TRADITIONAL CULTURAL PROPERTY INVENTORY TEMPLATE Smithsonian:______

Page 1 of 8

Smithsonian No.:

*County(s):

Part I Part II

Part I
*Date:*Compiler:
Additional Information Restrictions: (Yes/No/Unknown):
Affiliation(s):
SITE DESIGNATION
Traditional Name:
Common/local Name:
Geographic Name (if applicable):
LOCATION
*USGS Quad MapName(s): Series: Date:

*Legal Description: TR E/W:Section(s):

Quarter Section(s):

UTM: Zone Easting Northing

Latitude:Longitude: Elevation (ft/m):

Other Maps: Type:

Scale:Source:

Drainage, Major:Drainage, Minor: River Mile:

Aspect:Slope:

*Location Description(General to Specific):

*Directions(For Relocation Purposes):
ETHNOGRAPHIC SITE DESCRIPTION
*Site Type:
*Functional and/or Cultural Uses:
*Vegetation(On Site):
Local:Regional:
*Landforms (On Site):
Local:
*Water Resources(Type): Distance: Permanence:
*Ethnographically Defined Site Boundaries:
PHYSICAL SITE DESCRIPTION
*Dimensions(Overall Site Dimensions):
*Length: *Direction: x *Width: *Direction:
*Method of Horizontal Measurement:
*Depth: *Method of Vertical Measurement:
*Boundary Justification:
*Vegetation(On Site):
Local: Regional:
Landforms (On Site):
Local:
Water Resources (Type): Distance: Permanence:
*Narrative Description:
*Site integrity assessment: Intact Altered Unknown Explain:
ASSOCIATED SITES ON FILE (if applicable)
*Pre-Contact: Smithsonian Numbers:
*Historic: Smithsonian Numbers:
SITE HISTORY
*Previous Research:
REFERENCES
*Bibliographic References:
LAND OWNERSHIP
*Owner:
*Address:
*Tax Lot/ Parcel No:
SITE ACCESS
*Access to Property? Yes Since when:
No Since when:
Unknown
SITE CONSULTANTS
Name:
Affiliation :
Name:
Affiliation:
Name:
Affiliation:
SITE RECORDERS
Observed by: Address:
*Date Recorded:
*Recorded by (Professional Anthropologist):
*Organization: *Organization Phone Number:
*Organization Address: *Organization E-mail:
Date Revisited: Revisited By:
USGS MAP
*Quad Name(s):
*Series:
*Date(s):
*INSERT 7.5 MIN USGS MAP
*DELINEATING SITELOCATION AND BOUNDARIES
*INSERT LEGEND
SKETCH MAP
*Sketch Map Description:
*Legend:
Known Boundary Symbology: _-_-_-_-_-_
_-_-_-_-_-_-_-_-_-_-_-_
Possible Boundary Symbology:
Other Symbols (Other Than USGS):
* Or INSERT LEGEND
*Scale:
*North Arrow (Magnetic/True North): / *INSERT SKETCH MAP
PHOTOGRAPH(S)
Archival Photographs
*Source Information:
* Photograph Description(s):
Copyright or other restriction?:
*INSERT PHOTOGRAPH(S)
Contemporary Photographs
*Source Information:
*Photograph Description(s):
*INSERT PHOTOGRAPH(S)
Part II
RELEASE OF INFORMATION
The confidential information attached is hereby released by the to the Department of Archaeology and Historic Preservation of Washington State (hereafter referred to as DAHP), with the following restrictions:
  1. The attached ethnographic information will be made available only to the following classes of persons.
a)Staff of DAHP
b)Qualified archaeologist with need-to-know
  1. Use of the attached ethnographic information shall be limited in the following way:
a)No individual shall remove the information from the DAHP.
b)No information shall be microfilmed, photocopies, or otherwise duplicated.
c)No information shall be quoted or used without the written permission of the .
  1. Procedure for using quotation from attached ethnographic information:
a)If an excerpt or quotation from the attached information is to be published, the author(s) must submit a copy of the document for review and approval by the Council, prior to the document’s submittal for publication.
  1. All requests for ethnographic information made by persons other than those described above should be submitted in writing to the for individual review.
This agreement maybe revised or amended by mutual consent of the parties undersigned.
In full accord with the provisions of the Release of Information, I hereunto set my hand.
Staff / Date
Archivist / Date
Received on this day,
State Historic Preservation Officer
Department of Archaeology and Historic Preservation / Date
SPECIFIC ETHNOGRAPHIC INFORMATION
* Current Use:
* Past Use:
INTERVIEW INFORMATION
Information Sources (List all information necessary for retrieval):
Audio file / Accession Information:
Interview With: Conducted By: Date:
Video file / Accession Information:
Interview With: Conducted By: Date:
Personal Communication: Interview With: Conducted By: Date:
Lecture (Complete Citation):
Other:

*Mandatory Information for Official Smithsonian Number designation.Revised 11/2013