Biomass Crop Assistance Program (BCAP)

Instructions for Form BCAP-6, “Environmental Screening Worksheet.”

Sponsor’s of a proposed BCAP Project Area use this form to assist FSA in complying with certain environmental laws and regulations including the National Environmental Policy Act and the National Historic Preservation Act. This form must be completed as an attachment to the proposed BCAP Project Area Application. FSA will use this form to assist in the decision whether site specific environmental review will be required on individual producer BCAP applications.

Customers with electronic access may download the proposed BCAP Project Area application and all of the attached forms including BCAP-6 online. The electronic versions are available on the USDA Farm Service Agency’s web site at www.fsa.usda.gov/bcap.

For more information about the Application and any required forms please visit the USDA Farm Service Agency’s web site at www.fsa.usda.gov/bcap or contact Mike Linsenbigler at 202.720.5295 or [email protected].

Sponsors of a proposed BCAP Project Area must complete “Environmental Screening Worksheet,” for qualification, Items 1 through 15 and Items 19 and 20.

Items 1 - 20

Fld Name / Item No.	Instruction
1 Name of the BCAP Project Sponsor	This may be a group of farmers or biomass conversion facility. If a biomass conversion facility, the facility does not have to be a qualified biomass conversion facility for BCAP matching payment opportunities. The name of the facility must be the legal name for the facility according to business charters. If a group of farmers, please record an identifying farmer cooperative name or farmer cooperative organization name, according to organizational charters. If the group of famers is not a chartered entity please record the identifying title for the group. Note: A biomass conversion facility, according to section 9001 of the 2008 Farm Bill, is a facility that converts or proposes to convert renewable biomass into heat, power, biobased product or advanced biofuels.
2A – 2E Sponsor’s Contact Information	This information will be the mailing address of the group of farmers or biomass conversion facility. Note: This contact information will be posted on the BCAP web page, if a BCAP project area designation is approved for the proposed project area. The information will be listed for contact purposes.
3 County of Primary Location	This will be the county which contains the majority of the proposed BCAP Project Area.
4 State/County FIPS Code	The State/County Federal Information Processing Standard (FIPS) Code is assigned by the U.S. department of Commerce’s National Institute of Standards and Technology (NIST). The State and U.S. Territories FIPS Codes consist of two digits and the County FIPS Code consists of five digits. FIPS Codes can be found at the following USDA Economic Research Service URL: http://www.ers.usda.gov/Data/baseacres/Data/counties.xls and for FIPS updates please visit the NIST website at: http://www.itl.nist.gov/fipspubs/ These FIPS Codes will be used to formulate the Project Area’s ID # and are used for Geographic Information Systems (GIS) mapping.
5 Telephone number	The telephone number for the Sponsor is the number at which the Sponsor can receive telephonic communication from USDA, the general public, eligible material owners, or producers.
6 Email address	The email address for the Sponsor is the address where the Sponsor can receive electronic communication from USDA, the general public and eligible material owners.
7A & 7B Counties to be included in Proposed BCAP Project Area	List of all the counties that make up the proposed BCAP Project Area. Note: Include the State and County FIP codes in Item 7B (see Item 4) for all counties
8A & 8B Name of Bio mass Facility(ies)	List the exact name of the facility(ies) that will receive Biomass from the proposed BCAP Project Area. Note: Include the State and County FIP codes in Item 8B (see Item 4) for all counties in which the facility(ies) are located.
9 North American Industry Classification System (NAICS) Code	The North American Industry Classification System (NAICS) is the standard used by Federal statistical agencies in classifying business establishments for the purpose of collecting, analyzing, and publishing statistical data related to the U.S. business economy. NAICS was developed under the auspices of the Office of Management and Budget (OMB), and adopted in 1997 to replace the Standard Industrial Classification (SIC) system. To access the list of 2007 NAICS codes please visit: www.census.gov/eos/www/naics/ or call 1-888-75NAICS. For example, if your facility produces wood pellets, the NAICS code will be 321999.
10A & 10B Biomass Conversion Production Status: Production Since Expected	Please record the date that the conversion facility began production or will begin production. Production means the act of manufacturing, from raw biomass materials or intermediary feedstock, a bio-energy or biobased products yield. This production start date should be the date that the facility began or plans to begin operation under the applicable legal authorities from Federal, State, and local government(s) for the production of: heat, power, biobased products, or advanced biofuels. For facilities that are co-generation operations, please record the start date on which the facility began the biomass conversion processes. For example, if the facility is a mill and has added a recovery boiler to generate electricity and steam, please record the date that the conversion process (under legal authority) began operation. Please record your date in the following format: MM/DD/YYYY
11 Brief Overview of Facility Business Operations and Biomass Utilization	Please record items that give an overview concerning the facility operations and biomass use, such as the facility’s production goals and benchmarks, employee data, governing board and Executive team profile, credit arrangements, existing contracts, financial overview and company milestones. Attachments may also be submitted to supplement the response.
12 Energy/Fuel Produced	This selection range of types of energy and fuel produced concerns the energy and fuel production for the submitting biomass conversion facility(ies) only. Please check all that apply at present.
13A – 13D Biomass Material(s) Used	These selection ranges concern the type(s) of biomass used at the biomass conversion facility(ies). Please check all that apply at present or in cases of start-up operation, please indicate the projected type(s) of biomass to be used. NOTE: The BCAP list of eligible and ineligible materials to be used by qualified biomass conversion facilities can be found at www.fsa.usda.gov/bcap.
14 Permits Obtained	Please check either “YES” or “NO”. If “NO” is checked please explain what permit has not been obtained and the reason why it has not been obtained.
15 Harvesting	Please indicate the timing (e.g.; harvesting is completed between May 15-June15) and the frequency (e.g.; two times per year).
Protected Resources to be considered Items 16-18	These Items will be completed by FSA State Environmental Coordinator Note: If any Item in 16-18 are answered “YES” then site specific NEPA analysis may be required when individuals apply to participate in BCAP.
16 Threatened and Endangered Species	Please indicate either “YES” or “NO” after consulting with the U.S. Fish and Wildlife Service as to the presence of threatened and/or endangered species or critical habitat within the proposed BCAP Project Area.
17 Cultural Resources	Please indicate either “YES” or “NO” as to whether tree planting or harvesting will be conducted within the proposed BCAP Project Area
18 Wetlands	Please indicate either “YES” or “NO” as to presence of wetlands (as per paragraph 42 of 1-EQ) within the proposed BCAP Project Area
19A Print Name	Please record the first and last name of the representative for the submitting sponsor of the proposed BCAP Project Area that is signing the application.
19B Title	Please record the signing representative’s title that is assigned to the individual by the sponsor or best reflects the signing representative’s role with the sponsor.
19C Signature	Please record the signing representative’s first and last name in cursive.
19D Date	Please record the date on which the representative signed the proposed BCAP Project Area application. Please record the date in the following format: MM/DD/YYYY
20A Name	Please record the first and last name of the person that may be contacted by FSA or the public regarding the proposed BCAP Project Area.
20B Street Address	The address will be the physical location of the primary contact, including the street number, street name, city, state, and zip code.
20C Telephone Number	Please record the telephone number for the primary contact. This telephone number will be the number where the primary contact can receive telephonic communication from USDA and eligible material owners.
20D Email Address	The email address for the primary contact person that can receive electronic communication from USDA.