Cooperative Red Imported Fire Ant Project Notification Of Intent To Move Soil (Page 2 of 2) in pdf

Cooperative Red Imported Fire Ant Project Notification Of Intent To Move Soil Page 2

Cooperative Red Imported Fire Ant Project

Notification of Intent to Move Soil

From or within Quarantined Areas of

Riverside, Orange, and Los Angeles Counties

Phone: 760 776-8208, FAX 760 776-8091

Permit No. ___________________

Red imported fire ant (RIFA) Compliance

Issuing Agency: City/County

Agreement No.

……………………

_______________________

Name of Company Requesting Approval: _________________________________________

Contact Person: ______________________________________________________________

Address: __________________________________ City: _____________________________

Telephone: (_______)________________________ Fax: (_______)_____________________

Excavation Location: _________________________________________ TB* ____________

__________________________________________ Acres: ___________

Destination Location: _________________________________________ TB* ____________

___________________________________________Acres: __________

Estimated Quantity of Soil (Cubic Yards): _______Anticipated Date of Movement: ________

Urgency Level for Immediate Inspection and Release**: [Circle One] High

Medium

Low

TO BE COMPLETED BY RIFA PROJECT REGULATORY OFFICIAL ONLY:

Movement of soil is permitted.

Hold movement until site checked - WE WILL CALL AS SOON AS POSSIBLE

TO SCHEDULE INSPECTION DATE AND TIME.

Date Trapped: ____________ # of Traps: __________ Acres: _________________

Date Picked Up: __________ PDR #: ______________ Trapped by: ____________

Comments: _________________________________________________________

Soil Movement soil is strictly prohibited for the following reasons:

___________________________________________________________________

Name of RIFA Project Regulatory Official: _____________________________________

Signature: ________________________________ Date: __________________________

*TB is Thomas Brothers map page and grid information.

RIFA Form CA-1 CV Revised 8/16/06

**Please allow 2-4 working days for inspection (Mon-Thursday).

California Department of Food and Agriculture – RIFA Program PO Box 2017, Los Alamitos, CA 92627

Cooperative Red Imported Fire Ant Project Notification Of Intent To Move Soil Page 2