United States
Environmental Protection
Agency
Solid Waste And
Emergency Response
5401G
EPA510-B-01-001
August 2001
www.epa.gov/oust/
<®EPA The USTfields Initiative
Proposal Guidelines for
USTfields Pilots
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Table of Contents
Page
Introduction and Definitions /
What is EPA's USTfields Initiative? /
What is the USTfieldsInitiative intended to accomplish? /
What are USTfields Pilots? 2
How are USTfields related to land reuse? 2
Terminology. 2
Eligibility Requirements 4
Eligible Applicants 4
Eligible Properties 4
Eligible Activities 5
Applicable Regulations and OMB Circular. 6
The Selection Process 7
How many proposals can be submitted, where should they be sent, and
what is the deadline for submission? 7
Who do I contact if I have questions or want to submit a proposal? 7
How will theproposals be reviewed? 7
How will theproposals be evaluated? 7
When will the USTfields Pilots be announced? 8
Contents of USTfields Pilot Proposals 9
What must be in an USTfields Pilot proposal? 9
Appendix I: EPA Regional UST and Brownfields Contacts 13
Appendix II: State UST Implementing Agency Contacts 14
Appendix III: EPA Evaluation Criteria RatingForm 18
Appendix IV: Application for Federal Assistance 25
Appendix V: The Final Report 26
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USTfields Pilots Introduction and Definitions
Introduction and Definitions
What is EPA's USTfields Initiative?
The U.S. Environmental Protection Agency (EPA) defines "brownfields" as
abandoned, idled, or under-used industrial and commercial facilities where expansion or
redevelopment is complicated by real or perceived environmental contamination. The term
"USTfields" applies to abandoned or underutilized industrial and commercial properties
with real or perceived environmental contamination from petroleum from federally-
regulated underground storage tanks (USTs). Up to half of the estimated 450,000
brownfields sites1 in the U.S. may contain abandoned underground storage tanks or be
impacted by petroleum leaks from such tanks. However, petroleum contamination is
generally excluded from coverage under the Comprehensive Environmental Response,
Compensation, and Liability Act (CERCLA) and is not, therefore, covered under EPA's
Brownfields program.
EPA's Office of Underground Storage Tanks (OUST) is undertaking the USTfields
Initiative to address petroleum contamination from abandoned tanks generally excluded
from EPA's Brownfields redevelopment efforts. The Initiative is intended to take
advantage of the many advances in Brownfields work that could and should be applied to
the numerous USTfields sites. It is a continuation of EPA's efforts to ensure that releases
from underground storage tanks are detected and cleaned up to protect human health and
the environment.
What is the USTfields Initiative intended to accomplish?
The USTfields initiative is intended to:
• Clean up unused properties.
• Demonstrate what can be accomplished in the cleanup of brownfields sites
impacted by underground storage tanks when federal, state, tribal, intertribal
consortium, local, and private entities collaborate and combine their knowledge
and resources.
• Take advantage of the expertise and infrastructure already being employed in
similar EPA cleanup projects to maximize the utilization of available resources.
• Observe and learn from the challenges and accomplishments of pilot projects,
with a view to disseminating the "lessons learned" to other states, tribes,
intertribal consortia, territories, and local entities.
What are USTfields Pilots?
Many of EPA's cleanup initiatives (Brownfields Assessment, Brownfields
Showcase, and Superfund and RCRA [Resource Conservation and Recovery Act]
Brownfields estimate from U.S. General Accounting Office, Community Development, Reuse of Urban Industrial
Sites, GAO/RCED-95-172, June, 1995,w&EnvironmentalJustice, Urban Revitalization, and Brownfields,
EPA 500-R-96-002, December, 1996.
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USTfields Pilots Introduction and Definitions
Redevelopment) are plagued by underground storage tank petroleum releases. EPA
believes the USTfields Pilot projects funded under the USTfields Initiative will
demonstrate how to better use limited resources to assess and clean up petroleum-impacted
brownfields sites. Pilot projects will consist of eligible properties where USTfields Pilot
funds will be used to assess and clean up petroleum contamination from federally-regulated
underground storage tanks. Cooperative agreements between EPA and the selected eligible
applicants outline the terms and conditions for the pilots.
