<p>US Department of Agriculture WY-ECS-41 Part 2 NATURAL RESOURCES CONSERVATION SERVICE Revised 5/2004</p><p>ENVIRONMENTAL EVALUATION DATA SHEET CULTURAL RESOURCES SECTION 106 DOCUMENTATION</p><p>**A COPY OF THIS FORM (PART 2) MUST BE SENT TO THE NRCS STATE CULTURAL RESOURCE COORDINATOR AFTER COMPLETION</p><p>Landowner / Cooperator: Farm Bill Program (WHIP, EQIP, etc)</p><p>NRCS Office: County:</p><p>Person Completing Form Date of Inspection:</p><p>Type of Ground Disturbing Activity: Practice Code: </p><p>Location: T R S</p><p>Results of Pre-Field Check (SHPO Database): SHPO File Search Date</p><p>No Cultural Resource Present Resources present but not within 1/4 mile of APE Resources present within 1/4 Mile of APE – Cultural Resource Specialist NOTIFIED on (date)</p><p>APE (Area of Potential Effect) in acres: (linear miles x 12.1212=acres)</p><p>Results of Field Check: Inspection Method: (check one): 100% pedestrian (30m transect or less) 100% pedestrian by other agency (explain)</p><p>Select one of the following: Nothing Found (negative findings) ATTACH TOPOG MAP SHOWING AREA INSPECTED Stop here-you are done with this form.</p><p>Site(s) Found and Avoided by: more than 1/4 mile less than 1/4 mile, Cultural Resource Specialist notified on (date)</p><p>ATTACH TOPOG MAP SHOWING AREA INSPECTED and LOCATION OF SITES and COMPLETE REMAINDER OF FORM</p><p>Site Found and cannot be avoided Cultural Resource Specialist Notified on (date)</p><p>Condition of Archaeological Site (circle best description(s)]:</p><p>Intact Grazed Eroded Mechanical Disturbance Vandalized Other (describe)</p><p>1 US Department of Agriculture WY-ECS-41 Part 2 NATURAL RESOURCES CONSERVATION SERVICE Revised 5/2004</p><p>CULTURAL RESOURCES NOTED</p><p>Artifacts: Total estimated observed: Size of Artifact Area (meters, LxW, measured or est)</p><p>Prehistoric Artifacts: Flakes (chipped stone) Ground Stone Artifacts Other (list)</p><p>Historic Artifacts (Describe)</p><p>Prehistoric Features: (check all that apply) Stone structures (tipi rings, cairns, rock alignment) Sub-surface structures (pithouses, depressions) Thermal features (stained soils, hearths, fire-cracked rock) Rock art Other (describe)</p><p>Historic Features: (check all that apply) Habitation structures (houses, foundations, dugouts) Other structures (barns, cairns, outbuildings) Cemetery/graves (marked or unmarked) Dumps (dense historic artifact concentration) Mine related features (shafts, or transport/processing, tailings) Transportation related (roads, trails, railroad related, stage coach roads) Water distribution/control (flumes, diversions) Other (describe)</p><p>Has site been inspected by a Cultural Resource Specialist No Yes Date </p><p>Remarks:</p><p>ATTACH COPY OF TOPOG MAP HERE (Hi-lite area of potential effect)</p><p>2</p>