Form FEMA Form 086-0-35 FEMA Form 086-0-35 Environmental and Historic Preservation Certifications

DEPARTMENT OF HOMELAND SECURITY

Federal Emergency Management Agency
CRS COMMUNITY CERTIFICATIONS FOR ENVIRONMENTAL AND HISTORIC PRESERVATION

OMB Control Number: 1660-0022
Expiration: December 31, 2019

Public reporting burden for this form is estimated to average 1.6 hours for the environmental and historic preservation certifications, per
response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and submitting the form. This collection of information is voluntary. You are not required to respond to this
collection of information unless it displays a valid OMB control number. 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 Street, S.W., Washington, D.C. 20472, Paperwork Reduction Project (1660-0022). NOTE: Do not send your
completed form to this address.
Appendix F
This appendix contains forms for a community's certification of its compliance with environmental and historic preservation requirements.
These certifications are part of the documentation needed to obtain credit for certain activities under the National Flood Insurance Program's
Community Rating System (CRS). The certification forms are designed to be used in conjunction with the CRS Coordinator's Manual.
Community certification forms for non-environmental aspects of the CRS can be found in Appendix E.
Instructions for completing the certification forms can be found on each page.
Contents
• CC-520EHP Acquisition and Relocation --Certification of Compliance with Environmental and Historic Preservation Requirements
• CC-530EHP Flood Protection --Certification of Compliance with Environmental and Historic Preservation Requirements
• CC-540EHP Drainage System Maintenance --Certification of Compliance with Environmental and Historic Preservation Requirements
• CC-620EHP Levees --Certification of Compliance with Environmental and Historic Preservation Requirements

FEMA FORM 086-0-35B (12/16)

Page 1 of 17

OMB Control Number: 1660-0022
Expiration: Sept 30, 2019

Community

State

CID
(6-digit NFIP Community Identification Number)

CC-520EHP Acquisition and Relocation
Compliance with Environmental and Historic Preservation Requirements
(see Section 521.b(7) in the CRS Coordinator’s Manual)
In the table below, list each property for which credit is desired under Activity 520, indicate the project date, and check the box that identifies
the source of the project funding. Add additional copies of this page (CC-520EHP-1) as necessary. Then, complete pages CC-520EHP-2 and
CC-520EHP-3, as appropriate, based on the project’s funding source.
If any FEMA funding was included in the project, then the source of funding is “FEMA.” FEMA funding includes FEMA Hazard Mitigation
Assistance grants (under the Hazard Mitigation Grant Program or the Pre-disaster Mitigation, Flood Mitigation Assistance, Repetitive Flood
Claims, or Severe Repetitive Loss programs) and FEMA Public Assistance funds. If no FEMA funding was used but any other federal funds
were included (e.g., from the Corps of Engineers), then the funding source is “Other Federal Agency.” If the project was funded only by state,
local, and/or private funds, the source is “No Federal Funds.” An NFIP claim payment, including funds provided under Increased Cost of
Compliance coverage, is considered “No Federal Funds.”
NOTE: The self-certification of compliance with environmental and historic preservation requirements incorporated into this certification
applies only to projects implemented after the effective date of the 2013 Coordinator’s Manual (April 1, 2013).
Source of Project Funding
Property Address

Date Project Permitted or
Initiated

CC-520EHP-1
FEMA FORM 086-0-35B (12/16)

FEMA

Other Federal Agency No Federal Funds

[continued on next page]
Page 2 of 17

OMB Control Number: 1660-0022
Expiration: Sept 30, 2019

Community

State

CID
(6-digit NFIP Community Identification Number)

Acquisition and Relocation Projects
Project Name:
Project or Grant Number:
Project Description (or include as a attachment):

On each row of the table below, initial the box that applies to the project, signifying that the appropriate steps were taken (shaded areas are
"not applicable"). Then sign at the end of the certification. More information on these programs can be found in Figure 500-5 of the
Coordinator's Manual.
Federal
Funding

