-seated landslide with slopes ~ 65% □ Category E. Describe in "Other" below.

□ Other. Describe:

b. What activities may occur in or over potentially unstable slopes or landforms? Check all that apply:

□ Timber Harvest □ Road Construction □ Road Maintenance □ Suspending Cables

□ Yarding □ Tailholds □ Other. Describe:

None.

3.a. Are you conducting forest practices activities around potentially unstable slopes or landforms?

□ No. Skip to Question 4.a IZI Inner Gorge □ Bedrock Hollow □ Convergent Headwall

□ Groundwater recharge area of glacial deep-seated…