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FARMLAND CONVERSION IMPACT RATING

Department of Agriculture FARMLAND CONVERSION IMPACT RATING PART I (To be completed by Federal Agency) Date Of Land Evaluation Request Name of project Federal Agency Involved Proposed Land Use County and State PART II (To be completed by NRCS) Date Request Received By NRCS Person Completing Form: Does the site contain Prime, Unique, Statewide or Local Important FARMLAND ? (If no, the FPPA does not apply - do not complete additional parts of this form) YES NO Acres Irrigated Average Farm Size Major Crop(s) Farmable Land In Govt.

project such as transportation, power line and flood control, criteria #5 and #6 will not apply and will, be weighted zero, however, criterion #8 will be weighed a maximum of 25 points and criterion #11 a maximum of 25 points. 2. Federal agencies may assign relative weights among the 12 site assessment criteria other than those shown on the

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