*Fill out only what is applicable -- use tab key when filling out
electronically*

Date[     ]{.underline} Name[     ]{.underline}

Tract No[     ]{.underline} Address[     ]{.underline}

Phone No[     ]{.underline} City[     ]{.underline}

**Goals**

Increase milk production?

Increase forage diversity? Improve riparian areas?

Increase forage yields Increase gain/acre?

Use less hay or silage: Improve gain/head?

> in summer? Improve conception rates?
>
> in winter? Improve numbers of weaned animals?

Better distribute grazing? Control gully erosion

Start another livestock operation? Control stream bank erosion

Explore alternative sources of income? Wildlife -
Species?[     ]{.underline}

Other[     ]{.underline} Other[     ]{.underline}

**Progress in attaining Goals**[     ]{.underline}

[     ]{.underline}

**Livestock Inventory**

+------------+-----------+------+---------------+------+-------+-----+
| **Number   | Presen    | Ave  | Breeds        | Ave  | Cond  | Fr  |
| of**       | t/future? | rage |               | rage | ition | ame |
|            |           | We   |               | Age  | Score | Sc  |
| **l        |           | ight |               |      |       | ore |
| ivestock** |           |      |               |      |       |     |
+------------+-----------+------+---------------+------+-------+-----+
| Cows       |           |      |               |      |       |     |
|            |    /      |      |               |      |       |     |
+------------+-----------+------+---------------+------+-------+-----+
| Bulls      |           |      |               |      |       |     |
|            |    /      |      |               |      |       |     |
+------------+-----------+------+---------------+------+-------+-----+
| Steers     |           |      |               |      |       |     |
|            |    /      |      |               |      |       |     |
+------------+-----------+------+---------------+------+-------+-----+
| Heifers    |           |      |               |      |       |     |
|            |    /      |      |               |      |       |     |
+------------+-----------+------+---------------+------+-------+-----+
| Milkers    |           |      |               |      |       |     |
|            |    /      |      |               |      |       |     |
+------------+-----------+------+---------------+------+-------+-----+
| Dry cows   |           |      |               |      |       |     |
|            |    /      |      |               |      |       |     |
+------------+-----------+------+---------------+------+-------+-----+
| Ewes       |           |      |               |      |       |     |
|            |    /      |      |               |      |       |     |
+------------+-----------+------+---------------+------+-------+-----+
| Rams       |           |      |               |      |       |     |
|            |    /      |      |               |      |       |     |
+------------+-----------+------+---------------+------+-------+-----+
| Feeder     |           |      |               |      |       |     |
| Lambs      |    /      |      |               |      |       |     |
+------------+-----------+------+---------------+------+-------+-----+
| Goats      |           |      |               |      |       |     |
|            |    /      |      |               |      |       |     |
+------------+-----------+------+---------------+------+-------+-----+
| Horses     |           |      |               |      |       |     |
|            |    /      |      |               |      |       |     |
+------------+-----------+------+---------------+------+-------+-----+
| Hogs on    |           |      |               |      |       |     |
| Pasture    |    /      |      |               |      |       |     |
+------------+-----------+------+---------------+------+-------+-----+
| Other      |           |      |               |      |       |     |
| (     )    |    /      |      |               |      |       |     |
+------------+-----------+------+---------------+------+-------+-----+

Dates of breeding season[     ]{.underline}

Length of breeding season[     ]{.underline}

Number of herds & Number/herd[     ]{.underline}

Dates of: Calving[     ]{.underline} Lambing[     ]{.underline}
Foaling[     ]{.underline} Weaning[     ]{.underline}

**Potential problems**

Conception rate[     ]{.underline} Desired Conception
Rate[     ]{.underline}

Are weeds a problem in your pasture(s) or hay fields[     ]{.underline}

> What kind[     ]{.underline}
>
> Treatment(s)     

Do you have animal disease problems in any pasture(s)[     ]{.underline}

> What kind[     ]{.underline}

Any other livestock health problems[     ]{.underline}

Birth Problems[     ]{.underline}

Other issues[     ]{.underline}

**Grazing System & Forages Utilized**

  ------------------- ------- --------------- ------------------ ----------
  Grazing System Used Acres   Rest Period     Grazing Period     No. of AUs
                              (days)          (days)             

  Continuous                                                          

  Rotational System\                                                  
  (# of pastures)                                                

  Management                                                          
  Intensive Grazing                                              
  (MIG)\                                                         
  (# of paddocks)                                                

  Crop residues                                                       
  grazed Type                                                    
  ------------------- ------- --------------- ------------------ ----------

[Date grazing begins in Spring Date grazing ends]{.underline}

  -------------------- ------- -------------- -------------- --------------
  **Perennial forages                                        
  for grazing**                                              

