SECTION 1 – Tract and Planting Information
Tract Number:	County:	Date Sampled:
Landowner Name:	Farm Name:
Address:
Tract Location:
Phone:	Email:
Planted Acres:	Cost-Share Program:	Site:	Crop Field	Pasture	Planting Crew:
Date Planted:	Species Planted:	Spacing:	Trees Per Acre:
Site Preparation:	Disked	Chisel Plow	Ripped	Herbicide	Burned	Mowed	None	Other
Fencing Present:	Yes	No
Additional Site Preparation Information:
Planting Method:	Dibble	Hoedad	Auger	Machine	Other	Shelter:	Height:	Type:
Protection/Support:	Releasable Ties	Bird Nets (1 in. hole)	Plan makes other recommendations
SECTION 2 – Plot Tally (Take 30 sample points (sample tree closest to plot center)
TREE COUNT	At every tree, tally each that applies (any one deficiency fails the tree)	AT EVERY TREE, TALLY EACH THAT APPLIES (sum the number of deficiencies for each tree)	TALLY 6TH TREE, (any deficiency fails)	TALLY 6TH TREE
Tree	Species1	Other Defects2	Seedling Size3	Under Canopy4	Tube Not in Ground5	Pass/ Fail (P/F)	Spot Not Scalped6	Compet. Control7	Stake8	Tube Flare Down9	Sum	Stem Loose10 Pass/Fail (P/F)	Spacing11
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
TOTAL FAILED	TOTAL DEFICIENCIES	TOTAL TREES FAILED
7+ FAILS SITE	19+ FAILS SITE	2+ FAILS SITE
Recommendations:
SECTION 3 – Completed By
VDOF Employee Name (Print)	VDOF Employee Signature	Date
Species: Identify species by common name, place an “M” if the plant is missing, “U” if it is unidentifiable, or “D” if dead. 2 Other Defects: Tree in cable tie, no seedling, wrong depth (within an inch of nursery ground level), wrong tree/site match (upland species planted on wet site and vice versa, other defects. 3 Seedling Size: Tally if the seedling is less than 0.25 inch in diameter (wooden pencil diameter) or less than the specified height per species (trees and shrubs for CREP riparian buffers). 4 Under Canopy: Tally if the tree is under overstory trees. 5 Tube Not in Ground: Tally if the tube is not in the ground 2 to 3 inches.	6 Spot Not Scalped: Tally if the plant spot was not scalped prior to planting. 7 Compet. Control: Tally if competition has not been controlled (i.e. herbicide, mat). 8 Stake: Tally if stake is not white oak (quercus alba) or treated pine. 9 Tube Flare Down: Tally if the flared end of the tube is down and not up. 10 Stem Loose: Tally if the stem is loose and not planted tightly. 11 Spacing: Measure the spacing between trees in rows and between the rows to produce an average spacing distance to confirm proper plant density