Flood and Coastal Storm Damage Surveys

OMB CONTROL NUMBER: 0710-0017

OMB EXPIRATION DATE: XX/XX/XXXX

AGENCY DISCLOSURE NOTICE

The public reporting burden for this collection of information, 0710-0017, is estimated to average 30 minutes per survey, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

AGRICULTURAL FLOOD DAMAGE

Background Information

1. How many years have you operated a farm at this location?

Years

2. Does part of your farm flood frequently enough to require a change in cropping patterns?

1. No 2. Yes

3. How many acres are there in this frequently flooded area?

Acres

Crop Distribution and Production Practices

4. Crop Distribution/Yield Without Project:

In the area below, please describe the cropping patterns for the upper and lower areas of your farm under existing flood conditions. The lower areas are those areas subject to flooding frequently enough to cause a change in cropping patterns.

EXISTING CONDITONS
	LOWER AREA		UPPER AREA
Crop	Acres	Yield in Bushels or Bales	Acres	Yield in Bushels or Bales
Cotton
Soybeans
Rice
Wheat
Grain Sorghum (Milo)
Corn
Alfalfa
Hay
Pasture
Fallow
Other Specify ___________
Other Specify ___________

5. How many times since you first operated this farm has flooding caused delayed planting or replanting?

Times

6. How many times since you first operated this farm has flooding made you unable to harvest a crop?

Times

7. Please indicate the usual date for each stage of crops production activity.

Crop	Usual Beginning Plant Date for Production Practices			Last date to Plant
	Date to Begin Land Preparation	Date to Begin Planting	Date to Begin Harvesting

Crops Damage

8. Please fill in the following regarding the most recent flood.

8a. Date that flooding began: _______________ (month, day, year)

8b. Depth of flooding at deepest point: ____________ (feet)

8c. Longest duration of flooding at any part of your yard: _____________ (days)

9. DAMAGE TO CROPS AND PASTURE FROM FLOODING
Crop	No. of Acres	Yield/Acre After Flood	If flooding made it too late to plant this crop, what did you plant instead?	What additional production costs, if any, did you have because of the flooding?	What production costs did you NOT have because of the flooding?

Farm Property Damage

10. Please use the table below to identify the amount of damage for each non-crop item for the most recent flood event. Do not include any property related to fish production.

Item	Unit	Units Damaged	Total Estimated Damage in $
Farm Roads	Linear Feet
Drainage Ditches	Linear Feet
Fences	Linear Feet
Land Leveling	Acres
Land Damage	Acres
Equipment	Pieces of Equipment
Farm Buildings	Number of Buildings
Stored Feeds	Bushels
Pasture	Acres
Other

Fishpond Damage

11. Do you have any fishponds?

_____Yes _____No

If no, the questionnaire is completed.

12. If yes, have you ever incurred damage to your fishponds as a result of flooding?

_____Yes _____No

If no, the questionnaire is completed.

If yes, 13. What was the date of this last damaging flood to your fishponds?

_________________________________

14. If yes, how many acres of fishpond area were damaged?

Acres

15. Please list below the amount of dollar losses or damages during the most recent flooding that damaged your fishponds?

CATEGORY	($) LOSSES OR DAMAGES TO AQUACULTURE PROPERTY FROM FLOODING
Fish that Were Ready for Market
Pre-market Fish
Levees
Feed for Fish
Equipment
Miscellaneous
Total Damages

AGRICULTURAL FLOOD DAMAGE 3