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U.S. DEPARTMENT OF HOMELAND SECURITY - FEDERAL EMERGENCY MANAGEMENT AGENCY RIVERINE HYDROLOGY & HYDRAULICS FORM

O.M.B No. 1660-0016 Expires: 12/31/20130

PAPERWORK REDUCTION ACT

Public reporting burden for this form is estimated to average 3.25 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 Collections Management, U.S. 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

Reason for New Hydrologic Analysis (check all that apply) Not revised (skip to section B) No existing analysis Improved data Alternative methodology Proposed Conditions (CLOMR) Changed physical condition of watershed 2. Comparison of Representative 1%-Annual-Chance Discharges
Location	Drainage Area (Sq. Mi.)	Effective/FIS (cfs)	Revised (cfs)
     	     	     	     
     	     	     	     
     	     	     	     
3. Methodology for New Hydrologic Analysis (check all that apply) Statistical Analysis of Gage Records Precipitation/Runoff Model  Specify Model:       Regional Regression Equations Other (please attach description) 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 Was Is the hydrology for the revised flooding source(s) affected by sediment transportsediment transport considered? Yes No If yes, then fill out Section F (Sediment Transport) of Form 3. If No, then attach your explanation. for why sediment transport was not considered.

B. HYDRAULICS

1. Reach to be Revised
	Description	Cross Section	Water-Surface Elevations (ft.)
			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/Model Used:       2. Hydraulic Method/Model Used 3. Downstream Boundary Condition: Normal Depth (slope Area) Known Water Surface Elevation      

B. HYDRAULICS (CONTINUED)

3. Pre-Submittal Review of Hydraulic 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. These review programs may help verify that the hydraulic estimates and assumptions in the model data are in accordance with NFIP requirements, and that the data are comparable with the assumptions and limitations of HEC-2/HEC-RAS. CHECK-2 and CHECK-RAS identify areas of potential error or concern. These tools do not replace engineering judgment. CHECK-2 and CHECK-RAS can be downloaded from http://www.fema.gov/plan/prevent/fhm/frm_soft.shtm. We recommend that you review your HEC-2 and HEC-RAS models with CHECK-2 and CHECK-RAS. Review of your submittal and resolution of valid modeling discrepancies may result in reduced review time.

4.

Models Submitted	Natural Run		Floodway Run		Datum
Duplicate Effective Model*	File Name:      	Plan Name:      	File Name:      	Plan Name:      	     
Corrected Effective Model*	File Name:      	Plan Name:      	File Name:      	Plan Name:      	     
Existing or Pre-Project Conditions Model	File Name:      	Plan Name:      	File Name:      	Plan Name:      	     
Revised or Post-Project Conditions Model	File Name:      	Plan Name:      	File Name:      	Plan Name:      	     
Other - (attach description)	File Name:      	Plan Name:      	File Name:      	Plan Name:      	     

Models Submitted Natural Run Floodway Run Datum

Duplicate Effective Model* File Name:       Plan Name:       File Name:       Plan Name:            

Corrected Effective Model* File Name:       Plan Name:       File Name:       Plan Name:            

Existing or Pre-Project Conditions Model File Name:       Plan Name:       File Name:       Plan Name:            

Revised or Post-Project Conditions Model File Name:       Plan Name:       File Name:       Plan Name:            

Other - (attach description) File Name:       Plan Name:       File Name:       Plan Name:            

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

Digital Models Submitted? (Required)

C. MAPPING REQUIREMENTS

A certified 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 0.2%-annual-chance floodplains and regulatory floodway (for detailed 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 requester's 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.).

Digital Mapping (GIS/CADD) Data Submitted (preferred)will accelerate the map revision)

Topographic Information

Source:      

Date:      

Accuracy:      

Note that the boundaries of the existing or proposed conditions floodplains and regulatory floodway to be shown on the revised FIRM and/or FBFM must tie-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 0.2%-annual-chance floodplains and regulatory floodway that tie-in with the boundaries of the effective 1%- and 0.2%-annual-chance floodplain and regulatory floodway at the upstream and downstream limits of the area of revision.

Annotated FIRM and/or FBFM (Required)

D. COMMON REGULATORY REQUIREMENTS*

1. For LOMR/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 pre-project conditions.

• The proposed project encroaches upon a SFHA with or without BFEs established and would result in increases above 1.00 foot compared to pre-project conditions.t.

b. Does this LOMR For LOMR request cause increases s, does this request require property owner notification and acceptance ofin the BFE and/or SFHA compared with the current effective BFEs and/or SFHA? increases? Yes No

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

2. Does the request involve the placement or proposed placement of fill? Yes No

If Yes, the community must be able to certify that the area to be removed from the special flood 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 60.3(a)(3), 65.5(a)(4), and 65.6(a)(14). Please see the MT-2 instructions for more information.

3. For LOMR requests, is the regulatory floodway being revised? Yes No

If Yes, attach evidence of regulatory floodway revision notification. As per Paragraph 65.7(b)(1) of the NFIP Regulations, notification is required for requests involving revisions to the regulatory floodway. (Not required for revisions to approximate 1%-annual-chance floodplains [studied Zone A designation] unless a regulatory floodway is being established. added. Elements and examples of regulatory floodway revision notification can be found in the MT-2 Form 2 Instructions.)

4. For LOMR/CLOMR requests, p, does this request have the potential to impact an endangered speciescomply with the Endangered Species Act? Yes No

PIf Yes, pplease submit documentation to FEMA and the community to show that you have complied with Sections 9 and 10 of the Endangered Species Act (ESA). Section 9 of the ESA prohibits anyone from “taking” or harming an endangered species.  If an action might harm an endangered species, a permit is required from U.S. Fish and Wildlife Service or National Marine Fisheries Service under Section 10 of the ESA. Please see the MT-2 instructions for more information.

For actions authorized, funded, or being carried out by Federal or State agencies, please submit documentation from the agency showing its compliance with Section 7(a)(2) of the ESA. Please see the MT-2 instructions for more detail. information

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

DHS - FEMA Form 81-89A, DEC 107 Riverine Hydrology & Hydraulics Form MT-2 Form 2 Page 2 of 2