Natural Resource Conservation




County

Your Name:

Email:

Address:

Phone:

Site Name and Ownership:

Exact location of site (please be specific):

Size of site (approx. acres)

Date of observation

Site type:
Mature forest
Forested swamp
Shrub swamp
Marsh
Bog
Natural lake or pond
 High quality stream
Habitat for rare species
Rock outcrop or cliff
Cave
Other

Written description of site (try to convey a mental image of the site's features by including vegetation, significatn plants and animals, aquatic features land forms, geologic features, etc.)

Evidence of Disturbance
(logging, mining, erosion, sedimentation, filling, draining, grazing, etc.):

Please send any supplemental information such as species list, maps, photographs, etc. to: Natural Heritage Program, Western Pennsylvania Conervancy, 209 Fourth Avenue Pittsburgh, PA 15222. Phone: 412.288.2777. Printed copies of this form may be obtained from this office. Thank you for your contribution to the County Natural Heritage Inventory Program.