SHARE No. 000 … 11406

EMNRD Contract No. 10-521-2301-0191

San Juan Soil and Water Conservation District

1427 W. Aztec Blvd., Suite 1

Aztec, New Mexico 87410

LANDOWNER REQUEST FOR ASSISTANCE

Project Title: Northwest Riparian Hazardous Fuels Reduction

10-01-885

Name: ______

Address: ______Zip: ______

Phone: ______e-mail: ______

Legal Description:T______R______SEC______

Geographic Location: (subdivision)______

______

______

Property Owner: YES___ NO___ Proof Of Insurance: YES____ NO_____

Total Acres: ______

Interested in Thinning ___ Defensible Space____

FOREST TYPE:RUSSIAN-OLIVE______

SALT CEDAR ______

Mixed ______

Prior Activity (Please describe any forestry, erosion control, or wildlife enhancements performed in the last five years) ______

______

______

______

I understand that the defensible space and fuel reduction work will need to be maintained and agree to complete the maintenance work as long as I own this land.

Signature: ______Date: ______

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OFFICE USE: Approved ______For______

Rejected ______Reason______

Priority______Contractor______

LANDOWNER PRACTICE PLAN

PROJECT TITLE: Northwest Riparian Hazardous Fuels Reduction

10-01-885

NAME: Refer to attached Sheet

ADDRESS: ______ZIP: ______

PHONE: ______e-mail: ______

LEGAL DESCRIPTION: T______R______SEC______COUNTY:______

GEOGRAPHIC LOCATION: (subdivision)______

TOTAL ACRES: ______INSURANCE CO./POLICY #:______

LANDOWNER SHORT TERM OBJECTIVES: (CHECK ALL THAT APPLY)

__X_To create defensible space and reduce the wildfire hazard in a highly vulnerableWildland/Urban Interface or Hazardous Fuels Reduction area.

__X__To thin ___ acres of forested land to improve overall forest health and control disease and insect pests.

__X__To increase the vigor and growth rate of residual trees while removing excess, poor quality, dead, and dying trees.

__X__To improve the diversity of grasses, forbs, and wildflowers for wildlife forage production in the treated area.

____Other:______

______

______

LANDOWNER LONG TERM OBJECTIVES: (CHECK ALL THAT APPLY)

__X__To reduce the long-term wildfire hazard on the property in the wildland/urban interface or

hazardous fuels reduction area.

__X__To improve and maintain the overall health and vigor of the forest by periodic thinning of

overstocked stands.

__X__ To improve the productivity and health of the watershed.

__X__ To protect and improve wildlife habitat, and enhance the aesthetic value of the forest.

__X__To serve as an example to other residents of how active forest management

TREATMENT PLAN: (Narrative)

DEFENSIBLE SPACE:

Keep areas free of combustible materials such as litter, wood and needles around structures and equipment.

THINNING:

Maintain this mastication of Russian olive and salt cedar by treating re-sprouts and seedlings in years to come. Re-seed the area where applicable for erosion control.

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LANDOWNER RESPONSIBILITIES: (Define or describe landowner responsibilities. Examples for defensible space might include moving woodpile, raking needles and litter around structures, cleaning brush/debris around LP tank, installing spark arrestors on chimneys (required), etc. Examples for WUI or Hazardous Reduction thinning might include maintaining fences, maintaining access (roads), re-seeding where applicable, controlling erosion, maintaining defensible space and fuel loading with periodic cutting, clearing, etc.)

SITE DESCRIPTION….For Office Use Only

TREATED ACREAGE:FOREST TYPE:AVERAGE SLOPE CLASS:

Def. Space: ______RUSSIAN OLIVE ___ LESS THAN 10%

Thinning: ______SALT CEDAR ___10-20%

___Mixed ___ 20-30%

Aspect: ______Other ___ Greater Than 30%

BASAL AREA:Estimated # of Trees per acre

Before Treatment: _____Sq. Ft./Acre Removed: ______

After Treatment: ______Sq. Ft./Acre

Method of Slash Disposal: ______

Treatments Completed:

DATE: ______

CONTRACTOR: ______

CERTIFIED BY: ______

Rev. 02-16-101