Form 086-0-23A Community Rating System Annual Recertification

Community Rating System (CRS) Program-Application Worksheets and Commentary

FEMA Form 086-0-23A

Community Rating System Annual Recertification

OMB: 1660-0022

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1660-0022 can be found here:

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OMB No. 1660-0022
Expires: August 31, 2010

National Flood Insurance Program
Community Rating System

ACTIVITY
WORKSHEETS

OMB No. 1660-0022
Expires: August 31, 2010

Public reporting burden for this application is estimated to average 31 hours per response for the application
process and 4 hours for annual recertification. The burden estimate includes the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and submitting the
application. You are not required to respond to this collection of information unless a valid OMB control number is
displayed in the upper right corner of the application. Send comments regarding the accuracy of the burden
estimate and any suggestions for reducing the burden to Information Collections Management, Department of
Homeland Security, Federal Emergency Management Agency, 500 C St., S.W., Washington, D.C. 20472,
Paperwork Reduction Project (1660-0022). Note: do not send your completed form to this address.

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

INSTRUCTIONS
The following activity worksheets are to facilitate calculations of Community Rating System
(CRS) credit points. They are not used for a community’s initial application to the CRS. I NITIAL
APPLICATIONS FOR THE CRS ARE SUBMITTED USING THE WORKSHEET PAGES IN THE CRS
APPLICATION (FIA-15A/2007, FEMA Form No. 086-0-23).
These activity worksheets are for internal use by the community for submittal of modifications
and recertifications, and for use by the ISO/CRS Specialist during verification and cycle
verification of a community’s program.
These worksheets are designed to be used in conjunction with the CRS Coordinator’s Manual.
Each section of the worksheets corresponds to a section in the Coordinator’s Manual. If a
section is missing from the worksheets, it is because the Coordinator’s Manual shows that no
data or calculations are required for that section.
It is recommended that these worksheets be photocopied before they are used.
When used for submitting a modification, the Credit Points, Credit Calculation, and Credit
Documentation parts of the worksheets should be completed for each activity for which credit is
requested. Fill in the blanks with the value for each variable. DO NOT COMPLETE THE
VERIFICATION SECTIONS . That is done by the ISO/CRS Specialist during the verification or cycle
verification visit.
Each worksheet has a Credit Documentation section. Check the blanks to denote that all of the
required documentation is available. In some cases, the documentation must be provided with
the modification. In others, checking the appropriate spaces confirms that you will provide the
documentation when needed. Please consult the CRS Coordinator’s Manual if you have
questions about which documentation is to be provided with the request for a modification.
ATTACH

THE REQUIRED DOCUMENTATION FOR AN ACTIVITY TO THE WORKSHEET FOR THAT

ACTIVITY . If the documentation is ordinance language, attach only the necessary page(s) from
the ordinance.

M ARK THE MARGINS OF THE DOCUMENTATION WITH THE ACRONYM for the element so the
ISO/CRS Specialist can identify the basis for the credit. If the document is a certification, it
must have an original signature (and seal if required).
Not included in this document are the activity worksheets needed for obtaining credit for
management of special flood-related hazards, such as uncertain flow paths, closed basin lakes,
ice jams, land subsidence, coastal dunes and beaches, mudflows, coastal erosion, and tsunamis.
Those worksheets can be found in the appropriate publications listed in Appendix E of the CRS
Coordinator’s Manual and in Appendix B of the CRS Application.
One other worksheet is not part of this document: AW-501 (Repetitive Loss List) is generated
separately by the Department of Homeland Security’s Federal Emergency Management Agency
(FEMA) when needed, and provided to the community.

Activity Worksheets

iii

Edition: July 2007

[This page intentionally blank.]

OMB No. 1660-0022
Expires: August 31, 2010

U.S. DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY

NATIONAL FLOOD INSURANCE PROGRAM
COMMUNITY RATING SYSTEM

COMMUNITY RATING SYSTEM
ANNUAL RECERTIFICATION

FEMA FORM 086-0-23A, June 2007

Public reporting burden for this application is estimated to average 31 hours per response for the
application process and 4 hours for annual recertification. The burden estimate includes the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and submitting the application. You are not required to respond to this collection of
information unless a valid OMB control number is displayed in the upper right corner of the
application. Send comments regarding the accuracy of the burden estimate and any suggestions for
reducing the burden to Information Collections Management, Department of Homeland Security,
Federal Emergency Management Agency, 500 C St., S.W., Washington, D.C. 20472, Paperwork
Reduction Project (1660-0022). Note: do not send your completed form to this address.

FEMA FORM 086-0-23A, June 2007

OMB No. 1660-0022
Expires: August 31, 2010

COMMUNITY RATING SYSTEM ANNUAL RECERTIFICATION

Section 1. Community Data

If there are any changes or corrections to the information in this section, please line out the

old item and write in the correction.

Community:

State:

NFIP Number:

Recertification Date:

Chief Executive Officer:

Name:

Address:

CRS Coordinator:

Name:

Title:

Address:

Coordinator's Telephone:

Fax:

E-mail Address:

We are maintaining, to the best of my knowledge and belief, in force all flood insurance

policies that have been required of us as a condition of federal financial assistance for
insurable buildings owned by us and located in the Special Flood Hazard Area as shown
on our Flood Insurance Rate Map.
Section 2. Certification
I hereby certify that this community is continuing to implement the activities noted below as
credited under the Community Rating System and described in our original application and
subsequent modifications.

Signed: ___________________________________Date:_______________

Activity Worksheets

FEMA FORM 086-0-23A, June 2007

AW-214-1

Edition: July 2007

Public reporting burden for this application is estimated to average 31 hours per response for the
application process and 4 hours for annual recertification. The burden estimate includes the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and submitting the application. You are not required to respond to this collection of
information unless a valid OMB control number is displayed in the upper right corner of the
application. Send comments regarding the accuracy of the burden estimate and any suggestions for
reducing the burden to Information Collections Management, Department of Homeland Security,
Federal Emergency Management Agency, 500 C St., S.W., Washington, D.C. 20472, Paperwork
Reduction Project (1660-0022). Note: do not send your completed form to this address.

FEMA FORM 086-0-23A, June 2007

OMB No. 1660-0022
Expires: August 31, 2010

COMMUNITY RATING SYSTEM ANNUAL RECERTIFICATION

____ 310 We are maintaining Elevation Certificates on all new and substantially improved
buildings in our Special Flood Hazard Area.
____ 310 We have issued ______ [insert number] permits for new construction and substantial
improvements in the Special Flood Hazard Area in the last year.
____ 310 Attached are 5 Elevation Certificates for new or substantially improved structures
that have been completed in the last year.
____ 310 We are maintaining Elevation Certificate data in computer format. Attached is a disk
with the elevation certificate data obtained since our last submittal. [ _____ Initial
here if there have not been any new buildings or substantial improvements in the
floodplain since the last submittal. Do not attach a disk.]
____ 310 We continue to make copies of Elevation Certificates on newer properties available
at our present office location. [ _____ Initial here if your office address has changed
in the past year. Please provide new address with this form.]
____ 320 We are providing Flood Insurance Rate Map information and information on the
flood insurance purchase requirement to inquirers. [ ____ Initial here if the office
address or the manner in which requests may be submitted has changed in the last
year. Please provide the new office address or manner of submittal with this form.]
____ 320 Attached is a copy of the document that told lenders, insurance agents, and real
estate offices about this service this year, including informing insurance agents about
the availability of elevation certificates. [____ Initial here if the information is
included in your annual outreach project to the community or is part of your
community’s outreach projects strategy. Mark the attachment to Activity 330 to
show where this service is publicized.]
____ 320 Attached is a copy of one page of the log, a letter, or other record that we kept on
this service this year.
____ 320 We are continuing to keep our FIRM updated and maintain old copies of our FIRM.
____ 330 Attached is a copy of this year’s annual outreach project to the community.
____ 330 Attached is a description of this year’s annual outreach project to floodplain
residents.
____ 330 Attached is a copy of the additional outreach project(s) we conducted this year.

Activity Worksheets

FEMA FORM 086-0-23A, June 2007

AW-214-2

Edition: July 2007

Public reporting burden for this application is estimated to average 31 hours per response for the
application process and 4 hours for annual recertification. The burden estimate includes the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and submitting the application. You are not required to respond to this collection of
information unless a valid OMB control number is displayed in the upper right corner of the
application. Send comments regarding the accuracy of the burden estimate and any suggestions for
reducing the burden to Information Collections Management, Department of Homeland Security,
Federal Emergency Management Agency, 500 C St., S.W., Washington, D.C. 20472, Paperwork
Reduction Project (1660-0022). Note: do not send your completed form to this address.

FEMA FORM 086-0-23A, June 2007

OMB No. 1660-0022
Expires: August 31, 2010

COMMUNITY RATING SYSTEM ANNUAL RECERTIFICATION

____ 330 Attached is a copy of the annual evaluation of our public information program
strategy or a completed AW-332.
____ 330 Attached is a copy of the annual outreach conducted for the promotion of flood
insurance.
____ 340 People looking to purchase floodprone property are being advised of the flood
hazard through our credited hazard disclosure measures.
____ 350 Our public library continues to maintain flood protection materials.
____ 360 We continue to provide flood protection assistance to inquirers.
____ 360 Attached is a copy of the document that told others about this service this year.
[____ Initial here if the information is included in your annual outreach project to the
community or to the floodplain properties, or is a part of our community’s outreach
projects strategy. Mark the attachment to Activity 330 to show where this service is
publicized.]
____ 360 Attached is a copy of one page of the log, a letter, or other record that we kept on
this service this year.
____ 410 We continue to use our additional regulatory flood data before a new development
can proceed in our floodplain.
____ 420 We continue to preserve our open space in the floodplain.
____ 430 We continue to enforce the floodplain management provisions of our zoning,
subdivision and building code ordinances for which we are receiving credit. [____
Initial here if you have amended your floodplain regulations. Attach a copy of the
amendment.]
____ 430 We continue to keep track of building improvements and repairs. Before a new
permit is issued, we check the permit record and count the projects' dollar value
cumulatively to determine if a nonconforming building should be brought up to our
standards for new construction.
____ 430 We continue to enforce our zoning ordinance in the credited low-density zones
and/or areas of our community receiving credit for land development criteria. [____
Initial here if you have changed the allowable density of development in any of your
zoning districts or if you have changed your land development criteria. Attach a
copy of the amendment.]

Activity Worksheets

FEMA FORM 086-0-23A, June 2007

AW-214-3

Edition: July 2007

Public reporting burden for this application is estimated to average 31 hours per response for the
application process and 4 hours for annual recertification. The burden estimate includes the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and submitting the application. You are not required to respond to this collection of
information unless a valid OMB control number is displayed in the upper right corner of the
application. Send comments regarding the accuracy of the burden estimate and any suggestions for
reducing the burden to Information Collections Management, Department of Homeland Security,
Federal Emergency Management Agency, 500 C St., S.W., Washington, D.C. 20472, Paperwork
Reduction Project (1660-0022). Note: do not send your completed form to this address.

FEMA FORM 086-0-23A, June 2007

OMB No. 1660-0022
Expires: August 31, 2010

COMMUNITY RATING SYSTEM ANNUAL RECERTIFICATION

____ 430 We continue to enforce our current building code. [____ Initial here if you have
amended your building code. Attach a copy of the amendment.
____ 430 We continue to employ those staff credited for attaining their CFM, and those who
have attended the credited training courses. [_____ Initial here if your staff has
changed and attach a statement as to the staffing changes.
____ 440 We continue to use and update our flood data maintenance system on an annual basis
as needed.
____ 440 We continue to maintain our system of elevation reference marks. [ _____ Initial
here if any reference marks on your FIRM were found to be missing or inaccurate.
Attach a copy of the correct elevation or a description of the missing reference
mark].
____ 440 We continue to maintain our erosion data maintenance system.
____ 450 We continue to enforce the stormwater management provisions of our zoning,
subdivision and building code ordinances for new developments in the watershed.
[____ Initial here if you have amended your stormwater management regulations.
Attach a copy of the amendment.]
____ 450 We continue to enforce the requirement that all new buildings outside the SFHA
must be elevated above the street or otherwise protected from drainage problems.
____ 450 We continue to inspect and maintain all our private and public stormwater facilities
for which credit has been verified.
____ 450 We continue to enforce the provisions of our zoning, subdivision, and building codes
as they pertain to erosion and sediment control and water quality.
____ 502 Attached is a copy of this year’s notice on property protection that we sent to our
repetitive loss areas.
____ 502 We currently have ________ repetitive loss properties and send our notice to _____
properties in the repetitive loss areas.
____ 510 Attached is a copy of our floodplain management plan's annual progress report
and/or a copy of the annual progress report on the recommendations of the area
analyses.
____ 510 We have provided copies of this progress report to our governing board, local media,
and the State NFIP Coordinating office.

