•
WASHINGTON STATE DEPARTMENTOF
Natural Resources
-------FIWN ;, ¥!!/~/'7;-Received Date: .L k.;. -
WDFW Concurrence Due Date: -WDFW Concurrence Review
Forest Practices Application/Notification Completed:
Office Checklist Page 1 Northwest Region
Comments Due Date:
Decision Due Date:
FP Forester:
Shutdown Zone:
_'Q__,-.....~, --=--au-=--?-- I _,_----=--=---- I
RMAP~: ____________________ J -------------------------------- ------------------
FPA/N CLASSIFICATION: [ ] 1~111 [ ] IVG [ ] IVS RMAP Exempt: [ ] 80/20 [ ] No Forest Roads [ ] Ag [ ] LLO
Lando~~er Name~-d~~(?~_ _ _ _ ____ Project Name: _____ ~*~£c===c-WRIA: ;:) ec:-__ ___ ~zf1=3fie4 WAU: ____ - __ -___ -___ --__ -_-_________ -______ -_-___ -_____ -_____ -_____ -___ -___ -___ -____________ _
WRIA: _______________ WAU: ________________ _
Legal Description: ~e C?zlt~iied' {!<;~ ,"'Jt~;-sl;,; ~,f:/-~~i?zf,~ ~e) Activity Type: Harvest ______ ac Spray 2.JqGj 'f ac Stream Crossing(s) ___ _
Road Construction _____ ft Road Abandonment _____ ft ·-------- --------------·- ------ --
ALTERNATIVE PRESCRIPTIONS
[ ] Alternate Plan
[ ] Ten-Year Forest Management Plan
[ ] Columbia River Gorge National Scenic Area [ ] Watershed Analysis:. ________ _
-····-··----
RESOURCE REVIEW
---- ··-···----· ----· . - ---- ·-----" ------ ---·--- ---------------· ---
[ ] Habitat Conservation Plan
[ ] Landowner Option Plan for Northern Spotted Owl
[ ] Cooperative Habitat Enhancement Agreement
-- -------- ---- ----------- ---------
[ ] Unstable Slopes (Risk: Highway, Water;, ____ _ 'fxt'. Bull Trout Overlay [ ] Soils Map (Highly Erodible & Very Unstable) [] SLPSTAB [ ] Landslide Hazard Zonation
[ ] Landslide Polygon [ ] Rain-on-Snow and Outside Approved WA
1('Hydric Soils [ ] Wetland [ ] Forested, [ ] A, [ ] B
[ ] In WMZ of [ ] A, or [ ] B Wetland - [ ] In RMZ/ELZ of Type [ ] S, [ ] F, [ ] N water
1 f HCP Bull Trout Population [ ] Bald Eagle nest or roost within 660 feet ~Group A or B Water Supply (TRAX code OM or MU) [ ] Hatchery (TRAX code S)(Name: _________ _
[ ] Even-Aged Harvest greater than 120 Acres [ ] Ground-based Equipment on Slopes greater than 40% [ ] Road Construction on Slopes greater than 65% [ ] Saltwater Islands (Name:. ___________ _
lJ~~13rVerificatL<?_Q________________ _ ________ ________ ___ _ ___________________ _
ASSOCIATED NON-SCANNED DOCUMENTS- On file with the FPA/N at the region office.
[ ] SEPA Checklist/Documents
ASSOCIATED SCANNED DOCUMENTS
[ ] Conversion Option Harvest Plan [ ] FPHP Plans & Specifications [ ] Qualified Expert Report [ ] Natural Regeneration Plan [ ] Shoreline Permit [ ] Marbled Murrelet Form
[ ] FPBM Appendix(s) ---------[ ] Small Landowner RMAP Checklist [ ] CMZ Assessment Form
i~~~~iJ~Iteg~~~~e~J:-~fo
[ ] Large Landowner Road Maintenance and Abandonment Plan
[ ] Hardwood Conversion Form [ ] Wetland Mitigation Plan [ ] Water Protocol Surveys [ ] Modification
Form# __________ _
[ ] Water Classification Worksheet [ ] Shade Documentation (Stream Shade Assessment Worksheet) [ ] Watershed Analysis Worksheet [ ] DFC Printout
[ ] Slop:_~tability lnforma~io~~r:o::mpieted bYd(-61..•
Chapter 222-16
Question 1 (a)
1 (b)
Question
KEY FOR EVALUATION OF SITE SPECIFIC USE OF AERIALLY APPLIED PESTICIDES
Is the pesticide on the pesticide list (WAC 222-16-070(1))?
Is the pesticide being used under a Dept of Agriculture Experimental Use Permit (WAC 16-228-1460?
2 Is the toxicity rating for the pesticide to be used "Danger - Poison" as desi ated in the esticide list (WAC 222-16-070(1 (b))?
3 (a) Is Bacillus thuringiensis (BT) the only pesticide being used on this application?
3 (b) Is there a Threatened or Endangered species or the critical habitat (Federal) or critical habitat (State) of a species within the application area that is susceptible to the BT strain bein used?
4 (a) Is this operation occurring over ground water with a high susceptibility to contamination as specified in EPA 910/ 9-87-169 or in documentation provided by the department of ecology?
4 (b) Is this pesticide a state restricted use pesticide for the protection of ground water under WAC 16-228-1231?
5 (a) Is the operation adjacent (within 100 ft.) of surface water?
5 (b)
5 (c)
5 (d)
5 (e)
5 (t)
6 (a)
6 (b)
6 (c)
Determine the toxicity rating from the pesticide list: *Is the toxicity rating "Caution" or "Warning"? *Is the toxicity rating "Danger"? Is there a Group A or B water surface water system (WAC 246-290-020) intake OR a fish hatchery intake within one half mile downstream of the operation? Is there a Group A or B water surface system intake OR a fish hatchery intake within 1 mile downstream of the operation?
Is the operation within 200 feet of the intake of a Group A or B spring water system? Is the operation applying a pesticide in a Type A or B wetland?
Does any portion of the planned operation cover 240 or more contiguous acres? Pesticide treatment units will be considered contiguous if they are separated by less than 300 feet or treatment dates of adjacent units are less than 90 days a art. Is there a Threatened or Endangered species or the critical habitat (Federal) or critical habitat (State) of a species within the application area? If there is a special concern identified for this pesticide in the Board manual, does it 1 to this lication?