No Federal
Funding

Certification Statement for Acquisition and Relocation Projects
All properties marked "FEMA Funded" on CC-520EHP-1 were included in the above description of the
FEMA-funded project.
State and local requirements: In addition to federal laws, implementing regulations, and executive orders,
this project took into consideration the requirements of all state and local environmental and historic
preservation laws, ordinances, and permits that apply to this type of project. Communication with the
appropriate state agency and/or local government entity took place before project implementation. Any
recommendations made by the agency or office were carried out.
National Historic Preservation Act: If any acquired or relocated structure affected by this project was 50
years of age or older at the time of the acquisition, communication with the State Historic Preservation Officer
or Tribal Historic Preservation Officer (if on tribal land or reservation) took place to determine if the structure
was either on or eligible for the National Register of Historic Places (historic property) and to resolve any
adverse effect(s) to the historic property.
Protection of floodplains (E.O. 11988—Floodplain Management): Consideration was given to the
project's long- and short-term adverse impacts that are associated with the occupance and modification of
floodplains, and to avoiding direct and indirect support of floodplain development wherever there was a
practicable alternative.
E.O. 11990—Protection of Wetlands: Consideration was given to the possible loss or degradation of
wetlands associated with the construction of this project, as well as to the preservation and enhancement of
the natural and beneficial values of wetlands.
E.O. 12898—Environmental Justice in Minority and Low-income Populations: Consideration was given
to the possible negative impacts associated with the implementation of this project on minority and lowincome populations, and to avoiding those impacts where practicable.

CC-520EHP-2
FEMA FORM 086-0-35B (12/16)

[continued on next page]
Page 3 of 17

OMB Control Number: 1660-0022
Expiration: Sept 30, 2019

Community

State

CID
(6-digit NFIP Community Identification Number)

Federal
Funding

No Federal
Funding

Certification Statement for Acquisition and Relocation Projects (cont.)
For projects in areas subject to the Coastal Barrier Resources Act: There was communication with the
U.S. Fish and Wildlife Service regarding this project's potential to jeopardize any ecologically sensitive
coastal barrier resources. Any recommendations made by the Service were carried out.
For projects in coastal communities: There was communication concerning this project with the state's
lead coastal zone management agency regarding the enforcement of the policies of the state's coastal zone
management program in carrying out federally funded or federally authorized construction activities. Any
recommendations made by the agency were carried out.

In addition to the above, for projects that also involved the development of a new site on which to place the relocated building(s), continue
initialing in the appropriate boxes, below.
Endangered Species Act: Consideration was given to the protection and preservation of threatened and/or
endangered species (including plants and animals and their habitat) whose existence may have been
threatened by the construction activities. Communication took place with the U.S. Fish and Wildlife Service
(or the National Marine Fisheries Service if the project is in a coastal area) and the applicable state agencies
for state-protected species and/or their habitat. Any recommendations made by the Services or state
agencies were carried out.
Archaeological and Historic Preservation Act: The effects of the proposed relocation on archaeological
sites were considered.
Point source and non-point source discharge (Clean Water Act, Section 402): Consideration was given
to all permit requirements for municipal point source discharge (sewage treatment plant discharge) as well as
non-point discharge (surface runoff) of a pollutant into surface waters. Communication with the
Environmental Protection Agency or designated state office took place. Any recommendations made by the
agencies were carried out.
Dredge and fill materials (Clean Water Act, Section 404): Consideration was given to all permit
requirements for discharging dredge or fill material into waters of the United States, including wetlands, and
communication with the U.S. Army Corps of Engineers took place. Any recommendations made by the Corps
were carried out.
Farmland Protection Policy Act: Consideration was given to the protection of prime and unique farmlands
in the construction of this project. Communication with the U.S. Department of Agriculture's Natural
Resources Conservation Service took place. Any recommendations made by the Service were carried out.
I certify that the items initialed above are correct to the best of my knowledge.
Name (printed)

Title

Signature

Date

CC-520EHP-3
FEMA FORM 086-0-35B (12/16)

Page 4 of 17

OMB Control Number: 1660-0022
Expiration: Sept 30, 2019

Community

State

CID
(6-digit NFIP Community Identification Number)

CC-530EHP Flood Protection
Compliance with Environmental and Historic Preservation Requirements
(see Section 531.b(4) in the CRS Coordinator’s Manual)
NOTE: The self-certification of compliance with environmental and historic preservation requirements incorporated into this certification
applies ONLY to projects implemented AFTER the effective date of the 2013 Coordinator's Manual (April 1, 2013).