Activity Worksheets

FEMA FORM 086-0-23A, June 2007

AW-214-4

Edition: July 2007

Public reporting burden for this application is estimated to average 31 hours per response for the
application process and 4 hours for annual recertification. The burden estimate includes the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and submitting the application. You are not required to respond to this collection of
information unless a valid OMB control number is displayed in the upper right corner of the
application. Send comments regarding the accuracy of the burden estimate and any suggestions for
reducing the burden to Information Collections Management, Department of Homeland Security,
Federal Emergency Management Agency, 500 C St., S.W., Washington, D.C. 20472, Paperwork
Reduction Project (1660-0022). Note: do not send your completed form to this address.

FEMA FORM 086-0-23A, June 2007

OMB No. 1660-0022
Expires: August 31, 2010

COMMUNITY RATING SYSTEM ANNUAL RECERTIFICATION

____ 520 We continue to maintain as open space the lots where buildings were acquired or
relocated out of the floodplain. [________ Initial here if there have been any
changes (additions or deletions) to the parcels credited as open space. Attach a
description of those changes.]
____ 530 We continue to encourage property owners interested in retrofitting their buildings to
protect them from flood damage. [______ Initial here if there have been any changes
(additions or deletions) to the building credited as being flood protected. Attach a
description of those changes.]
____ 540 We continue to implement our drainage system maintenance program.
____ 540 We continue to implement the sections of our Capital Improvements Program which
pertain to the drainage system maintenance.
____ 540 Attached is a copy of a typical inspection report and a copy of the record that shows
that any needed maintenance was performed.
____ 540 We continue to enforce our stream dumping regulations.
____ 540 Attached is a copy of this year's outreach project that explained our stream dumping
regulations. [____ Initial here if the information is included in your annual outreach
project to the community or is part of your community’s outreach projects strategy.
Mark the attachment to Activity 330 to show where your stream dumping regulations
are explained.] [____ Initial here if you publicize the regulations with “no dumping”
signs instead of through an outreach project.]
____ 540 We continue to maintain our coastal erosion protection program.
____ 610 We have maintained and tested our flood threat recognition system.
____ 610 Attached is a report evaluating how our flood warning program worked during the
flood(s) we had this year. [____Initial here if your community did not have a flood
that qualifies for evaluating the program (i.e., a flood that damaged more than 10
buildings, caused more than $50,000 in property damage, or caused the death of one
or more persons.)]
____ 610 We tested our warning dissemination equipment and procedures this year.
____ 610 Attached is a copy of this year’s outreach document that told people about the flood
warnings and safety measures. [____ Initial here if the information is included in
your annual outreach project to the community or to floodplain properties, or is a
part of your community’s outreach projects strategy. Mark the attachment to Activity
330 to show where the flood warnings and safety measures are explained.]
Activity Worksheets

FEMA FORM 086-0-23A, June 2007

AW-214-5

Edition: July 2007

Public reporting burden for this application is estimated to average 31 hours per response for the
application process and 4 hours for annual recertification. The burden estimate includes the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and submitting the application. You are not required to respond to this collection of
information unless a valid OMB control number is displayed in the upper right corner of the
application. Send comments regarding the accuracy of the burden estimate and any suggestions for
reducing the burden to Information Collections Management, Department of Homeland Security,
Federal Emergency Management Agency, 500 C St., S.W., Washington, D.C. 20472, Paperwork
Reduction Project (1660-0022). Note: do not send your completed form to this address.

FEMA FORM 086-0-23A, June 2007

OMB No. 1660-0022
Expires: August 31, 2010

COMMUNITY RATING SYSTEM ANNUAL RECERTIFICATION

____ 610 We conducted at least one exercise of our flood response plan this year.
____ 610 We have completed our annual update of the names and telephone numbers of the
operators of all critical facilities affected by flooding.
____ 620 Attached is the annual maintenance certification on our levee(s).
____ 630 We continue to enforce the building construction requirements in the area subject to
dam failure inundation.
____ 630 We conducted at least one exercise of our dam failure emergency action plan this
year.

Activity Worksheets

FEMA FORM 086-0-23A, June 2007

AW-214-6

Edition: July 2007

Public reporting burden for this application is estimated to average 31 hours per response for the
application process and 4 hours for annual recertification. The burden estimate includes the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and submitting the application. You are not required to respond to this collection of
information unless a valid OMB control number is displayed in the upper right corner of the
application. Send comments regarding the accuracy of the burden estimate and any suggestions for
reducing the burden to Information Collections Management, Department of Homeland Security,
Federal Emergency Management Agency, 500 C St., S.W., Washington, D.C. 20472, Paperwork
Reduction Project (1660-0022). Note: do not send your completed form to this address.

FEMA FORM 086-0-23A, June 2007

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

230 MODIFICATION/CYCLE COVER PAGE
1. Community Name: _______________________________State: ____ BCEGS: _____/_____
NFIP Number: ________________

FIRM Effective Date: ____________________, ______

Population: ___________________ Current FIRM Date: ______________________, ______
Modification/Cycle Date: ___________, 200____
2.

County: __________________________

Chief Executive Officer:

CRS Coordinator:

Name:

_______________________________ ___________________________________

Title:

_______________________________ ___________________________________

Address: _______________________________ ___________________________________
_______________________________ ___________________________________
Coordinator’s Telephone: ____________________________ Fax: ______________________
Coordinator’s email:___________________________________
3. I hereby certify that ___________________________[community name] is implementing the
following activities (check the ones that apply). We are modifying or adding activities that have
an “m” for modifying, “a” for addition, or “d” for dropping in the blank and have attached new
activity worksheets and documentation. We will continue to implement these activities and will
advise FEMA if any of them are not being conducted in accordance with this certification. We
will cooperate with the ISO/CRS Specialist verification visit and will submit the documentation
and annual recertification needed to validate our program.
____
____
____
____
____
____
____
____
____
____

310 Elevation Certificates
320 Map Information Service
330 Outreach Projects
340 Hazard Disclosure
350 Flood Protection Information
360 Flood Protection Assistance
410 Additional Flood Data
420 Open Space Preservation
430 Higher Regulatory Standards
430LD Land Development Criteria

____
____
____
____
____
____
____
____
____
____

440 Flood Data Maintenance
450 Stormwater Management
Repetitive Loss Requirements
510 Floodplain Management Planning
520 Acquisition and Relocation
530 Flood Protection
540 Drainage System Maintenance
610 Flood Warning Program
620 Levee Safety
630 Dam Safety

4. I hereby certify that to the best of my knowledge and belief, we are maintaining in force all flood
insurance policies that have been required of us as a condition of federal financial assistance for
insurable buildings owned by us and located in the Special Flood Hazard Area shown on our
Flood Insurance Rate Map. I further understand that disaster assistance for flooded public
buildings in the Special Flood Hazard Area will be reduced by the amount of flood insurance
available from the National Flood Insurance Program for the buildings, even if we do not have a
policy.
5. Signed: __________________________ (Chief Executive Officer)

Activity Worksheets 086-0-23A

AW-230-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

086-0-23A

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

310 ELEVATION CERTIFICATES
312 Impact Adjustment:
a. Option 1:
1. rECPO = 1.0

2. rECPR = 1.0

3. rECCF = 1.0

4. rECWS = 1.0

b. Option 2:
1. rECPO = 0.25

2. rECPR = 0.25

3. rECCF = 0.25

4. rECWS = 0.25

c. Option 3:
1. rECPO = bECPO
bPO _____

= ______

2. rECPR = bECPR
bPR_______

3. rECCF =
bECCF
bEC ______ + bECPO ______ + bECPR ______

= ______

4. rECWS =
bECWS
= ______

bEC ______ + bECPO ______ + bECPR ______

313 Credit Calculation:
a. cEC

cEC =

b. cECPO = ECPO ______ x rECPO ______

cECPO = ______

c. cECPR = ECPR ______ x rECPR ______

cECPR = ______

d. cECCF = ECCF ______ x rECCF ______

cECCF = ______

e. cECWS = ECWS ______ x rECWS ______

cECWS = ______

f. cORS = ORS

______

cORS = ______

g. Add lines a through f above =

______

c310 = value above rounded to the nearest whole number:

c310 = ______

Enter this value on AW-720-1.

Activity Worksheets 086-0-23A

AW-310-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

086-0-23A

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
314 Credit Documentation:
___ a. [If the community applies for credit under ECPO or ECPR and used a form different
from FEMA’s] A copy of the local elevation certificate, along with documentation
that FEMA has approved it. Note that a local elevation certificate can only be
credited if it was used before 1999 or before the community joined the CRS,
whichever is later.
___ b. [If the community applies for ECCF credit and is NOT using the CRS “Computerized
Format for FEMA elevation certificates”] a copy of the computer format being used.
___ c. EC – Copies of completed elevation certificates
OR

___
___
___
___
___
___ d.

Certification letter if no new construction or substantial improvements.
ECPO – Copies of completed post-FIRM elevation certificates.
ECPR – Copies of completed pre-FIRM elevation certificates.
ECCF – Printout of sample Certificates.
ECWS – Printout of sample Certificates. Website address _____________________
Documentation showing how the impact adjustment ratios were determined and how
the community maintains, stores, and provides copies of elevation certificates.

The following will be needed at the annual recertification:
___ e. ECCF – A disk with the elevation and floodproofing certificate data in computer
format obtained since the last submittal.

Starting month/year for which certificates are consistently available: ____________ ,
________
Office where requests should be submitted: _________________________________________
Address _____________________________________________________________________
City ________________________________ State ______________ Zip ________________
Phone ______________ Fax __________________ e-mail ____________________________
How should requests for elevation and/or floodproofing certificates be submitted (mail, phone,
fax, etc.)? ______________________________

Comments:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

Activity Worksheet 086-0-23A

AW-310-2

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

320 MAP INFORMATION SERVICE
322 Credit Calculation:
c320 = MI =

c320 =

Enter this value on AW-720-1.

323 Credit Documentation:
a. Documentation that shows how the community publicizes the service each year.
1. If the community publicizes this service through an annual outreach project
credited under Activity 330 (OPC or OPS), “320” must be noted in the margin of
the outreach project to the community (OPC) where the map information service
is addressed. If an OPS is used, the public information strategy document must
discuss the best way to publicize the map information service to the target
audiences.
2. If the community publicizes this service through an annual outreach project that is
not credited under Activity 330, attach a copy of the project. The materials must
be distributed each year and must reach at least 90% of the target audience.
3. If the community sends a letter or e-mail directly to lending institutions and real
estate and insurance agencies, attach a copy of the letter or e-mail message.
4. If the community notifies organizations of lending institutions and real estate and
insurance agencies, attach copies of the notifications in their publications. If any
organization has not yet published the notifications, documentation must include
written assurance from the organization that it intends to publish the notification
within six months of the Community Rating System (CRS) application date.
b. If another agency provides map information, documentation that the agency agrees
to provide the service to all inquirers and will allow the CRS to verify its work.
c. Records of which institutions and agencies were notified of the service. If the

community sends letters to institutions and agencies, a mailing list for those

institutions and agencies.

d. A record or log that shows the level of service provided.
e. Documentation or notations on how the community keeps the FIRM updated.
Documentation or notations that the community has copies of all FIRMs since 1999
or the date the community applied for this credit, whichever is later.
Starting month/year for which certificates are consistently available: ______________ , ____
Office where requests should be submitted _______________________________________
Address _____________________________________________________________________
City ________________________________________________ State ________ Zip ________
Phone ______________________ Fax __________________ e-mail______________________
How should requests for the service be made (mail, phone, fax, etc.)? ____________________

Activity Worksheet 086-0-23A

AW-320-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

330 OUTREACH PROJECTS
331 Credit Points:
a.—c.
Variable:

OPC

Points per topic:

OPF

OPA1

OPA2

OPA3

Topics covered

1. Local flood hazard:
2. Flood safety:
3. Flood insurance:
4. Property protection:
5. Natural & beneficial functions:
6. Local flood hazard map:
7. Flood warning system:
8. Permit requirements:
9. Substantial improvement/damage:
10. Drainage maintenance:

Total of above:

OPC =

OPF =
OPA1 =
OPA2 =
OPA3 =

d. OPS

1. Outreach Project pursuant to a strategy (100 points):

2. Multi-hazard strategy (25 points):

OPS = the total of lines 1 and 2 above:

OPS =

e. PFI
1. Brochure or letter (10 or 45 points):
2. Inclusion of photo(s) (5 points):
3. Explanation of FIRM zones (15 points):

PFI = the total of lines 1, 2, and 3 above:

PFI =

332 Credit Calculation:
c330 = EITHER

OPC
OR

+ OPF
OPC

+ OPA1

+ OPF

+ OPA2
+ OPS

+ OPA3
+ PFI

+ PFI

c330 =

Enter this value on AW-720-1.