Definitions
Action goto 2 go to l(b) Class III Class IVS
go to 5(c) goto5(d) Class IV Sp go to 5(e) Class IV Sp go to 5(e)
Class IV Sp go to 5(±) Class IV Sp oto 6 a
Class IV Sp go to 6(b)
Class IV Sp go to 6(c) Class IV Sp Class III
(1) Special concerns (see WAC 222-16-070 (2)6(c)) shall be evaluated by the department of agriculture. Information regarding special concerns shall be presented to the board for review. Approved special concerns shall be included in the board manual. Special concerns shall include situations where use of pesticides has the potential for a substantial impact on the environment, beyond those covered specifically in the key in subsection (2) of this section.
16-32 lb.2814707
WRIA
Snohomish
Stillaguamish
Lower Skagit-Samish
Upper Skagit
Nooksack
WAU
Beckler River
Deception
Foss River
Skykomish River
Jim Creek
Canyon Creek
French-Boulder
Lower NF Stilly
Lake Cavanaugh
Deer Creek
Hazel
Day Creek
Samish River
Finney Creek
Grandy
Jackman Creek
Hutchinson Creek
Skookum Creek
Porter Canyon
Howard Creek
lb.?C,14707
Legals:
1-26-llE
31-26-12E
14, 15, 20, 21, 23, 28-27-09E
10, 11, 14, 21, 23, 25, 26, 28, 29-31-07E
25,26,27,28,33,34,35,36-32-07E
10-33-06E
3, 4, 10, 15, 21, 28-33-07E
21-35-08E
3, 4, 9, 10-35-09E
4-36-05E
10, 11-37-05E
7, 8-37-06E
29-38-06E
!fa ') 0 L. u 1 4 7 0 7
•
WASHINGTON STATE DEPARTMENTOF
Natural Resources Forest Practices Application/Notification
For Aerial Chemicals
For DNR Region Office Use Only
FPA/N #:
Region:
Received Date:
YOU MUST USE THE INSTRUCTIONS TO COMPLETE THIS APPLICATION.
TYPE OR PRINT IN INK:
1. Landowner, Timber Owner and Operator
Legal Name of LANDOWNER Legal Name of TIMBER OWNER Legal Name of OPERA TOR Weyerhaeuser Columbia Timberlands Weyerhaeuser NR Weyerhaeuser NR
Mailing Address: Mailing Address: Mailing Address:
500 Metcalf St, Building F-5E 500 Metcalf St, Building F-5E 500 Metcalf St, Building F-5E
City, State, Zip City, State, Zip City, State, Zip Sedro Woolley, WA 98284 Sedro Woolley, WA 98284 Sedro Woolley, WA 98284
Phone (360 ) 424-2014 Phone (306 ) 424-2014 Phone (360 ) 424-2014
Email: [email protected] Email: [email protected] Email: [email protected]
2. Contact person.
Contact Person
Kelly Dougherty
Phone (912 ) 318-4627
Email: [email protected]
3. Are you substituting prescriptions from an approved state or federal conservation agreement or watershed analysis?
['] No. [ ] Yes. Write "Using prescriptions" in tables that apply. Attach or reference prescriptions/crosswalk on file.
4. Complete the following property description:
% % (quarter quarter) Section Township Range EasUWest County
see attachment
RECEIVED NW REGION
JUL 21,2015 ,, 'l 0 1 7 i:J {_ u 4 0 7
Aerial chemical revised 5-30-2013 Page 1
5. Is this proposal: (Answer every question)
a. [,] No. [ ] Yes. Within the city limits or an urban growth area? If Yes, include SEPA Checklist or SEPA Determination or approved 10-year management plan
b. [•] No. [ ] Yes. Within a public park? If Yes, include SEPA Checklist or SEPA Determination
c. [•] No. [ ] Yes. Within 500 feet of a public park? Park name:-------------
d. [•] No. [ ] Yes. For an Alternate Plan? If yes, include a copy of the Alternate Plan
e. [•] No. [ ] Yes.
f. [•] No. [ ] Yes.
6. Ch . 11 f f em1ca n orma ion -
Using a chemical that is not registered or for a use that is not allowed under the label? If yes, include a copy of your Experimental Use Permit and a SEPA Checklist
Applying a pesticide in a Type A or Type B Wetland? If Yes, include a SEPA Checklist or SEPA Determination
Sh owa II b ff u ers on vour A f "t M C IVICY ap Type of EPA Number Contiguous Acres Will You Spray Within Will You Will You Spray Chemical Being Treated 100 feet of Agricultural Spray Within Within 100 feet
Land? 200 feet of a of Surface (Herbicide, Residence? Water? rodenticide
' insecticide,
See attachment
7. Have you reviewed this forest practices activity area to determine whether it may involve historic sites and/or Native American cultural resources? Read the instructions before answering this question.
[•]No. []Yes.
8. We understand that applying chemicals is not an activity included as part of the DNR's Incidental Take Permit for aquatic species. We affirm that the information contained herein is true, and understand that this proposed forest practice is subject to the Forest Practices Act and Rules as well as all other federal, state or local regulations. Compliance with the Forest Practices Act and Rules does not ensure compliance with the Endangered Species Act or other federal, state or local laws.
