Form R5-3400-1 - Forest Pest Detection Report - Department Of Agriculture
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United States Department of Agriculture - Forest Service
California Forest Pest Council
FOREST PEST DETECTION REPORT
I. FIELD INFORMATION (See instructions on reverse)
1. County:
2. Forest (FS only):
3. District (FS only):
4. Legal Description:
6. Location:
7. Landownership:
T.
R.
National Forest
Other Federal
Section (s)
State
5. Date:
UTM:
Private
8. Suspected Cause of Injury:
9. Size of Trees Affected:
10. Part(s) of Tree Affected:
1. Insect
5. Chemical
1. Seedling
4. Sawtimber
1. Root
5. Twig
2. Disease
6. Mechanical
2. Sapling
5. Overmature
2. Branch
6. Foliage
3. Animal
7. Weed
3. Pole
3. Leader
7. Bud
4. Weather
8. Unknown
4. Bole
8. Cone
11. Species Affected:
12. Number Affected:
13. Acres Affected:
14. Injury Distribution:
15. Status of Injury:
16. Elevation:
1. Scattered
2. Grouped
1. Decreasing
2. Static
3. Increasing
17. Plantation?
18. Stand Composition (species): 19. Stand Age and Site Class:
1. Yes
2. No
Age:
Class:
20. Stand Density:
21. Site Quality:
22. Pest Names (if known) and Remarks (symptoms and contributing factors):
23. Sample Forwarded:
24. Action Requested:
25. Reporter's Name:
26. Reporter's Agency:
1. Yes
2. No
1. Information only
2. Lab Identification
3. Field Evaluation
27. Reporter's Address, email and Phone Number:
email:
phone:
Address 1:
Address 2:
City:
State:
Zip:
II. Reply (Pest Management Use)
28. Response:
29. Report Number:
30. Date:
31. Examiner's Signature:
R5-3400-1 (Rev. 3/02)
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