Activity Worksheet 086-0-23A

AW-330-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
333 Credit Documentation:
a. OPC: Copies of the materials, marked with the topics covered.

Date sent:_________________________________

OPF: Copies of the materials, marked with the topics covered.

Date sent:_________________________________

90% Coverage Documentation
OPA1: A description of the project with copies of the public information materials that
were distributed, marked with the topics covered.
Date undertaken:__________________
Example or description:________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
OPA2: A description of the project with copies of the public information materials that
were distributed, marked with the topics covered.
Date undertaken:__________________
Example or description:________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
OPA3: A description of the project with copies of the public information materials that
were distributed, marked with the topics covered.
Date undertaken:__________________
Example or description:________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
PFI:

A copy of the letter or brochure mailed to __ entire community or __ SFHA properties

b. OPS: A copy of the public information program strategy marked with the criteria that must
be met. Include documentation that the strategy is being implemented.
c. Documentation that shows when the projects were undertaken.
d. PFI
1.
2.
3.
4.
5.

- Prerequisites:
Number of buildings in the community:
Number of apartments and condominium units in the community:
Number of buildings in the SFHA:
Number of apartments and condominiums in the SFHA:
Notes on how these numbers were calculated:

The following will be needed at the annual recertification:
___ e. Copies of the outreach projects that were conducted that year.
___ f. OPS − A copy of the annual OPS evaluation.
Activity Worksheet 086-0-23A

AW-330-2

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
333.e Public Information Program Strategy Evaluation
[See page 330–25 of the CRS Coordinator's Manual for a completed example.

1. Goals of the community’s Public Information Program Strategy:

2. Projects implemented to meet those goals and their objectives:

3. Were any projects not implemented or objectives not reached? If not, why?

4. What new projects should be implemented and what projects or objectives should be
revised?

For more information, contact: _________________________ Phone: ______________

Activity Worksheet 086-0-23A

AW-330-3

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

340 HAZARD DISCLOSURE
342 Credit Calculation:
a. DFH:

DFH = ______

b. ODR:

ODR = ______

c. REB:

REB = ______

d. DOH:

DOH = ______

e. Add lines a through d above:

c340 = ______

Enter this value on AW-720-1.

343 Credit Documentation:
a. DFH: Documentation that demonstrates that real estate agents are advising potential
property purchasers of the flood hazard and the flood insurance purchase
requirement.
Disclosure notices from at least five real estate agencies. Blank forms are not
acceptable documentation. OR
__

State law that requires real estate agents to advise people whether a property is
located in a Special Flood Hazard Area.

b. ODR: A copy of ordinance or law language requiring one or more additional
disclosure methods at the time of sale or rental of a property. The acronym “ODR”
must be marked in the margin of the sections that pertain to this element.
ODR1: Regulation: _______________________________________
ODR2: Regulation: _______________________________________
ODR3: Regulation: _______________________________________
c. REB: A brochure or other document that is made available to interested parties by
real estate agents. The document must advise people looking to purchase property to
investigate the flood hazard before they buy.
d. DOH: Documentation that the DFH notification includes disclosure of other floodrelated hazards, such as erosion, subsidence, or wetlands.

__________________________________________________________________________

Activity Worksheet 086-0-23A

AW-340-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

350 FLOOD PROTECTION INFORMATION
351 Credit Points:
a. LIB:
1. FIRM, Floodway Map, and explanation (4 points):

______

2. Flood insurance (2 points):

______

3. Building protection measures (8 points):

______

4. Floodplain management or hazard mitigation (3 points):

______

5. Natural and beneficial floodplain functions (3 points):

______

6. Directory of local sources of more information (3 points):

______

7. Special Hazards (2 points)

______

LIB = the total of lines 1 through 7 above

LIB = ______

b. LPD:

LPD = ______

c. WEB:
1. Prerequisites:

__ (a) Site is easy to locate using the community’s name.

__ (b) Easy to get to the flood information from the home page.

__ (c) Links are pertinent to the community’s flood conditions.

__ (d) At least one link to FEMA’s website.

__ (e) Site is reviewed and updated at least once each year.

2.(a) Outreach Project Topics:

1. Local flood hazard (4 points):

______

2. Flood safety (4 points):

______

3. Flood insurance (4 points):

______

4. Property protection (4 points):

______

5. Natural & beneficial functions (4 points):

______

6. Local flood hazard map (4 points):

______

7. Flood warning system (4 points):

______

8. Permit requirements (4 points):

______

9. Substantial improvement/damage (4 points):

______

10. Drainage maintenance (4 points):

______

(b) Publicizing elevation certificates (2 points):

______

(d) Other flood warning information (20 points):

______

WEB = the total of lines 2(a)—2(d) above:

WEB = ______

352 Credit Calculation:
Add LIB, LPD, and WEB:

c350 = ______

Enter this value on AW-720-1.
Activity Worksheet 086-0-23A

AW-350-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
353 Credit Documentation:
a. LIB: A statement from the head of the library that includes:
1. A list of the documents available in the library with their publication dates. Note
which ones also qualify as locally pertinent documents for LPD credit. AND
2. E ITHER:
(a) Certification that the documents have been entered into the library’s card
catalog or similar system. OR
(b) A copy of the card catalog cards or printout of the automated system’s
inventory of flood documents. AND
3. A statement that adequate numbers of documents will be maintained and that the
FIRMs and other materials will be kept up to date.
b. WEB:

The URL of the community’s website: ______________________________

If appropriate, documentation that the website is publicized through an outreach
project reaching 90% of community.
The following will be needed at the annual recertification:
c. WEB: Certification that the community has conducted its annual review and update

of the information and links in its flood protection website.

Activity Worksheet 086-0-23A

AW-350-2

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

360 FLOOD PROTECTION ASSISTANCE
361 Credit Points:
FPA:
a. Providing site-specific flood and flood-related data (10 points):

______

b. Providing names of contractors and consultants (4 points):

______

c. Providing material on how to select a contractor (3 points):

______

d. Making site visits to review flood, drainage, and
sewer problems (35 points):

______

e. Advising and assisting on retrofitting techniques (14 points):

______

f. Retrofitting Floodprone Residential Buildings course
at EMI (5 points) OR FEMA’s Retrofitting home study
course (2 points):

______

FPA = the total of lines a through f above:

FPA = ______

362 Credit Calculation:
c360 = FPA

c360 = ______

Enter this value on AW-720-1.

363 Credit Documentation:
a. A copy of the document used to publicize the service.
An outreach project to the community (OPC or OPF) credited under Activity 330.
An outreach project pursuant to the public information strategy (OPS) credited in
Activity 330, provided the public information strategy document discusses the best
way to advise the target audiences. OR
An annual outreach project that advises all residents and businesses in the
community or in the floodplain about the service, but is not credited under Activity
330 (e.g., a short notice with all tax or utility bills). The materials must be distributed
each year and must reach at least 90% of the target audience.
b. A description of the technical qualifications of all persons who are providing the site
visit and retrofitting assistance credited under Sections 361.d and e.
If credit is being sought under Section 361.f for graduation from the EMI retrofitting
course, a copy of the certificate of graduation.
c. If the person is not a community employee, a letter stating that the person and/or
agency have agreed to do the work.
d. If the community is applying for credit under Section 361.b or c, a list of the names of
contractors or consultants and/or a copy of the material the community provides on
how to select a contractor.
e. If the community is applying for credit under Section 361.d or e, records noting the
date and type of assistance given. The records must include the details of the
findings and recommendations provided to the inquirer.
Activity Worksheet 086-0-23A

AW-360-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

410 ADDITIONAL FLOOD DATA
NOTE: Make a copy of this worksheet for each AFD.

This worksheet is for AFD ____

411 Credit Points:
a. NS _____
1. Delineation of an approximate A Zone:

______

2. Flood elevations for a site at time of development:

______

3. New profile or length of shoreline:

______

4. New profile with floodway or length of shoreline
with coastal velocity zone delineation:

______

5. Repetitive loss area(s):

______

Add lines 1 through 5:

NS__= ______

b. LEV__ EITHER
1. Non-FEMA share of study
Total cost of study

= ______

2. A total of the following:
(a) 0.25 if better topographic map was contributed:
(b) 0.15 if other contributions were made to the study:

= ______
LEV__= ______

c. HSS__
1. Delineation of an approximate A Zone:

______

2. Flood elevations for a site at time of development:

______

3. New profile or length of shoreline:

______
HSS__ = ______

d. FWS__

FWS__ = ______

e. CTP2__

CTP2__ = ______

412 AFDi ___ Impact Adjustment:
a. Option 1: rAFD__ = 1.0

b. Option 2: rAFD__ = 0.25

c. Option 3: rAFD__ = aAFD
= ______

aSFHA ______

Activity Worksheet 086-0-23A

AW-410-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

413 Credit Calculation:
a. cAFDi = ((NSi x LEVi) + HSSi + FWS) x rAFDi x CTP2i

cAFD1 = ((____ x ____) + ____ + ____) x ____ x ____

cAFD1 = ______

cAFD2 = ((____ x ____) + ____ + ____) x ____ x ____

cAFD2 = ______

cAFD3 = ((____ x ____) + ____ + ____) x ____ x ____

cAFD3 = ______

cAFD4 = ((____ x ____) + ____ + ____) x ____ x ____

cAFD4 = ______

cAFD5 = ((____ x ____) + ____ + ____) x ____ x ____

cAFD5 = ______

cAFD6 = ((____ x ____) + ____ + ____) x ____ x ____

cAFD6 = ______

b. ΣAFDi = the total of cAFD1 through cAFD6:

ΣAFDi = ______

AFDSH______ (enter total 410 credit from all Special Hazards Worksheets)
cAFDSH = AFDSH ______ x CTP2 ______

cAFDSH = ______

CTP1

CTP1 = ______

Add the lines under b above =

______

c410 = value above rounded to the nearest whole number:

c410 = ______

Enter this value on AW-720-1.

Activity Worksheet 086-0-23A

AW-410-2

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
414 Credit Documentation:
a. The ordinance or law that adopts the flood study for regulatory purposes. AND / OR
___

The ordinance that requires site-specific flood elevation or floodway studies to be
conducted at the time of permit application.
b. E ITHER:

___

A copy of each study or an explanation of the technique used and a licensed
professional engineer’s statement that the study technique is approved by FEMA. OR

___

A copy of the Flood Insurance Study pages or Letter of Map Revision (LOMR) that
show that the study has been accepted by FEMA to revise the FIRM.

___ c. If the community requested credit for the independent review, documentation that
the state or other agency reviewed and accepted the study or analysis techniques
for which credit is being requested.
___

NS: Documentation that new base flood elevations are higher than those shown in
the FIRM.

___

NS: If credit for mapping a repetitive loss area is requested, the area must be
identified on a map.

___

HSS: Documentation of the higher study standard used in the flood study.

___

FWS: The state or local law that sets the maximum allowable surcharge used in the
study and a copy of the Floodway Data Table or similar documentation that shows
the surcharge used in the study.

___

CTP1: Documentation that the community or other entity has signed the CTP
agreement.

___

CTP2: Documentation showing the relationship between the study and the CTP
agreement.

___ d. LEV: Documentation of the non-FEMA share of the study and who paid for it.
___ e. The Impact Adjustment Map if Option 3 is used.
___ f.

CTP2: Documentation that shows the relation between the study or standard and
the CTP agreement.

The following will be needed at the cycle verification visit:
___ g. [If the community has received credit for a new study (NS) under Section 411.a] A
certification by the community’s engineer that its regulatory floodplain maps and
related data reflect current conditions.

