U.S. Department of Agriculture NV-EVC-01

Natural Resources Conservation Service page 2 of 2

CULTURAL RESOURCES WORKSHEET

to be completed by a planner trained and certified in cultural resources for intrusive undertakings
(category A or B)
NRCS OFFICE: / County: / Phone:
Planner: / USGS Quad Name:
Section: / Township: / Range:
GPS Coordinates (UTM NAD83): / N / E
Geographic Unit (Valley name, etc.): / Landowner/User:
Proposed Undertakingsdescribe:
APE Acreage: / Previous Disturbance(s) describe:
Landowner signed release form?  YES no / Attached / In Case File (referenced location)
Attach copy of 7.5' USGS Topographic Map, clearly showing the practice locations and Area of Potential Effect (APE).
Include plan maps or photos if available.
records search and reviews(Enter comments as necessary)
1. Check for listing of historic structures on National Register List (eFOTG Section II) 
2. Call, FAX or mail NV-EVC-01 to NV State Museum or Harry Reid Center-UNLV for Records Search  / Date:
Records Found In Search / No / Yes / Date: / (Date of confirmation of records search and results)
3. Consult Landowner or Land Managing Agency 
4. Other CR references/sources used(List) :
Once Records Search and Review are completed: Walk APE using transect method at no more than 30-ft intervals to locate cultural resources. Cultural resources include both features and historic artifacts, buildings, structures, or ditches over 50 years old as well as flakes, arrowheads, and bone. Complete the following:
Describe transect method and spacing:
No cultural resources found  Cultural resources found 
If cultural resourcesare present, fill out Preliminary SiteForm below.
DO NOT PROCEED with projectUNTIL NOTIFIED BY CULTURAL RESOURCES COORDINATOR
PRELIMINARY SITE FORM (complete IF CULTURAL RESOURCES ARE PRESENT)
Site Type: / Prehistoric  Historic  SiteAge
Artifacts Present: / Rock chips/fragments; Pottery; Glass, bottles ; Charcoal; Bone; Other (list):
Concentration: / Sparse  Moderate  Dense 
Plant Community:
Soil Type/Texture:
Recommend and describe how the site can be avoided or will or will not be impacted:

If cultural resources are found during practice implementation, construction will halt, and the NRCS Cultural Resources Coordinator will be notified.

NRCS Signature: / Date:
List tribes consulted: / Tribal CR Protocol: NO YES

Mail NV-EVC-01 and Maps to NRCS Cultural Resources Coordinator:

Jaime Schoneberg

Cultural Resource Coordinator

555 W. Silver St. Suite 101

Elko, NV 89801 / NRCS CRC Review Initials: / Date:

U.S. Department of Agriculture NV-EVC-01

Natural Resources Conservation Service page 2 of 2

Guidance for Completing Cultural Resources Worksheet (NV-EVC-01)

i. Determine if the proposed activity is an undertaking. Refer to the Nevada Cultural Resources Help Sheet for a list of undertakings.

a. If the activity is not considered an undertaking, document this on the NV-CPA-52 and continue with the planning process.

b. If the activity is considered and undertaking, the NV-EVC-01 must be completed. Proceed toStep II below.

ii. Complete the first section of NV-EVC-01by entering: NRCS Office, County, Office Phone No., Planner Name, USGS Quad Name, Section, Township, Range, GPS Coordinates (if available), Geographic Unit (mountain range, valley name), and Landowner/User.

iii. Complete the second sectionof NV-EVC-01

a. Proposed undertakings – Describe as thoroughly as possible, make sure to list the practices not just the code.

iv. APE Acreage – Think of this as a foot print of the project, include all ground disturbing aspects of the project implementation. (You must include all areas to be altered, such as access and haul roads, borrow areas, areas where spoil will be placed, as well as the area of the actual conservation practice).

a. Previous Disturbances – List and describe all disturbances, you could even place them on a map.

b. Landowner Release Form – Inform the landowner of NRCS' responsibility as a Federal Agency to consult with the Nevada SHPO and Native American Tribes concerning the proposed undertaking. Landowner is to sign and date NV-EVC-02 ("Authorization for NRCS Release of Conservation Plan Information"), agreeing to have NRCS consult with the SHPO and Tribes. If the landowner agreesand signs the release form, enter YES and attach to the NV-EVC-01 or reference to the location of the NV-EVC-02 in the case file. If the landowner does not agree to have NRCS consult with the SHPO and Tribes, NRCS must withdraw assistance until the landowner can show that consultation has been satisfactorily completed with the SHPO and Tribes.

c. Attach required map(s) of the APE.

V. Records Searches

a. Check the National Register of Historic Places – National Register of Historic Places located in Section II of the eFOTG. Indicateby checking the box that the National Register of Historic Places has been consulted. If there are National Register listed sites within or in close proximity to the APE, note this on the NV-EVC-01 and proceed with the records search.

b. Check with either the StateMuseum or the HarryReidCenter for the records search - If either institution determines that there are recorded sites within or in close proximity to the APE, document findings on the NV-EVC-01 and enter date that confirmation of records search was received.

c. Consult with the landowner or land managing agency – Document results on NV-EVC-01.

d. List any other Cultural Resources references used.

VI. Once the Records Searches are complete, continue with the Field Survey only if you have successfully completed NRCS-NEDCCR training modules 1-8.

Initiate field inventory of APE and describe transect method used. Transect methods should be described in a way that someone else can repeat the procedure.

a. If NO cultural resources are found during the survey, check the corresponding box and proceed to Step VIII.

b. If cultural resources are found during the survey, check the corresponding box and proceed to Step VII.

VII. Complete the preliminary site form

a. Site Type – enter appropriate site type:Prehistoric and/or Historic, and approximate Site Age – estimate to the best of your abilities

b. Artifacts Present: Indicatetype of artifacts that are present and describe - take pictures, draw diagrams, and note sizes. Any additional information is beneficial.

c. Concentration: Mark sparse, moderate, or dense. Support your choice by documenting how many artifacts were present per square foot, meter, or yard.

d. Complete the Plant Community: For rangeland or forest, enter ecological site name and number with major plant life formspresent on site (i.e.,sagebrush-perennial bunchgrass, cheatgrass-annual forbs, black greasewood-basin wildrye, pinyon-juniper, etc).

e. Complete the Soil Type/Texture:

VIII. Planner must sign and date the NV-EVC-01.

IX. List the Tribe(s) that have been consulted regarding proposed project.

X. Send completed NV-EVC-01( mail or email),with maps and all other supporting documentation, to the Nevada Cultural Resources Coordinator(CRC). The Nevada CRC will send the documentation to SHPO.

DO NOT proceed with project implementation until notified by the CRC of the outcome of consultation with the Nevada SHPO