USACE/PennDOT Section
106
Field Assessments and
Finding
Combined Early Notification/Finding?
Yes
No
Concurrence required or requested:
Yes
No
Funding Source: STATE
Lead Agency: USACE
MPMS:
ER# (if consultation with PHMC required):
County:
SR:
Section:
Municipality:
Name of Project:
Attached:
USGS Quad:
Field View Date:
Yes
No
I.
Project Description (describe project activities or note attachment): Attached:
II.A
Permit Area (describe dimensions of Permit Area, land use, and type and % of disturbance,
if present): See Individual Archaeology Attachment A or Above-Ground Attachment B
II.B
III.
Yes
No
Additional Area of Potential Effect under State History Code (see additional Documentation)
Finding of Effects (Permit Area only)
Project Effects (include Attachments A and B)
Archaeological Effects – Partial (include Attachment A)
Above-ground Resources Effects –
Archaeology Finding:
No Archaeological Properties
Affected
No Adverse Effect
Adverse Effect
IV.
Above Ground Finding:
No Historic Properties Affected
No Adverse Effect
Project Effects Finding:
No Historic Properties
Affected
No Adverse Effect
Signatures:
District Archaeologist:
Date:
District Architectural Historian:
(if requested or required:)
Date:
PHMC Concurrence: _________________________________________ Date: ____________
Name:
USACE/ PennDOT Field Assessment and Finding
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MPMS: ________
County: ______________
SR: _____
Section: ______
Archaeology Attachment - A
II.
Permit Area (describe dimensions of Permit Area, land use, and type and % of disturbance,
if present):
A.
Background Research Sources Checked:
 CRGIS/PASS Files (list Known Archaeological Sites below)
 Historic Maps (list):
 USGS County Soils Map(s) (list soils in Permit Area)
 Stream Order (if stream present):
 Other (list):
Known Archaeological Sites:
(list PASS number and National Register determination (if known). Do not release site locations to the public)
1.
2.
3.
4.
B.
Consultation with Federally Recognized Tribes & Nations, Consulting Parties and the Public (list
Tribes/Nations contacted, if applicable. Explain efforts to identify consulting parties and involve the
public, commensurate with the nature and effect of project activities):
C.
Archaeological potential (explain probability and likely location(s) for sites based on the
background research, field view, and consultation):
A) Historic:
B) Pre-Contact:
D.
National Register Eligibility Determination (if site(s) identified in Permit Area):
Site Name(s) & Number(s):
Not eligible
Eligible
Undetermined
USACE/ PennDOT Field Assessment and Finding - Archaeology Attachment A
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MPMS: ________
E.
County: ______________
SR: _____
Section: ______
Archaeology Finding:
No Archaeological Properties Affected
No Archaeological Properties Present
Archaeological Properties Present but Not Affected
No Adverse Effect
Site protected with geotextile and fill during construction
Site protected with fencing or other barrier during construction
Explain:
F.
Attachments:
PHMC Negative Survey Form
PHMC Record of Disturbance Form
Geomorphology Report
Archaeology Sensitivity Report (Phase IA)
Archaeology Identification (Phase I) Report
Archaeology Identification and Evaluation (Phase I & II) Report
Other (List):

G.
Additional Information:
(Include information such as consultation with PHMC [when applicable], efforts to identify consulting parties,
& efforts to involve the public to date and anticipated activities, efforts to avoid/minimize effects)
USACE/ PennDOT Field Assessment and Finding - Archaeology Attachment A
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MPMS: ________
County: ______________
SR: _____
Section: _____
Above-Ground Resources Attachment - B
II.
Permit Area (describe dimensions of Permit Area, land use, and type and % of disturbance,
if present):
A.
Background Research Sources Checked:
 CRGIS/PHRS/National Register Files (list previously evaluated properties below
noting eligibility determination or date of NR listing)
 Historic Maps (list):
 Local Historic Society or Library (name):
 State Archives
 Historic Bridge Inventory
 Other (list):
Previously Recorded and Evaluated Resources:
(Name and address (or location) of resource, PHMC Key No. and determination)
1.
2.
3.
(If additional space is required, please use the Other Comments section at the end of this form.)
B.
Historic Resource Survey Forms Completed (if applicable) - National Register Eligibility
Determination - and NR Committee Request
1. Property Name & Address (or Location):
For NR Committee Review
Not Eligible
Eligible
2. Property Name & Address (or Location):
For NR Committee Review
Not Eligible
Eligible
3. Property Name & Address (or Location):
For NR Committee Review
Not Eligible
Eligible
USACE/ PennDOT Field Assessment and Finding - Above-Ground Resources Attachment - B
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MPMS: ________
C.
County: ______________
SR: _____
Section: _____
Above Ground Finding:
No Historic Properties Affected
No Historic Properties Present
Historic Properties Present but Not Affected
No Adverse Effect
Basis for Finding:
D.
Attachments:
Historic Resource Survey Form(s) (full or short forms) 
Identification and Evaluation Report
Feasibility Analysis/Preliminary Case Study (typically for bridges)
Determination of Effect Tables
Determination of Effect Report
Other (list)

E.
Additional Information:
(Include information such as consultation with PHMC [when applicable], efforts to identify consulting parties,
& efforts to involve the public to date and anticipated activities, efforts to avoid/minimize effects)
USACE/ PennDOT Field Assessment and Finding - Above-Ground Resources Attachment - B
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