**SOUTHEAST** **REGION**

**INTRA-SERVICE SECTION 7**

**BIOLOGICAL EVALUATION FORM**

\[Federally endangered, threatened, and candidate species\]

**Originating Person: \_\_**

**Telephone Number: \_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ E-Mail:
\_**

**Date: \_**

**PROJECT NAME (Grant Title/Number):\_\_\_**

**I. Service Program:**

> **\_\_\_ Ecological Services**
>
> **\_\_\_ Federal Aid**

**\_\_\_ Clean Vessel Act**

> **\_\_\_ Coastal Wetlands**
>
> **\_\_\_ Endangered Species Section 6**
>
> **\_\_\_ Partners for Fish and Wildlife**
>
> **\_\_\_ Sport Fish Restoration**
>
> **\_\_\_ Wildlife Restoration**
>
> **\_\_\_ Fisheries**
>
> **\_\_\_ Refuges/Wildlife**

II. **State/Agency:**

> **III. Station Name:**

**IV. Description of Proposed Action (attach additional pages as
needed):**

**V. Pertinent Species and Habitat:**

> **A. Include species/habitat occurrence map:**

B.  **Complete the following table:**

  -----------------------------------------------------------------------
  **SPECIES/CRITICAL HABITAT**                     **STATUS**^1^
  ------------------------------------------------ ----------------------
                                                   

                                                   

                                                   

                                                   

                                                   

                                                   

                                                   

                                                   

                                                   

                                                   
  -----------------------------------------------------------------------

^1^STATUS: E=endangered, T=threatened, PE=proposed endangered,
PT=proposed threatened, CH=critical habitat, PCH=proposed critical
habitat, C=candidate species

> Identify listed, proposed and candidate species as well as designated
> and proposed critical habitat within the action area and their status.
> The action area includes the immediate area where the proposed action
> will occur, as well as any other areas where direct or indirect
> impacts of the action may be expected. For example, effects of an
> action in the headwaters of a stream may affect endangered fish that
> occur 20 miles downstream. A compilation of species or critical
> habitats that possibly occur in the action area may be generated by
> the Project Leader, or it may be requested from the appropriate
> Ecological Services Office.
>
> Note: All experimental populations of listed species are treated as
> threatened species. However, for the purposes of intra-Service section
> 7 consultation, they are treated as species *proposed* for listing if
> they occur off National Wildlife Refuge or National Park System lands
> and they are classed as \"non-essential\" experimental populations.
>
> List all listed, proposed or candidate species and designated or
> proposed critical habitat that may occur within the action area. This
> informs the reviewer what species have been considered.

**VI. Location (attach map):**

> **A. Ecoregion Number and Name:**
>
> **B. County and State:**
>
> **C. Section, township, and range (or latitude and longitude):**
>
> **D. Distance (miles) and direction to nearest town:**
>
> **E. Species/habitat occurrence:**

**VII. Determination of Effects:**

> **A. Explanation of effects of the action on species and critical
> habitats in item V. B (attach additional pages as needed):**
>
> .

+-------------------+--------------------------------------------------+
| **SPECIES/**      | **IMPACTS TO SPECIES/CRITICAL HABITAT**          |
|                   |                                                  |
| **CRITICAL        |                                                  |
| HABITAT**         |                                                  |
+===================+==================================================+
|                   |                                                  |
+-------------------+--------------------------------------------------+
|                   |                                                  |
+-------------------+--------------------------------------------------+
|                   |                                                  |
+-------------------+--------------------------------------------------+
|                   |                                                  |
+-------------------+--------------------------------------------------+
|                   |                                                  |
+-------------------+--------------------------------------------------+
|                   |                                                  |
+-------------------+--------------------------------------------------+
|                   |                                                  |
+-------------------+--------------------------------------------------+
|                   |                                                  |
+-------------------+--------------------------------------------------+
|                   |                                                  |
+-------------------+--------------------------------------------------+

> **B. Explanation of actions to be implemented to reduce adverse
> effects:**

+--------------------+-------------------------------------------------+
| **SPECIES/**       | **ACTIONS TO MINIMIZE IMPACTS**                 |
|                    |                                                 |
| **CRITICAL         |                                                 |
| HABITAT**          |                                                 |
+====================+=================================================+
|                    |                                                 |
+--------------------+-------------------------------------------------+
|                    |                                                 |
+--------------------+-------------------------------------------------+
|                    |                                                 |
+--------------------+-------------------------------------------------+
|                    |                                                 |
+--------------------+-------------------------------------------------+
|                    |                                                 |
+--------------------+-------------------------------------------------+
|                    |                                                 |
+--------------------+-------------------------------------------------+
|                    |                                                 |
+--------------------+-------------------------------------------------+
|                    |                                                 |
+--------------------+-------------------------------------------------+
|                    |                                                 |
+--------------------+-------------------------------------------------+

**VIII. Effect Determination and Response Requested:**

+-------------------------------+------+-------+-------+-------------+
| **SPECIES/**                  | **DE |       |       | **RE        |
|                               | TERM |       |       | SPONSE^1^** |
| **CRITICAL HABITAT**          | INAT |       |       |             |
|                               | ION^ |       |       | **          |
|                               | 1^** |       |       | REQUESTED** |
+===============================+======+=======+=======+=============+
|                               | **   | *     | *     |             |
|                               | NE** | *NA** | *AA** |             |
+-------------------------------+------+-------+-------+-------------+
|                               |      |       |       |             |
+-------------------------------+------+-------+-------+-------------+
|                               |      |       |       |             |
+-------------------------------+------+-------+-------+-------------+
|                               |      |       |       |             |
+-------------------------------+------+-------+-------+-------------+
|                               |      |       |       |             |
+-------------------------------+------+-------+-------+-------------+
|                               |      |       |       |             |
+-------------------------------+------+-------+-------+-------------+
|                               |      |       |       |             |
+-------------------------------+------+-------+-------+-------------+
|                               |      |       |       |             |
+-------------------------------+------+-------+-------+-------------+

^1^DETERMINATION/ RESPONSE REQUESTED:

> NE = no effect. This determination is appropriate when the proposed
> action will not directly, indirectly, or cumulatively impact, either
> positively or negatively, any listed, proposed, candidate species or
> designated/proposed critical habitat. Response Requested is optional
> but a AConcurrence@ is recommended for a complete Administrative
> Record.
>
> NA = not likely to adversely affect. This determination is appropriate
> when the proposed action is not likely to adversely impact any listed,
> proposed, candidate species or designated/proposed critical habitat or
> there may be beneficial effects to these resources. Response Requested
> is a@Concurrence@.
>
> AA = likely to adversely affect. This determination is appropriate
> when the proposed action is likely to adversely impact any listed,
> proposed, candidate species or designated/proposed critical habitat.
> Response Requested for listed species is AFormal Consultation@.
> Response requested for proposed and candidate species is AConference@.
>
> **\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> \_\_\_\_\_\_\_\_**
>
> **Signature** (originating station) **date**
>
> **\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**
>
> **Title**

**IX. Reviewing Ecological Services Office Evaluation:**

> **A. Concurrence \_\_\_\_\_\_ Nonconcurrence \_\_\_\_\_\_\_**
>
> **B. Formal consultation required \_\_\_\_\_\_\_**
>
> **C. Conference required \_\_\_\_\_\_\_**
>
> **D. Informal conference required \_\_\_\_\_\_\_\_**
>
> **E. Remarks (attach additional pages as needed):**
>
> **\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> \_\_\_\_\_\_\_\_\_**
>
> **Signature date**
>
> **\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**
>
> **Title office**