Comments: ________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Activity Worksheet 086-0-23A

AW-410-3

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

420 OPEN SPACE PRESERVATION
422 Impact Adjustment:
a. Option 1: 1. rOS = 1.0

2. rDR = 1.0

3. rNB = 1.0

b. Option 2: 1. rOS = 0.05

2. rDR = 0.1

3. rNB = 0.1

c. Option 3:
1. rOS = aOS
aRF

2. rDR = aDR
aRF

3. rNB = aNB
aRF

423 Credit Calculation:
a. cOS = 725 x rOS ______

cOS = ______

b. cDR =

75 x rDR ______

cDR = ______

c. cNB = 100 x rNB ______

cNB = ______

d. cSHOS (Enter total 420 credit from

all Special Hazards Worksheets)

cSHOS = ______

e. Add lines a through d above =

______

c420 = value above rounded to the nearest whole number:

c420 = ______

Enter this value on AW-720-1.

424 Credit Documentation:
___ a. Provide assurance that eligible properties will remain open with a marked-up copy of
the restrictive ordinance language.
___ b. Provide assurance that eligible properties will remain open with a document from the
owner(s).
___ c. DR: Attach a copy of the deed restriction(s).
___ d. NB: Attach a copy of the documentation from a professional in a natural science that
the parcel has been preserved in or restored to an undeveloped natural state, or is
otherwise deserving of preservation because of the natural and beneficial function(s)
that it serves.
___ e. The Impact Adjustment Map.
___ f. E ITHER the open space areas are ___ located within the SFHA, OR ___ outside the
SFHA and documentation is attached showing that floodplain regulations are in effect
in the area outside the SFHA.

Activity Worksheet 086-0-23A

AW-420-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022

Expires: August 31, 2010

Community : ____________________________

Activity Worksheet 086-0-23A

AW-420-2

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

430 HIGHER REGULATORY STANDARDS
432 Impact Adjustment:
a. Option 1: Enter rOS from AW-420-1.

If the community did not apply for Activity 420, then rOS = 0

1. rFRB = 1.0 - rOS ______ = ______

6. rPSC = 1.0 - rOS ______ = _______

2. rFDN = 1.0 - rOS ______ = ______

7. rNBR = 1.0 - rOS ______ = _______

3. rCSI = 1.0 - rOS ______ = ______

8. rENL = 1.0 - rOS ______ = _______

4. rLSI = 1.0 - rOS ______ = ______

9. rOHS = 1.0 - rOS ______ = _______

5. rPCF = 1.0 – rOS ______ = ______

10. rCAZ = 1.0 - rOS ______ = _______

b. Option 2:
1. rFRB = 0.25

6. rPSC = 0.25

2. rFDN = 0.25

7. rNBR = 0.25

3. rCSI = 0.25

8. rENL = 0.25

4. rLSI = 0.25

9. rOHS = 0.25

5. rPCF = 0.25

10. rCAZ = 0.1

c. Option 3:
1. rFRB = aFRB
aRF

= ______

6. rPSC = aPSC
aRF _____

= ______

2. rFDN = aFDN
aRF

= ______

7. rNBR = aNBR
aRF _____

= ______

3. rCSI = aCSI
aRF

= ______

8. rENL = aENL
= ______
aRF _____

4. rLSI = aLSI
aRF

= ______

9. rOHS = aOHS
aRF _____

5. rPCF = aPCF
a500

= ______

10. rCAZ = aCAZ
= ______
aRF _____

Activity Worksheet 086-0-23A

AW-430-1

= ______

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
433 Credit Calculation:
a. cFRB = FRB ______ x rFRB ______

cFRB = ______

b. cFDN = FDN ______ x rFDN ______

cFDN = ______

c. cCSI =

CSI ______ x rCSI _______

cCSI = ______

d. cLSI =

LSI ______ x rLSI _______

cLSI = ______

e. cPCF = PCF ______ x rPCF ______

cPCF = ______

f. cPSC = PSC ______ x rPSC ______

cPSC = ______

g. cNBR = NBR ______ x rNBR ______

cNBR = ______

h. cENL = ENL ______ x rENL ______

cENL = ______

i. cOHS = OHS ______ x rOHS ______

cOHS = ______

j. c430LD (from AW-430LD-2 and LD values from
Special Hazards Worksheets):

c430LD = ______

k. cSH (Enter total 430 credit from all Special Hazards Worksheets):
l. SMS

cSH = ______

____ FRB

____ FDN

____ CSI

____ LSI

____ PCF

____ PSC

____ NBR

____ ENL

____ OHS

____ LD

____ SH

____ BC

____ STF

____ MHP

____ CAZ

____ NS

____ HSS

____ FWS

____ OS

____ SMR

____ (Other SMS: ________)

1. 0.1 x (credit for SMS elements ______ )
2. Insurance agent training
cSMS = the total of 1 and 2 above:

= ______
= ______
cSMS = ______

m. BC
1. 15 x (7 – BCEGS rating ______ )

= ______

2. I-Codes credit IBC ____ + IRC ____ + Other codes_____ = ______
cBC = total of 1 and 2 above:

cBC = ______

n. STF
1. All regulatory staff are CFMs (50 points) ______
2. All development projects reviewed and approved by CFM (25 points) ______
3. 5 points for each CFM or EMI course graduate (max 25 points) ______
cSTF = 1 or 2 or 3 above:
cSTF = ______
o. MHP

cMHP = ______

p. cCAZ = CAZ ______x rCAZ ______

cCAZ = ______

q. Add lines a through p above =

______

c430 = value above rounded to the nearest whole number:

c430 = ______

Enter this value on AW-720-1.

Activity Worksheet 086-0-23A

AW-430-2

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
434 Credit Documentation:
a. Law or ordinance c. Explanation/documentation
Language
of enforcement procedures

Copies of relevant
permit records

FRB

_____

FDN

_____

CSI

_____

LSI

_____

PCF

_____

PSC

_____

ENL

_____

OHS

_____

NBR

_____

MHP

_____

CAZ

_____

NBR

_____ If credit is for regulations adopted pursuant to a Habitat Conservation
Plan, attach the appropriate pages of the plan.

_____ AW-430LD is attached.

_____ AW and relevant documentation for each special hazard for which
credit is requested is attached.

SMS _____ State law or regulation mandating a floodplain management standard is
attached.
_____ State law or regulation has been approved under Uniform Minimum Credit.
_____ State law or regulation mandating flood insurance training for property
insurance agents is attached.
BC

_____ Law or ordinance language adopting I-Codes is attached.

MHP _____ Map showing one or more existing manufactured home parks or
subdivisions in the regulatory floodplain. The base flood elevations are
greater than 3 feet deep in these parks/subdivisions.
CAZ _____ Map of the community’s designated Coastal AE Zone.
_____ b. Impact Adjustment Option 3 – Attached is the Impact Adjustment Map.
_____ d. STF: A copy of the certificate(s) of graduation or CFM certificate(s).

AW-430-3

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

430LD LAND DEVELOPMENT CRITERIA
432LD Impact Adjustment:
a. Option 1: Enter rOS from AW-420-1.

If the community did not apply for Activity 420, then rOS = 0

rLZ__ = 1.0 - rOS ______ = ______

b. Option 2:
1. rLZ__ = 0.05
2. rLZ__ = 0.05
c. Option 3:
1. rLZ___ = aLZ
aRF

= ______

2. rLZ___ = aLZ
aRF

= ______

3. rLZ___ = aLZ
aRF

= ______

433LD Credit Calculation:
a. cLZ _ = LZ__ ___ x rLZ__ ____

cLZ__ = ______

cLZ _ = LZ__ ___ x rLZ__ ____

cLZ__ = ______

cLZ _ = LZ__ ___ x rLZ__ ____

cLZ__ = ______

cLDC = LDC ______

cLDC = ______

b. Add the lines above =

______

c430LD = value above rounded to the nearest whole number:

c430LD = ______

Enter this value on AW-430-3.

434LD Credit Documentation:
____ a. Ordinance language that adopts the land development criteria or low density
zoning.
____ b. The Impact Adjustment Map.
____ c. Attached is an explanation of how the regulations are enforced.
____ d. Attached are examples of developments constructed in accordance with the
regulations.

Activity Worksheet 086-0-23A

AW-430LD-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
To facilitate verification of this activity, please provide the names of the CRS Coordinator and
planning director if other than the CRS Coordinator:
CRS Coordinator

Local Planning Director

Name:
Title:
Phone:

Fax:

Address:
E-mail:

Activity Worksheet 086-0-23A

AW-430LD-2

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

440 FLOOD DATA MAINTENANCE
441 Credit Points:
a. AMD:
1. Prerequisites:

___ (a) The system is used regularly by the community regulatory staff.

___ (b) New data are added at least annually.
___ (c) Digitized data will be made available annually to FEMA.
2. Credit Points:
(a) Regulatory floodplain, corporate limits, streets,
and parcels/lots (32 points):

______

(b) Location of buildings (15 points):

______

(d) Base flood elevations (8 points):

______

(e) FIRM zone attributes (6 points):

______

(f) 500-year elevations or boundaries (8 points):

______

(g) Other natural hazard areas (8 points):

______

(h) Topographic contour lines (10 or 20 points):

______

(i) Floodplain data in tax assessment data base (8 points):

______

(j) Overlays for previous FIRMs (8 points):

______

(k) Other regulatory or mitigation overlays (8 points):

______

AMD = the total of lines (a) through (k) above:

AMD = ______

b. BMM:
BMM = 15 x ((NSRS x 1.5) + LBM = _______
aRFM
d. FM:

Activity Worksheet 086-0-23A

BMM = ______

FM = ______

AW-440-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
442 Impact Adjustment:
a. Option 1:

rAMD = 1.0

b. Option 2:

rAMD = 0.25

c. Option 3:

rAMD =

aAMD
aRF

= _________

443 Credit Calculation:
a. cAMD = AMD ______ x rAMD ______ =

cAMD = ______

b. BMM:

BMM = ______

c. EDM (from AW-CE):

EDM= ______

d. FM:

FM = ______

Add the lines above =

______

c440 = value above rounded to the nearest whole number:

c440 = ______

Enter this value on AW-720-1.

444 Credit Documentation:
____ a. A summary or example showing the types of data in the data maintenance program.
____ b. If the data maintenance program does not include the entire community, the Impact
Adjustment Map.
____ c. Copies of the digitized mapping, parcel records, or overlay maps, as appropriate.
____

Copies of the shoreline erosion records.

____

Copies of the old FIRMs, Floodway Maps, Flood Insurance Studies, and/or Flood
Hazard Boundary Maps.

____ d. The data on the qualifying benchmarks, the surveyor’s statement (for those
benchmarks not in the NSRS), and the map showing their locations.
____ e. Information on reference marks that appear on the FIRM that were found to be
missing or inaccurate.

Activity Worksheet 086-0-23A

AW-440-2

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No .1660-0022
Expires: August 31, 2010

Community : ____________________________

450 STORMWATER MANAGEMENT
451 Credit Points:
a. SMR
1. SZ

SZ = ______

2. DS

DS = ______

3. PUB

PUB = ______

SMR = the total of lines 1 through 3:

SMR = ______

b. WMP
1. The four prerequisites are met (80 points):

______

2. The plan is also based on the 100-year storm (25 points):

______

3. The community also manages peaks and volumes (40 points):

______

4. The community uses the 5-day event (25 points):

______

5. Identification of wetlands, etc. (15 points):

______

6. Protection of natural channels (10 points):

______

7. Requiring “soft” techniques for bank stabilization (10 points):

______

8. Coordination with the floodplain management plan (20 points):

______

WMP = the total of lines 1 through 8:

WMP =______

452 Impact Adjustment:
a. Option 1: 1. rSMR = 1.0

2. rWMP = 1.0

b. Option 2: 1. rSMR = 0.25

2. rWMP = 0.25

c. Option 3: 1. rSMR = aSMR
aW

= ______

2. rWMP = aWMP
= ______

aW ______

453 Credit Calculation:
a. cSMR = SMR

x rSMR

b. cWMP = WMP

cSMR = ______

x rWMP

cWMP = ______

c. FRX = ____ x ____height in feet of lowest floor or opening, OR

50, where site plan accounts for drainage, OR

20, where positive drainage required

FRX = ______

d. ESC

ESC = ______

e. WQ

WQ = ______

Add the lines a—e above =

______

c450 = value above rounded to the nearest whole number:

c450 = ______

Enter this value on AW-720-1.

Activity Worksheet 086-0-23A

AW-450-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
454 Credit Documentation:
a.