Part A. Retrofitting Projects (TUE, TUD, TUW, TUS)
In the table below, list each retrofitted property for which credit is desired under Activity 530, indicate the type of project, check the box that
identifies the source of project funding, and insert the project date. Add additional copies of this page (CC-530EHP-1) as needed for the
number of properties. Then, complete pages CC-530EHP-2 and CC-530EHP-3 as appropriate, based on the project's funding source.
If any FEMA funding was included in the project, then the source of funding is "FEMA." FEMA funding includes FEMA Hazard Mitigation
Assistance grants (under the Hazard Mitigation Grant Program or the Pre-disaster Mitigation, Flood Mitigation Assistance, Repetitive Flood
Claims, or Severe Repetitive Loss programs) or FEMA Public Assistance funds. If no FEMA funding was used but any other federal funds
were included (e.g., from the Corps of Engineers), then the funding source is "Other Federal Agency." If the project was funded only by state,
local, and/or private funds, the source is "No Federal Funds." An NFIP claim payment, including funds provided under Increased Cost of
Compliance coverage, is considered "No Federal Funds."

Property Address for Retrofitted
Building

Date Project
Permitted or
Initiated

Type of Project
TUE=Elevation
TUD=Dry Floodproofing
TUW=Wet Floodproofing
TUS=Sewer backup

CC-530EHP-1
FEMA FORM 086-0-35B (12/16)

Source of Project Funding
FEMA

Other Federal
Agency

No Federal
Funds

[continued on next page]
Page 5 of 17

OMB Control Number: 1660-0022
Expiration: Sept 30, 2019

Community

State

CID
(6-digit NFIP Community Identification Number)

Part A. Retrofitting Projects (TUE, TUD, TUW, TUS) (cont.):
Project Name:
Project or Grant Number:
Project Description (or include as a attachment):

On each row of the table below, initial the box that applies to the project, signifying that the appropriate steps were taken (shaded areas are
"not applicable"). Then sign at the end of the certification. More information on these programs can be found in Figure 500-5 of the
Coordinator's Manual.
Federal
Funding

No Federal
Funding

Certification Statement for Retrofitting Projects
All properties marked "FEMA Funded" on CC-530EHP-1 were included in the above description of the
FEMA-funded project.
State and local requirements: In addition to federal laws, implementing regulations, and executive orders,
this project took into consideration the requirements of all state and local environmental and historic
preservation laws, ordinances, and permits that apply to this type of project. Communication with the
appropriate state agency and/or local government entity took place before project implementation. Any
recommendations made by the agency or office were carried out.
For projects that affected buildings 50 years of age or older (National Historic Preservation Act): If
any retrofitted structure affected by this project was 50 years of age or older at the time of the acquisition,
communication with the State Historic Preservation Officer or Tribal Historic Preservation Officer (if on tribal
land or reservation) took place to determine if the structure was either on or eligible for the National Register
of Historic Places (historic property) and to resolve any adverse effect(s) to the historic property.
Protection of floodplains (E.O. 11988—Floodplain Management): Consideration was given to the
project's long- and short-term adverse impacts that are associated with the occupance and modification of
floodplains, and to avoiding direct and indirect support of floodplain development wherever there was a
practicable alternative.
E.O. 11990—Protection of Wetlands: Consideration was given to the possible loss or degradation of
wetlands associated with the construction of this project, as well as to the preservation and enhancement of
the natural and beneficial values of wetlands.

CC-530EHP-2
FEMA FORM 086-0-35B (12/16)

[continued on next page]
Page 6 of 17

OMB Control Number: 1660-0022
Expiration: Sept 30, 2019

Community

State

CID
(6-digit NFIP Community Identification Number)

Federal
Funding

No Federal
Funding

Certification Statement for Retrofitting Projects (cont.)
E.O. 12898—Environmental Justice in Minority and Low-income Populations: Consideration was given
to the possible negative impacts associated with the implementation of this project on minority and lowincome populations, and to avoiding those impacts where practicable.
For projects in areas subject to the Coastal Barrier Resources Act: There was communication with the
U.S. Fish and Wildlife Service regarding this project's potential to jeopardize any ecologically sensitive
coastal barrier resources. Any recommendations made by the Service were carried out.
For projects in coastal communities: There was communication concerning this project with the state's
lead coastal zone management agency regarding the enforcement of the policies of the state's coastal zone
management program in carrying out federally funded or federally authorized construction activities. Any
recommendations made by the agency were carried out.

