SECTION 1 – Identification Information
County:	Landowner Name:
Operator Name:	NAID Number:
SECTION 2 – Harvest Inspection Information
Harvest Number:	Inspection Date:
Harvest Status:	In Progress	Inactive	Latitude:
Acres Cut to Date:	Longitude:
SMZ Overharvested?	Yes	No
Water Quality Concerns Discovered?	Yes	No	(Notify Water Quality Engineer or Specialist)
Final Inspection Reason:	Operator Completed Job	Operator Moved Off Site	Non-Silvicultural Harvest
No Hydrologic Features	Harvest Cancelled
Harvest Method:	Total Harvest	Thinning	Commercial Selection
Seed Tree	Shelterwood Deferment	Group Selection
Salvage Harvest?	Yes	No
Industry Land?	Yes	No
Harvest Recommended By:	DOF Personnel	Consulting Forester	Industry Forester
No Professional Advice Used	Unknown
Professional Advice Used During Harvest Planning or Execution?	Yes	No
Written Pre-Harvest Plan?	Yes	No
Chipper Used Onsite?	Yes	No
Subject to Seed Tree Law?	Yes	No
Only for REC-eligible Biomass Harvests:
Material utilized for biomass that is not REC-eligible?	Yes	No
Productive capacity of the site for forest growth reduced?	Yes	No
Non-Silvicultural Acres:	Silvicultural Acres:
Percent Softwood in Silvicultural Acres:
Inspection Comments:
SECTION 3 – DOF Inspector Information
Final Inspection?	Yes	No
Inspector Name (Print)	Date