NNF_field_sheet.pdf

NEBRASKA NOXIOUS WEED FORM

1 | P a g e V e r s i o n 2 0 . 0 3 2 5

(Page 1 – Complete for both inventory and treatment)

INFESTATION_ID __ __ __ __ __ __ __ __ __ same calculation as in the user guide

District # Year District Letter Sequential #

(01, 02, 05, 06, 09) (B,S,P,O,FR,W,FP)

LOCATION: District: BRD BN SRM PRRD ONG FRRD WRD FPNG

Agency: PVT STATE USFS

INVENTORY DATE (Ex. 04/21/2005) ___________________

PROJECT NAME _______________________________________________

SITE DESCRIPTION (Check One)

Administration FS-Nursery Meadow Riparian Trailhead Campground Gravel Pit Pasture Roadside Upland

Exclosure Irrigation Ditch Rangeland Stream / River Wetland Forest Lake / Ponds Right of Way Trail Wildlife Exclosure

SURVEYOR or APPLICATOR 1 (License #) _______________________________ ( )

SURVEYOR or APPLICATOR 2 (License #) _______________________________ ( )

Select One: POINT____POLYGON_____LINE _____ RADIUS/WIDTH in Feet for Point or Line__________

(For lines, enter the width inventoried/treated on ONLY ONE SIDE of a line or road, even though both sides are inventoried/treated. Points and Lines will be converted to polygons for the final database, and the RADIUS/WIDTH field will be used to buffer the points and lines. For points, small value to enter is 38 feet).

Cover Class Code (Circle One): Trace < 1% Low 1 – 5% Moderate 5 – 25% High 25 – 100%

PLANT CODE: __________ (Enter the Species code for the primary target invasive species)

ASSOCIATED SPECIES 1 ____________

ASSOCIATED SPECIES 2 ____________

TREND (Circle One): Decreasing Stable Increasing

SOURCE SCALE (Ex. 24000): _____________ only needed if using paper map and drawing site

MAPSOURCE (Circle One): Aerial Photos Topo map Travel Maps GPS Other_______

INFESTATION CAUSES: 1 for primary, 2 for secondary – only include 2 causes.

Corral Fire Reservoir Slash Pile Timber Sale Wildlife Developed Rec Site Livestock Riparian Area Stock/Trail Unknown Wind Dispersed Rec Site Range Improvement Road/Trail Timber Plantation Utility Corridor Other

COMMENTS (Additional information specific to the INVENTORY or TREATMENT)

NEBRASKA NOXIOUS WEED FORM

2 | P a g e V e r s i o n 2 0 . 0 3 2 5

(Page 2 – Complete this page in addition to page 1 for treatments only)

TREATMENT TYPE [Circle One] HERBICIDE INSECTS FIRE MECHANICAL

TREATMENT DATE __________ (Ex. 04/21/2005) TREATMENT START TIME __________ (Ex. 1145)

TREATMENT CATEGORY (Check One) Contractor County Sioux Landowner Weed Crew

County Custer Direct Permittee MDVM

County Dawes Fire Crew Recreation Crew Other list below

County Fall River Grazing Association Super Sprayers

Complete the information below for herbicide, insects, fire or chemical treatment depending on which box was checked above.

CHEMICAL TREATMENT

Product Label Product Label Product Rate

(Label Rate) Per Acre

CHECK ONE

Herbicide 1 (prod1appl) EPA Number EPA Batch No. Pints Ounces Pounds

Herbicide 2 (prod2appl)

Herbicide 3 (prod3appl)

Temperature __________ Wind Direction __________ Wind speed __________

Application Rate (calibrated volume per acre) _________________

Total Application Amount Applied for the Feature _______ (Use .1 minimum)

Units for Application Rate & Amount (Circle One) Gallons Pounds

BIOLOGICAL TREATMENT

Insect Release 1 Total Released Insect Release 2 Total Released

EQUIPMENT CODES FOR EACH ACTIVITY (Check One)

2530 - Mechanical / Physical 2540 - Fire 2510 - Pesticide

Hand Work Helitorch Hand sprayer

Axe Drip torch Backpack sprayer

Hand saw Propane torch Mobile ground sprayer

Chain Saw Other – LIST BELOW Other – LIST BELOW

Pruners

Shears

Shovel

Mower

Mulcher

TREATMENT STOP TIME __________ (Ex. 1315)