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APPENDIX A Sheet I. NRCS clearance for prime or unique farmland on TRSWA. <br />U.S. Department of Agriculture <br />FARMLAND CONVERSION IMPACT RATING <br />PART I (To be COMPlered by Federal Agency) Dan! Of Land Evaeuati <br />Pr000sed Land Feder I Age <br /><0/ <br />" . <br />PART 11 F'1s —4 1,-17d'ill 'oZntY And State <br />-/- <br />(To be completed <br />CSI' <br />Does the site cont: quest Rec <br />d ideorloc#Impbrtah. <br />does not n <br />(If no, the FPPA li-firl'la 0.1 -:R <br />Zr— Average Par <br />Major cropill ii&;nplele addidional-illoal. -jIcres irriga, <br />ItIle <br />Land 4.... <br />and In Go, <br />Amount <br />J. Amount <br />Of- Farmland As Deli <br />Name of Land Evaluation System Used <br />Lol 1; <br />essnen <br />PART Date <br />Land Evaluation <br />Returns <br />0 be COMPleted by Federal Agency] <br />A. <br />Total ACTIM I", Be Alternative site Ratin <br />11 Converted led Directly Site A Site 8 Size c <br />B. Total Act To Be Converted Indil <br />C. Total Acres <br />PART IV 17-0 be leteil ya uation Information <br />A. Total Acres Prime And 8. Total Acres Statewide And Ul Farmland <br />C. Local Important Farmland <br />a <br />Percentage Of Farmland In County <br />rcentac a Of F-arl 111,3 )(C a Govt. Unit ToGeConverted '._.• �_ • _,�'_� w <br />PART V (i'cl beco "I'll With Same Or Higher Relative <br />M" Land Evaluat <br />P etli!1:11 !7Y-S2T1---10 tive Value- t- <br />Relative Value Of Farmland To Be Converted (Scale Criterion <br />PART Vi (To be completed by Federal 0 f 0 to 100 P"O' in <br />Site Assessment criteria /These crrill are. Agency) <br />Maximum um <br />------- xPleined in 7 CPR 658.5(b1' Po.m <br />1. Area In No ints <br />nurban Use <br />Perimeter In Nonurban Use <br />3. Percent of Site le i n,; Farmed <br />4- Protection Provided BY State And Local Government <br />5- Distance From Urban Bl Are <br />- Distance Support Services <br />7. :11ZE Of Present Farm Unit Compared To Average <br />a III I Of 4onfarm, I I I a Farmland <br />1.1'''lla-nd <br />9. Availability Of l <br />arm Su port Services <br />10* un•Farm Investments <br />'I- Effects Of Conversion On Farm Support Services <br />12- Com atibili With Existin A ricultural Use <br />TOTAL SITE ASSESSMENT POINTS 160 <br />PART VII (To be completed by Federal Agency) <br />Relative Value Of Farmland (From part V) <br />Total Site Ass' 100 <br />site assessment sment <br />(From Parr V/ above or a local <br />TOTAL POINTS JTor,1 of above 2 lines/ 160 <br />260 <br />Site Selected: <br />Date Of $eleCtl on Was A Local Site Assessment Used? <br />Ile.,.- For Selection: ,.—. Yes 5 No ❑ <br />/see <br />Side, <br />M.Size <br />ned in fPPA <br />11vl,il (5CS) <br />Form 0.1006 (10.83) <br />