Location: / Click here to enter text. / County: / Click here to enter text. /
Farm Name: / Click here to enter text. / Tract Number: / Click here to enter text. /
Index
☐ / Cover Sheet☐ / Specifications
☐ / Drawings
☐ / Operation & Maintenance
Utility Safety/
One-Call System
Information
Click here to enter text. /
Description of work:
Click here to enter text. /NRCSReviewOnly
Designed By: / Click here to enter text. / Date / Click here to enter a date. /Checked By: / Click here to enter text. / Date / Click here to enter a date. /
Approved By: / Click here to enter text. / Date / Click here to enter a date. /
Page 1 of 4
The Practice Purpose(s): (check all that apply)☐ / Stabilize areas with existing or expected high rates of soil erosion by wind or water.
☐ / Stabilize stream and channel banks, pond and other shorelines, earthen features of structural conservation practices.
☐ / Stabilize areas such as sand dunes and riparian areas
Site Conditions
Slope range / pH range / Soil type/soil texture / Soil drainage class / Current vegetation or site conditionslope range / pH range / soil type & texture / drainage class / vegetation/site condition /
Permanent Seed and/or Plant Requirements
Site preparation earthmoving (if applicable), etc.:Click here to enter text.
Seedbed preparation:
Click here to enter text.
Top soiling requirements (if applicable):
Click here to enter text. /
Seeding time:
Click here to enter text. /
Permanent Seed/Plant Species Mixture / Acres / Lbs/ac PLS,Or
plants spacing in feet / Total lbs needed
or total plants needed
1. seed/plant mixture / acres / lbs/ac / lbs or plants needed /
2. seed/plant mixture / acres / lbs/ac / lbs or plants needed /
3. seed/plant mixture / acres / lbs/ac / lbs or plants needed /
4. seed/plant mixture / acres / lbs/ac / lbs or plants needed /
5. seed/plant mixture / acres / lbs/ac / lbs or plants needed /
Amendments
Fertilizer requirements / Source / Lbs/acre / Total / NotesNitrogen / source / lbs/acre / total / notes /
Phosphate (P2O5) / source / lbs/acre / total / notes /
Potash (K2O) / source / lbs/acre / acre / notes /
Lime requirements / Source / Tons/acre / Total / Notes
Lime / source / tons/acre / total / notes /
Method of seedbed preparation / enter prep method /
Method of seeding/planting/sodding: / enter seed method /
Mulch requirements (type, rate/ac) / enter mulch requirements /
Other notes (e.g., inoculants, irrigating, management, plant protection, etc.) / enter notes /
“Temporary Cover Establishment” Seed and/or Plant Requirements (If Applicable)
Site preparation earthmoving (if applicable), etc.: / enter site prep /
Seedbed preparation: / enter seedbed prep /
Top soiling requirements (if applicable): / enter top soil requirements /
Seeding time: / enter seed time /
Temporary seed/plant species mixture / Acres / Lbs/ac PLS
plants spacing in feet / Total lbs needed
or total plants needed
6. temp seed/plant mixture / acres / lbs/ac / total lbs/plants /
7. temp seed/plant mixture / acres / lbs/ac / total lbs/plants /
8. temp seed/plant mixture / acres / lbs/ac / total lbs/plants /
9. temp seed/plant mixture / acres / lbs/ac / total lbs/plants /
10. temp seed/plant mixture / acres / lbs/ac / total lbs/plants /
Amendments for Temporary Cover
Fertilizer requirements) / Source / Lbs/acre / Total / NotesNitrogen / source / lbs/acre / total / notes /
Phosphate (P2O5) / source / lbs/acre / total / notes /
Potash (K2O) / source / lbs/acre / total / notes /
Lime / Source / Tons/acre / Total / Notes
Lime / source / tons/ac / total / notes /
Method of seedbed preparation / enter seedbed prep /
Method of seeding/planting/sodding: / enter method of seeding /
Mulch requirements (type, rate/ac) / enter mulch requirements /
Other notes (e.g., inoculants, irrigating, management, plant protection, etc.) / enter other notes /
Page 1 of 4
Additional Layout Drawings (if needed). / . / . / . / . / . / .
. / . / . / . / . / . / .
. / . / . / . / . / . / .
. / . / . / . / . / . / .
. / . / . / . / . / . / .
Page 1 of 4
Certification Statement:
I certify that implementation of this conservation practice is complete, meets criteria for the stated purpose(s), and meets the NRCS conservation practice standard and specifications.
Page 1 of 4