Sjgnatyre of TIMBER OWNER (If different than landowner)
Sjgnatyre of OPERATOR (If different than landowner)
:'::i. 'i .~ 1 4 7 0 7
Aerial chemical revised 5-30-2013 Page 2
Oh {p lo/ 3) I~ HUN 1/41/4 Section Township Range County
15170 N2NE4 1 26 11 King
15170 N2SE4 1 26 11 King
15170 SE4NE4 1 26 11 King
15170 SW4SE4 1 26 11 King
13644 S2NW4 31 26 12 King
13644 N2SW4 31 26 12 King
14493 SE4SW4 31 26 12 King
14493 SW4SE4 31 26 12 King
14494 S2SW4 31 26 12 King
11710 NW4 10 33 6 Skagit
11710 S2NE4 10 33 6 Skagit
11710 NW4NE4 10 33 6 Skagit
13991 W2NW4 3 33 7 Skagit
13991 NW4SW4 3 33 7 Skagit
13991 S2NE4 4 33 7 Skagit
13991 NE4NE4 4 33 7 Skagit
13991 NE4SE4 4 33 7 Skagit
15756 SW4 15 33 7 Skagit
15756 S2NW4 15 33 7 Skagit
16005 E2SW4 21 33 7 Skagit
16005 W2SE4 21 33 7 Skagit
16005 NE4NW4 28 33 7 Skagit
16020 SE4 3 33 7 Skagit
16020 N2NE4 10 33 7 Skagit 16024 E2SW4 21 33 7 Skagit
16024 SE4NW4 21 33 7 Skagit
16024 SW4NE4 21 33 7 Skagit
16024 NW4SE4 21 33 7 Skagit
16030 E2SW4 15 33 7 Skagit
16030 S2SE4 15 33 7 Skagit
16030 NW4SE4 15 33 7 Skagit
16050 N2NW4 3 33 7 Skagit
16050 SW4NW4 3 33 7 Skagit
15214 NW4 30 34 7 Skagit
15214 S2NE4 30 34 7 Skagit
15214 NW4NE4 30 34 7 Skagit
16298 S2SE4 14 35 7 Skagit
16298 NE4 23 35 7 Skagit
16298 E2NW4 23 35 7 Skagit
15971 S2SE4 21 35 8 Skagit
12499 SW4SW4 3 35 9 Skagit
12499 S2SE4 4 35 9 Skagit
12499 SE4SW4 4 35 9 Skagit
12499 N2NE4 9 35 9 Skagit
12499 NE4NW4 9 35 9 Skagit
12499 NW4NW4 10 35 9 Skagit
HUN 1/41/4 Section Township Range County 16250 S2NW4 3 35 9 Skagit
16250 W2NE4 3 35 9 Skagit
16250 NE4NW4 3 35 9 Skagit
16250 NE4SW4 3 35 9 Skagit
16250 NW4SE4 3 35 9 Skagit
13633 SE4NW4 4 36 5 Skagit
13633 SW4NE4 4 36 5 Skagit
14579 S2NE4 4 36 5 Skagit
14579 N2SE4 4 36 5 Skagit
4462 SW4SE4 21 27 9 Snohomish
4462 W2NE4 28 27 9 Snohomish
4462 W2SE4 28 27 9 Snohomish
4462 SE4NW4 28 27 9 Snohomish
4462 NE4SW4 28 27 9 Snohomish
14472 E2SE4 20 27 9 Snohomish
14472 SE4NE4 20 27 9 Snohomish
14472 W2SW4 21 27 9 Snohomish
14472 SW4NW4 21 27 9 Snohomish
23356 S2SW4 14 27 9 Snohomish
23356 S2SE4 15 27 9 Snohomish
23356 N2NW4 23 27 9 Snohomish
13490 W2SW4 28 31 7 Snohomish
13490 SW4NW4 28 31 7 Snohomish
13490 E2SE4 29 31 7 Snohomish
13490 SE4NE4 29 31 7 Snohomish
15570 NE4 10 31 7 Snohomish
15570 NW4 11 31 7 Snohomish
15985 S2NW4 25 31 7 Snohomish
15985 N2SW4 25 31 7 Snohomish
15985 SW4SW4 25 31 7 Snohomish
15985 SE4NE4 26 31 7 Snohomish
15985 NE4SE4 26 31 7 Snohomish
16230 SE4SE4 11 31 7 Snohomish
16230 NE4NE4 14 31 7 Snohomish
16236 S2SE4 23 31 7 Snohomish
16236 SE4SW4 23 31 7 Snohomish
16236 N2NE4 26 31 7 Snohomish
23422 SE4SE4 20 31 7 Snohomish
23422 SW4 21 31 7 Snohomish
23422 NW4NW4 28 31 7 Snohomish
23422 E2NE4 29 31 7 Snohomish
11697 E2SW4 28 32 7 Snohomish
11697 W2SE4 28 32 7 Snohomish
11716 S2NE4 25 32 7 Snohomish
11716 E2SW4 25 32 7 Snohomish
11716 N2SE4 25 32 7 Snohomish
HUN 1/41/4 Section Township Range County
11716 SE4NW4 25 32 7 Snohomish
11716 SW4SE4 25 32 7 Snohomish
13722 E2SE4 34 32 7 Snohomish
13722 SW4 35 32 7 Snohomish
13722 SW4NW4 35 32 7 Snohomish
13724 SE4SE4 25 32 7 Snohomish
13724 N2NE4 36 32 7 Snohomish
15162 NE4 33 32 7 Snohomish
15162 NE4SE4 33 32 7 Snohomish
15162 SW4NW4 34 32 7 Snohomish
15190 N2SW4 27 32 7 Snohomish
15190 SW4NW4 27 32 7 Snohomish
15190 NE4SE4 28 32 7 Snohomish
15207 S2SW4 25 32 7 Snohomish
15207 NW4SW4 25 32 7 Snohomish
15207 SW4SE4 25 32 7 Snohomish
15207 E2SE4 26 32 7 Snohomish
15207 NE4NE4 35 32 7 Snohomish
15207 N2NW4 36 32 7 Snohomish
23141 SE4SW4 27 32 7 Snohomish
23141 NW4 34 32 7 Snohomish
23141 W2NE4 34 32 7 Snohomish
23141 NE4SW4 34 32 7 Snohomish
15871 S2NE4 10 37 5 Whatcom
15871 NW4NE4 10 37 5 Whatcom
15871 NE4SE4 10 37 5 Whatcom
15872 E2NW4 11 37 5 Whatcom
15872 SW4NE4 11 37 5 Whatcom
16288 S2NE4 11 37 5 Whatcom
16288 N2SE4 11 37 5 Whatcom
16288 NE4NE4 11 37 5 Whatcom
15786 NE4 7 37 6 Whatcom
15786 N2SE4 7 37 6 Whatcom
15786 SE4SE4 7 37 6 Whatcom
15786 W2SW4 8 37 6 Whatcom
15786 SW4NW4 8 37 6 Whatcom
15925 NW4 29 38 6 Whatcom
15925 N2SW4 29 38 6 Whatcom
15925 W2SE4 29 38 6 Whatcom
15925 SW4NE4 29 38 6 Whatcom
~:-"
\_J
--:..
,J::::,.
...... 0 ......
