Form 5500-1 Attachment G

PFC_5500_1_ATTACHMENT_G.docx

Passenger Facility Charge (PFC) Application

FORM 5500-1 ATTACHMENT G

OMB: 2120-0557

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ATTACHMENT G: AIRPORT LAYOUT PLAN (ALP), AIRSPACE, AND

ENVIRONMENTAL FINDINGS


ALL PROJECTS FOR WHICH IMPOSE AND USE OR USE AUTHORITY IS REQUESTED IN THE APPLICATION MUST BE LISTED UNDER EACH TYPE OF FINDING BELOW.


*****FOR FAA USE*********************************************************************************************

PFC Application Number:

*******************************************************************************************************************

  1. ALP Findings

  1. Current ALP approval date:

List proposed project(s) shown on this ALP:


  1. List proposed project(s) not required to be shown on an ALP:


*****FOR FAA USE**********************************************************************************************

Public agency information confirmed? YES [ ] PARTIALLY [ ] NO [ ]

For each project which the ADO/RO disagrees with the public agency’s finding, discuss the reason(s) for the FAA’s nonconcurrance below.

********************************************************************************************************************

  1. Airspace Findings

  1. FAA Airspace finding date: __________________ (repeat as necessary)

List proposed project(s) covered by this finding:


  1. List proposed project(s) not required to have an airspace determination


*****FOR FAA USE**********************************************************************************************

Public agency information confirmed? YES [ ] PARTIALLY [ ] NO [ ]

For each project which the ADO/RO disagrees with the public agency’s finding, discuss the reason(s) for the FAA’s nonconcurrance below.

*******************************************************************************************************************

  1. Environmental Findings


  1. List proposed project(s) which are categorically excluded from the requirement for formal environmental review:


  1. Date of FAA Finding of No Significant Impact: _______________

(repeat as necessary)

List proposed project(s) covered by this finding:


  1. Date of FAA environmental record of decision: ________________

(repeat as necessary)

List proposed project(s) covered by this finding:


*****FOR FAA USE*********************************************************************************************

Public agency information confirmed? YES [ ] PARTIALLY [ ] NO [ ]

For each project which the ADO/RO disagrees with the public agency’s finding, discuss the reason(s) for the FAA’s nonconcurrance below.

*******************************************************************************************************************

Application Reviewed by:


____________________________ ____________________ _________________

Name Routing Symbol Date

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleATTACHMENT G: AIRPORT LAYOUT PLAN (ALP), AIRSPACE, AND
AuthorPreferred Customer
File Modified0000-00-00
File Created2021-01-13

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