Signature Name Notary Public in and for the State of (SEAL) Residing at My commission expires Appendix IX Water Survey Form For BPA Funded Transactions (work element 5 and 92) and Selected Water Conservation Actions (work elements 82, 149, 150, 151) INSTRUCTIONS: The project sponsor or BPA project manager must complete this form for land transaction work elements, including Land Acquisitions (5) and Land (92). This form should be completed during the pre-acquisition phase for a land transaction, and attached to the particular Land Acquisition (5) or Lease Land (92) work element for the property involved. Project sponsors shall also use the form for the water conservation work elements designed to conserve water, including Install Well (82), Install Pipeline (149), Install Sprinkler (150), or Line Diversion Ditch (151). BPA Project Manager: ________________________________________________ Project #: ____-___-__ Name of Project Sponsor: ________________________________________________ Name of Property: ________________________________________________ Are there surface water sources (including springs), indications of water use (e.g., canals, irrigation equipment, irrigated lands), wells, or other groundwater sources on or immediately adjacent to the property boundary? If not, please add your contact information, and attach this form in Pisces as a Survey” attachment to your contract. “Water
Signature Name Notary Public in and for the State of (SEAL) Residing at My commission expires Appendix IX Water Survey Form For BPA Funded Transactions (work element 5 and 92) and Selected Water Conservation Actions (work elements 82, 149, 150, 151) INSTRUCTIONS: The project sponsor or BPA project manager must complete this form for land transaction work elements, including Land Acquisitions (5) and Land (92). This form should be completed during the pre-acquisition phase for a land transaction, and attached to the particular Land Acquisition (5) or Lease Land (92) work element for the property involved. Project sponsors shall also use the form for the water conservation work elements designed to conserve water, including Install Well (82), Install Pipeline (149), Install Sprinkler (150), or Line Diversion Ditch (151). BPA Project Manager: ________________________________________________ Project #: ____-___-__ Name of Project Sponsor: ________________________________________________ Name of Property: ________________________________________________ Are there surface water sources (including springs), indications of water use (e.g., canals, irrigation equipment, irrigated lands), wells, or other groundwater sources on or immediately adjacent to the property boundary? If not, please add your contact information, and attach this form in Pisces as a “Water Survey” attachment to your contract.
20161117LandsDeskbookAppendicesFINAL.docx