Ouesi-1oV1 :t!: L !Will you spray rwm you spray Will you spray
Contiguous Acres within 100' of within 200' of a within 100' of
Type of Chemical Chemical Name EPA Number Being Treated agricultural land? residence? water?
Herbicide Accord XRT II 62719-556 v see individual maps No No Yes
Herbicide Alligare Glyphosate 5.4 81927-8 v see individual maps No No Yes
Herbicide Escort XP 352-439 v' see individual maps No No Yes
Herbicide lmazapyr 4 SL 81927-24 ~
v see individual maps No No Yes
Herbicide MSM 60 DF 81927-26 v see individual maps No No Yes
Herbicide Oust Extra 352-622 v see individual maps No No Yes
Herbicide Oust XP 352-601 v see individual maps No No Yes
Herbicide Polaris 228-534 v see individual maps No No Yes
Herbicide Polaris AC 228-480 v I/ see individual maps No No Yes
Herbicide Polaris AC Complete 228-570 v v see individual maps No No Yes
Herbicide Polaris SP 228-536 v see individual maps No No Yes
Herbicide Rodeo 62719-324 y see individual maps No No Yes
Herbicide Rotary 2 SL 81927-6 v see individual maps No No Yes
Herbicide SFM 75 81927-26 Iv' , see individual maps No No Yes
Herbicide SFM Extra 81927-5 v see individual maps No No Yes
Herbicide Sulfomet Extra 352-622-85588 v see individual maps No No Yes
Helps solublize Climb WA 2935-0900111 see individual maps No No Yes
Deposition aid Cross hair WA 2935-11001 1 see individual maps No No Yes
Surfactant Ll-700 , WA 34 704-04007 see individual maps No No Yes
Surfactant Liberate WA 34 704-04008· V' see individual maps No No Yes
Surfactant Sy I-coat WA 2935-12002"' ".,see individual maps No No Yes
Surfactant Syl-tac WA 2935-00004\ see individual maps No No Yes
**All units have been or are currently permitted by the DNR for harvest. The waters were identified prior to FPA approval and will be protected. **Not all of these chemicals will be sprayed. The exact chemical mix for each unit is yet to be determined. This list encompasses all products that
may be used. Many of the chemicals on this list have the same active ingredient and are only listed because the operator could use any chemical
with the same active ingredient.
WY Columbia Timberlands Chelan Tree Farm
s Gate -·-·- WCT Property Line
• Road Block ,~'-' 40ft Contours
r=- Paved Road ~ Type S, F Stream
~ Gravel Road ~ Type Np Stream
Trails . Untyped Stream
@ Heliport
W Siteprep Aerial
Fall Release
RMZ I No-entry Areas
c::=s Existing Buffers I
W Additional Buffer
Scale 1 in = 1000 ft
, 1
T26N R11 E sec 01 King County
[ 7 0 7
7/16/2015
N
i
Wf Columbia Timberlands Chelan Tree Farm
121 · 2o·o·w
Gate WCT Property Line
• Road Block ,~"---../ 40ft Contours
,r=- Paved Road ~Type S, F Stream
_r= Gravel Road ~ Type Np Stream
Dirt Road
Trails
Type Ns Stream
Untyped Stream
121 · 19·o·w
@ Heliport
W Siteprep Aerial
Fall Release
RMZ I No-entry Areas
W Existing Buffers
(:3 Additional Buffers
Scale 1 in = 1000 ft
T26N R12E sec 31 King County
121· 1s·3o·w
«--""e~ 18464 80 ! ffi I
26N R12E sec 30/
c_-,_/ \ '
r_, r. ,.., 1 4 7 0 7
7/16/2015
N
!
WY Columbia Timberlands
Chelan Tree Farm 121 · 2o·o·w
:~_)
Gate -·-·- WCT Property Line
• Road Block '~._ _ _,, 40ft Contours
~ Paved Road ~ Type S, F Stream
~ Gravel Road ~ Type Np Stream
,.---... ~-' Type Ns Stream
Trails Untyped Stream
121 ' 19'0''W
@ Heliport
W Siteprep Aerial
Fall Release
RMZ I No-entry Areas
W Existing Buffers
W Additional Buffers
Scale 1 in = 1000 ft
"
T26N R12E sec 31 King County
3 1 4 70 7
7/16/2015
N
~
WY Columbia Timberlands Chelan Tree Farm
s Gate -·-·- WCT Property Line
• Road Block ,~"---' 40ft Contours
~ Paved Road ~ Type S, F Stream
,r= Gravel Road ~ Type Np Stream
Trails
,.- .... ,,_, Type Ns Stream
Untyped Stream
@ Heliport
W Siteprep Aerial
Fall Release
RMZ I No-entry A reas
C=3 Existing Buffers
C3 Additional Buffers
Scale 1 in = 1000 ft
T26N R12E sec 31 King County
1 !l 7 0 7
7/1 6/2015
N
~
WY Columbia Timberlands Chelan Tree Farm
s Gate -·-·- WCT Property Line
• Road Block '~, _ _,, 40ft Contours
,r=- Paved Road ~Type S, F Stream
,r= Gravel Road ~ Type Np Stream
.. ~~~""' Dirt Road
/,------ Trails ·· · ·-. ____ . Untyped Stream
@ Heliport
W Siteprep Aerial
Fall Release
RMZ I No-entry Areas
C--'( ~ Existing Buffers
W Additional Buffers
Scale 1 in = 1000 ft
T27N R09E sec 15 Snohomish County
., 1 11 7 0 7
7/16/2015
N
i
s
•
WY Columbia Timberlands
Chelan Tree Farm
121 · 41·o·w 121 · 40·3o·w
Gate -·-·- WCT Property Line
Road Block ,~'---' 40ft Contours
,r=- Paved Road ~ Type S, F Stream
_r= Gravel Road ~ Type Np Stream
.. ~ ~~== , Dirt Road ,- .... ' .... _, Type Ns Stream
, , , Trails Untyped Stream
121 · 4o·o·w
® Heliport
c:3 Siteprep Aerial
Fall Release
RMZ I No-entry Areas
C:3 Existing Buffers
w Additional Buffers
Scale 1 in = 1000 ft
.,
T27N R09E sec 20 Snohomish County
121 ·39·30·w
1 4 7 0 7
7/16/2015
N
i
WY Columbia Timberlands Chelan Tree Farm
s Gate -·-·- WCT Property Line
• Road Block -~"--../ 40ft Contours
,r=- Paved Road ~Type S, F Stream
~ Gravel Road ~ Type Np Stream
Trails
,-,,,_, Type Ns Stream
· ·- .... · Untyped Stream
121·39·3o·w
121 '39'30"W
@ Heliport
W Siteprep Aerial
Fall Release
RMZ I No-entry Areas
C=3 Existing Buffers
W Additional Buffers
Scale 1 in = 1000 ft
T27N R09E sec 28 Snohomish County
1 4 7 0 7
7/16/2015
N
!