Stormwater Management Regulation (SMR):

1. A copy of the ordinance or law language regulating surface water runoff from new developments in
the watershed. For SMR credit, the language must require that peak runoff from new developments
be no greater than the runoff from the site in its pre-development condition. As an alternative to
such a performance standard, the language may be based on criteria designed to produce the
same result on a regional basis (e.g., a standard allowable discharge per acre based on a regional
study). The margin next to where this appears in the ordinance must be marked “SMR.”
Ordinance language from other communities within the watershed with the same or
similar regulations. The margin next to where this appears in the ordinance must be
marked “SMR,” OR
Written assurance from a county, regional, or state agency that similar standards are in
effect in the upstream communities.
Development and permit records that demonstrate enforcement.
2. SZ: The ordinance language that includes the types of development regulated to ensure that
peak runoff from new developments be no greater than the runoff from the site in its predevelopment condition. Include the part of the ordinance that specifies exemptions to this
requirement. The margin next to where this appears in the ordinance must be marked “SZ.”
Ordinance language from other communities within the watershed with the same or
similar regulations. The margin next to where this appears in the ordinance must be
marked “SZ,” OR .
Provide written assurance from a county, regional, or state agency that similar
standards are in effect in the upstream communities.
3. DS: The ordinance language that includes the design storm(s) used by the community for
stormwater management regulation. This is the recurrence interval for the storm(s) that is/are
regulated to prevent increased runoff due to development. If credit is based on language that does
not include storm recurrence intervals, the community must provide an estimate of the recurrence
intervals. The margin next to where this appears in the ordinance must be marked “DS.”
Ordinance language from upstream communities within the watershed with the same or
similar regulations. The margin next to where this appears in the ordinance must be
marked “DS.” OR
Provide written assurance from a county, regional, or state agency that similar
standards are in effect in the upstream communities.
4. PUB: The ordinance language that shows that the community has the authority to inspect
all private and public stormwater facilities and ensure that they are properly maintained.
The margin next to where this appears in the ordinance must be marked “PUB.”
Ordinance language that requires that all stormwater facilities be dedicated to the
community.” OR
Ordinance language that allows community staff to enter private property to inspect
stormwater facilities, AND allows community staff to perform necessary maintenance.” OR
Ordinance language that requires the owner(s) of private stormwater facilities to have
them inspected at least annually by a registered engineer, to perform all maintenance
indicated by such inspections, and to submit copies of all inspection reports and
maintenance reports to the community.

Activity Worksheet 086-0-23A

AW-450-2

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
A list or map that shows the locations of all publicly and privately owned stormwater
facilities for which the community is requesting PUB credit.
Documentation that shows that all public and private stormwater facilities have been
inspected at least annually. This documentation should include a standard operating
procedure for inspections and records of actual inspections and maintenance. This
documentation is similar to, and may be combined with, documentation for channel
debris removal (CDR) in Activity 540.
5. Impact adjustment. E ITHER
If the community uses Option 1, it must document that all of the watershed that affects
the community is regulated to the same standard. This is true if there is a regional
stormwater management standard applied by all upstream communities, or if the
community is entirely on an island, and no other communities on the island drain into
the community, or if the community’s upstream boundaries exactly match the
watershed boundaries. Provide an Impact Adjustment Map that shows the area
regulated by the community (usually the community’s boundaries) (marked “aSMR”)
and the boundaries of the watershed that affects the community (marked “aW”). aSMR
and aW must be equal. OR
If the community uses Option 2, rSMR = 0.25 and no documentation is required. OR
If the community uses Option 3, it must provide an Impact Adjustment Map. Provide an
Impact Adjustment Map that shows the area regulated by the community (usually the
community’s boundaries) (marked “aSMR”) and the boundaries of the watershed that
affects the community (marked “aW”). If areas within the upstream watershed are
regulated by other communities, their boundaries must also be marked.
b.

Watershed Master Plan (WMP):

1. WMP Prerequisites (one prerequisite is credit for SMR):
a. Documentation that the community has adopted a watershed management master
plan for one or more of the watersheds that drain into the community. The margin
next to where this appears in the documentation must be marked “WMP 1.a.”
c. The section of the plan that includes regulatory standards to manage future peak
flows so that they do not increase over present values. The margin next to where this
appears in the documentation must be marked “WMP 1.c.”
d. The section of the plan that includes regulatory standards to manage runoff from all
storms up to and including at least the 25-year event. The margin next to where this
appears in the documentation must be marked “WMP 1.c.”
2. WMP Credit (Basic credit is provided for meeting the prerequisites):
b. Documentation that shows management of peak flows for all storms up to and
including the 100-year storm. The margin next to where this appears in the
documentation must be marked “WMP 2.b.”
c. Documentation that shows management of peak flows AND volumes so that they do
not exceed present values. The plan must include either regulations that meet these
criteria, or must be based on a rainfall/runoff model that achieves these results. The
margin next to where this appears in the documentation must be marked “WMP 2.c.”

Activity Worksheet 086-0-23A

AW-450-3

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
d. Documentation that shows management of the runoff from all storms up to and
including the 5-day event. If a community can demonstrate that an event shorter than
five days is the locally appropriate “worst-case” runoff event for stormwater
management, it may receive the credit if it uses that event for its regulatory standard.
The margin next to where this appears in the documentation must be marked “WMP
2.d.”
e. Documentation that the plan identifies existing wetlands or other natural open space
areas to be preserved from development to provide natural attenuation, retention, or
detention of runoff. The margin next to where this appears in the documentation must
be marked “WMP 2.e.”
f. Documentation that the plan prohibits development, alteration, or modification of
existing natural channels. The margin next to where this appears in the
documentation must be marked “WMP 2.f.”
g. Documentation that the plan requires that channel improvement projects use natural
or “soft” approaches rather than gabions, riprap, concrete, or other “hard” techniques.
The margin next to where this appears in the documentation must be marked “WMP
2.g.”
h. Documentation that the plan was prepared in coordination with or as a part of the
community's floodplain management plan credited under Activity 510. The margin
next to where this appears in the documentation must be marked “WMP 2.h.” EITHER
The Floodplain Management Plan is mentioned prominently in the stormwater master
plan and references in the watershed master plan demonstrate that it is intended to
help implement the Floodplain Management Plan. OR
Hydrologic output from the watershed master plan is used as input for the Floodplain
Management Plan.
3. Impact adjustment. Either:
If the community uses Option 1, it must document that all of the watershed that affects
the community is covered by its watershed master plan(s). This is true if there is a
regional stormwater management plan applied by all upstream communities, or if the
community is entirely on an island, and no other communities on the island drain into
the community, or if the community’s upstream boundaries exactly match the watershed
boundaries. Provide an Impact Adjustment Map that shows the area covered by the
watershed master plan(s) (marked “aWMP”) and the boundaries of the watershed that
affects the community (marked “aW”). aWMP and aW must be equal. OR
If the community uses Option 2, rWMP = 0.25 and no documentation is required. OR
If the community uses Option 3, it must provide an Impact Adjustment Map. Provide an
Impact Adjustment map that shows the area covered by the watershed master plan(s)
(marked “aWMP”) and the boundaries of the watershed that affects the community
(marked “aW”).
c. Freeboard in B, C, D, and X Zones (FRX):
A copy of the ordinance or law language that requires elevation of the lowest floor or
lowest opening of new buildings. The margin next to where this appears in the
documentation must be marked “FRX.”
Development and building permit records that demonstrate enforcement.

Activity Worksheet 086-0-23A

AW-450-4

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
d. Erosion and sedimentation control regulations (ESC):
A copy of the ordinance or law language that requires developers or property owners to
use techniques that prevent erosion and soil loss from exposed land. The ordinance(s)
or law must designate an office or official responsible for receiving complaints and
monitoring compliance and it must include enforcement and abatement provisions. The
margin next to where this appears in the documentation must be marked “ESC.”
Development and building permit records that demonstrate enforcement.
e. Water quality regulations (WQ):
A copy of the ordinance or law language that requires new developments to implement
appropriate best management practices to improve water quality. The margin next to
where this appears in the documentation must be marked “WQ.”
Development and building permit records that demonstrate enforcement.

To facilitate verification of this activity, please provide the names of the CRS Coordinator and
local stormwater manager if other than the CRS Coordinator:
CRS Coordinator

Local Stormwater Manager

Name:
Title:
Phone:

Fax:

Address:
E-mail:

Comments:

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Activity Worksheet 086-0-23A

AW-450-5

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

REPETITIVE LOSS REQUIREMENTS
501 Repetitive Loss List:
___ The community has reviewed the repetitive loss list dated ___________, 200___, and
___

Attached are updated Repetitive Loss Update Worksheets, AW-501. OR

___

There are no changes to FEMA’s repetitive loss list.

As the current CRS Coordinator for ______________________[community name], I have
examined the repetitive loss data provided for each of our ______[#] assigned repetitive loss
properties. For each property in need of update, I have attached an AW-501 that reflects the
current and accurate address, the correct NFIP community identification number, and all known
mitigation actions with the primary source of funding noted. In addition, to the best of my
knowledge and belief, any AW-501 not updated and submitted as part of this application has been
checked and is not in need of update at this time.
Signature: ___________________________________________ (Community CRS Coordinator)

502 Repetitive Loss Category:
After updating, the number of properties counted for CRS purposes is:___ This community is a:
___ Category A community because it has removed all properties from being counted as
repetitive loss properties for CRS purposes.
___ Category B community with 1 to 9 properties counted for CRS purposes. OR
___ Category C community with 10 or more properties counted for CRS purposes.
N OTE : A LL C ATEGORY B AND C REPETITIVE LOSS COMMUNITIES MUST COMPLETE THE FOLLOWING
S ECTION 503 AND SUBMIT THE ACCOMPANYING DOCUMENTATION. CATEGORY C COMMUNITIES MUST
ALSO RECEIVE CREDIT FOR A F LOODPLAIN M ANAGEMENT P LAN UNDER A CTIVITY 510 (F LOODPLAIN
M ANAGEMENT P LANNING ). A CATEGORY C COMMUNITY WILL REVERT TO C LASS 10 IF IT FAILS TO
SUBMIT A PLAN .

503 Repetitive Loss Area Outreach Project:
___ a. A description of the causes of the repetitive flooding.

___ b. A map with the repetitive loss areas identified.

___ c. The addresses for all the properties in the repetitive loss areas.

d. The number of buildings in the repetitive loss areas is: ________( = bRLA).
___ e. The outreach project sent to all properties in the repetitive loss areas.
The following will be needed at the annual recertification:
___

The outreach project sent to all properties in the repetitive loss areas.

Activity Worksheet 086-0-23A

AW-500-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
To facilitate verification of this activity, please provide the names of the CRS Coordinator and
local repetitive loss contact person, if other than the CRS Coordinator:
CRS Coordinator

Repetitive Loss Contact

Name:
Title:
Phone:

Fax:

Address:
E-mail:

Activity Worksheet 086-0-23A

AW-500-2

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

510 FLOODPLAIN MANAGEMENT PLANNING

511.a Floodplain Management Planning (FMP)
Credit Points: Enter the section or page number in the plan where each credited item can be found.
Step
Section/Page

CRS Step

Score

Total

1. Organize to prepare the plan.
a. Supervision or direction of a professional planner (2)
b. Planning committee of department staff (6)
c. Process formally created by the community’s governing board (2)
2. Involve the public.
a. Planning process conducted through a planning committee (40)
b. Public meetings held at the beginning of the planning process (15)
c. Public meeting held on draft plan (15)
d. Questionnaires ask the public for information (5)
e. Recommendations are solicited from advisory groups, etc. (5)
f . Other public information activities to encourage input (5)

Item

3. Coordinate with other agencies.
a. Review of existing studies and plans (REQUIRED) (3)
b. Invited neighboring communities and other agencies (REQUIRED) (1)
c. Contacted communities and NFIP and EM agencies (4)
d. NWS, ARC and others are asked how they can help community (4)
e. Meetings are held with agencies on mitigation strategies (10)
f. Draft action plan sent to agencies for comments (3)
4. Assess the hazard.
a. Plan includes an assessment of the flood hazard (REQUIRED) with:
(1) A map of known flood hazards (5)
(2) A description of known flood hazard (5)
(3) A discussion of past floods (5)
b. The plan describes other natural hazards (REQUIRED FOR DMA) (5)
AW-510-1

Activity Worksheet 086-0-23A

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Public reporting burden for this application is estimated to average 31 hours per response for the application process and 4 hours for annual
recertification. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and submitting the application. You are not required to respond to this collection of information unless a valid
OMB control number is displayed in the upper right corner of the application. Send comments regarding the accuracy of the burden estimate
and any suggestions for reducing the burden to Information Collections Management, Department of Homeland Security, Federal Emergency
Management Agency, 500 C St., S.W., Washington, D.C. 20472, Paperwork Reduction Project (1660-0022). Note: do not send your
completed form to this address.