I certify that the items initialed above are correct to the best of my knowledge.
Name (printed)

Title

Signature

Date

CC-530EHP-3
FEMA FORM 086-0-35B (12/16)

[continued on next page]
Page 7 of 17

OMB Control Number: 1660-0022
Expiration: Sept 30, 2019

Community

State

CID
(6-digit NFIP Community Identification Number)

Part B. Flood Control Projects (TUB, TUC, TUF)
In the table below, list each property for which credit is desired under Activity 530 for flood control projects (TUB, TUC, and TUF), indicate the
type of project, check the box that identifies the source of project funding, and insert the project date. Add additional pages (page
CC-530EHP-4 as necessary. Then, complete pages CC-530EHP-5 through CC-530EHP-11 as appropriate, based on the project's funding
source.
If any FEMA funding was included in the project, then the source of funding is "FEMA." FEMA funding includes FEMA Hazard Mitigation
Assistance grants (under the Hazard Mitigation Grant Program or the Pre-disaster Mitigation, Flood Mitigation Assistance, Repetitive Flood
Claims, or Severe Repetitive Loss programs) or FEMA Public Assistance funds. If no FEMA funding was used but any other federal funds
were included (e.g., from the Corps of Engineers), then the funding source is "Other Federal Agency." If the project was funded only by state,
local, and/or private funds, the source is "No Federal Funds." An NFIP claim payment, including funds provided under Increased Cost of
Compliance coverage, is considered "No Federal Funds."
NOTE: The self-certification of compliance with environmental and historic preservation requirements incorporated into this certification
applies ONLY to projects implemented AFTER the effective date of the 2013 Coordinator's Manual (April 1, 2013).
Type of Project
Property Address of Flood Control
Project

Date Project
Permitted or
Initiated

TUB=Barriers, levees, floodwalls
TUC=Bridge or culvert projects,
channel modifications, storm drain
improvements, diversions
TUF=Storage facilities

CC-530EHP-4
FEMA FORM 086-0-35B (12/16)

Source of Project Funding

FEMA

Other Federal
Agency

No Federal
Funds

[continued on next page]
Page 8 of 17

OMB Control Number: 1660-0022
Expiration: Sept 30, 2019

Community

State

CID
(6-digit NFIP Community Identification Number)

TUB—Barriers, Levees, Floodwalls
Project Name:
Project or Grant Number:
Project Description (or include as a attachment):

On each row of the table below, initial the box that applies to the project, signifying that the appropriate steps were taken (shaded areas are
"not applicable"). Then sign at the end of the certification. More information on these programs can be found in Figure 500-5 of the
Coordinator's Manual.
Federal
Funding

No Federal
Funding

Certification Statement for Barriers, Levees, and Floodwalls (TUB)
All properties marked "FEMA Funded" on CC-530EHP-1 were included in the above description of the
FEMA-funded project.
State and local requirements: In addition to federal laws, implementing regulations, and executive orders,
this project took into consideration the requirements of all state and local environmental and historic
preservation laws, ordinances, and permits that apply to this type of project. Communication with the
appropriate state agency and/or local government entity took place before project implementation. Any
recommendations made by the agency or office were carried out.
For projects that affected buildings 50 years of age or older: (National Historic Preservation Act and
Archaeological and Historic Preservation Act): (1) If any structure affected by this project was 50 years of
age or older at the time of the project implementation, communication with the State Historic Preservation
Officer or Tribal Historic Preservation Officer (if on tribal land or reservation) took place to determine if the
structure was either on or eligible for the National Register of Historic Places (historic property) and to
resolve any adverse effect(s) to the historic property. (2) The effects of the project on archaeological sites
were considered.
Protection of threatened and endangered species (Endangered Species Act): Consideration was given
to the protection and preservation of threatened and/or endangered species (including plants and animals
and their habitat) whose existence may have been threatened by the construction activities. Communication
took place with the U.S. Fish and Wildlife Service (or the National Marine Fisheries Service if the project is in
a coastal area) and the applicable state agencies for state-protected species and/or their habitat. Any
recommendations made by the Services or state agencies were carried out.
Discharge of dredge and fill materials (Clean Water Act, Section 404): Consideration was given to all
permit requirements for discharging dredge and fill materials into waters of the United States, including
wetlands, and communication with the U.S. Army Corps of Engineers took place. Any recommendations
made by the Corps were carried out.
CC-530EHP-5

