Facility Guarantee Program (FGP) Preliminary Environment

CCC's Facility Guarantee Program (FGP)

FINAL FGP Preliminary Environmental Screening Document

OMB: 0551-0032

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OMB Control No. #0551-0032

Expiration Date: 11/30/2022



Facility Guarantee Program (FGP) Preliminary Environmental and Social Screening Document



The information provided on this form will be used to categorize the proposed project/transaction and determine the additional information needed (if any) for FAS to evaluate the environmental and social effects of the project/transaction.

What is the project or transaction? Please give a brief description of the proposed project/transaction, including a summary of the goods and/or services to be exported.

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________



Estimated Guaranteed Value to be requested (USD): _____________________________

Are the products goods and/or services to be covered in your application destined for an identified physical project?

Shape1 No. Please explain: what is the specific use of the goods/services if they are not intended for a specific project? (Then skip to “Project or Transaction Sector/Industry” section) ______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Shape2 Yes, a) Identify the project:______________________________________________________



b) Provide a brief description of the project:

_______________________________________________________________________



c) Output and capacity/size of the project:

________________________________________________________________________



d) Indicate whether this is a new project, a rehabilitation, or an expansion in size or


output of an existing project: ______________________________________________


_______________________________________________________________________



e) Estimated date of project completion: ________________________________________


f) Project location (physical address, including city and country): ___________________

(g) Is the project located in or near an environmentally sensitive site or area? (Check all applicable, if any):

Shape3 Tropical Forests or Other Areas with High Biological Diversity
Shape4 Nationally or Internationally Designated Protected Areas, such as Wetlands, Seashores, Wilde- lands or Refuges, National Parks
Shape5 Habitat of Endangered Species
Shape6 Location Affecting Indigenous, Tribal or Other Vulnerable Populations
Shape7 Location having Historical / Archaeological Significance
Shape8 Large Scale Resettlement (Potential Number of People Affected: ____________________)
Shape9 Properties on the UNESCO World Heritage Site List



Project or Transaction Sector/Industry

Check classification(s) describing sector/industry of the project and/or specific goods or services:

Shape10 Airport Facilities
Shape11 Ports/harbors/Upgrades
Shape12 Highways
Shape13 Other Large Infrastructure

Shape14 Transportation (please specify)

Shape15 Cold Storage Facility/Refrigerated Warehouse
Shape16 Pulp & Paper Plant
Shape17 Flour Mill
Shape18 Poultry Production/Processing Facility

Shape19 Grain Discharge and Handling

Shape20 Oil/Meal Processing

Shape21 Warehouse Facility

Shape22 Grocery Store

Shape23 Beef Cattle Operations

Shape24 Food Packaging and Labeling
Shape25 Agricultural Production Facility

Shape26 Refrigerated Trucks

Shape27 Storage Bins

Shape28 Other, specify: _____________________________



Name of Seller ______________________________________ Date __________________



Applicant Signature and Title__________________________________________



If the information contained on this form changes or becomes clarified after initial submission, it must be resubmitted to the FAS Credit Programs Division.


For inquiries and information please contact the FAS Credit Programs Division at (202) 720-6211.



Public Burden Statement. According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The public reporting burden for this information collection is estimated to average 30 minutes per response, including the time for reviewing instructions, and completing and submitting the collection of information.


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorMichelle.DeGraaf
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File Created2023-08-30

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