WY Columbia Timberlands North Cascades Tree Farm
z Gate WCT Property Line
• Road Block -~'-----' 40ft Contours
,r=- Paved Road ~Type S, F Stream
r== Gravel Road ~ Type Np Stream
-:-~ ~===, Dirt Road ,- ... ' ~-' Type Ns Stream
' - Trails Untyped Stream
® Heliport
c:3 Siteprep Aerial
Fall Release
RMZ I No-entry Areas
C:3 Existing Buffers
C3 Additional Buffers
Scale 1 in = 1000 ft
T31 N R07E sec 10 Snohomish County
.. .i 1 4 7 0 7
7/1 6/2015
N
i
WY Columbia Timberlands North Cascades Tree Farm
Gate WCT Property Line
• Road Block ,~'------' 40ft Contours
,r=- Paved Road ~ Type S, F Stream
,r= Gravel Road ~ Type Np Stream
,-..... "' ..... -/ Type Ns Stream
Trails Untyped Stream
@ Heliport
C3 Siteprep Aerial
Fall Release
RMZ I No-entry Areas
C:3 Existing Buffers
W Additional Buffers
Scale 1 in = 1000 ft
T31 N R07E sec 11 Snohomish County
..... 1 4 7 0 7
7/16/2015
N
~
W{ Columbia Timberlands North Cascades Tree Farm
s Gate -·-·- WCT Property Line
• Road Block -~"---'' 40ft Contours
,r=- Paved Road ~Type S, F Stream
~ Gravel Road ~ Type Np Stream
Trails
,---,~-' Type Ns Stream
. Untyped Stream
® Heliport
W Siteprep Aerial
Fall Release
RMZ I No-entry Areas
C:3 Existing Buffers
W Additional Buffers
Scale 1 in = 1000 ft
T31 N R07E sec 21 Snohomish County
1 1 7 0 7
7/16/2015
N
!
WY Columbia Timberlands North Cascades Tree Farm
z Gate -·-·- WCT Property Line
• Road Block '~..____,, 40ft Contours
~ Paved Road ~ Type S, F Stream
~ Gravel Road ~ Type Np Stream
Trails
/- .... ,~_, Type Ns Stream
· ·-..... Untyped Stream
® Heliport
W Siteprep Aerial
Fall Release
RMZ I No-entry Areas
C:3 Existing Buffers
W Additional Buffers
Scale 1 in = 1000 ft
T31 N R07E sec 23 Snohomish County
7 0 7
7/16/2015
N
i
WY Columbia Timberlands North Cascades Tree Farm
Gate -·-·- WCT Property Line
• Road Block -~'-----" 40ft Contours
r=- Paved Road ~ Type S, F Stream
~ Gravel Road ~ Type Np Stream
.. ~~~== , Dirt Road
/ ---- --. Trails
,--., ___ , Type Ns Stream
Untyped Stream
@ Heliport
W Siteprep Aerial
Fall Release
RMZ I No-entry Areas
C:3 Ex isting Buffers
C3 Additional Buffers
Scale 1 in = 1000 ft
T31 N R07E sec 25 Snohomish County
1 4 7 0 7
7/16/2015
N
i
WY Columbia Timberlands North Cascades Tree Farm
121 ·55·3o·w 121·55·o·w
s Gate -·-·- WCT Property Line
• Road Block ,~"----'' 40ft Contours
~ Paved Road ~ Type S, F Stream
,r= Gravel Road ~ Type Np Stream
,,,~ ~~~= , Dirt Road ,.-, " ,_, Type Ns Stream
, Trails Untyped Stream
121·ss·3o·w
® Heliport
w Siteprep Aerial
Fa ll Release
RMZ I No-entry Areas
C:3 Existing Buffers
w Additional Buffers
Scale 1 in = 1000 ft
T31 N R07E sec 29 Snohomish County
121·ss·o·w
1 4 7 0 7
7/16/2015
N
i
WY Columbia Timberlands North Cascades Tree Farm
z Gate -·-·- WCT Property Line
• Road Block ,~ '---' 40ft Contours
~ Paved Road ~Type S, F Stream
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Scale 1 in = 1000 ft
T32N RO?E sec 25 Snohomish County
~ 1 4 7 0 7
7/1 6/2015
N
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WY Columbia Timberlands North Cascades Tree Farm
::: Gate -·-·- WCT Property Line
• Road Block ,~'----' 40ft Contours
,r=- Paved Road ~Type S, F Stream
_r= Gravel Road ~ Type Np Stream
.. ~ ~~~= , Dirt Road
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T32N R07E sec 25 Snohomish County
.1 14707
7/16/2015
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121 ·s1·o·w
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T32N R07E sec 25 Snohomish County
~ 7 0 7
7/1 6/2015
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~
WY Columbia Timberlands North Cascades Tree Farm
s Gate -·-·- WCT Property Line
• Road Block -~'---'' 40ft Contours
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T32N R07E sec 27 Snohomish County
1 4 7 0 7
7/1 6/2015
N
!
WY Columbia Timberlands North Cascades Tree Farm
s Gate -·-·- WCT Property Line
• Road Block ,~'---" 40ft Contours
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,, .. ~~== , Dirt Road ,,- ... ..,,_, Type Ns Stream
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Scale 1 in = 1000 ft
T32N R07E sec 28 Snohomish County
1 4 7 0 7
7/16/2015
N
!
