6200-14 Brownfields Area-Wide Planning Cooperative Agreement Rep

Brownfields Programs - Accomplishment Reporting (Renewal)

2104.06 BF AWP Reporting Form 6200-14.xlsx

State, Local, Tribal Government Reporting

OMB: 2050-0192

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DRAFT 4-11-16
United States
ENVIRONMENTAL PROTECTION AGENCY
Washington, DC 20460

BROWNFIELDS AREA-WIDE PLANNING (BF AWP) COOPERATIVE AGREEMENT REPORTING FORM
Public reporting burden for this collection of information is estimated to average 3.5 hours per response, including the time for reviewing instructions, searching data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate, or any other aspect of this collection of information, including suggestions for reducing this burden, to the Environmental Protection Agency, Office of Environmental Information, Code 2822T, Washington, DC 20460; and to the Paperwork Reduction Project, Office of Management and Budget, Washington, DC 20503. DO NOT RETURN your form to either of these addresses. Send your completed form to the address provided by the issuing office.
Reporting requirements:
The cooperative agreement recipient (CAR) must use the Brownfields Program on-line reporting system, known as Assessment, Cleanup and Redevelopment Exchange System (ACRES), to associate to the BF AWP grant all relevant property records (such as site assessments and cleanups) that are already in ACRES.
• The CAR will not create any new property records under the BF AWP grant.
• If the CAR is also a recipient of an EPA Brownfields assessment, cleanup or revolving loan fund (RLF) grant for a property within the BF AWP project area, then the CAR must first create property record(s) in ACRES as required under their assessment, cleanup or RLF grant, and then associate the appropriate property record(s) to the BF AWP grant.
• If EPA provides a Targeted Brownfields Assessment (TBA) within the BF AWP project area, the CAR will work with EPA to associate this TBA to the BF AWP grant.

The CAR must also track and report all leveraging information (resources) and accomplishments for the BF AWP project area. CAR will ensure that any leveraging that is already otherwise associated to a particular property in ACRES is not double counted (e.g., the same leveraging resource and amount should not be captured for both the BF AWP grant and the assessment, cleanup or RLF grant).

The CAR must enter the data in ACRES no later than 30 days after the end of each reporting quarter. The CAR will update this form and ACRES as new accomplishments, leveraged resources, associated properties, implementation actions and other information pertaining to revitalizing the BF AWP project area is available.

Please note, additional reporting requirements may be included in the terms and conditions of your cooperative agreement.













COOPERATIVE AGREEMENT RECIPIENT INFORMATION
1. BF AWP Cooperative Agreement Recipient Name:





2a. City:

2b. County:
2c. State:
2d. ZIP Code:









3. Cooperative Agreement Number:
4. Indicate if this form is the initial or updated form:
PART I: BF AWP PROJECT AREA INFORMATION
5. Name of BF AWP Project Area:
6a. Boundaries of the BF AWP Project Area: Include constructed (e.g. street) and natural (e.g. river) boundaries as needed. please be very specific to assist with analysis and mapping
6b. Insert map of project area within broader context of the city or larger community:





7. Project area size (in acres):









8. Project area description may copy & paste this section from grant workplan

ACRES - Associated Brownfields Sites
9. Number of brownfields properties within the BF AWP project area that have an ACRES ID: these are the sites within the project area that already have an ACRES ID because they have received EPA brownfields resources for assessment and/or cleanup













10a. Associated brownfields site 1

enter ACRES ID




















ADD INFORMATION FOR ADDITIONAL ASSOCIATED PROPERTIES AS NEEDED











10b. Associated brownfields site 2 (or 3, 4, 5, etc)

enter ACRES ID




















Catalyst Site(s) within the BF AWP project area
11. Number of catalyst/high priority brownfield site(s) within BF AWP project area: these are properties within the project area that are considered to be the catalyst/high priority brownfield sites within the BF AWP project area, as identified in the grant workplan.













For each site that is considered a catalyst/high priority brownfield within the BF AWP project area, specify whether the site has an ACRES ID. If a site does not have an ACRES ID, provide the site name, address and size (in acres).