EPA expects to implement up to 50 state/local or EPA/tribal USTfields Pilots in
two phases. Ten (10) USTfields Pilots were selected and announced by EPA in Phase I in
November 2000. Each Pilot was awarded up to $100,000 in Leaking Underground Storage
Tank (LUST) Trust funds under authority in section 9003(h) of RCRA to implement its
work. EPA is soliciting project proposals from eligible applicants for the next round of up
to 40 USTfields Pilots, each of which is also eligible to receive up to $100,000 and is
expected to be announced in 2001. These guidelines describe the eligibility requirements
and the elements a written USTfields Pilot proposal must contain in order for a state, tribe,
or intertribal consortium to be considered for a pilot. It also includes the criteria that will
be used to evaluate proposals.
How are USTfields related to land reuse?
The USTfields Initiative is an important step in preparing property for reuse. Reuse
is not part of EPA's USTfields Initiative, but the cleanup and subsequent reuse of
USTfields can turn otherwise unusable land into recreational, residential, community,
ecological, or public property. It makes the land productive again and helps to spur private
and public sector investment in housing, job-producing businesses, and open space that can
help communities improve their neighborhoods. Cleaning up USTfields fosters recycling
land instead of developing pristine land.
Terminology
The following definitions may help in your understanding of this guidance.
Applicant-A state, tribe, or intertribal consortium that is submitting an USTfields
Pilot proposal. States, tribes, and intertribal consortia that meet the eligibility
requirements for the grant may apply.
Implementing Agency-The state agency(ies) with an existing cooperative
agreement with EPA. For tribes and intertribal consortia, EPA is the implementing
agency.
Intertribal Consortium: A partnership between two or more tribes that is
authorized by the governing bodies of those tribes to apply for and receive
assistance under an EPA grant program. An intertribal consortium must have
adequate documentation of the existence of the partnership and the authorization to
apply for and receive assistance (see 64 FR 52503 [September 29, 1999]).
Pilot-(l) The city, county, town, or other political subdivision that is partnering
with its state, or (2) a tribe or intertribal consortium that is partnering with its EPA
Regional office.
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VST fields Pilots Introduction and Definitions
Partners-The stakeholders that have agreed with the state, tribe, or intertribal
consortium to participate in the implementation of the project.
Property-The parcel(s) of land within the proposed pilot's jurisdiction where
USTfields Pilot LUST Trust funds are intended to be used.
Recipient: Any entity that has been awarded and accepted an EPA assistance
agreement.
State-For the purposes of the proposal guidelines for USTfields Pilots, the term
"state" means any of the several states, the District of Columbia, the
Commonwealth of Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa,
and the Commonwealth of the Northern Mariana Islands.
Tribe: Any Indian tribe, band, nation, or other recognized group or community,
including any Alaska Native village, which is recognized as eligible by the U.S.
Department of Interior for the special services provided by the United States to
Indians because of their status as Indians. The U.S. Department of Interior
publishes a list of tribes; for further information, see
www.doi.gov/bia/tribes/entry.html.
Cooperative Agreement-The document negotiated between EPA and the
applicants EPA selects to receive USTfields Pilot LUST Trust funds. The
cooperative agreement awards federal LUST Trust funds and outlines the terms and
conditions to be met by the recipient of the funds. Statutory authorities for these
grants [RCRA 9003(h) and PL 105-276] allow EPA to make awards only to states,
U.S. territories, tribes, and intertribal consortia. [PL 105-276 authorizes the EPA
Administrator to make assistance agreements with federally-recognized Indian
tribes for the same purposes as set forth in section 9003(h).] Use of these funds
must be in accordance with the LUST Trust Fund: all USTfields Pilots require a 10
percent cost share match, except there is no matching requirement for tribes or
intertribal consortia. All rules and restrictions for LUST Trust Fund money and
cooperative agreements awarded under 9003 (h) apply to these pilots and are
outlined in OSWER Directive 9650.10A, "LUST Trust Fund Cooperative Agree-
ment Guidelines, May 27, 1994 (www.epa.gov/swerustl/directiv/d965010a.htm).
OSWER Directive 9610.10A, "Cost Recovery Policy for the Leaking Underground
Storage Tank Trust Fund," May 24, 1994, except with respect to pre-award costs, is
fully applicable to these cooperative agreements; see
www.epa.gov/swerustl/directiv/d961010a.htm). LUST Trust funds cannot be used
for redevelopment work. However, redevelopment work may be financed by state,
local, or other parties. Funds cannot be awarded to projects intended for the direct
use or benefit of the Federal Government.