WY Columbia Timberlands North Cascades Tree Farm
s Gate -·-·- WCT Property Line
• Road Block '~'-.___./ 40ft Contours
,r=- Paved Road ~ Type S, F Stream
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T32N R07E sec 33 Snohomish County
7/1 6/2015
N
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WY Columbia Timberlands North Cascades Tree Farm
s Gate -·-·- WCT Property Line
• Road Block ,~'----' 40ft Contours
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T32N R07E sec 34 Snohomish County
1 1 7 0 7
7/16/201 5
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W( Columbia Timberlands
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• Road Block -~'--'' 40ft Contours
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,r= Gravel Road ~ Type Np Stream
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T32N R07E sec 35 Snohomish County
121 "52'0'W
1 11. 70 7
7/16/2015
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\IVY Columbia Timberlands North Cascades Tree Farm
(~
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T37N R05E sec 10 Whatcom County
•' 7 0 7
7/16/2015
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• Road Block ,~"-----' 40ft Contours
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T37N R05E sec 11 Whatcom County
T 0 7
7/16/2015
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122' 8'0'W 122' 7'30''W
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T37N ROSE sec 11 Whatcom County
122'6'30''W
7 0 7
7/1 6/2015
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T37N R06E sec 07 Whatcom County
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7/16/2015
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T38N R06E sec 29 Whatcom County
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7/16/2015
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T33N R06E sec 10 Skagit County
122· 1·o·w 122·0·3o·w
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121·s3·3o·w
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T33N R07E sec 03 Skagit County
'- · '-121"52'30'W
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7/16/2015
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T33N R07E sec 03 Skagit County
121 "53'0'W
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7/16/2015
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T33N R07E sec 04 Skagit County
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7/1 6/2015
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• Road Block ,~ '------' 40ft Contours
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T33N R07E sec 15 Skagit County
1
7/1 6/2015
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Wf Columbia Timberlands North Cascades Tree Farm
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• Road Block '~"----" 40ft Contours
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T33N R07E sec 15 Skagit County
7
7/16/2015
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WY Columbia Timberlands North Cascades Tree Farm
121'55'0'W
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T33N R07E sec 21 Skagit County
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T34N R07E sec 30 Skagit County
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T35N R08E sec 21 Skagit County
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7/16/2015
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T35N R07E sec 23 Skagit County
121"51'30"W 121"51 '0"W
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T35N R09E sec 04 Skagit County
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7/16/2015
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7/16/2015
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T36N ROSE sec 04 Skagit County
7/16/2015
N
~
FPA/N No: _2814707 ___ _
WASHINGTON STATE DEPARTMENT OF
Natural Resources Effective Date: _8/20/2015 ____ _
Peter Goldmark- Commissioner of Public Lands Expiration Date: _8/20/2018 ____ _
Forest Practices Application/Notification Shut Down Zone:
Notice of Decision EARR Tax Credit: [] Eligible [X] Non-eligible
DECISION:
[] NOTIFICATION
[X] APPROVED
[] DISAPPROVED
[] CLOSED
Reference: Aerial Spray
Operations shall not begin before the effective date.
This Forest Practices Application is subject to the conditions listed below.
This Forest Practices Application is disapproved for the reasons listed below.
Applicant has withdrawn FPA/N.
FPA/N CLASSIFICATION Number of Years Granted on Multi-Year Request
[] Class II [X] Class Ill [] Class IVG [] Class IVS [ ] 4yrs [ ] 5 yrs
Conditions on Approval I Reasons for Disapproval
1) Contact the Dept. of Natural Resources, at least two (2) business days (Monday through Friday) prior to the start of operations. Call (360) 856-3500 for the Northwest Region Office -Forest Practices, or directly by cellular telephone to the Forest Practice Forester, and provide the application number and legal description for your operation.
2) Spray buffers must be clearly marked or easily identifiable by the Forest Practice Forester in the field prior to aerial application. Field markers and/or buffers for all open and/or flowing waters must be clearly visible by the pilot from the air. The operator and/or landowner representative will identify and notify the pilot of all water locations prior to the spray application.
Note: Aerial chemical application areas shall be posted by the landowner by signing at significant points of regular access at least 5 days prior to treatment. Posting shall remain at least 15 days after the spraying is complete.
NOTICE:
As of August 15, 2014, the United States Environmental Protection Agency (EPA) reinstated nospray buffer zones for ground and aerial applications of certain pesticides around salmonsupporting waters in Washington, Oregon, and California.
Where the EPA buffers are wider than those required by the Washington State forest practices rules, the EPA buffers shall be used.
To determine if you will need to leave the EPA buffers on your spray operation, refer to the Washington State Department of Agriculture's internet web site at:
Washington State Department of Natural Resources • Notice of Decision July 10, 2012 Page 1of3
http://agr.wa.gov/pestfert/natresources/buffers.aspx .
It is important to check the Department of Agriculture's website immediately before spraying to ensure that you have the most current information.
For questions regarding the EPA buffers email [email protected]. For help with interpreting the maps and tables on the website or for additional information on applying pesticides, contact the Washington State Department of Agriculture - Pesticide Management Division at 360 902 2040.
Issued By: _Todd Olson, _ ___.._~-+-·--'(.J. __ _ Region: _Northwest. ____ _
Title: _Stillaguamish Forest Practice Forester __ Date: _8/20/2015 ____ _
Copies to: [X ] Landowner, Timber Owner and Operator Issued in Person: []Landowner, [ ]Timber Owner [ ] Operator By: ________________ _
Washington State Department of Natural Resources • Notice of Decision July 10, 2012 Page 2 of 3
Appeal Information You have thirty (30) days to appeal this Decision and any related State Environmental Policy Act determinations to the Pollution Control Hearings Board in writing at the following addresses: Physical address: 1111 Israel Rd. SW, Ste 301, Tumwater, WA 98501 Mailing address: P.O. BOX 40903, OLYMPIA, WA 98504-0903 Information regarding the Pollution Control Hearings Board can be found at: http://www.eluho.wa.gov/ At the same time you file an appeal with the Pollution Control Hearings Board, also send a copy of the appeal to the Department of Natural Resources' region office and the Office of the Attorney General at the following addresses:
Office of the Attorney General Department Of Natural Resources Natural Resources Division Northwest Region 1125 Washington Street SE And 919 N Township Street PO Box 40100 Sedro-Woolley, WA 98284 Olympia, WA 98504-0100
Other Applicable Laws
Operating as described in this application/notification does not ensure compliance with the Endangered Species Act, or other federal, state, or local laws.
