Montana Wetland Field Evaluation Form (revised 7/1/96) 



I. Project Name; 



2. Project # and Control H: 



3. Evaluation Dale: 



4. EvaluatoKs): 



5.WeUand/Site#(s): 



6. Wetland Location(s): 



7. Evaluation is to assess fimctions and values of: 



Wetlands that may be affected by an MDT project 



Mitigation wetlands: pre-constiuction 



Mitigation Wetlands: post-constniction 



Other: 



8. Estimated total wetland size (acres): 



9. Estimated acreage of assessment area (AA): 

 (see detailed instructions on bow to determine AA) 



10. Classification of AA (HGM according to Brinson; system, subsystem,class, water regime, and special modifier according to Cowardin [1979]) 



HGM Class 

 (Brinson) 



System 

 (Cowardin) 



Subsystem 

 (Cowardin) 



Class 

 (Cowardin) 



Water Regime 

 (Cowardin) 



Modifier 

 (Cowardin) 



•/.of 

 AA 



1 1. Circle estimated relative abundance (see defmitions) of similarly classified sites within the same Major Montana Watershed Basin: 

 Rare Common Abundant 



12. Circle general condition of AA (see definitions): Undisturbed 



Encroached Upon 



Directly Distuit)ed 



13. Habitat Diversity 



A). # of persistent vegetated 



classes (circle points^ 



13" 5 points 

 2 = 3 points 



i I = 1 point 



Comments: 



B). Open water (see definition) 

 in the AA Is (circle points^ 

 present = 2 points 

 absent = I point 



Score is (A) X (B) = . 



14. Brief descriptive summary of AA and surrounding land use and habitat: 



15. Functions and Values Assessment 



15.a) Habitat for Federally Listed, Proposed, or Candidate Threatened or Endangered Plants or Animals 

 AA is documented or suspected (circle D or S> to receive: 



D S Regular use or is designated critical habitat (list species): 



D S Occasional (infiequent, sporadic) use (list species): 



D S Incidental (chance, inconsequential) use (list species): 



D S No use 



Source(s) for docunxnted use (e.g., observauon, records, etc.): 

 Comments: 



15.b) Habitat for Plants or Animals Rated SI, S2, or S3 by the Montana Namral HeriUge Program 



(Not including species listed in I5.a) above.) 



AA is documented or susnected (circle D or S) to receive: 



D S Regular use Gist species): 



D S Occasional (infrequent, sporadic) use Gist species): 



D S Incidental (chance, inconsequential) use (list species): 



D S No use 



Source(s) for documented use (e.g., observ ation, records, etc.): 



Comments: ' 



Highest 

 Level Uk: 



doc/reg 



doc/occ 



Rxdag 



High 



High 



Functiooal 

 Points 



(Fl) 