FEMA FORM 086-0-35B (12/16)

[continued on next page]
Page 9 of 17

OMB Control Number: 1660-0022
Expiration: Sept 30, 2019

Community

State

CID
(6-digit NFIP Community Identification Number)

Federal
Funding

No Federal
Funding

Certification Statement for Barriers, Levees, and Floodwalls (cont.)
Protection of floodplains (E.O. 11988—Floodplain Management): Consideration was given to the
project’s long- and short-term adverse impacts that are associated with the occupance and modification of
floodplains, and to avoiding direct and indirect support of floodplain development wherever there was a
practicable alternative.
E.O. 11990—Protection of Wetlands: Consideration was given to the possible loss or degradation of
wetlands associated with the construction of this project, as well as to the preservation and enhancement of
the natural and beneficial values of wetlands.
E.O. 12898—Environmental Justice in Minority and Low-income Populations: Consideration was given
to the possible negative impacts associated with the implementation of this project on minority and lowincome populations, and to avoiding those impacts where practicable.
For projects in areas subject to the Coastal Barrier Resources Act: There was communication with the
U.S. Fish and Wildlife Service regarding this project's potential to jeopardize any ecologically sensitive
coastal barrier resources. Any recommendations made by the Service were carried out.
For projects in coastal communities: There was communication concerning this project with the state's
lead coastal zone management agency regarding the enforcement of the policies of the state's coastal zone
management program in carrying out federally funded or federally authorized construction activities. Any
recommendations made by the agency were carried out.

I certify that the items initialed above are correct to the best of my knowledge.
Name (printed)

Title

Signature

Date

CC-530EHP-6
FEMA FORM 086-0-35B (12/16)

[continued on next page]
Page 10 of 17

OMB Control Number: 1660-0022
Expiration: Sept 30, 2019

Community

State

CID
(6-digit NFIP Community Identification Number)

TUC— Bridge or Culvert Projects, Channel Modification, Channel Diversion, Pump Station Improvements, Storm Drain
Improvements, or Other Projects
Project Name:
Project or Grant Number:
Project Description (or include as a attachment):

On each row of the table below, initial the box that applies to the project, signifying that the appropriate steps were taken (shaded areas are
"not applicable"). Then sign at the end of the certification. More information on these programs can be found in Figure 500-5 of the
Coordinator's Manual.
The creditable projects include:
• Bridge or culvert projects;
• Channel modification or channel diversion;
• Pump station improvements;
• Storm drain improvements; and
• Other (project not listed in Activity 530, but being considered for CRS credit).
Also see the matrix of the various environmental and historical preservation compliance requirements as they relate to these types of projects.
It is available at www.CRSresources.org/500.
Federal
Funding

Certification Statement for Bridge or Culvert Projects, Channel Modification, Channel
Diversion, Pump Station Improvements, Storm Drain Improvements, or Other Projects
(TUC)

No Federal
Funding

All properties marked "FEMA Funded" on CC-530EHP-1 were included in the above description of the
FEMA-funded project.
For bridge or culvert projects, channel modification, channel diversion, storm drain improvements, pump station improvements, or
other projects:
State and local requirements: In addition to federal laws, implementing regulations, and executive orders,
this project took into consideration the requirements of all state and local environmental and historic
preservation laws, ordinances, and permits that apply to this type of project. Communication with the
appropriate state agency and/or local government entity took place before project implementation. Any
recommendations made by the agency or office were carried out.
Protection of threatened and endangered species (Endangered Species Act): Consideration was given
to the protection and preservation of threatened and/or endangered species (including plants and animals
and their habitat) whose existence may have been threatened by the construction activities. Communication
took place with the U.S. Fish and Wildlife Service (or the National Marine Fisheries Service if the project is in
a coastal area) and the applicable state agencies for state-protected species and/or their habitat. Any
recommendations made by the Services or state agencies were carried out.
Protection of floodplains (E.O. 11988—Floodplain Management): Consideration was given to the
project’s long- and short-term adverse impacts that are associated with the occupance and modification of
floodplains, and to avoiding direct and indirect support of floodplain development wherever there was a
practicable alternative.

