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Please Print Form, Fill Out, Send to:
Commonwealth of Massachusetts
Wetlands Restoration Program Loosestrife Project
Executive Office of Environmental Affairs
One Winter Street 5th Floor, Boston, MA 02108

Phone: (617) 626-1177
E-mail: wetlands.restoration@state.ma.us

GROWetlands SITE NOMINATION FORM: Purple Loosestrife Control Project

Project Name: Purple Loosestrife Biomonitoring Project

Project Location (city/town):__________________________________

Watershed: ________________________________________________
Please attach a USGS quad sheet or other map on which the site location has been marked. If available, please attach current and historic photos and aerial photos of the project site.

Project Sponsor: _____________________________________________

Designated Representative: ___________________________________

Telephone:_________________________________________________

E-mail:____________________________________________________

Address:___________________________________________________

Project Co-Sponsors:__________________________________________

Has landowner expressed support for the reduction of Purple Loosestrife at the site? (circle one) NoYes

Briefly describe the current condition of the wetland to be restored: (i.e. wetland type (Phragmites swamp, wet meadow, forested wetland, etc), habitat value, state of degredation if appropriate, etc.). Please also attach a sketch of the area showing the wetland to be restored, adjacent wetlands and waterbodies, roads and buildings in the immediate vicinity, and other pertinent information to describe the site.
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Is the wetland part of an agricultural facility or was it farmland in the past?
(circle one)
Is in agricultural use now. Was never farmed. Was formerly agricultural land.
Explain:
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Is the wetland area under an outstanding enforcement order? (circle one) NoYes
Explain:
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What is the approximate size of the wetland?
<1 acre ___1 acre ___acres ___

What is the approximate percent coverage of the loosestrife growth within the wetland? _____%
If known, what was the wetland type(s) prior to loosestrife innundation?
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What is the approximate size of adjacent wetland areas, if any?
<1 acre__ 1 acre ____ acres ____

What is the approximate duration of flooding? (It is critical to the beetle lifecycle to know the hydrology.) State months of flooding and receding.
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Has any funding or other support been identified for this project? (circle one) NoYes
If yes, describe:
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Would you like MWRP to arrange a site visit and project evaluation? (circle one) NoYes

Signed: ________________________________________Date:____________

Please print name.

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