*Plumas & Sierra County Livestock Disaster Pass Registration

The University of California Cooperative Extension is assisting the Plumas-Sierra County Agricultural Department and other local agencies to manage a program to provide access to commercial livestock operators within evacuation zones to care for livestock. During times of restricted access caused by a natural disaster, this registration MAY enable owners the ability to feed, water and medically treat large scale commercial livestock.

University of California Cooperative Extension is providing this survey tool to streamline registration for the Plumas-SierraCounty Agricultural Department. All information shared in this survey will be passed along to the Plumas-Sierra County Agricultural Department for program administration, training registration and pass approval.

✻ = Required

First Name ✻

Last Name ✻

Ranch/Business Name ✻

Mailing Address ✻

City ✻

State ✻

email ✻

Cell Phone ✻

Birthdate (must be 18 by JUNE 5, 2024 to participate in the program this year) ✻

Training and contingency ✻

I understand that the pass will be contingent upon county review and will require participation in mandatory training in Plumas or Sierra County (June 5, 2024) or other county.

Commercial Livestock Operation ✻

I attest that I am a commercial livestock operator defined by this program as an owner of livestock consisting of 50 head of livestock that reside in Plumas or Sierra County for at least a portion of the year, or a person who, through an agreement with that owner of livestock, has authority and is responsible to oversee the care and well-being of the owner’s livestock.

Conditional Access with Livestock Pass ✻

I understand that decisions for access can rapidly change during a fire or other natural disaster and will be dependent on safety conditions at the time and upon approval of emergency personnel.

Insurance and Risk: ✻

I understand access in an area closed to the public during a disaster may affect the coverage of my property liability insurance, vehicle or equipment insurance and worker’s compensation coverage. Program administrators, collaborators and trainers shall not be liable for injury or death of someone participating in activities resulting from the inherent risk of re-entering damage areas to feed, water and medically treat livestock.

Violations of Pass ✻

I understand the utilization of the pass is to care for commercial livestock within the evacuation zone. Thus, if you are found outside of the scope of commercial livestock pass your pass may be permanently revoked.

Liability ✻

I understand program administrators, collaborators and trainers shall not be liable for injury or death of someone participating in activities resulting from the inherent risk of re-entering damage areas to feed, water, transport and medically treat livestock.

Please let us know what Pass Training you plan to participate in:

✻

June 5 2024 - 9:00 am - 1 pm Taylorsville Historical Hall June 5 2024 - 3:30 - 7:30 pm Sierraville School Already complete training in another county.

Additional family and employees for training: Please provide first name, last name, birthdate and email for all additional drivers who will be participating in the training.

(THERE WILL BE NO ADDITIONAL GUESTS ALLOWED AT TRAINING, ONLY THOSE WHO ARE PRE-REGISTERED) ✻

Livestock Location - Please provide APN, Season of use, livestock description for all PLUMAS & SIERRA COUNTY sites. EXAMPLE 1: 001-222-333, Year-Round, 75 head of cattle and 20 sheep

EXAMPLE 2: 111-222-444, 111-222-443, 111-222-445, Nov.-May, 250 head of cattle

EXAMPLE 3: Allotment Name - June-October 500 head

EXAMPLE 4: 60 bee hives 111-222-3333 November-April, 25 bee hive ✻

Cattle Operators - You must answer ALL questions in this section

Cattle Brand(s) # (e.g. A 072750):

https://www.cdfa.ca.gov/AHFSS/Livestock_ID/2010_Brand_Book.html.

CATTLE - Other Identifiable Livestock Markings including ear tags, ear notches, etc. (copy)

Bee Operators - You must answer ALL questions in this section

Are you a registered beekeeper in Plumas or Sierra County?

Yes No

Bee - Other Identifiable Hive markings such as brands, hive color, etc. etc.

Information Sharing

Other Information

Information shared on this form will be used to create a database maintained and updated by UC Cooperative Extension and Plumas-Sierra County Agricultural Department. Data will be available by key agencies, including Plumas-Sierra County Agricultural Department, Cal-Fire, California Highway Patrol, Plumas County Sheriff, Sierra County Sheriff, US Forest Service, etc. ✻

I understand my information will be shared, I am voluntarily completing this form.

** To the best of my knowledge, the information entered above is true and correct. **

Please type name - ✻