[For statutory authorities, see RCRA 9003 (h),
www.epa.gov/swerustl/fedlaws/sttlitxt.htm and PL 105-276,
www.access.gpo.gov/nara/publaw/105publ.html. For applicable regulations, see 40
CFR Part 31 (www.access.gpo.gov/nara/cfr/waisidx_00/40cfr3 l_00.html).]
For more on EPA's USTfields Initiative, see www. epa. gov/swerust 1 /ustfield/index.htm.
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USTfields Pilots Eligibility Requ irements
Eligibility Requirements
What are the eligibility requirements to become an USTfields Pilot?
In order for an USTfields Pilot proposal to be considered, each of the following
eligibility requirements must be met:
Eligible Applicants
• The applicant must be a state implementing agency, tribe, or intertribal
consortium. All applicants must have the legal authorities to carry out a
project. If the applicant is a state, it must meet the 10 percent cost share
match.
• The ten (10) currently-designated USTfields Pilots are not eligible for this
round of pilot proposals.
• Intertribal consortia must meet the following requirements in order to be
eligible for financial assistance for an USTfields Pilot: The intertribal
consortium demonstrates that all members of the consortium (1) meet the
eligibility requirements for the grant and (2) authorize the consortium to
apply for and receive assistance. (Notice of EPA Policy Regarding Certain
Grants to Intertribal Consortia, Federal Register. Vol. 64, No. 188, Sept.
29, 1999)
Eligible Properties
• A property within a pilot with any release of petroleum from a federally-
regulated underground storage tank may be eligible. States should work in
partnership with their political subdivisions (e.g., cities, counties, towns) to
identify properties. Tribes or intertribal consortia wishing to apply should
work in partnership with their EPA Regional office to identify properties.
For purposes of determining eligibility, the implementing agency may also
rely on experience or information on the likelihood of a release from an
underground storage tank (e.g., tank type, age, condition).
• Proposed properties within the pilot are eligible if corrective action
(including site assessments) as determined by the implementing agency is
necessary to protect human health and the environment and one or more of
the following exist:
1. No person can be found within 90 days or less, who is an owner or
operator of the underground storage tank, subject to corrective action
regulations, and capable of carrying out such corrective action properly.
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USTfields Pilots Eligibility Requ irements
2. A situation exists which requires prompt action by the implementing
agency to protect human health and the environment.
3. Corrective action costs at a facility exceed the amount of coverage
required by financial assurance requirements and use of the LUST
Trust Fund is necessary to assure an effective corrective action.
4. The owner or operator of the underground storage tank has failed or
refused to comply with an order of an implementing agency to comply
with the corrective action regulations.
[See RCRA § 9003(h)(2), 42 U.S.C. 6991b(h)(2).]
• A property for which the implementing agency anticipates likely
contamination but for which a site assessment is needed to confirm the
existence and extent of a release is eligible. If after the assessment it is
found that a property is not a high priority, USTfields Pilot LUST Trust
funds can no longer be used for activities at that property. The proposed
properties within the pilot are considered "high priority" as defined by the
implementing agency. (For projects in Indian Country, tribes or intertribal
consortia should consult with their EPA Regional office on whether
properties are considered high priority.)
• Only properties on which petroleum will no longer be deposited in or
dispensed from any federally-regulated underground storage tank after the
date of the Federal Register notice, "Leaking Underground Storage Tank
(LUST) Trust Fund Cooperative Agreements-USTfields Pilots;
Announcement of Proposal Deadline for Request for Proposals for the
Competition for USTfields Pilots," are eligible.
Eligible Activities
• USTfields Pilot LUST Trust funds may be used for corrective action and
oversight activities at eligible properties, including:
1. Assessments to determine whether there are chemicals of concern.
2. Cleanup of petroleum contamination.
3. Monitoring of soil and groundwater to help evaluate whether the
chemicals of concern have been removed.
4. Public/community participation involving assessment and/or
cleanup activities planned at the site(s) in that community (for
example, a public meeting to discuss contamination found at a site
and the removal plans).
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VST fields Pilots Eligibility Req uiremen ts
• USTfields Pilot LUST Trust funds may not be used for certain activities,
such as:
1. Redevelopment activities (e.g., construction of a new facility,
marketing, or purchase of property).
2. General education or job training activities.
3. Supporting "lobbying" efforts, including those associated with
obtaining grants, cooperative agreements, contracts, or loans.
