Nonpoint Source Evaluation for Individual Streams or Stream Segments

Stream Evaluation for ________________________in the _______________Watershed or Subwatershed

Total stream miles in watershed _________________

Perennial miles _______________Intermittent miles_______________

Is there the potential for this stream to respond to NPS control practices? (circle one)

Yes - continue survey; No? Stop Survey

1. Is the waterbody in a high ranked watershed or subwatershed ? Yes? (stop survey and submit for grant program) No? (continue)

2. Does the watershed/stream table information indicate that the stream has NPS related problems and sources? If Yes, fill out the form below and submit with a request to the WT Bureau to amend the basin's integrated plan have that stream or stream segment a high ranked priority for NPS problems (you can skip #3 below).

3. Is the waterbody discussed in the most recent integrated basin plan as having nonpoint source related problems and/or that it would benefit from NPS control practices? If Yes, fill out the form below and submit with a request to the WT Bureau to amend the basin's integrated plan have that stream or stream segment a high ranked priority for NPS problems.

Water Quality Evaluation

Document if stream has any of the following problems and to what degree. Attach copies of data or studies supporting this determination or list below verbal or written communication regarding the indicated information and need.

Fish population and diversity ____________________________________

Recurring fish kills ____________________________________________

Endangered Resources _________________________________________

Water Quality: ________________________________________________

Incl. DO violations______________________________________

NH3 Violations ________________________________________

NO3 >10 mg/l _________________________________________

NPS toxicity problems ___________________________________

Mean TSS > 420 mg/l ___________________________________

Biotic Index ___________________________________________________

Stream bed sedimentation_________________________________________

Physical modification____________________________________________

Undesirable vegetation___________________________________________

Threatened water quality? If Yes, explain __________________________

Is stream ORW or ERW? ________________________________________