CC-530EHP-7
FEMA FORM 086-0-35B (12/16)

[continued on next page]
Page 11 of 17

OMB Control Number: 1660-0022
Expiration: Sept 30, 2019

Community

State

CID
(6-digit NFIP Community Identification Number)

Federal
Funding

Certification Statement for Bridge or Culvert Projects, Channel Modification, Channel
Diversion, Pump Station Improvements, Storm Drain Improvements, or Other Projects
(cont.)

No Federal
Funding

Bridge or culvert projects, channel modification, channel diversion, storm drain improvements, pump station improvements, or
other projects (cont.)
E.O. 11990—Protection of Wetlands: Consideration was given to the possible loss or degradation of
wetlands associated with the construction of this project, as well as to the preservation and enhancement of
the natural and beneficial values of wetlands.
E.O. 12898—Environmental Justice in Minority and Low-income Populations: Consideration was given
to the possible negative impacts associated with the implementation of this project on minority and lowincome populations, and to avoiding those impacts where practicable.
For projects in areas subject to the Coastal Barrier Resources Act: There was communication with the
U.S. Fish and Wildlife Service regarding this project's potential to jeopardize any ecologically sensitive
coastal barrier resources. Any recommendations made by the Service were carried out.
For projects in coastal communities: There was communication concerning this project with the state's
lead coastal zone management agency regarding the enforcement of the policies of the state's coastal zone
management program in carrying out federally funded or federally authorized construction activities. Any
recommendations made by the agency were carried out.
In addition to the above, for bridge or culvert projects, storm drain improvements, or other projects:
For projects that affected structures 50 years of age or older: (National Historic Preservation Act): If
any protected structure affected by this project was 50 years of age or older at the time of the project,
communication with the State Historical Preservation Officer or Tribal Historical Preservation Officer (if on
tribal land or reservation) took place to determine if the structure was either on or eligible for the National
Register of Historic Places (historic property) and to resolve any adverse effect(s) to the historic property.
In addition to the above, for bridge or culvert projects, channel modification, channel diversion, storm drain improvements, or
other projects:
Archaeological and Historic Preservation Act: The effects of the project on archaeological sites were
considered.
In addition to the above, for bridge or culvert projects, channel modification, channel diversion, and other projects:
Dredge and fill materials (Clean Water Act, Section 404): Consideration was given to all permit
requirements for discharging dredge and fill material into waters of the United States, including wetlands, and
communication with the U.S. Army Corps of Engineers took place. Any recommendations made by the Corps
were carried out.
Rivers and Harbors Act, Section 10: Consideration was given to any permit requirements for the project's
impact on navigable waterways. Communication with the U.S. Army Corps of Engineers took place.

CC-530EHP-8
FEMA FORM 086-0-35B (12/16)

[continued on next page]
Page 12 of 17

OMB Control Number: 1660-0022
Expiration: Sept 30, 2019

Community

State

CID
(6-digit NFIP Community Identification Number)

Federal
Funding

Certification Statement for Bridge or Culvert Projects, Channel Modification, Channel
Diversion, Pump Station Improvements, Storm Drain Improvements, or Other Projects
(cont.)

No Federal
Funding

For bridge or culvert projects, channel modification, channel diversion, or other projects (cont.)
Fish and Wildlife Coordination Act: Consideration was given to the potential for this project to result in the
control or modification of a natural stream or body of water. Communication with the U.S. Fish and Wildlife
Service (or National Marine Fisheries Service if the project is in a coastal area) took place. Any
recommendations made by the agencies were carried out.
For pump station improvements, storm drain improvements, and other projects:
Point source and non-point source discharge (Clean Water Act, Section 402): Consideration was given
to all permit requirements for municipal point source discharge (sewage treatment plant discharge) as well as
non-point discharge (surface runoff) of a pollutant into surface waters. Communication with the
Environmental Protection Agency or designated state office took place. Any recommendations made by the
agencies were carried out.
For channel modification, channel diversion, and other projects:
Farmland Protection Policy Act: Consideration was given to the protection of prime and unique farmlands
in the construction of this project. Communication with the U.S. Department of Agriculture, Natural
Resources Conservation Service took place. Any recommendations made by the Service were carried out.
I certify that the items initialed above are correct to the best of my knowledge.
Name (printed)

Title

Signature

Date

CC-530EHP-9
FEMA FORM 086-0-35B (12/16)

[continued on next page]
Page 13 of 17

OMB Control Number: 1660-0022
Expiration: Sept 30, 2019

Community

State

CID
(6-digit NFIP Community Identification Number)