4. Matching any other federal funds without specific statutory
authority. (See 40 CFR 31.24,
www.access.gpo. gov/nara/cfr/waisidx 00/40cfr31 00 .html.)
5. Paying any fines or penalties.
Applicable Regulations and OMB Circular
• The regulations that govern the award and administration of USTfields
Pilots are the "Uniform Administrative Requirements for Grants and
Cooperative Agreements to State and Local Governments" set forth at 40
CFR Part 31 (www.access.gpo.gov/nara/cfr/waisidx 00/40cfr31 OO.html).
• Allowable costs are governed by OMB Circular A-87. (See:
http ://www. whitehouse. gov/omb/circulars/a08 7/aO 8 7-all .html.)
USTfields Pilot recipients are authorized to incur pre-award costs. Pilot
recipients may be reimbursed for pre-award costs they incur up to 90 days prior to
the award without prior concurrence by the EPA Project Officer or Award Official
provided that such costs are included in the application and the application is
approved in its entirety. Pre-award costs incurred more than 90 calendar days prior
to award are incurred at the pilot recipient's own risk; however, pilot recipients may
be reimbursed with the approval of an EPA Award Official and the concurrence of
the EPA Project Officer.
EPA is under no obligation to reimburse unsuccessful applicants for costs
incurred in anticipation of an award.
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VST fields Pilots Selection Process
The Selection Process
How many proposals can be submitted, where should they be sent, and what is the
deadline for submission?
Each applicant may submit up to three (3) pilot proposals to its respective EPA
Regional office. All proposals must be postmarked and/or sent via registered or tracked
mail by October 22, 2001, to your EPA Regional office contact. See Appendix I for EPA
Regional office contacts and addresses.
Who do I contact if I have questions or want to submit a proposal?
Any state, tribe, or intertribal consortium that has questions or wishes to apply for
an USTfields Pilot may contact its EPA Regional office (Appendix I).
Any city, county, town, or other political subdivision that has questions or is
interested in applying for an USTfields Pilot should contact its respective state
implementing agency. See Appendix II for a list of each state's implementing agency with
its contact information.
EPA will conduct a series of conference calls to help potential state, tribal, and
intertribal consortium applicants. The dates of the calls and additional information will be
available on the EPA Home Page at www.epa.gov/oust/: for instance, "frequently asked
questions" about the USTfields Pilots and this guidance will be available. Questions may
also be addressed to the RCRA, Superfund, and EPCRA Call Center at the following
telephone numbers: Callers outside the Washington, DC, metro area at 1-800-424-9346;
callers in the Washington, DC, metro area at (703)412-9810; TDD for the hearing impaired
at 1-800-553-7672.
How will the proposals be reviewed?
An EPA Regional review panel in each EPA Region will evaluate all proposals
based on the criteria outlined in this document. After the Regional review, the Regions will
send the proposals to EPA Headquarters for selection of up to 40 USTfields Pilots.
How will the proposals be evaluated?
Proposals must be clear and concise, follow the requirements, and provide
sufficient detail for the review panels to compare the merits of each proposal and decide
which best support the intent of the pilot program. Vague descriptions and redundancy will
reduce the chance of a favorable review.
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VST fields Pilots Selection Process
The evaluation form that will be used by the review panels to assess each proposal
is attached as Appendix III. The evaluation criteria are described in that form.
EPA has a geographical preference and anticipates that at least one USTfields Pilot
in addition to the initial ten pilots will be awarded in each of its ten Regions. EPA also
anticipates that at least one USTfields Pilot will be awarded for a pilot submitted by a tribal
or intertribal consortium applicant. EPA reserves the right to reject all proposals and make
no awards.
When will the USTfields Pilots be announced?
The approximate schedule for awarding EPA's USTfields Pilots is:
October 22, 2001 Deadline for submission of USTfields Pilot proposals to EPA
Regional offices
November 2001 EPA Regional and Headquarters review
December 2001 Selected USTfields Pilots are announced
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VST fields Pilots Conten ts of Prop osals
Contents of USTfields Pilot Proposals
What must be in an USTfields Pilot proposal?
Proposals for USTfields Pilot projects should contain the following sections:
1. Application for Federal Assistance (SF-424A)
2. Cover Page (1 page)
3. Project Overview (3-4 pages)
4. Budget Plan (2 pages)
5. Leveraging (1 -2 pages)
6. Attachments (as appropriate; please include a list of all attachments)
Applicants should clearly mark information they consider confidential, and EPA
will make final confidentiality decisions in accordance with Agency regulations at 40 CFR
Part 2, Subpart B.
