Assistance - Template

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Assistance ID:

Staff Assisting:

Program Type:

Contact:

Action Date:

Report

Attached Files/Reports

File Name	File Type	File Date	Note

Comments

Date	Comment	Commenter
6/29/2009	The facility's PCS permit has expired and I contacted them to determine if they still need a permit. I emailed Tim several documents to review.	MICHELLE JOHNSON

Assistance Details:

Field Office Compliance - Assistance