TUF—Storage Facilities
Project Name:
Project or Grant Number:
Project Description (or include as a attachment):

On each row of the table below, initial the box that applies to the project, signifying that the appropriate steps were taken (shaded areas are
"not applicable"). Then sign at the end of the certification. More information on these programs can be found in Figure 500-5 of the
Coordinator's Manual.
Federal
Funding

No Federal
Funding

Certification Statement for Storage Facilities (TUF)
All properties marked "FEMA Funded" on CC-530EHP-1 were included in the above description of the
FEMA-funded project.
State and local requirements: In addition to federal laws, implementing regulations, and executive orders,
this project took into consideration the requirements of all state and local environmental and historic
preservation laws, ordinances, and permits that apply to this type of project. Communication with the
appropriate state agency and/or local government entity took place before project implementation. Any
recommendations made by the agency or office were carried out.
Archaeological and Historic Preservation Act: The effects of the project on archaeological sites were
considered.
Protection of threatened and endangered species (Endangered Species Act): Consideration was given
to the protection and preservation of threatened and/or endangered species (including plants and animals
and their habitat) whose existence may have been threatened by the construction activities. Communication
took place with the U.S. Fish and Wildlife Service (or the National Marine Fisheries Service if the project is in
a coastal area) and the applicable state agencies for state-protected species and/or their habitat. Any
recommendations made by the Services or state agencies were carried out.
Point source and non-point source discharge (Clean Water Act, Section 402): Consideration was given
to all permit requirements for municipal point source discharge (sewage treatment plant discharge) as well as
non-point discharge (surface runoff) of a pollutant into surface waters. Communication with the
Environmental Protection Agency or designated state office took place. Any recommendations made by the
agencies were carried out.
Dredge and fill materials (Clean Water Act, Section 404): Consideration was given to all permit
requirements for discharging dredge and fill material into waters of the United States, including wetlands, and
communication with the U.S. Army Corps of Engineers took place. Any recommendations made by the Corps
were carried out.
CC-530EHP-10

FEMA FORM 086-0-35B (12/16)

[continued on next page]
Page 14 of 17

OMB Control Number: 1660-0022
Expiration: Sept 30, 2019

Community

State

CID
(6-digit NFIP Community Identification Number)

Federal
Funding

No Federal
Funding

Certification Statement for Storage Facilities (cont.)
Farmland Protection Policy Act: Consideration was given to the protection of prime and unique farmlands
in the construction of this project. Communication with the U.S. Department of Agriculture, Natural
Resources Conservation Service took place. Any recommendations made by the Service were carried out.
Protection of floodplains (E.O. 11988—Floodplain Management): Consideration was given to the
project’s long- and short-term adverse impacts that are associated with the occupance and modification of
floodplains, and to avoiding direct and indirect support of floodplain development wherever there was a
practicable alternative.
E.O. 11990—Protection of Wetlands: Consideration was given to the possible loss or degradation of
wetlands associated with the construction of this project, as well as to the preservation and enhancement of
the natural and beneficial values of wetlands.
E.O. 12898—Environmental Justice in Minority and Low-income Populations: Consideration was given
to the possible negative impacts associated with the implementation of this project on minority and lowincome populations, and to avoiding those impacts where practicable.
For projects in areas subject to the Coastal Barrier Resources Act: There was communication with the
U.S. Fish and Wildlife Service regarding this project's potential to jeopardize any ecologically sensitive
coastal barrier resources. Any recommendations made by the Service were carried out.
For projects in coastal communities: There was communication concerning this project with the state's
lead coastal zone management agency regarding the enforcement of the policies of the state's coastal zone
management program in carrying out federally funded or federally authorized construction activities. Any
recommendations made by the agency were carried out.

I certify that the items initialed above are correct to the best of my knowledge.
Name (printed)

Title

Signature

Date

CC-530EHP-11
FEMA FORM 086-0-35B (12/16)

[continued on next page]
Page 15 of 17

OMB Control Number: 1660-0022
Expiration: Sept 30, 2019

Community

State

CID
(6-digit NFIP Community Identification Number)

CC-540EHP Drainage System Maintenance
Compliance with Environmental and Historic Preservation Requirements
(see Section 541.b(4) in the CRS Coordinator’s Manual)
On each row of the table below, initial the box that applies to the project, signifying that the appropriate steps were taken (shaded areas are
"not applicable"). Then sign at the end of the certification. More information on these programs can be found in Figure 500-5 of the
Coordinator's Manual.
NOTE: To receive credit under Activity 540, the self-certification of compliance with environmental and historical preservation requirements
incorporated in this certification must be submitted with a CRS application, a modification, or a cycle verification.

