intra-s7_form_revised_fillable.pdf

Intra-Service Section 7 Biological Evaluation Form Region 3

Originating Person: Date Submitted:

Telephone Number:

For assistance with section 7 reviews, go to Region 3’s Section 7 Technical Assistance website:

http://www.fws.gov/midwest/endangered/section7/s7process/

I. Service Program and Geographic Area or Station Name:

II. Location: Location of the project including County, State and TSR (township, section & range):

III. Species/Critical Habitat: List federally-listed, proposed, and candidate species or designated or proposed critical habitat that may occur within the action area:

IV. Project Description: Describe the proposed project or action, including all conservation elements. If referencing other documents, prepare an executive summary. Include map and photos of site, if possible. (Attach additional pages as needed):

V. Determination of Effects:

A. Description of Effects: Describe how the action(s) will affect the species and critical habitats listed in item III, including how Part IV conservation elements benefit or avoid adverse effects. Your rationale for the Section 7 determinations made below (VB.) should be fully described here.

http://www.fws.gov/midwest/endangered/section7/s7process/

B. Determination: Determine the anticipated effects of the proposed project on species and critical habitats listed in item III. Check all applicable boxes and list the species (or attach a list) associated with each determination. For assistance with making appropriate Section 7 determinations, go to Region 3’s Section 7 Technical Assistance website: http://www.fws.gov/midwest/endangered/section7/s7process/

Determination

No Effect: This determination is appropriate when the proposed project will not directly or indirectly affect (neither negatively nor beneficially) individuals of listed/proposed/candidate species or designated/proposed critical habitat of such species. No concurrence from ESFO required.

May Affect but Not Likely to Adversely Affect: This determination is appropriate when the proposed project is likely to cause insignificant, discountable, or wholly beneficial effects to individuals and designated critical habitat. Concurrence from ESFO required.

May Affect and Likely to Adversely Affect: This determination is appropriate when the proposed project is likely to adversely impact individuals of listed species or designated critical habitat of such species. Concurrence from ESFO required.

Not Likely to Jeopardize candidate or proposed species/critical habitat:

This determination is appropriate when the proposed project is not expected to jeopardize the continued existence of a species proposed for listing or a candidate species, or adversely modify an area proposed for designation as critical habitat. Concurrence from ESFO required.

Likely to Jeopardize candidate or proposed species/critical habitat:

This determination is appropriate when the proposed project is reasonably expected to jeopardize the continued existence of a species proposed for listing or a candidate species, or adversely modify an area proposed for designation as critical habitat. Concurrence from ESFO required.

Signature Date [Supervisor at originating station]

Reviewing Ecological Services Office Evaluation (check all that apply):

A. Concurrence _____ Nonconcurrence _____ Explanation for nonconcurrence:

B. Formal consultation required _____ List species or critical habitat unit

C. Conference required _____ List species or critical habitat unit

Name of Reviewing ES Office

Signature Date

O:\TE\S7\FORMS\R3intra-s7_form.wpd\30 August 2019 JSzymanski\19 June 2002

IV. Project Description: Describe the proposed project or action, including all conservation elements. If referencing other documents, prepare an executive summary. Include map and photos of site, if possible. (Attach additional pages as needed):