1. Application for Federal Assistance (SF-424A)
Fill out and include an Application for Federal Assistance (see
www.epa.gov/ogd/how to applv.htm or Appendix IV). The Application may be either an
amendment to an existing agreement (see Item 8 on SF-424A) or a new agreement. The
information you will need to fill in some items is listed below.
Top Right Section (under Federal Identifier): Please select the applicable Program
Code from these two choices:
For Amendment (to an existing agreement): LS
For New Application: LP
Section 10 (under Catalog of Federal Domestic Assistance Number): 66.805
(NOTE: This number applies to both an amendment or a new application)
Section 10 (under Title): Please select the applicable Title from these two choices:
For Amendment (to an existing agreement): Leaking Underground
Storage Tanks
For New Application: Leaking Underground Storage Tanks USTfields
Pilots for States, Tribes, and Intertribal Consortia
Section 11 (under Descriptive Title of Applicant's Project): Please select the
applicable Descriptive Title of Applicant's Project from these two choices:
For Amendment: LUST Trust Fund Cooperative Agreement
(Statewide Remedial Actions for Leaking
Underground Storage Tanks)
For New Application: Leaking Underground Storage Tanks USTfields
Pilots for States, Tribes, and Intertribal
Consortia
Statutory Authority: 137
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VST fields Pilots Conten ts of Prop osals
Section 16: Applicants must include a statement indicating the applicability of
Executive Order 12372, Intergovernmental Review of Federal Programs.
2. Cover Page
The cover page is intended to identify the USTfields Pilot applicant and a point of
contact. This should be on a single page and can be in the format of your choice. The
cover page should display these elements.
a. Project Title-The title should be as specific as possible.
b. Pilot Location-The city, county, or town that is working in partnership with its
state. The tribal location that is working with its EPA Regional office.
c. State or Tribal Project Contact-The name, mailing and e-mail addresses, and
telephone and fax numbers of the state or tribal person who is the designated
point of contact for the project and who may be contacted if we need further
information. (EPA's relationship is with the cooperative agreement
recipient-the state, tribe, or intertribal consortium-and not the local
government "partners" or subgrantee.)
d. Cooperative Partners-A list of other stakeholders that have agreed to
participate in the implementation of the project.
e. List of Proposed Properties-A list of the proposed properties within the pilot
area where the USTfields Pilot LUST Trust funds will be used.
f. Existing Cleanup Programs-Identify the existing EPA Brownfields cleanup
program (if any) associated with the proposed pilot.
3. Project Overview
The project overview is an important opportunity to summarize the proposed pilot's
goals, objectives, and activities and to address each of the evaluation criteria. The project
overview should be brief but provide information sufficient to evaluate the merits of the
proposed project and should include letters and other documentation as appropriate to
support the proposal.
a. Project Overview: Describe the goals and objectives of the project,
including a brief description of: the factual, historical, demographic,
economic, and geographical context of the properties (please include a map
of the proposed pilot properties); the planned future uses for the properties
(if there is no planned use, describe how the project will solicit interest in
the properties); the anticipated flow of ownership of sites throughout the
project and any foreseeable problems related to liability associated with the
ownership of the sites; and the plans for measuring success, such as: the
number of tanks and tank sites cleaned up and reused, the expected long
lasting benefits to the community from the project, and how the project will
10
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VST fields Pilots Conten ts of Prop osals
advance existing state, tribal, and local efforts to address other abandoned
sites (measures should be specific and quantifiable where possible and
linked to the goals and objectives established for the pilot).
b. Eligibility Requirements: Describe how the proposal meets each of the
eligibility requirements on pages 4, 5, and 6.
c. Resource Use and Leveraging: Describe how the project plans to make use
of potential USTfields Pilot LUST Trust funds; how the project
complements and will leverage existing infrastructure and existing reuse
plans (e.g., Brownfields Assessment Demonstration Pilots); how it plans to
augment USTfields Pilot resources, as may be necessary, to complete the
project; and provide letters of support from the proposed project partners
listed in item d on the Cover Page documenting the type of support,
including the source and amount of funds and other resources described in
the Leveraging section, that each partner will contribute to the project.