Certification Statement for Drainage System Maintenance

All Projects

State and local requirements: In addition to federal laws, implementing regulations, and executive orders,
this project took into consideration the requirements of all state and local environmental and historic
preservation laws, ordinances, and permits that apply to this type of project. Communication with the
appropriate state agency and/or local government entity took place before project implementation. Any
recommendations made by the agency or office were carried out.
Protection of threatened and endangered species (Endangered Species Act): Consideration was given
to the protection and preservation of threatened and/or endangered species (including plants and animals
and their habitat) whose existence may have been threatened by the construction activities. Communication
took place with the U.S. Fish and Wildlife Service (or the National Marine Fisheries Service if the project is in
a coastal area) and the applicable state agencies for state-protected species and/or their habitat. Any
recommendations made by the Services or state agencies were carried out.
Dredge and fill materials (Clean Water Act, Section 404): Consideration was given to all permit
requirements for discharging dredge and fill material into waters of the United States, including wetlands, and
communication with the U.S. Army Corps of Engineers took place. Any recommendations made by the Corps
were carried out.
For all activities that involve heavy equipment and result in the disturbance and release of sediment,
such as dredging, channel alteration, bank stabilization, debris removal, and other activities, consideration is
given to any permit requirements under the Clean Water Act, Section 404. Communication with the U.S.
Army Corps of Engineers takes place. Any recommendations made by the Corps are carried out.
I certify that the items initialed above are correct to the best of my knowledge.
Name (printed)

Title

Signature

Date

CC-540EHP-1
FEMA FORM 086-0-35B (12/16)

Page 16 of 17

OMB Control Number: 1660-0022
Expiration: Sept 30, 2019

Community

State

CID
(6-digit NFIP Community Identification Number)

CC-620EHP Levess
Compliance with Environmental and Historic Preservation Requirements
(see Section 622.a in the CRS Coordinator’s Manual)
On each row of the table below, initial the box that applies to the project, signifying that the appropriate steps were taken (shaded areas are
"not applicable"). Then sign at the end of the certification. More information on these programs can be found in Figure 500-5 of the
Coordinator's Manual.
NOTE: To receive credit under Activity 620, the self-certification of compliance with environmental and historical preservation requirements
incorporated in this form (CC-620EHP-1) must be submitted with a CRS application, a modification, or a cycle verification.

Certification Statement for Levee Maintenance

All Projects

State and local requirements: In addition to federal laws, implementing regulations, and executive orders,
this project took into consideration the requirements of all state and local environmental and historic
preservation laws, ordinances, and permits that apply to this type of project. Communication with the
appropriate state agency and/or local government entity took place before project implementation. Any
recommendations made by the agency or office were carried out.
Protection of threatened and endangered species (Endangered Species Act): Consideration was given
to the protection and preservation of threatened and/or endangered species (including plants and animals
and their habitat) whose existence may have been threatened by the construction activities. Communication
took place with the U.S. Fish and Wildlife Service (or the National Marine Fisheries Service if the project is in
a coastal area) and the applicable state agencies for state-protected species and/or their habitat. Any
recommendations made by the Services or state agencies were carried out.
Dredge and fill materials (Clean Water Act, Section 404): Consideration was given to all permit
requirements for discharging dredge and fill material into waters of the United States, including wetlands, and
communication with the U.S. Army Corps of Engineers took place. Any recommendations made by the Corps
were carried out.
For all activities that involve heavy equipment and result in the disturbance and release of sediment,
such as dredging, channel alteration, bank stabilization, debris removal, and other activities, consideration is
given to any permit requirements under the Clean Water Act, Section 404. Communication with the U.S.
Army Corps of Engineers takes place. Any recommendations made by the Corps are carried out.
I certify that the items initialed above are correct to the best of my knowledge.
Name (printed)

Title

Signature

Date

CC-620EHP-1
FEMA FORM 086-0-35B (12/16)

Page 17 of 17