The Middle Nemah River is a major tributary to the Willapa Bay Estuary in southwest Washington. It is vital habitat for anadromous Pacific salmon and steelhead with opportunities for restoration actions with substantial benefit for overall river health. Ecological Engineering provided water resource and habitat restoration engineering support to Cramer Fish Sciences for the identification and design of river restoration opportunities expected to have significant benefits to native fish populations. Ecological Engineering conducted field work to support site assessment activities, participated in stakeholder engagement, reviewed hydraulic modeling results, conducted restoration design, prepared stability analysis for 51 large wood structures, prepared construction cost estimates, and wrote sections of the Basis of Design report. Field work involved walking the project reach of the Middle Nemah River to identify the location, type, and size of large wood structures proposed for installation and to determine best construction methods to minimize disturbance of existing vegetation. All work was completed for the Pacific Conservation District to meet the standards and requirements of the Washington Salmon Recovery Funding Board (SFRB) Manual 18.