12a. Catalyst/high priority site 1:
enter ACRES ID OR site name:
address:
site size (in acres):














ADD INFORMATION FOR ADDITIONAL CATALYST/HIGH PRIORITY SITES AS NEEDED











12b. Catalyst/high priority site 2 (or 3,4,5, etc): enter ACRES ID OR site name:
address:
site size (in acres):














PART II: LEVERAGED RESOURCES
Table A: Leveraged Resources










Source of Resources
Enter one source of resources or funding per line
Name of Entity Providing Resources Year Resources Awarded or Provided Resources Used for Amount of Resources Leveraged in Support of BF AWP Project/Area-wide Revitalization
Other Federal State/Tribal Local
Gov't
Private/
Other
select a category from dropdown specific description





(include drop down boxes) (include drop down boxes for infrastructure improvement; supporting study; community outreach/education; recreation/greenspace improvements; building (new/rehab); other)

























add additional lines as needed














TOTAL: $0

PART III: BROWNFIELDS AREA-WIDE PLANNING DOCUMENTS
13. Provide weblink to final brownfields area-wide plan document(s):
14. Provide weblink for project photographs:
15. Share highlights from the final brownfields area-wide plan: include highlights from the final brownfields area-wide plan, include overall BF AWP project approach and the community's goals as identified through the BF AWP process













16. Describe past/existing land uses and planned future land uses within the BF AWP project area


Past or existing land uses (conditions prior to changes related to the brownfields area-wide plan)


Planned future land uses (as described within the brownfields area-wide plan)


Residential

(include dropdown boxes for acres or sq ft)



(include dropdown boxes for acres or sq ft)


Greenspace








Industrial







Commercial








Other

further describe other use here


further describe other use here


PART IV: IMPLEMENTATION ACTIVITIES
17. Which of these plan implementation activities relate to your BF AWP project area? Check all that apply & provide specific example(s)
·         Conducting brownfield site assessments, cleanup or other site preparation activities within the project area (include drop down boxes for Completed, Underway, Not Yet Started & Not Applicable) provide specific example(s)
·         Continuing to reach out to community members and project partners, and create opportunities to be involved with plan implementation provide specific example(s)
·         Working with local property owners, developers, and/or securing parcels as needed, to prepare brownfields for reuse provide specific example(s)
·         Targeting infrastructure and housing improvements (including design/construction/abatement activities) to the project area provide specific example(s)
·         Tying the BF AWP implementation efforts to other city or regional planning efforts provide specific example(s)
·         Changing/updating policy: e.g., local zoning, creating tax increment (or similar) financing or business improvement districts, adopting the brownfields area-wide plan, making other changes provide specific example(s)
·         Leveraging infrastructure investments that enable revitalization provide specific example(s)
·         Securing grants or technical assistance opportunities to help further implementation provide specific example(s)
·         Securing nonprofit or private funds to help further implementation provide specific example(s)
·         Working with developers to help further implementation provide specific example(s)
·   Strengthening relationships with federal, state, tribal, regional and local partners to continue support for the BF AWP revitalization goals provide specific example(s)
·         List other implementation activities (add additional activities as needed) provide specific example(s)













18. Have any catalyst/high priority sites and/or other associated brownfield properties within the BF AWP project area been redeveloped or reused consistent with the goals of the brownfields area-wide plan? (include dropdown boxes for Yes/No/Underway)
If YES or UNDERWAY selected: How is site being redeveloped or reused consistent with the goals of the brownfields area-wide plan? Select all that apply: Amount of acres or sq ft of each land use selected Acres or
sq ft

If YES or UNDERWAY selected: How is site being redeveloped or reused consistent with the goals of the brownfields area-wide plan? Select all that apply: Amount of acres or sq ft of each land use selected Acres or
sq ft

19a-1. Catalyst/high priority site 1 (automatically populate with information from 12a) (include dropdown boxes for residential/greenspace/industrial/commercial/other; may select more than one land use type)


19b-1. Associated brownfields site 1 (automatically populate with information from 10a) (include dropdown boxes for residential/greenspace/industrial/commercial/other; may select more than one land use type)














If needed
19a-2. Catalyst/high priority site 2 (automatically populate with information from 12b)



if needed
19b-2. Associated brownfields site 2 (automatically populate with information from 10b)




























PART V: SUCCESSES, CHALLENGES & LESSONS LEARNED
20. Share one or more activities and/or approaches that worked well for your BF AWP project:
21. Share one or more major challenges and/or barriers identified during the BF AWP project:
22. Share key lessons learned and/or any advice you would give to future BF AWP cooperative agreement recipients:
23. Describe how the cooperative agreement term & condition for considering changing climate conditions was met during the BF AWP process:













Approvals





















24. Cooperative Agreement Recipient Project Manager







Name (please print):

Signature















25. US EPA Regional Representative








Name (please print):

Signature
















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