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320

Elevation Certificates
Map Information Service

AW-330
AW-340
AW-350
AW-360

Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

Activity Worksheet No.
AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Title
Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
Section/Page

CRS Step

Score

Total

5. Assess the problem.
a. Summary of each hazard identified in the hazard assessment and
their community impact (REQUIRED) (2)
b. Description of the impact of the hazards on:
(1) Life, safety, health, procedures for warning and evacuation (5)
(2) Critical facilities and infrastructure (5)
(3) The community’s economy and tax base (5)
c. Number and types of buildings subject to the hazards (5)
d. Review of all flood insurance claims (4)
e. Natural and beneficial functions (4)
Development, redevelopment, and population trends (5)
f.
6. Set goals. (REQUIRED) (2)
7. Review possible activities.
a. Preventive activities (5)
b. Property protection activities (5)
c. Natural resource protection activities (5)
d. Emergency services activities (5)
e. Structural projects (5)
f . Public information activities (5)

8. Draft an action plan.
Actions must be prioritized (REQUIRED)
a. Recommendations for activities from two of the six categories (10)
b. Recommendations for activities from three of the six categories (20)
c. Recommendations for activities from four of the six categories (30)
d. Recommendations for activities from five of the six categories (45)
e. Post-disaster mitigation policies and procedures (10)
f . Recommendations from Habitat Conservation Plan (10)
g. Action items for mitigation of other hazards (5)
AW-510-2

Activity Worksheet 086-0-23A

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Public reporting burden for this application is estimated to average 31 hours per response for the application process and 4 hours for annual
recertification. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and submitting the application. You are not required to respond to this collection of information unless a valid
OMB control number is displayed in the upper right corner of the application. Send comments regarding the accuracy of the burden estimate
and any suggestions for reducing the burden to Information Collections Management, Department of Homeland Security, Federal Emergency
Management Agency, 500 C St., S.W., Washington, D.C. 20472, Paperwork Reduction Project (1660-0022). Note: do not send your
completed form to this address.

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320

Elevation Certificates
Map Information Service

AW-330
AW-340
AW-350
AW-360

Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

Activity Worksheet No.
AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Title
Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

Section/Page

CRS Step

Score

Total

9. Adopt the plan. (2)

10. Implement, evaluate, and revise.
a. Procedures to monitor and recommend revisions (REQUIRED) (2)
b. Same planning committee or successor committee that qualifies
under Section 511.a.2(a) does the evaluation (13)

Add the totals for steps 1 through 10 above:

514 Credit Documentation:

___ b. A copy of the floodplain management plan, hazard mitigation plan, and/or Habitat Conservation
FMP= Plan.

___ a. FMP: The completed CRS activity worksheet (AW-510-1−510-3) or the mitigation plan review crosswalk.

___ c. Documentation showing how the public was involved in preparing or reviewing the plan, including a copy of the notice(s)
advising residents about the public meeting(s) held pursuant to steps 2(b) and (c), and a record of the meeting(s).
___ d. Copies of correspondence, meeting notes, or other materials that document the coordination with other municipalities,
agencies, and organizations credited under Sections 511.a.3(b) – (f).
___ e. Documentation showing that the plan was adopted by the community’s governing board.
The following will be needed at the annual recertification:
___ g. An annual report on evaluating progress toward implementing the action plan’s objectives.
The following will be needed at least every five years:

___ h. An update to the floodplain management or hazard mitigation plan.
AW-510-3

Activity Worksheet 086-0-23A

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Public reporting burden for this application is estimated to average 31 hours per response for the application process and 4 hours for annual
recertification. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and submitting the application. You are not required to respond to this collection of information unless a valid
OMB control number is displayed in the upper right corner of the application. Send comments regarding the accuracy of the burden estimate
and any suggestions for reducing the burden to Information Collections Management, Department of Homeland Security, Federal Emergency
Management Agency, 500 C St., S.W., Washington, D.C. 20472, Paperwork Reduction Project (1660-0022). Note: do not send your
completed form to this address.

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320

Elevation Certificates
Map Information Service

AW-330
AW-340
AW-350
AW-360

Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

Activity Worksheet No.
AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Title
Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

511.b Repetitive Loss Area Analysis (RLAA) Credit Points:
Complete one copy of this page for each analysis.
___ 1. Show that all repetitive loss areas are mapped as described in Section 503.b.
___ 2. Upon request, provide the data collected on each building in the area(s) using the “limited data view” of the National Flood
Mitigation Data Collection Tool.
3. Enter the section or page number in the analysis where each credited item can be found.
____

Step 1. Property owners were advised that the analysis would be conducted.

____

Step 2. Data were collected on each building and the cause(s) of the repetitive flood damage was determined.

____

Step 3. Alternative mitigation approaches were reviewed to determine whether any property protection measures or drainage
improvements are feasible.

____

Step 4. Agencies or organizations that may have plans that could affect the cause or impacts of the flooding were contacted.

____

Step 5. Document the findings, including a map showing all parcels in the area, recommendations, and how the
recommendations will be funded.

____4. A memo or other documentation showing that the head of the appropriate department has approved the analysis.
____

If the community did not conduct analyses of all the repetitive loss areas, provide the following:
a. The number of buildings in the repetitive loss areas where the analyses have been completed (bAA) ____________.
b. The number of buildings in all of the community’s repetitive loss areas (bRLA) _____________.

514 Credit Documentation:

___

RLAA: The completed CRS activity worksheet (AW-510-4) for each analysis.

___ e. A copy of each repetitive loss area analysis to be credited and a memo or other documentation showing that the head of the
appropriate department has approved it. The National Flood Mitigation Data Collection Tool database file must also be provided,
if requested.
The following will be needed at the annual recertification:

___ f. An annual report on evaluating progress toward implementing the action plan’s objectives and/or the recommendations of the
area analyses. A single report may be prepared for all analyses.
AW-510-4

Activity Worksheet 086-0-23A

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Public reporting burden for this application is estimated to average 31 hours per response for the application process and 4 hours for annual
recertification. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and submitting the application. You are not required to respond to this collection of information unless a valid
OMB control number is displayed in the upper right corner of the application. Send comments regarding the accuracy of the burden estimate
and any suggestions for reducing the burden to Information Collections Management, Department of Homeland Security, Federal Emergency
Management Agency, 500 C St., S.W., Washington, D.C. 20472, Paperwork Reduction Project (1660-0022). Note: do not send your
completed form to this address.

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320

Elevation Certificates
Map Information Service

AW-330
AW-340
AW-350
AW-360

Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

Activity Worksheet No.
AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Title
Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
512 Impact Adjustment:
rRLAA = 1.0

b. Option 2:

rFMP = 0.25

rRLAA = 0.25

c. Option 3.

rRLAA = bAA__________ = ________

rFMP = 1.0

a. Option 1:

513 Credit Calculation:

bRLA ________
a. FMP = ______. If any of the step totals in subsections 511.a.1–10 is 0, then FMP = 0.

cFMP = ______

RLAA ______ x rRLAA ______

cRLAA = ______

cHCP = ______

______

c510 = ______

b. FMP ______ x rFMP ______
HCP ______
Add the lines above =

c510 = value above rounded to the nearest whole number:

Enter this value on AW-720-1.

Comments:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________

AW-510-5

Activity Worksheet 086-0-23A

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Public reporting burden for this application is estimated to average 31 hours per response for the application process and 4 hours for annual
recertification. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and submitting the application. You are not required to respond to this collection of information unless a valid
OMB control number is displayed in the upper right corner of the application. Send comments regarding the accuracy of the burden estimate
and any suggestions for reducing the burden to Information Collections Management, Department of Homeland Security, Federal Emergency
Management Agency, 500 C St., S.W., Washington, D.C. 20472, Paperwork Reduction Project (1660-0022). Note: do not send your
completed form to this address.

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320

Elevation Certificates
Map Information Service

AW-330
AW-340
AW-350
AW-360

Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

Activity Worksheet No.
AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Title
Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

520 ACQUISITION AND RELOCATION
522 Impact Adjustment:
a. Option 1: (bAR _____ x 5) + (bRL _____ x 10) + (bSRL _____ x 15) = ______. Under
Option 1, the maximum value for bAR, bRL or bSRL is 20. The maximum credit
for c520 under Option 1 is 300.
b. Option 2: rAR = 100 x (bAR
bSF

) + (3 x bSRL
+ bSRL _____

)) = ______

a. Option 1: c520 = (bAR ____ x 5) + (bRL)____ x 10) + (bSRL _____ x 15)

= ______

+ bAR

+ (2 x bRL
+ bRL

rAR cannot be greater than 100.0.

523 Credit Calculation:
b. Option 2: c520 = 32 x rAR ______ = ______

______

c520 = value above rounded to the nearest whole number:

c520 = ______

Enter this value on AW-720-1.

524 Credit Documentation:
___ a. A map showing the location of parcels where buildings have been demolished or
relocated since the effective date of the FIRM and the total number of such buildings.
___ b. Documentation showing that each site credited can also qualify for credit as
preserved open space.
___ c. Impact Adjustment Option 2 – Calculations showing the number of buildings in the
SFHA (bSF).
___ d. Real estate or permit records that document the date of removal of each building.
___ e. Either the non-repetitive loss buildings (bAR) are ___ located within the SFHA OR
___ outside the SFHA and documentation is attached showing that floodplain
regulations are in effect in the area outside the SFHA.

504 National Flood Insurance Reform Act of 1994:
___

No projects with CRS credit were funded with Flood Mitigation Assistance Program Funds.

___

Flood Mitigation Assistance Program Funds were used to finance the acquisition and
relocation of ____ buildings which are on the list of buildings for CRS credit.

________________________________________________________________________________
Activity Worksheet 086-0-23A

AW-520-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

530 FLOOD PROTECTION
532 Impact Adjustment:
a. Option 1.
Number of protected non-repetitive loss buildings in the regulatory floodplain: _____
Number of protected non-Severe Repetitive Loss buildings ___ x 2

= _____

Number of protected Severe Repetitive Loss buildings ___ x 3

= _____

Add the above lines

_____

rPB = 0.15 x the total of the above ____
b. Option 2. rPB = 100 x PB
bSF ______

= ______

533 Credit Calculation:
28 x rPB ______

= ______

c530 = value above rounded to the nearest whole number:

c530 = ______

Enter this value on AW-720-1.

534 Credit Documentation:
___ a. and b. Elevation certificates, completed AW-530-3, or other documentation that
shows that each protection project meets this activity’s prerequisites and
shows the type of protection measure and protection level for each retrofitted
building.
___ c. A map showing the location of all protected buildings for which credit is being
applied.
___ d. Impact Adjustment Option 2 – Calculations showing the number of buildings in the
SFHA (bSF).
___ e. Either the non-repetitive loss protected buildings are _____ located within the SFHA
OR ___ outside the SFHA and documentation is attached showing that floodplain
regulations are in effect in the area outside the SFHA.

504 National Flood Insurance Reform Act of 1994:
___

No projects with CRS credit were funded with Flood Mitigation Assistance program funds.

___

Flood Mitigation Assistance program funds were used to finance the protection of ______
buildings which are on the list of buildings for CRS credit.

AW-530-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
531 RETROFITTED BUILDINGS
If the building is a repetitive loss or Severe Repetitive Loss building, use ditto marks and enter the
same address two or three times as appropriate.

