USE:
REFUGE NAME:
ESTABLISHING AND ACQUISITION AUTHORITY(IES):
REFUGE PURPOSE(S):
NATIONAL WILDLIFE REFUGE SYSTEM MISSION:
DESCRIPTION OF USE:
AVAILABILITY OF RESOURCES:
ANTICIPATED IMPACTS OF THE USE:
PUBLIC REVIEW AND COMMENT:
DETERMINATION (CHECK ONE BELOW):
____ USE IS NOT COMPATIBLE____ USE IS COMPATIBLE WITH FOLLOWING STIPULATIONS
STIPULATIONS NECESSARY TO ENSURE COMPATIBILITY:
JUSTIFICATION:
SIGNATURE: REFUGE MANAGER:_________________________________________________________
(signature and date)
CONCURRENCE: REGIONAL CHIEF:___________________________________________________________
(signature and date)
MANDATORY 10- OR 15-YEAR REEVALUATION DATE: _______________________________________