SECTION 1 – Basic Information
State:	VA	Plan Identifier/Number:	Monitoring Date:
Monitoring Method:	On-Site	Remote
Who is being interviewed during this monitoring visit?	Landowner	Representative	N/A
Monitoring Team:
SECTION 2 – Landowner Objectives: (Check all that apply)
Aesthetic Quality Timber	Fire	Timber
Agroforestry Timber	Fish and Wildlife	T&E Species
Archeological, Cultural, Historic Sites Timber	Forest Health	Tree Growth and Regeneration
Biological Diversity Timber	Recreation	Water
Carbon Sequestration Timber	Soil	Wetlands
Other:
SECTION 3 – Management Practices Implemented: (Identify practices completed or started)
C-S SOURCE: (State, NRCS, Other, N/A)
Agroforestry	#	Unit	C-S Source
Tree Planting (Includes Shelterbelt Windbreak Establishment)	Acres
Shelterbelt/Windbreak Renovation	Acres
Other
Archeological, Cultural and Historic Sites
Cultural Resource Enhancement	Each
Cultural Site Protection	Each
Other
Fire
Prescribed Burn	Acres
Site Preparation for Planting	Acres
New Fuel Break/Fireline	Miles
Chipping of Fuels	Acres
Maintenance of Fuel Breaks/Firelines	Miles
Other
Fish and Wildlife
Wildlife Habitat Improvement	Acres
Planting Annual/Perennial Crops or Soft/Hard Mast Producing Trees/Shrubs	Acres
Planting Native Grasses and Forbs	Acres
Wildlife Habitat Fertilization	Acres
Creating Openings/Early Successional Habitat	Acres
Rehabilitate or Maintain Openings (Mow, Spot Herbicide, etc.)	Acres
Hedgerow Planting Expanding BMPs/Riparian Corridors	Acres
Other

Forest Health
Invasive Plant Control – Chemical	Each/Acre
Invasive Plant Control – Mechanical	Each/Acre
Insect and Disease Surveys	Each
Forest Monitoring for Damage from Insects and Disease and Weather	Each/Acre
Insect and Disease Control/Prevention – Mechanical, Chemical or Biocontrol	Acres
Other
Landowner Assistance
Tree Farm Certification – ATFS	Each
Recreation
Trail Construction	Miles
Trail Maintenance	Miles
Trail Reconstruction	Miles
Visual Enhancement	Each
Other
Reforestation
Planting Trees with Seeds/Acorns	Acres
Planting Tree Seedlings	Acres
Fill-in or Replant Trees	Acres
Chemical/Mechanical Site Prep. for Planting or Natural Regeneration	Acres
Other
Silviculture (Timber)
Pine Straw Raking	Acres
Underplanting (Longleaf Restoration)	Acres
Patch Clearcut	Acres
Stand Clearcut	Acres
Commercial Thin	Acres
Salvage Cut for Regeneration	Acres
Salvage Cut (Intermediate Treatment not Regeneration)	Acres
Tree Release and Weed Control	Acres
Precommercial Thin	Acres
Prune	Each
Control of Understory Vegetation (Mechanical or Chemical)	Each
Fertilization (11)	Acres
Animal Control for TSI	Each
Marking/Designation	Acres
Road Construction	Miles
Road Improvements (Water Crossings, Replacing Culverts, etc.)	Miles
Road Maintenance (Shaping/Grading, Waterbars, Turnouts, Gravel, etc.)	Miles
Other

Soil and Water
Seeding/Planting for Erosion Control	Acres
Fencing for Watershed Protection	Miles
Riparian Forest Buffer Establishment	Acres
Riparian Forest Buffer Improvement/Maintenance	Acres
Other
Threatened and Endangered Species
Other
SECTION 4 – Primary Resource Objectives Addressed as a result of implemented practices: (Check all that apply)
Aesthetic Quality	Fire	Timber
Agroforestry	Fish and Wildlife	T & E Species
Archeological, Cultural, Historic Sites	Forest Health	Water
Biological Diversity	Recreation Opportunity	Wetlands
Carbon Sequestration	Soil	Other
SECTION 5 – Were there any management barriers leading to difficulty managing the property? (Check all that apply)
Catastrophic Events	Ownership/Objective Change	Lack of Cost-Share
Lack of Time	Lack of Markets/Loggers	Lack of Contractors
SECTION 6 – Has this Forest Stewardship Management Plan been implemented?	Yes	No
Send completed form to the Forest Resource Management Coordinator.