SURVEY FORM 



Budget Bureau No. i|2-5923 

 Approval expires March 31j I96O 



SURVEY OF FISHING IN PONDS STOCKED 

 BY THE BUREAU OF SPORT FISHERIES AND WILDLIFE 



Name of Pond or Owner State Siarvey No, 



Post Office Address Coiinty Hatchery- 



Date of Survey Acreage of Pond Interviewer 



Stocking Record: (Complete for all species) 



Form 3-1666 No. 

 From Hatchery Species Number Date 



Information from Pond Ovmer 



1. What is the principal purpose (or p\irposes) of your pond? 

 Livestock water / /, Irrigation / /, Fishing / /, 

 Wildlife / /, Swimming / / , Other / /. 



2. Is the pond providing fishing? Yes / / , No / /. 



a. For family / /, Tenants / /, Friends / /, Other / /. 



3. Is special permission required for the public to fish the p ond? 



Yes I 7, No I 7. 

 U. Amount of fishing provided: 



a. What Is your estimate of the ntmiber of (separate) persons who fished 

 the pond in 1959? 



(15 yrs. or less) 



b. How many of these were: men , women , children /. 



c. What is yovir estimate of the total number of daily fishing trips or 

 fishermen days that the pond provided: . 



18 