Building #

Address

FPP -

FPB =

FPI

= FPI x TU

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______

___

____________________________ ______ - ______ = ______ x ______ = ______
Add the lines above: PB = (TUi x FPIi) =

______

Add the total of each page to obtain (TUi x FPIi) for the value of PB.
Activity Worksheet 086-0-23A

AW-530-2

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
RETROFITTING WORKSHEET
This is an optional form that may be used to record CRS credit criteria for retrofitting projects
that are not in a high hazard area and that do not need to be designed or approved by an
engineer or architect. Elevated buildings should be documented with a FEMA elevation
certificate.
Property Address: ___________________________________________________

___________________________________________________
Permit record. EITHER Permit # _________________ Date of Permit: ______________
OR

___ The project meets all requirements of the regulations currently in effect.
___ The project was completed after the effective date of the initial FIRM.
Building/project condition.
___ The building or project appears to be maintained.
Human intervention. EITHER:

___ The project does not require human intervention. OR

___ The project requires human intervention and there is adequate warning time.

Approximate duration of flood events: ________________ hours/days.
High hazard area. EITHER:
___ The building is NOT located in a V Zone, floodway with velocity > 5 feet per second, or an area
subject to special hazard. OR
___ The building is located in one of the high hazard areas and the design was certified by a
licensed professional engineer or architect.
Dry floodproofing.
___ The project was designed by an engineer and the design accounts for interior drainage,
seepage, and underdrainage. (TU = 0.6)
___ The project does not depend on human intervention to close openings; the project protects to
a level less than 3 feet over the first floor; the design accounts for internal drainage, seepage,
and underdrainage; and the building does not have a basement. (TU = 0.4)
___ There is no documentation of how openings, internal drainage, seepage, or underdrainage are
handled. (TU = 0.2)

Activity Worksheet 086-0-23A

AW-530-3

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
Wet floodproofing.
___ The project was designed by a licensed engineer or architect. (TU = 0.5)
___ The project was not designed by a licensed engineer or architect. (TU = 0.3)
___ The furnace, water heater, electrical breaker box, and other utilities are relocated above flood
level. (TU = 0.2)
Sewer backup protection.
___ The building is located in the SFHA. (TU = 0.2)
___ The building is located outside of the SFHA and the community has a building code or other
regulations that require positive drain sewers or other measures that prevent sewer backup
into new buildings. (TU = 0.1)
Flood protection improvement (FPI).
Before the retrofitting project, the building was protected from the ____-year flood FPB = ____
After the retrofitting project, the building was protected from the ____-year flood

FPP = ____

The values for FPB and FPP are:
0.0 for protection to less than the 10-year flood
0.3 for protection to the 10-year flood, but less than the 25-year flood
0.5 for protection to the 25-year flood, but less than the 50-year flood
0.8 for protection to the 50-year flood, but less than the 100-year flood
0.9 for protection to the 100-year flood
1.0 for protection to the 100-year plus one foot or more
1.0 for protection to the 500-year flood
Source of flood recurrence interval if other than FIS:___________________________________
CRS scores: TU =

FPB =

FPP =

___ This property is on the FEMA repetitive loss list.
___ This property is on the FEMA Severe Repetitive Loss list.

I certify that the items checked above are correct to the best of my knowledge.
Name (signed): ___________________________________________________________
Name (printed): _______________________________________ Date: _______________

Activity Worksheet 086-0-23A

AW-530-4

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

540 DRAINAGE SYSTEM MAINTENANCE
541 Credit Points:
a. CDR
1. 200, if the program includes all four requirements:
2. 50, if there are measures for specific problem sites:
3. 50, if there is a capital improvement program:
CDR = the total of lines 1 through 3 above:

______
______
______
CDR = ______

542 Impact Adjustment:
a. Option 1: rCDR = 1.0
b. Option 2: rCDR = 0.2
c. Option 3: rCDR = aCDR
= ______
aDC ______

543 Credit Calculation:
a. cCDR = CDR ______ x rCDR ______

cCDR = ______

b. SDR

SDR = ______

c. cEPM (from AW-CE)

cEPM = ______

Add the lines above =
c540 = above rounded to nearest whole number:
Enter this value on AW-720-1.

______
c540 = ______

544 Credit Documentation:
a. CDR: Drainage inspection and maintenance procedures, instructions, or other documents
that explain the community’s routine inspection and debris removal program:
1. Identification of the person or position responsible for the various aspects of the
maintenance program;
2. Description of the community’s drainage system and areas subject to the maintenance
program;
3. Explanation of the procedures for inspection, including when regular inspections are
conducted and how soon inspections are conducted after a complaint or a storm;
4. Explanation of the debris removal procedures, i.e., how soon after an inspection an area
must be cleared and what can and cannot be removed; and
5. Samples of records that are kept to document both the inspections and the removal
projects.
If the community is requesting credit for special inspection and maintenance of problem
sites (Section 431.a.2), attach a master list of the community’s drainage maintenance
problem sites that are inspected and maintained differently or more frequently. The
problem sites must be part of the drainage system that the community has mapped for its
CDR credit.

Activity Worksheet 086-0-23A

AW-540-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
b. CDR: Capital improvement program: If the community is requesting credit for an ongoing
program, such as a capital improvements plan, to eliminate or correct problem sites or to
construct “low maintenance” channels or other facilities (Section 431.a.3):
1. A master list of the community’s drainage maintenance problem sites that are in need of
elimination or correction. The problem sites must be part of the drainage system that the
community has mapped for its CDR credit.
2. Recommended correction measures for the problem sites.
3. Documentation that funds are spent on improvement projects each year.
c. SDR: Stream dumping regulations:
A copy of the regulatory language that prohibits dumping in the community’s drainage
system. The ordinance or law must designate an office or official responsible for
receiving complaints and monitoring compliance and it must include enforcement and
abatement provisions. Mark this documentation “SDR.”
d. SDR: Stream dumping regulations publicity – EITHER
A copy of the outreach project. OR
Photographs of “no dumping” signs.
e. CDR: Impact Adjustment Map:
A map showing all parts of the surface drainage system in the developed areas of the
community and showing those parts that are inspected and maintained under CDR.
f. CDR: Records:
Copies of inspection and maintenance records.

Activity Worksheet 086-0-23A

AW-540-2

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

610 FLOOD WARNING PROGRAM
611 Credit Points:
a. 2. Flood threat recognition system (FTR):
(a) (1) Act on NWS warning (20 points):

______

(2) Prediction model (5 or 20 points):

______

(b) (1) Data collection (15 or 20 points):

______

(2) Gage density (10 points):

______

(3) Prediction model (5 or 10 points):

______

FTR = the total of (a)(1) and (2) OR (b)(1) through (b)(3) above:

FTR = ______

b. 2. Emergency warning dissemination (EWD):
(a) Adopted policy (10 points):

______

(b) Outdoor system (15 points):

______

(d) Emergency Alert System (10 points):

______

(e) Telephone (15 points):

______

(f) Cable TV override (10 points):

______

(g) AM transmitters (10 points):

______

(h) Other system:

______

EWD = the total of (a) through (h) above.

If the total is greater than 60, then EWD = 60.:

EWD = ______

c. 2. Other response efforts (ORE):
(a) Plan keyed to predicted flood levels (20 points):

______

(b) Plan assigns tasks (10 points):

______

ORE = the total of (a) through (c) above:

ORE = ______

d. 2. Critical facilities planning (CFP):
(a) CFP1 Names and numbers (10 points):

CFP1 = ______

(b) CFP2 Warning coordination (20 points):

CFP2 = ______

CFP3 = ______

e. SRC

SRC = ______

Activity Worksheet 086-0-23A

AW-610-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
612 Impact Adjustment:

a. Option 1: 1. rFTR = 1.0

2. rEWD = 1.0

3. rORE = 1.0

4. rCFP3 = 1.0

b. Option 2: 1. rFTR = 0.25

2. rEWD = 0.25

3. rORE = 0.25

4. rCFP3 = 0.25

c. Option 3: 1. rFTR = bFTR
bSF

= ______

2. rEWD = bEWD
bSF

= ______

3. rORE = bORE
= ______

bSF ______

613 Credit Calculation:
a. cFTR = FTR

x rFTR

cFTR = ______

b. cEWD = EWD

x rEWD

cEWD = ______

c. cORE = ORE

x rORE

cORE = ______

d. cCFP = CFP1 _____ + CFP2 _____ + (CFP3 _____ x rCFP3 _____)

cCFP = ______

e. SRC

SRC = _______

f. Add lines a through e above =

______

c610 = value above rounded to the nearest whole number:

c610 = ______

Enter this value on AW-720-1.
To facilitate verification of this activity, please provide the names of the CRS Coordinator and
local emergency manager if other than the CRS Coordinator:
CRS Coordinator

Local Emergency Manager

Name:
Title:
Phone:

Fax:

Address:
E-mail:

Activity Worksheet 086-0-23A

AW-610-2

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
614 Credit Documentation:
Note: If Activity 610 credit has been received before and there is no change in the flood warning
program and/or the emergency operations plan, go to page AW-610-5.

Flood Threat Recognition System (FTR):
1. Provide a description of the local flood hazards. [Include sources of flooding, areas affected
and impact of flooding on the community.] [See Attachment ____ pages ______________.]
If the community does NOT HAVE a description of its flood hazards, FTR=0 and c610=0.
2. Provide a description of the Flood Threat Recognition System. [Include documentation of early
notice of a flood at one or more locations within the community. If appropriate, describe show
how the community provides flood forecasts for areas other than the above forecast points.]
[See Attachment ____ pages _______________.]
3. If the community or another local agency use rainfall and/or runoff data on a real-time basis
and makes flood forecasts from these data, provide a description of the system. [Tell whether
the collection system is based on precipitation and/or river gage data that are manually or
automatically read and reported, the location gage network density, etc.]
[See Attachment ____ pages _______________.]
4. Provide documentation showing the method used to predict downstream arrival time and peak
flow or elevations. [See Attachment ____ pages _______________.]
5. If flood warnings are received from another agency,
• Include a description of how the notice is received.
[See Attachment ____ pages ________________.]
• Identify local agency procedures for monitoring the system. [Include the written
instructions available to the person monitoring the warning system.]
[See Attachment ____ pages ________________.]
6. Provide examples of one or more flood forecast notices issued for the community.
[See Attachment ____ pages _______________.]
7. Provide documentation of the annual maintenance and testing of the data collection,
communications, and data analysis components of the flood threat recognition system.
[See Attachment ____ pages _______________.]

Emergency Warning Dissemination (EWD):
8. Provide documentation that the local government has adopted an emergency response plan.
[See Attachment ____ pages _______________.]
9. Describe the community’s program for testing warning dissemination equipment and
procedures. [Include the frequency of the test.] [See Attachment ____ pages ____________.]
Activity Worksheet 086-0-23A

AW-610-3

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
Provide a copy of the adopted policy that specifies when and how a warning is issued. [Include the
written procedures that tell warning point personnel when, how and what messages to issue.] [See
Attachment ____ pages _______________.]
10. If the community uses either a sound or siren system to disseminate flood warnings, provide a
map showing the location of the sirens and the coverage area where they can be heard inside
a closed building during storm conditions. [See Attachment ____ pages _______________.]
11. If the community uses door-to-door contact or a mobile public address system for flood
warning, provided documentation describing how the tasks are organized and conducted.
[See Attachment ____ pages _______________.]
12. If the community’s response plan includes flood warning using the Emergency Alert System,
provide a copy of the community’s activation policies, procedures, and example messages.
[See Attachment ____ pages _______________.]
13. If a telephonic system is used to warn all residents in the SFHA, provide documentation
describing how and when the system is updated, and its backup system for warning residents
when there is no telephone answer provided. [See Attachment ____ pages ______________.]
15. If the community uses a cable television override system for flood warning, provide
documentation of its procedures for activating the system. [See Attachment ____
pages _______________.]
16. If the community has established local AM radio transmitters used for public warning
announcements, provide documentation on the procedures for their use.
[See Attachment ____ pages _______________.]
17. If the community has other warning methods not described above, these may be submitted for
credit evaluation. [See Attachment ____ pages _______________.]

Other Response Efforts (ORE):
18. Provide a copy of those sections of the local emergency operations plan, flood response plan,
standard operating procedures, and other documentation that show how the local government
responds to floods. [See Attachment ____ pages _______________.]

Critical Facilities Planning (CFP):
19. If the community maintains the names and telephone numbers of the operators of ALL critical
facilities affected by flooding, provide documentation that this information is updated at least
annually. [See Attachment ____ pages _______________.]
20. If the community provides special flood warnings or early notifications directly to ALL facilities
that need them, provide a copy of the section of the adopted plan that describes these
arrangements and how they are implemented. [See Attachment ____ pages _____________.]
21. Provide a list of critical facilities that need flood response plans. Identify those critical facilities
with flood response plans that have been developed, reviewed, or accepted by the community.
[NOTE: The local government may be asked to provide one or more of the plans on the list to
the technical reviewer.] [See Attachment ____ pages _______________.]
Activity Worksheet 086-0-23A

AW-610-4

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
Cycle verification of previously credited flood warning program
22. What is the date of the current flood warning program (Emergency Operations Plan)?
If this date is more recent than the date of the plan used for the
previous verification, obtain a copy of those portions related to flood warning and flood
operations. Send these materials for technical review. [See Attachment ____.]
23. Has there been a flood insurance restudy since the last verification?

Yes

A. If yes, did the new Flood Insurance Study add streams to the SFHA?
Yes
No If yes, mark these on the FIRM and send for review.
[See Attachment ____.]
B. Have these new streams been included in the flood warning program?
Yes. Provide a description of the flood threat recognition system for these
areas. Tell how many SFHA buildings are covered by the expanded
warning area. [See Attachment ____.]
No. What percentage of the SFHA buildings are located in the area not
covered by flood forecast with peak flow or elevation data? ______
24. Has there been a flood since the last verification that resulted in the loss of life or
$50,000 in damage?
Yes
No
A. Was a flood warning evaluation report prepared?
Yes
copy of the report to this form. [See Attachment ____.]

