6200-18 Brownfields Program Activity (PAL) Reporting Form

United States
ENVIRONMENTAL PROTECTION AGENCY
Washington, DC 20460

EPA Form: 6200-18
OMB Control No.: 2050-0192
Expiration Date: XX-XX-XXXX

BROWNFIELDS PROGRAM ACTIVITY LEVEL ('PAL') REPORTING FORM
This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2050-0192). Responses to this collection of information are
mandatory (2 CFR 200.328, 2 CFR 200.333, 2 CFR 200.335, 40 CFR 30-31). 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. The public reporting and recordkeeping burden for this collection of information is estimated to be 2 hours per response. Send comments on
the Agency’s need for this information, the accuracy of the provided burden estimates and any suggested methods for minimizing respondent burden to the Regulatory Support Division
Director, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the
completed form to this address.

The Office of Brownfields and Land Revitalization is requesting the information below to capture impacts from the funding received under the
Section 128(a) State and Tribal Response Program.
Responses should consider programs impacted by broader capacity-building activities (e.g., regulation development, database tracking
enhancements, site inventories, or staff training) and/or site-specific activities (e.g., brownfields assessment, cleanup oversight, or public
participation) on properties (or sites) that are supported under any hazardous and solid waste programs.
Cooperative Agreement Recipients (“CARs”) must submit the requested PAL information on or before the due date in your Cooperative
Agreement Terms and Conditions. Beginning in FY 2023, CARs must submit PAL information directly into EPA’s Assessment, Cleanup, and
Redevelopment Exchange System (“ACRES”) database. For detailed instructions on how to report PALs in ACRES, please see the quick reference
guide at https://www.epa.gov/brownfields/brownfields-grantee-reporting-using-assessment-cleanup-and-redevelopment-exchange.

Responses to the questions below should reflect activities for the period covering the last federal
fiscal year (October 1 – September 30).
COOPERATIVE AGREEMENT RECIPIENT INFORMATION
1. State or Tribe:

2. Cooperative Agreement Recipient Name:

3. Cooperative Agreement Number:

PROGRAM ACTIVITY INFORMATION
4. Select one or more of the following environmental programs where CERCLA Section 128(a) funds were used
to support capacity-building (general program support, non-site-specific work) in the last federal fiscal year:

Brownfields

Underground Storage Tanks/Leaking Underground Storage Tanks
Federal Facilities
Solid Waste

Superfund
Hazardous Waste Facilities
VCP (Voluntary Cleanup Program, Independent Cleanup Program, etc)
Other
(

)

5. Number of properties (or sites) enrolled in a response
program during the last federal fiscal year:
6. Number of properties (or sites) where documentation
indicates that cleanup work is complete AND all required
Institutional Controls (“ICs”) or Engineering Controls (“ECs”)
are either in place or not required (during the last federal fiscal
year):
6a. Total number of acres associated with properties (or sites)
identified in number 6 above:
7. If ICs/ECs have previously been placed on properties (or
sites), the total number of audits, inspections, reviews, or
other types of monitoring that have been conducted in the last
federal fiscal year to ensure that the ICs / ECs are still
maintained and fully effective:
8. Date of the last update to the Public Record:
9. OPTIONAL- Total number of properties where assistance
was provided, but the properties were not enrolled in a
response program:
10. Did you develop or revise legislation, regulations, codes,
guidance documents or policies related to establishing or
enhancing your Voluntary Cleanup Program/Response
Program during the most recent fiscal year?

10a. If yes, please indicate the type and whether it was new or revised:

Yes

No