(This form may be used if the Phase I guidelines have been followed and no cultural resources have been identified.)

1. Project Identification:

ER Number

Project Name &/or Agency Tracking #:

Agency: Applicant:

Preparers Name and affiliation:

Date Prepared:

Project Area County/Municipality (list all)

County	Municipality

2. Project Setting: (check all that apply)

urban/suburban; rural

upland; floodplain/terrace (active; stable terrace)

7.5” USGS Quadrangle(s) Name (list all):

Name	Date

Physiographic Zone(s)(list All. Use DCNR Map 13 compiled by W.D. Sevon, Fourth Edition, 2000.):

Physiographic Zone

Project Area Drainage(s), (list all) (Sub-basin and Watershed can be obtained from CRGIS):

Sub-basin	Watershed	Major Stream	Minor Stream

3. Basic Field Conditions:

(Text fields will expand as needed. Please be complete)

Area of APE / Project Area in hectares: Hectares tested:

General Description of APE / Project Area:

Type of Proposed Project / Impact:

Date of field investigation(s):

Description of Field Conditions including percentage of surface visibility:

4. Previously Recorded Archaeological Sites within APE / Project Area and not relocated by this project:

PASS Site Number	Reason not re-located

5. Survey Methodology: (check all that apply to the entire project; attach any supporting documents)

PASS file Research	Contacted Local Historical Association/Commission/Park/Etc.

Informant Data	Historic Records/Maps/Photos	SCS Soil Maps

Surface Survey	Geomorphological Borings	STPs

Test Units	Geomorphological Trenches	Remote Sensing

Other:

Professional Geomorphologist was Present or Not Present During Field Investigations

Name:	Affiliation:

Formal Geomorphological Report Prepared: Yes	No

6. Results: (Describe both the design and the results of every methodology checked in 5. Include the size and condition of the area tested by each. )

7. Statewide Pre-Contact Probability Model Analysis: (Use the model from CRGIS to determine portions of the project area that were located within each sensitivity tier and list all testing methods used within each tier. If more than one method was used, estimate the percentage of the tier tested by each method. In the Sites Located section, include Isolated Finds for which a number is assigned.)

Sensitivity Tier	Area within this Tier	Percent of Total Project Area	Method(s) Used to test this tier (Use list from 5 above. Include % if multiple. )	Number of Sites Located
High	sq. m.	%
Moderate	sq. m.	%
Low	sq. m.	%

8. Required Attachments:

7.5’ USGS Quadrangle Map delineating APE / Project Area

Project map showing testing strategy(ies)

Testing strategy justification / predictive model

Supporting photographs with descriptions of view and view direction

Engineering / Project Plans if prepared

Geomorphological Report if prepared

Representative excavation profiles and descriptions

List all other attachments to this Negative Survey Form:

Attachment Type