Installation Report & Certification
To be Completed By: the project Verifier Submitted to: Program
Administrator, Buyer, & Seller
Project ID: __________________________________
Prepared by:
County Conservation District, and State _________________________________
Name: _____________________________ e-mail: ______________________________
Date: ______________________________
Conservation Practice Type:
________________________________________________________________________________
Practice Documentation:
Confirm whether the following documents have been completed and attached hereto as part of this Installation Report
and Certification:
On-site photos, date stamped (pre- and post-installation)
Revised Project Application (if applicable)
Practice Installation:
Date of Installation: _____________________________
Date of confirmation by the County: __________________________
Name of person doing the confirmation: ______________________________________
On-site Inspection (attach additional pages as necessary):
A. Describe any deviations between installed conservation practices and Project Application commitments.
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
B. If any deviations were reported above, describe how they nevertheless conform to the requirements of the Erie
P Market program (Note: a Revised Project Application must be completed and attached to this form if any
deviations occurred.)
___________________________________________________________________________________________
___________________________________________________________________________________________
Adapted from EPRI’s Ohio River Basin pilot project.
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
C. Confirm whether the conservation practices specified in the Project Application were installed in accordance
with the relevant NRCS Practice Standards.
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
D. Please include any comments here.
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Attestation:
I certify that the conservation practices specified in the Project Application dated <insert date of approved application>
were installed and that there were no deviations between the installed and contracted practices, other than those noted
herein.
Signed: _______________________________________ Date: _______________________
Print name: ___________________________________
November 2017