  Species              Acres   Date Planted   Begin Grazing  End Grazing

                                                                  

                                                                  

                                                                  

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

  -------------------- ------- -------------- -------------- --------------
  **Annuals planted                                          
  for grazing                                                
  (Brassicas, Cereal                                         
  Grains, etc.)**                                            

  Species              Acres   Date Planted   Begin Grazing  End Grazing

                                                                  

                                                                  

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

**Supplemental Feed**

  ------------------- ---------- --------------- ------------------------ ---------------
  **Supplemental                                                          
  Feeds Drylot**                                                          
  **Pasture**                                                             

  **Kind**            **Amt.**   **Cost/Unit**   **Produced/Purchased**   **Storage
                                                                          Method**

                                                                               

                                                                               

                                                                               

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

Feeding Date(s) and rate/day[     ]{.underline}

Kind and amount of hay produced annually[     ]{.underline}

Kind and amount of hay purchased annually[     ]{.underline}

Hay storage method[     ]{.underline}

Begin feeding hay[     ]{.underline} Pounds fed/day/head free
choice[     ]{.underline}

Hay cost/unit[     ]{.underline} Fed in free choice dry-lot Fed in open
pasture

How is manure managed when livestock are in confinement?

> Solid Liquid N/A

**Forage analysis (Attach results if available)**

Forage[     ]{.underline}

%CP[     ]{.underline} %TDN[     ]{.underline} DOM[     ]{.underline}

N.E. Maint[     ]{.underline} N.E.Gain[     ]{.underline} N.E.
Lact[     ]{.underline}

RFV[     ]{.underline} NDF[     ]{.underline} ADF[     ]{.underline}

Forage[     ]{.underline}

%CP[     ]{.underline} %TDN[     ]{.underline} DOM[     ]{.underline}

N.E. Maint[     ]{.underline} N.E.Gain[     ]{.underline} N.E.
Lact[     ]{.underline}

RFV[     ]{.underline} NDF[     ]{.underline} ADF[     ]{.underline}

Forage[     ]{.underline}

%CP[     ]{.underline} %TDN[     ]{.underline} DOM[     ]{.underline}

N.E. Maint[     ]{.underline} N.E.Gain[     ]{.underline} N.E.
Lact[     ]{.underline}

RFV[     ]{.underline} NDF[     ]{.underline} ADF[     ]{.underline}

**Dairy Data**

What is your average peak milk yield per cow[     ]{.underline} lbs./day

What is your average milk production (rolling herd
average)[     ]{.underline} lbs./year

What is your average butterfat production per cow[     ]{.underline}
lbs.

What is your average protein production per cow[     ]{.underline} lbs.

In an average year how many pounds of milk do you
sell[     ]{.underline} lbs.

What is your average somatic cell count[     ]{.underline}

What is your average bacteria count[     ]{.underline}

**Planning Map Information**

PLAN MAPS:

a.  Include/draw on map (attach legend and include field acres, and
    forage species):

> pasture, hay fields, combination pasture/hay fields, grazed woodlands,
> fences (permanent and temporary), gates, ponds, springs (seeps),
> watering tanks, water pipelines, corrals, active gullies, riparian
> areas, permanent pasture oiler and/or mineral stations.

b.  Show water and gas pipelines and other utilities that cross fields.

c.  Wintering Areas, Calving Areas, Feedlots, Corrals.

d.  Show acres and species

**Present water source** - well, rural water, pond, stream,
other[     ]{.underline}

> Dependable water source? Yes/No[     ]{.underline}
>
> Expected pressure range if pressurized[     ]{.underline}
>
> Place location of water source on map[     ]{.underline}
>
> Date well was drilled[     ]{.underline}
>
> Depth to water in well[     ]{.underline}
>
> Depth of well[     ]{.underline}

**Present water supply**

> Hydrants -- No.[     ]{.underline} (Show on Plan
> Map)[     ]{.underline}
>
> Fountains -- No.[     ]{.underline} (Show on Plan
> Map)[     ]{.underline}
>
> Troughs -- No.[     ]{.underline} (Show on Plan
> Map)[     ]{.underline}
>
> Other (Show on Plan Map)[     ]{.underline}
>
> (example: hydrant 1 top of hill in corner between pastures 1 and 2 --
> use extra sheet if needed)

**Critical pipeline information** - such as distances from property
lines, fences or buildings, distances between hydrants, size & type,
etc) Mark on map as possible[     ]{.underline}

[     ]{.underline}

[     ]{.underline}

[     ]{.underline}

[     ]{.underline}

Present maximum walking distance to water[     ]{.underline}

**Fertility**

Pasture/Hayland Fertility Program (List soil test dates and attach
results):

[     ]{.underline}

[     ]{.underline}

[     ]{.underline}

[     ]{.underline}