Form ATF F 5000.29 ATF F 5000.29 Environmental information

OMB No. 1140-0096 (xx/xx/xxxx)

U.S. Department of Justice
Bureau of Alcohol, Tobacco, Firearms and Explosives

Environmental Information
Instructions

1. Completion. Answer all items in sufficient detail or as not applicable to your activity. The information on all items should relate to the activity in
which the Bureau has an interest. If additional space is required for any item, please attach a separate sheet identified by the item number of this
form. Your answer are evaluated by the Bureau to determine whether the activity will have a significant effect on the environment. If ATF Form
5000. 30, Supplemental Information on Water Qualtiy Considerations-Under 33 U.S.C. 1341(a), is also being submitted for your activity, you may
make reference to any relevant information given on ATF Form 5000. 30 for items 6 and 7 of this form.
2. Filing. Submit an original and one copy of this form to the Bureau of Alcohol, Tobacco, Firearms and Explosives office processing the application,
notice, bond, or request for your activity.
3. Disposition. After final action taken on the related application or other document, the copy of this form will be returned to the applicant.
1. Name and Principal Business Address of Applicant

2. Description of Activity in which Bureau of Alcohol, Tobacco,
Firearms and Explosives has an interest

3. Number of
Employees

4. Location Where Activity is to be Conducted (Be specific, Number, Street, City, State, ZIP Code; describe locations of buildings and outside equipment
and their situation relative to surrounding environment including other structures, land use, lakes, streams, roads, railroad facilities, etc. Maps,
photos, or drawings may be provided.)

5. Heat and Power:
A. Describe types of heat and power to be used and their sources. If they are to be produced in connection with the proposed activity, estimate type
and quantity of fuel to be used for each purpose. (Example: 40 tons/yr. anthracite coal for heat, 20 million cu-ft./yr. natural for power generating.)

B. Describe any air pollution control equipment proposed for use in connection with fuel burning equipment, boilers, or smokestacks.

6. Solid Waste:
A. Describe amount and composition of all solid waste to be generated.

B. Discuss proposed methods of disposal (Incineration, open burning, landfill, government or commercial garbage collection, etc.)

C. Describe any air pollution control equipment proposed for use in connection with any incinerators.

ATF Form 5000.29
Revised March 2010

7. Liquid Waste: (Complete this item irrespective of any certification obtained as to compliance with any environmental quality standards of any Federal,
State, or local agency having responsibilty for environmental protection including any certification under the Federal Water Pollution Control Act.)
A. Describe amount and content of any liquid waste to be generated.

B. Describe proposed method of disposal (Sewer, flaming, recycling, etc). Describe any proposed means to monitor quality and characteristics, and
any proposed equipment or facilities for treatment or control of liquid wastes

8. Noise (Describe operational noise sources other than those normally associated with office operations, building maintenance, or utilities.)

Under Penalties of Perjury, I Declare That I Have Examined the Information Shown on This Form and, to the Best of My Knowledge and Belief,
it is True, Correct, and Complete. I Agree That Copies of This Form May Be Furnished to Concerned Federal, State, and Local Agencies Having
Responsibilities for Environmental Protection and That the Information Hereon May Be Used in the Preparation of an Environmental Statement
Pursuant to the Requirements of the National Environmental Policy Act, 42 U.S.C. 4332.
9. Date

10. Applicant

11. By (Signature and Title)

Bureau of Alcohol, Tobacco, Firearms and Explosives Determination of Effect. After Consideration of all available environmental information relevant to
the proposed activity, it is determined that:
The conduct of the activity decribed in item 2, pursuant to issuance or approval of the
(Specify whether application, bond, formula, permit, license, etc.)
will

will not significantly affect the environment.
Date

Signature and Title of ATF Official

Paperwork Reduction Act Notice
This request is in accordance with Section 3507, Public Law 96-511, Paperwork Reduction Act of 1995. This information collection is used by ATF to
determine if any environmental impact statement or environmental permit is necessary for the proposed operation. The information is required to obtain a
benefit.
The estimated average burden associated with this collection of information is 30 minutes per respondent or recordkeeper, depending or individual
circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be addressed to Reports Management Officer, Document Services, Bureau of Alcohol, Tobacco, Firearms and Explosives, Washington, DC 20226.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB
control number.
ATF Form 5000. 29
Revised March 2010