Hydraulic Project Approval {HPA) (Chapter 77.55RCW and WAC 222-50-020(2))
The Department of Fish and Wildlife (WDFW), as the jurisdictional agency issuing HPAs, has final authority for approving water crossing structures in Type S and F waters. WDFW continues to have authority on Type N waters and may exercise that authority on some Type N waters.
Notice: The HPA water crossing requirements supersede what is indicated on the FPA. Landowners are required by law to follow the provisions as directed on the HPA.
Transfer of Forest Practices Application/Notification (WAC 222-20-010)
Use the "Notice of Transfer of Approved Forest Practices Application/Notification" form. This form is available at region offices and on the Forest Practices Division website: http://www.dnr.wa.gov/businesspermits/forestpractices. Notify DNA of new Operators within 48 hours.
Continuing Forest Land Obligations (RCW 76.09.060, RCW 76.09.070, RCW 76.09.390, and WAC 222-20-055)
Obligations include reforestation, road maintenance and abandonment plans, conversions of forest land to nonforestry use and/or harvest strategies on perennial non-fish habitat (Type Np) waters in Eastern Washington.
Before the sale or transfer of land or perpetual timber rights subject to continuing forest land obligations, the seller must notify the buyer of such an obligation on a form titled "Notice of Continuing Forest Land Obligation". The seller and buyer must both sign the "Notice of Continuing Forest Land Obligation" form and send it to the DNA Region Office for retention. This form is available at DNA region offices.
If the seller fails to notify the buyer about the continuing forest land obligation, the seller must pay the buyer's costs related to continuing forest land obligations, including all legal costs and reasonable attorneys' fees incurred by the buyer in enforcing the continuing forest land obligation against the seller.
Failure by the seller to send the required notice to the DNA at the time of sale will be prima facie evidence in an action by the buyer against the seller for costs related to the continuing forest land obligation prior to sale.
DNR affidavit of mailing:
On this day _8-21-15 , I placed in the United States mail at Sedro-Woolley, WA, postage paid,
a true and accurate copy of the attached document. FPA #_2814707 __ ___ L Utgard ___ _
(Printed name)
Washington State Department of Natural Resources • Notice of Decision July 10, 2012 Page 3 of 3 ........... -----------------~~-
WASHINGTON STATE DEPARTMENT OF
Natural Resources FPA/N No:
Peter Goldmark· Commissioner of Public Lands Date of Service:
Request to Amend Forest Practices Application/Notification
Reference: _Aerial Spray ____ _
DNR's Decision Decision
)4'' Approved This request for an amendment is approved and subject to the conditions listed below
[ ] Disapproved This request for an amendment is disapproved for the reasons listed below
Conditions on Approval/Reasons for Disapproval
Appeal Information (RCW 76.09.090(3), WAC 222-46-030(4), and WAC 332-08-215 (3).
The Landowner, Timber Owner, or Operator has 15 calendar days from the Date of Service to request a Brief Adjudicative Proceeding for this amendment which is a Notice to Comply for an authorized deviation. Appeal requests must:
• Be in writing • Include signature(s) • Include the factual basis for the appeal and the issue to be adjudicated • Sent to the Region Office at 919 N Township St. Sedro-Woolley WA 98284 • With a copy sent to the Department of Natural Resources, Forest Practices Division, PO Box 47012, Olympia,
WA 98504-7012
Issued By~ (~-yJ;-,u,;; ,4.,..Title: Forest Practice Fo1e9ter
Copies Sent To: Landowner (via US Mail), Timber Owner (via US Mail), Operator (via US Mail), WDFW, DOE, Affected Indian Tribes, LGE, other: FPDM, FPCOORD,
DNA affidavit of mailing:
On this day r ·~ -I -(date)
, I placed in the United States mail at Sedro-Woolley, WA,
(post office location)
postage p7id, a Jr.~ ue and accurate copy of this Amendmen quest Notice of Decision for FPA # f!!.?l4'1i> / 0- f ?!Ip.A?( ---"'--.t---'<-~=-::::;~:~=·~==--:-=----
(Printed name) (Signature)
Washington State Department of Natural Resources • Amendment Request Notice of Decision • July 1, 2010
•
WASHINGTON STATE DEPARTMENT OF
Natural Resources
Request to Amend Forest Practices Application/Notification
For DNR Region Office Use Only
Region:
Use this to request an amendment to an approved Western Washington, Eastern Washington, or Aerial Chemical Applications/Notifications
TYPE OR PRINT IN INK:
1. Landowner, Timber Owner, and Operator information
2.
3.
4.
5.
Legal Name of LANDOWNER Legal Name of TIMBER OWNER Legal Name of OPERA TOR
Weyerhaeuser Columbia Weyerhaeuser NR Timberlands
Mailing Address: Mailing Address: Mailing Address:
500 Metcalf St, Building F-5E Same
City, State, Zip City, State, Zip City, State, Zip
Sedro Woolley, WA 98284 Same
Phone ( 360) 424-2014 Phone ( ) Same Phone ( )
Email: kelly.dougherty Email:@weyerhaeuser.com Email:
Approved FPA/N Number _2_8_1_4_70_7 ___________ _
Describe the proposed amendment to the original FPA/N. You can attach revised pages of an FPA/N, or give specific details. Include a new Activity Map if you are proposing any changes to the original.
Add: Superspread MSO, WA Reg#: 2935-03001
I affirm that the information contained herein is true, and understand that this proposed forest practice is subject to the Forest Practices Act and Rules, as well as all other federal, state or local regulations. Compliance with the Forest Practices Act and Rules does not ensure compliance with the Endangered Species Act or other federal, state or local laws. I understand this amendment is a request for a Notice to comp for an authorized deviation as descri ed in WAC 222-20-060. f // f /;S
~ I
Landowner's Signature Date
QQ-46W (Revised 12/22/06)
Pesticide Information Center Online (PICOL)
WSPRS
Pesticide Information Center Online
PICOL OUTPUT - SUMMARY
EPA Number EQ 2935-03001
States EQ WA
Year EQ 2015
Format Labels I
PID ·.·• 43066
REGISTRANT .. WILBUR-ELLIS COMPANY
NAME ... SUPER SPREAD MSO [55 WA
EPA# 2935-03001
COMPANY ID···· F-033015
DATE-ADDED ... 2004-05-26
DATE-MODIFIED··· 2015-07-31
SIGNAL WORD .• WARNING
FORMULATION ... Oil
USE CATEGORY··· GENERAL USE
INTENDED USER .. COMMERCIAL
APPLICATION GROUND
SlN # ..
