Form 086-0-27A Riverine Hydrology & Hydraulics Form

DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY

O.M.B. NO. 1660-0016
Expires December 31, 2010

RIVERINE HYDROLOGY & HYDRAULICS FORM

PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this form is estimated to average 3.5 hours per response . The burden estimate includes the time for reviewing instructions,
searching existing data sources, gathering and maintaining the needed data, and completing , reviewing , and submitting the form . You are not required
to respond to this collection of information unless a valid OMB control number appears in the upper right corner of this form . Send comments
regarding the accuracy of the burden estimate and any suggestions for reducing this burden to : Information Co llections Management, Department of
Homeland Security, Federal Emergency Management Agency, 500 C Street, SW, Washington, DC, 20472, Paperwork Reduction Project
(1660-0016). Submission of the form is required to obtain or retain benefits under the National Flood Insurance Program . Please do not send your
completed survey to the above address.

Flooding Source:
Note : Fill out one form for each flooding source studied.
A. HYDROLOGY
1. Reason for New Hydrologic Analysis (check all that apply)
D

Not revised (skip to section B)

D

No existing analysis

D

Improved data

D

Alternative methodology

D

Proposed Cond itions (CLOMR)

D

Changed physical condition of watershed

2. Comparison of Representative 10/0-Annual-Chance Discharges
Drainage Area (Sq . Mi.)

Location

FIS (cfs)

Revised (cfs)

3. Methodology for New Hydrologic Analysis (check all that apply)

D

Statistical Analysis of Gage Records

D

Precip itation/runoff Model

D

Regional Regression Equations

D

Other (please attach description)

Specify Model

Please enclose all relevant models in digital format , maps, computations (including computation of parameters), and documentation to support the
new analysis .
4. Review/Approval of Analysis.
If your community requires a regional, state, or federal agency to review the hydrologic analysis, please attach evidence of approval/review.
5. Impacts of Sediment Transport on Hydrology

Is the hydrology for the revised flooding source(s) affected by sediment transport?

DYes

D

No

If Yes , then fill out Section F (Sediment Transport) of Form 3. If No, then attach you explanation .

B. HYDRAULICS
1. Reach to be Revised

Water-Surface Elevations (ft .)

Description

Cross Section

Effective

Proposed/Revised

Downstream Limit

Upstream Limit

'Proposed/Revised elevations must tie-into the Effective elevations within 0.5 foot at the downstream and upstream limits of revision ,

2. Hydraulic Method Used

DHS/FEMA Form 086-0-27A, AUG 201

PREVIOUSLY FF 81-89

MT-2 Form 2

Page 1 of 3

B. HYDRAULICS (continued)
3. Pre-Submittal Review of Hvdraulic Models
DHS/FEMA has developed two review programs, CHECK-2 and CHECK-RAS to aid in the review of HEC-2 and HEC-RAS hydraulic models,
respectively. We recommend that you review your HEC-2 and HEC-RAS models with CHECK-2 and CHECK-RAS.

4.

Datum

Floodway Run

Natural Run

Models Submitted
Duplicate Effective Model'

Eile

~ame

Elan !':lame

Eile ~ame

Elao !':lame

Corrective Effective Model'

Eile Name

Plan Name

File Name

Plan Name

Existing or Pre-Project
Conditions Model

Eilel:wme

Plan Name

File Name

Plan Name

Revised or Post-Project
Conditions Model

Eile [',lame

Elao Name

File Name

Plan Name

Other - (attach description)

File Name

PI;!O !::lame

FilS! Name

Plan Nam!,l

* For details, refer to the corresponding section of the instructions.

Digital Models Submitted? (Required)
C. MAPPING REQUIREMENTS
topographic work map must be submitted showing the following information (where applicable): the boundaries of the effective, existing,
and proposed conditions 1%-annual-chance floodplain (for approximate Zone A revisions) or the boundaries of the 1%-and O.2%-annual-chance
floodplains and regulatory floodway (for detaJled Zone AE, AO, and AH revisions); location and alignment of all cross sections with stationing control
indicated; stream, road, and other alignments (e.g. dams, levees, etc.); current community easements and boundaries; boundaries of the requesters
property; certification of a registered professional engineer registered in the subject State; location and description of reference marks; and the
referenced vertical datum (NGVD, NAVD, etc.).

o

Digital Mapping (GIS/CADD) Data Submitted

Topographic Information
Source

Date

Accuracy

Note that the boundaries of Ihe existing or proposed conditions floodplains and regulatory floodway 10 be shown on the revised FIRM and/or FBFM
must lie-in with the effective floodplain and regulatory floodway boundaries. Please attach a copy of the effective FIRM and/or FBFM, at the same
scale as the original, annotated to show the boundaries of the revised 1%-and O.2%-annual-chance floodplains and regulatory floodway that tie-in
with the boundaries of the effective 1%-and O.2%-annual-chance floodplain and regulatory floodway at the upsl'eam and downstream limits of the
area on revision.
Annotated FIRM and/or FBFM (Required)

DHS/FEMA Form 086-0-27A, .JAN 08

PREVIOUSLY fF81·89A

MT-2 Form 2

Page 2 of 3

D. COMMON REGULATORY REQUIREMENTS
For CLOMR Requests, do Base Flood Elevations (BFEs) Increase?

Yes

No

a. For CLOMR requests, if either of the following is true, please submit evidence of compliance with Section 65.12 of the NFIP regulations:
• The proposed project encroaches upon a regulatory floodway and would result in increases above 0.00 foot compared to per-project
conditions
• The proposed project encroaches upon a SFHAwith or without BFEs established and would result in increases above 1.00 foot

compared to pre- project conditions.

b. Does this LOMR cause increases in the BFE and/or SFHA compared with the effective BFS's and/or SFHA?

If Yes, please attach proof of property owner notification and acceptance (if
notifications can be found in the MT-2 Form 2 Instructions

DYes

No

Elements of and examples of property owner

2. Does this request involve the placement of fill?

DYes

No

If Yes, the community must be able to
that the area to be removed from the speCial hazard area, to include any structures or proposed
structures, meets all of the standards of the local floodplain ordinances, and is reasonably safe from flooding in accordance with the NFIP
regulations set forth at 44 CFR 603(a), 65.5(a)(14). Please see the MT-2 instructions for more information.

3. For LOMR request, is the regulatory f100dway being revised?

Yes

No

If Yes, attach evidence of regulatory floodway revision notification. As per Paragraph
of the NFIP Regulations, notification is
required for request involving revisions tot he regulatory floodway. (Not required for revisions to approximate 1%-annual-chance floodplains
[studied Zone A designation] unless a
floodway is being established. Elements and examples of regulatory f100dway revision
notification can be found in the MT-2 Form 2 Instructions.)

4. For CLOMR request, please submit documentation to FEMA and the community to show thai you have complied with Sections 9 and 10 of the
Endangered Species Act (ESA).
For actions authorized, funded, or
carried out by Federal or State agencies, please submit documentation from the agency
compliance with Section 7(aO(2) of the ESA. Please see the MT-2- Instructions for more detail.

its

*Not inclusive of all applicable regulatory requirements. For details, see 44 CFR parts 60 and 65.

DHS/FEMA Form 086-0-27A, AUG 2010

PREVIOUSLY Ff81-89A

MT·2 Form 2

Page 3 of 3