No If yes, attach a

B. Were changes made to the flood warning program as a result of the evaluation report?
Yes
No If yes, attach a copy of the changes to this form.
[See Attachment ____.]
25. Has the flood warning program been modified since the last verification for other reasons?
Yes
No If yes, attach a copy of the changes to this form.

[See Attachment ____.]

26. Have emergency warning dissemination methods been added, deleted, or modified since the
last verification?
Yes
No If yes, attach a copy of the changes.

[See Attachment ____.]

27. Has the local government’s area of jurisdiction changed since the last verification?
Yes
No
A. If yes, do the changes add SFHA to the community’s area of jurisdiction?
Yes
No If yes, mark these new areas on the FIRM and attach.
[See Attachment ____.]
B. If yes, have these new streams been included in the flood warning program?
Yes. Provide a description of the flood threat recognition system for these areas.
[See Attachment ____.]
No. What percentage of the SFHA buildings are located in the area not covered
by flood forecast with peak flow or elevation data? ______
Activity Worksheet 086-0-23A

AW-610-5

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
If the local government requested credit for critical facilities planning,
A. How many critical facilities within the community’s jurisdiction need advanced warning
for a flood event? _______
B. How many critical facility managers receive the advanced warning they have identified
they need to prepare for a flood? _______ Send a list of critical facilities with their
required warning time and contact information for technical review.
[See Attachment ____.]
28. How many critical facilities have flood response plans that have been developed, reviewed,
or approved by the local government? ______ Send a list of critical facilities with flood
response plans that have been developed, reviewed or approved by the local government.
[See Attachment ____.]

Activity Worksheet 086-0-23A

AW-610-6

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
612 Impact Adjustment:
Credit points for each element are adjusted to reflect the extent of coverage of the flood warning
program. Local governments should describe the impact of their flood warning program using one
of the following options.

Option 1:
The flood threat recognition system, the warning dissemination system, and the flood response
tasks COVER THE ENTIRE Special Flood Hazard Area (SFHA). ____ Yes _____No [Remember,
the area credited by the flood warning program is the area where the warning program can
forecast specific flood conditions in the future. This includes areas where flood elevations and
arrival times can be forecast. It does not include areas where the National Weather Service or
others can only predict flooding “along streams and low areas.”]

Option 2:
If the flood threat recognition system, the warning dissemination system, and the flood response
tasks COVER LESS THAN THE ENTIRE SFHA, the local government may use a default value of 0.25 for
rFTR, rEWD, and rORE. ______ Yes _______ No

Option 3:
Where local flood warning programs COVER MORE THAN 25% OF THE STRUCTURES, BUT NOT ALL OF
in the SFHA, the community may use Option 3. Using this option the impact
adjustment ratios for FTR, EWD, and ORE are computed by dividing the number of buildings
affected by each element by the total number of buildings in the SFHA (bSF).
THE STRUCTURES

rFTR=bFTR
bSF

rFTR= _________ = __________

Activity Worksheet 086-0-23A

AW-610-7

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

620 LEVEE SAFETY
622 Impact Adjustment:
a. Option 1: rLP = 1.0
b. Option 2: rLP = 0.01
c. Option 3: rLP = bLP
= ______
bSF______

623 Credit Calculation:
9 x LPL ______ x rLP ______

= ______

c620 = value above rounded to the nearest whole number:

c620 = ______

Enter this value on AW-720-1.

624 Credit Documentation:
a. Levee protection level documentation. EITHER:
___
A statement signed by the U.S. Army Corps of Engineers that states the levee protection level
and the date of construction, OR
___
A certification by a licensed professional engineer that states that the levee meets all the NFIP
levee recognition requirements except for height, provides the date of construction, the levee
protection level, and shows that all mechanized interior drainage systems have been tested.
___ b. The levee emergency response plan that specifies actions to take at various flood stages.

___ c. The map showing the area protected by the levee, designated as "LP."

___ d. The Impact Adjustment Map (if Option 2 or 3 is used). and

___

Documentation showing how bLP and bSF were determined.

The following will be needed at the annual recertification:
___ e. A certification by a licensed professional engineer that the levee has been maintained in such
a manner that it meets all the NFIP levee maintenance requirements.
___ f. Documentation of the monthly communications checks between local emergency officials and
the agency responsible for the levee and a description of the exercise or drill of the levee
emergency plan or the response to an actual emergency or disaster conducted during the
previous year.

___ g. A copy of the materials that notify occupants of the area protected by the credited levee.

AW-620-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

630 DAM SAFETY
632 Impact Adjustment:
a. Option 1: rDFP = 1.0
b. Option 2: rDFP = 0.25
c. Option 3: rDFP = bDFP
= ______

bSF _______

633 Credit Calculation:
a. SDS

SDS = ______

b. cDFP = (DFP1 _____ + DFP2 _____ + DFP3 _____) x rDFP _____

= ______

c. Add SDS and DFP =

______

c630 = value above rounded to the nearest whole number:

c630 = ______

Enter this value on AW-720-1.

634 Credit Documentation:
There is no documentation required for state dam safety program (SDS) credit.
a. Dam failure plan (DFP): Pages from the adopted emergency response plan, marked “DFP1,”
that
(a)(1) Specify that the community will be notified in the event of an impending or actual
failure of a dam upstream from the community;
(a)(2) Provide projected inundation areas, flood elevations, and estimated arrival times for
flood peaks arising from a failure of the dam; and
(a)(3) Call for an exercise at least annually. The results of the exercise are evaluated and
used to revise the response plan.
(b) A procedure to obtain annual reports by the dam operators on the safety and

operational status of their dams. Copies of these reports must be sent to the

community and the state dam safety office; and

emergency services officials.

b. DFP warning credit (Mark the documentation for this section “DFP2”): An emergency response
plan that details at least three methods of notifying affected residents of an imminent flood
resulting from a possible or ongoing dam failure. At least three of the following notification
methods must be available:
___

Sound or voice siren system.

___

Telephonic notification, AM transmitters and receivers dedicated to dam failure
notification.

___

NOAA Weather Radio. Receivers with Specific Area Message Encoding (SAME) are
preferred.
Mobile public address.

Activity Worksheet 086-0-23A

AW-630-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________
Emergency Alert System.
Cable television override.
Door-to-door notification.
c. DFP evacuation planning credit (Mark the documentation for this section “DFP3”):
1. Documentation that the adopted emergency plan that includes evacuation routes and
detailed procedures for notifying and evacuating critical facilities, specifically including
schools, hospitals, nursing homes, jails, and other locations where there are populations that may have difficulty evacuating the dam failure inundation area; and
2. Documentation of at least annual notification of occupants in the dam failure area of
the hazard, the area affected, evacuation routes, and flood safety topics appropriate to
the hazard.
___

d. The Impact Adjustment Map (if Option 1 or 3 is used), and

___

Documentation showing how bLP and bSF were determined.

The following will be needed at the annual recertification:
_____ e. Documentation of the monthly communications checks between local emergency
officials and the agency responsible for the dam and a description of the exercise or
drill of the dam failure emergency plan or the response to an actual emergency or
disaster conducted during the previous year.
To facilitate verification of DFP, provide the names of the CRS Coordinator and flood warning
contact or emergency manager if other than the CRS Coordinator:
CRS Coordinator:

Flood Warning Contact or
Emergency Management Coordinator:

Name:
Title:
Phone:

Fax:

Address:

Email:
Comments:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
_________________________________________________________________________________
Activity Worksheet 086-0-23A

AW-630-2

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

710 COMMUNITY GROWTH ADJUSTMENT
712 Growth Adjustment Calculation:
a. Average Growth Rate:

AGR1 = USGR = ______

AGR2 = USGR

+ CMGR
2

= ______

AGR = the larger of the two (AGR1 or AGR2)
If AGR is less than 0.0, then AGR = 0.0
If AGR is greater than 5.0, then AGR = 5.0

AGR = ______

b. Community Growth Adjustment:
CGA = 1 + (0.1 x AGR ______):

CGA = ______

Enter this value on AW-720-1.

713 Credit Documentation:
___ If CMGR is used, documentation that the community growth rate (CMGR) data have been accepted by
a state or federal agency for reporting requirements.

________________________________________________________________________________

Activity Worksheet 086-0-23A

AW-710-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

720 COMMUNITY CREDIT CALCULATIONS
Calculation Section:
Verified Activity Calculations:

Credit

c310 ______ =
c320 ______ =
c330 ______ =
c340 ______ =
c350 ______ =
c360 ______ =

______
______
______
______
______
______

c410 ______ x CGA ______ =
c420 ______ x CGA ______ =
c430 ______ x CGA ______ =
c440 ______ x CGA ______ =
c450 ______ x CGA ______ =

______
______
______
______
______

c510 ______ =
c520 ______ =
c530 ______ =
c540 ______ =

______
______
______
______

c610 ______ =
c620 ______ =
c630 ______ =

______
______
______

722 Community Classification Calculation:
cT = total of above

cT = ______

Community Classification (from Appendix C):
CEO Name / Address

Class = ______
CRS Coordinator Name / Address

Date Report Prepared:___________________

Activity Worksheet 086-0-23A

AW-720-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

OMB No. 1660-0022
Expires: August 31, 2010

Community : ____________________________

720m COMMUNITY CREDIT CALCULATIONS (MODIFICATION):
Calculation Section:
Previous
Score

Modified
Score

Current
Credit

CGA
Credit

Activity
Total

c310 ______
c320 ______
c330 ______
c340 ______
c350 ______
c360 ______

c310 ______ =
c320 ______ =
c330 ______ =
c340 ______ =
c350 ______ =
c360 ______ =

______
______
______
______
______
______

c410 ______
c420 ______
c430 ______
c440 ______
c450 ______

c410 ______ x CGA ______ =
c420 ______ x CGA ______ =
c430 ______ x CGA ______ =
c440 ______ x CGA ______ =
c450 ______ x CGA ______ =

______
______
______
______
______

c510 ______
c520 ______
c530 ______
c540 ______

c510 ______ =
c520 ______ =
c530 ______ =
c540 ______ =

______
______
______
______

c610 ______ c610 ______ c610 ______ =
c620 ______ c620 ______ c620 ______ =
c630 ______ c630 ______ c630 ______ =

______
______
______

722 Community Classification Calculation:
cT = total of above:

cT = ______

Community Classification (from Appendix C):

Class = ______

CEO Name / Address
____________________________________

CRS Coordinator Name / Address
_______________________________________

____________________________________

_______________________________________

____________________________________

_______________________________________

____________________________________

_______________________________________

Date Report Prepared:____________________

Activity Worksheet 086-0-23A

AW-720m-1

Edition: July 2007

OMB No. 1660-0022
Expires: August 31, 2010

Activity Worksheet No.

Title

AW-210
AW-214
AW-230

CRS Application Cover Page
Recertification Worksheet
Modification/Cycle Cover Page

AW-310
AW-320
AW-330
AW-340
AW-350
AW-360

Elevation Certificates
Map Information Service
Outreach Projects
Hazard Disclosure
Flood Protection Information
Flood Protection Assistance

AW-410
AW-420
AW-430
AW-430LD
AW-440
AW-450

Additional Flood Data
Open Space Preservation
Higher Regulatory Standards
Land Development Criteria
Flood Data Maintenance
Stormwater Management

AW-500
AW-510
AW-520
AW-530
AW-540

Repetitive Loss Requirements
Floodplain Management Planning
Acquisition and Relocation
Flood Protection
Drainage System Maintenance

AW-610
AW-620
AW-630

Flood Warning Program
Levee Safety
Dam Safety

AW-710
AW-720
AW-720m

Community Growth Adjustment
Community Credit Calculations
Community Credit Calculations (Modification)

AW-CB
AW-CE
AW-DB
AW-IJ
AW-MF
AW-SU
AW-TS
AW-UF

Closed Basin Lake Hazards
Coastal Erosion Hazards
Dunes and Beaches
Ice Jam Hazards
Mudflow Hazards
Land Subsidence Hazards
Tsunami Hazards
Uncertain Flow Path Hazards

File Type	application/pdf
File Title	Microsoft Word - 1 cover and foreword with replacement pages.doc
Author	Owner
File Modified	2010-03-11
File Created	2010-03-11