d. Community Involvement: Describe the community's current and expected
long-term involvement in the project, and provide a list of involved and
supportive organizations in the project, including community-based
organizations; federal, state, tribal, intertribal consortium, and local
environmental, economic development, and/or health agencies; and others,
along with documentation of support from each of these organizations (for a
specific entity, you can refer to item c above if you have already provided
documentation there).
e. Communication and Outreach: Describe the project's communication and
outreach activities for sharing information with the public and others
interested in similar USTfields work, such as plans to use the Internet and/or
other user-friendly methods to provide, for each of the proposed pilot
properties, photographs, maps, and other suggested documentation listed in
Appendix V.
f. Corrective Action Challenge: Describe the corrective action challenges of
the project (e.g., if the pilot plans to address multiple abandoned tanks,
properties with methyl tertiary butyl ether (MTBE) contamination, or
properties in proximity to residential neighborhoods, sensitive sub-
populations, and/or environmental receptors).
g. Project Planning and Schedule: Describe the proposed planned project
phases (from assessment through cleanup and reuse) as well as the schedule,
including expected time frames for each phase.
4. Budget Plan
Provide a proposed budget for the project. The budget should show the distribution
of the USTfields Pilot LUST Trust funds, plus the state's 10% match,2 including cost
Please note that EPA does not have a preference requiring how states will meet their matching requirement as long as those
resources are used for eligible activities.
11
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VST fields Pilots
Contents of Proposals
estimates for each of the proposed pilot activities.3 A significant portion of the budget
should be for site-specific activities (e.g., site assessment, design, and cleanup planning),
while administrative costs should be kept to a minimum. The following is a suggested
format for your budget.
Budget Categories
Personnel
Fringe Benefits
Travel
Equipment
Supplies
Contractual
Other
Total
Project Tasks
Task I: (fill in
task title*)
Task2:(/z//m
task title)
Task 3:
Task 4:
Total
*Example: Task 1: Phase 1 Environmental Assessment(s); create as many task columns as you need
Briefly describe each task and the activities anticipated under each budget category
for that task.
5. Leveraging
Describe funding sources (other than USTfields Pilot funding) for the project (e.g.,
PRPs; potential purchasers; financial institutions; state, tribal, intertribal consortia, and
local funding programs; other federal grants). State whether the USTfields Pilot funding
along with the other funding sources listed in the proposal would complete the funding for
this project.
6. Attachments
Please provide a list of all the attachments to the proposal.
Please note that the 10% match does not apply to tribes or intertribal consortia.
12
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Appendix I: EPA Regional UST and Brownfields (BF) Contacts
For EPA EPA Regional Contacts
Region Phone Numbers
E-Mail Address of Contact
Mailing Address of
EPA Regional Office
Region 1
CT, MA,
ME, NH,
RI, VT
Region 2
NJ, NY,
PR, VI
Region 3
DE, DC,
MD, PA,
VA, WV
Region 4
AL, FL,
GA, KY,
MS, NC,
SC,TN
Region 5
IL, IN,
MI, MN,
OH, WI
Region 6
AR, LA,
NM, OK,
TX
Region 7
IA, KS,
MO, NE
Region 8
CO, MT,
ND, SD,
UT, WY
Region 9
AZ, CA,
HI, NV,
AS, MP,
GU
Region 10
AK, ID,
OR, WA
UST: Andrea Beland
(617)918-1313
BF: Lynne Jennings
(617)918-1210
UST: Ben Singh
(212)637-4237
BF: Larry D' Andrea
(212)637-4314
UST: Karen Bowen
(215)814-3382
BF: Tom Stolle
(215)814-3129
UST: Dana Hayworth
(404)562-9481
BF: Mickey Hartnett
(404)562-8661
UST: Kevin Hill
(312)886-6087
BF: Deborah Orr
(312)886-7190
UST: Christine Cherrett
(214)665-7342
BF: StanHitt
(214)665-6736
UST: Janet Hallier
(913)551-7532
BF: Susan Klein
(913)551-7786
UST: Jo Taylor
(303)312-6152
BF: Kathie Atencio
(303)312-6803
UST: Matthew Small
(415)744-2078
BF: Jim Hanson
(415)744-2237
UST: Wally Moon
(206)553-6903
BF: Tim Brincefield
(206)553-2100
beland.andreafajepa.gov
j ennings lynnefajepa. go v
singh.benfajepa.gov
dandrea.larry(2)yepa.gov
bowen.karenfgjepa.gov
stolle. tomfa^epa.gov
hayworth.danata^epa.gov
hartnettmickevfajepa.gov
hill.kevin(5)/epa.gov
orr.deborah (5jepa.gov
cherrettchristinefSjepa.gov
hitt.stan(2)/epa.gov
hallier.janet(2),epa.gov
klein.susanfa^epa.gov
taylor.ioefajepa.gov
atencioJtathiefajepa.gov
small, matthewffljepa. go v
hanson. jim (5jepa.gov
moon.wallvfSJepa.gov
brincefield.timothv(2),epa.gov
(Name of contact)
US EPA Region 1
JF Kennedy Federal Bldg
Suite 1100
One Congress Street
Boston, MA 02114-2023
(Name of contact)
US EPA Region 2
290 Broadway
New York, NY 10007-1866
(Name of contact)
US EPA Region 3
1650 Arch Street
Philadelphia, PA 19103
(Name of contact)
