6200-14 Job Training Reporting Form

United States
ENVIRONMENTAL PROTECTION AGENCY
Washington, DC 20460

Draft For Approval
OMB Number no.
2050-0192
Expires xx-xx-xx

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:
2d. ZIP Code:
3. Cooperative Agreement Number:

2b. County:

2c. State:

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.
6b. Insert map of project area within broader context of the city or larger community:

EPA Form # 6200-14

please be very specific to assist with analysis and mapping

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 these are the sites within the project area that already have an ACRES ID because they have received EPA brownfields resources for
have an ACRES ID:
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
these are properties within the project area that are considered to be the catalyst/high priority brownfield sites within the BF AWP
project area:
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:

ADD INFORMATION FOR ADDITIONAL CATALYST/HIGH PRIORITY SITES AS NEEDED
12b. Catalyst/high priority site 2 (or
enter ACRES ID
OR
site name:
3,4,5, etc):

address:

site size (in acres):

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

Other
Federal

State/Tribal

Local
Gov't

Year
Resources
Awarded or
Private/Ot
her
Name of Entity Providing Resources Provided

Resources Used for

select a category from
dropdown

specific
description

Amount of Resources Leveraged
in Support of BF AWP
Project/Area-wide Revitalization

add additional lines as needed
TOTAL:

EPA Form # 6200-14

$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
Planned future land uses (as described within the

changes related to the
brownfields area-wide plan )

Residential
Greenspace
Industrial
Commercial
Other

(include
dropdown
boxes for
acres or sq
ft)

brownfields area-wide plan)
(include
dropdown
boxes for acres
or sq ft)
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
provide specific example(s)

 Continuing to reach out to community members and project partners, and create opportunities to be
involved with plan implementation
 Working with local property owners, developers, and/or securing parcels as needed, to prepare brownfields
for reuse
 Targeting infrastructure and housing improvements (including design/construction/abatement activities) to
the project area


Tying the BF AWP implementation efforts to other city or regional planning efforts

 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


Leveraging infrastructure investments that enable revitalization

EPA Form # 6200-14

provide specific example(s)
provide specific example(s)
provide specific example(s)
provide specific example(s)
provide specific example(s)
provide specific example(s)



Securing grants or technical assistance opportunities to help further implementation



Securing nonprofit or private funds to help further implementation



Working with developers to help further implementation

provide specific example(s)
provide specific example(s)
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 (include dropdown boxes
consistent with the goals of the brownfields area-wide plan?
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:

If YES or UNDERWAY selected:

Amount
of acres
or sq ft of
each land
use
Acres or
selected
sq ft

19a-1. Catalyst/high priority site 1
(automatically populate with information
from 12a)

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

19b-1. Associated brownfields site 1
(automatically populate with information from 10a)

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:

EPA Form # 6200-14

How is site
being
redevelope
d or reused
consistent
with the
goals of the
brownfields
area-wide
plan? Select

Amount
of acres
or sq ft of
each land
use
all that apply: selected

Acres or
sq ft

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):

EPA Form # 6200-14

Signature