SLN Name .•.
GROUNDWATER ADVISORY STMT NO
1-502/1-692 ··NO
WASHINGTON REG .... 2015
OREGON REG.
SUPPLEMENTAL.LABEL ·•·
SUPPLEMENTAL Name .•.
TYPE ADJS-SURFACTANT
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INGREDIENTS ··. NO ACTIVE INGREDIENTS 0%
Spanish ·•· NO
OM RI logo •• NO
ESA Notice ·""" NO
Master Label
Section 18 Section 18 Expiration .-.·
CROP-UST ..
PEST LIST••
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Puyallup Research and Extensjon Center, 2606 West Pioneer, Puyallup, WA, 98371 -4900, 253- 445·-4611, ~
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WASHINGTON STATE. DEPARTMENT OF
Natural Resources FPA/N No: 2814707 -----' ' 09/09/15 Peter Goldmark • Commissioner of Publ le Lands Date of Service:
Request to Amend Forest Practices Application/Notification
Reference: _spray ____ _
DNR's Decision Decision
[X] Approved This request for an amendment is approved and subject to the conditions listed below
[ ] Disapproved This request for an amendment is disapproved for the reasons listed below
Conditions on Approval/Reasons for Disapproval
Appeal Information (RCW 76.09.090(3), WAC 222-46-030(4), and WAC 332-08-215 (3).
The Landowner, Timber Owner, or Operator has 15 calendar days from the Date of Service to request a Brief Adjudicative Proceeding for this amendment which is a Notice to Comply for an authorized deviation. Appeal requests must:
• Be in writing • Include signature(s) • Include the factual basis for the appeal and the issue to be adjudicated • Sent to the Region Office at 919 N Township St, Sedro-Woolley WA 98284 • With a copy sent to the Department of Natural Resources, Forest Practices Division, PO Box 47012, Olympia,
WA 98504-7012
Issued By: ?:£: (£ S:§ ~ Jo~ Dt-St> <
Title: Forest Practice Forester
Copies Sent To: Landowner (via US Mail), Timber Owner (via US.Mail), Operator (via US Mail), WDFW, DOE, Affected Indian Tribes, LGE, other: FPDM, FPCOORD, £-~/ CJ'-7'-/ .:>-
DNR affidavit of mailing:
On this day ________ , I placed in the United States mail at Sedro-Woolley, WA,
(date) (post office location)
postage paid, a tru~and accurate copy of this Arnendrne .. q.lUJ!SJ Noti~e;if Decision for FPA #!2.>J/7t:?J1' ?, I /~qi ---=-+-·-""'-~-*"'-.:::..__.:c_~ __
(Printed name) (Signatur
Washington State Department of Natural Resources • Amendment Request Notice of Decision • July 1, 2010
•
WASHINGTON STATE DEPARTMENT OF
Natural Resources
Request to Amend Forest Practices Application/Notification
Use this to request an amendment to an approved Western Washington, Eastern Washington, or Aerial Chemical Applications/Notifications
TYPE OR PRINT IN INK:
1. Landowner, Timber Owner, and Operator information
Legal Name of LANDOWNER Legal Name of TIMBER OWNER Legal Name of OPERATOR
Weyerhaeuser Columbia Weyerhaeuser NR Timberlands
Mailing Address: Mailing Address: Mailing Address:
500 Metcalf St, Building F-5E Same
City, State, Zip City, State, Zip City, State, Zip
Sedro Woolley, WA 98284 Same
Phone ( 360) 424-2014 Phone ( > Same Phone ( )
Email: kelly.dougherty Email: @weyerhaeuser.com Email:
2. Approved FPA/N Number_2_8_14_7_0_7 __________ _
3. Describe the proposed amendment to the original FPA/N. You can attach revised pages of an FPA/N, or give specific details. Include a new Activity Map if you are proposing any changes to the original.
Add: MSO Concentrate with Leci-Tech, WA Reg#: 34704-07001
4. I affirm that the information contained herein is true, and understand that this proposed forest practice is subject to the Forest Practices Act and Rules, as well as all other federal, state or local regulations. Compliance with the Forest Practices Act and Rules does not ensure compliance with the Endangered Species Act or other federal, state or local laws. I understand this amendment is a request for a Notice to Comply for an authorized deviation as described in WAC 222-20-060.
5. 09/08/2015 --------~ Landowner's Signature Date
QQ-46W (Revised 12/22/06)
Pesticide Information Center Online (PICOL)
WSPRS
Pesticide Information Center Online
PICOL OUTPUT- SUMMARY
EPA Number EQ 34704-07001 States EQ WA
Year EQ 201 S
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PIO·-·· 48583
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REGISTRANT ··- LOVELAND PROD. /CROP PROTECTION SVCS
NAME~ MSOCONCW/LECI-TECH 1180WA EPA# 34704-07001 COMPANY ID GOS 14 DATE-ADDED··- 2007-03-01 DATE-MODIFIED ... 2015-07-24 SIGNAL WORD WARNING
FORMULATION ... OIL
USE CATEGORY-.. GENERAL USE
INTENDED USER ·• COMMERCIAL APPLICATION-··- GROUND
SLN# ··-SLN Name ..
GROUNDWATER ADVISORY STMT •• NO
1-502/1-692 -- NO
WASHINGTON REG. "" 2015 OREGON REG.···
SUPPLEMENTAL LABEL ..
SUPPLEMENTAL Name
TYPE .. ADJS-SURFACTANT
INGREDIENTS NO ACTIVE INGREDIENTS 0% Spanish .. _ NO
OMRI Logo -··· NO ESA Notice "--'- NO
Master Label ·.··
Section 18 ~··
Section 18 Expiration ~-
CROP-UST· ADJUVANT (CROP); ADJUVANT (NON-CROP)
!PEST -LISl "" IINO PESTS LISTED
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Puyallup Rtsearch and Exten;r.jon Center, 2606 West Pioneer, Puyallup. WA, 98371-4900, 253·445·-4611, ~
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