US EPA Region 4
Atlanta Federal Center
61 Forsyth St., S.W.
Atlanta, GA 30303-8960
(Name of contact)
US EPA Region 5
77 West Jackson Blvd
Chicago, IL 60604-3507
(Name of contact)
US EPA Region 6
First Interstate Bk Tower at
Fountain PL, Suite 1200
1445 Ross Avenue
Dallas, TX 75202-2733
(Name of contact)
US EPA Region 7
901 N. 5th Street
Kansas City, KS 66101-2728
(Name of contact)
US EPA Region 8
999 18th Street
Suite 500
Denver, CO 80202-2466
(Name of contact)
US EPA Region 9
75 Hawthorne Street
San Francisco, CA 94105
(Name of contact)
US EPA Region 10
1200 Sixth Avenue
Seattle, WA 98101
13
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Appendix II: State USTImplementing Agency Contacts
ALABAMA
Sonja Massey, Chief
Groundwater Branch
AL Dept. of Environmental Management
1400 Coliseum Blvd.
Montgomery, Alabama 36130-1463
(Phone 334-271-7832
(Fax) 334-271-7950
ALASKA
Cynthia Pring-Ham
AK Dept. of Environmental Conservation
Storage Tank Program
410 Willoughby Ave, Suite 303
Juneau, AK 99801
(Phone 907-465-5301
(Fax) 907-465-5218
ARKANSAS
James Shell, Manager
AR Dept of Environmental Quality
Regulated Storage Tank Div.
P.O. Box 8913
8001 National Drive
Little Rock, AR 72219-8913
(Phone) 501-682-0999
(Fax) 501-682-0971
AMERICAN SAMOA
Carl Goldstein, American Samoa Program
Manager
US EPA Region 9
75 Hawthorne Street
Mail Code: CMD-5
San Francisco, CA 94105-3901
(Phone) 415-744-2170
(Fax) 415-744-1604
ARIZONA
Ronald Kern, Section Manager
AZ Dept. of Environmental Quality
Waste Programs Division
UST and Program Support Section
3033 North Central Ave, T/4026
Phoenix, AZ 85012
(Phone) 602-207-4242
(Fax) 602-207-4346
CALIFORNIA
Kevin Graves, Manager
CA State Water Resources Control Board
Division of Clean Water Programs
UST Program
P.O. Box944212
Sacramento, CA 94244-2120
(Phone) 916-341-5752
(Fax) 916-341-5707
COLORADO
Marilyn Hajicek
Remediation Section Manager
Division of Oil and Public Safety
Colorado Department of Labor and
Employment
1515 Arapahoe St.
TowerS, Suite 610
Denver, CO 80202
(Phone) 303-318-8530
(Fax 303-318-8546
COMMONWEALTH OF THE NORTHERN
MARIANA ISLANDS
Patricia Young, CNMI Program Manager
US EPA Region 9
75 Hawthorne Street
Mail Code: CMD-5
San Francisco, CA 94105-3901
(Phone) 415-744-1594
(Fax) 415-744-1604
CONNECTICUT
Peter Zack, Manager
CT Dept of Environmental. Protection
Waste Management Bureau
LUST program
State Office Bldg.
79 Elm Street
Hartford, CT 06106
(Phone) 860-424-3337
(Fax) 860-424-4061
DELAWARE
Ellen Malenfant, Manager
DE Dept of Natural Resources & Envl. Control
UST Branch
391 Lukens Drive, Riveredge Park
Newcastle, DE 19720
(Phone) 302-395-2500
(Fax) 302-395-2601
DISTRICT OF COLUMBIA
V. Screenivas, Manager
DC Department of Health
Environmental Health Administration
Underground Storage Tanks Division
51 N Street, NE
Washington, DC 20002
(Phone) 202-535-1746
(Fax) 202-535-1383
FLORIDA
Michael E. Ashey, Chief
Bureau of Petroleum Storage Systems
FL Department of Environmental Protection
2600 Blair Stone Road MS-4575
Tallahassee, Florida 32399-2400
(Phone) 850-921-0874
(Fax) 850-922-4939
GEORGIA
Randolph D. Williams, Manager
Underground Storage Tank Management Program
GA Department of Natural Resources
4244 International Parkway, Suite 104
Atlanta, Georgia 30354
(Phone) 404-362-2687
(Fax) 404-362-2654
GUAM
Ben Machol, Guam Program Manager
US EPA Region 9
75 Hawthorne Street
Mail Code: CMD-5
San Francisco, CA 94105-3901
(Phone) 415-744-1977
(Fax 415-744-1604
14
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Appendix II: State USTImplementing Agency Contacts
HAWAII
Greg Olmsted, Manager
HI Dept of Health
Solid & Hazardous Waste Branch
919 Ala Moana Blvd Suite 212
Honolulu HI 96814
(Phone) 808-586-4226
(Fax) 808-586-7509
IDAHO
Rick Jarvis, Manager
ID Div of Environmental Quality
1410 North Hilton St.
Boise ID 83706
(Phone) 208-373-0247
(Fax) 208-373-0 154
ILLINOIS
Doug Clay, Manager
IL EPA, Bureau of Land
Div. of Remediation Management
LUST Section
P.O. Box19276
2200 Churchill Road
Springfield IL 62794-9276
(Phone) 21 7-782-6762
(Fax) 2 17-524-4 193
INDIANA
Craig Schroer, Manager
IN Deptof Env'l. Management
Office of Environmental. Response
LIST Branch IGCN-1 255,
PO Box 60 15
1 00 N Senate Ave
Indianapolis IN 46206-6015
(Phone) 31 7-308-3026
(Fax) 31 7-308-3086
Jim Humeston, Manager
IA Dept. of Natural Resources
UST Section
Wallace State Office Bldg
900 East Grand
Des Moines IA50319
(Phone) 51 5-281 -81 35
(Fax) 51 5-281 -8895
KANSAS
Roger Boeken, Unit Chief
KS Dept. of Health & Environment
LUST Investigation Unit
Forbes Field, Bldg. 740
Topeka KS 66620-0001
(Phone) 785-296-1 674
(Fax) 785-296-6 190
KENTUCKY
Lori R. Terry Manager
Underground Storage Tank Branch
Div of Waste Management
KY Dept of Environmental Protection
14 Reilly Road
Frankfort KY 40601
(Phone) 502-564-6716 Ext# 213
(Fax) 502-564-1 939
LOUISIANA
Keith Casanova, UST Contact
Louisiana Department of Environmental
Quality
Remediation Services Division
UST Program
PO Box 82 178
Baton Rouge LA 70884-2178
(Phone) 225-765-0333
(Fax 225-765-0617
MAINE
George Seel, LUST Program Manager
ME Dept of Environmental Protection
Bur. of Remediation & Waste Management.
Div. of Oil & Hazardous Waste Facilities Regulation Technical
Services
17 State House Station, Ray Building
Augusta ME 04333-0017
(Phone) 207-287-2651
(Fax) 207-287-7826
MARYLAND
Mick Butler, Manager
MD Dept of Environment
Waste Management Administration
Oil Control Program
2500 Broening Highway
Baltimore MD 21224
(Phone) 410-631-3442
(Fax) 410-631-3092
MASSACHUSETTS
Eric Arvedon, Manager
MA Dept. of Environmental Protection
Bur. of Waste Site Cleanup
Leaking Underground Storage
Tank Section
One Winter Street, 7th Floor
Boston MA 02108
(Phone) 617-292-5887
(Fax) 617-292-5530
MICHIGAN
Roger Przybysz, Chief
Ml Dept. of Environmental Quality
Storage Tank Division
PO Box 30157
Lansing Ml 48909-7657
(Phone) 517-373-2789
(Fax) 517-335-2245
MINNESOTA
Richard Newquist, Supervisor
MN Pollution Control Agency
Leaking Underground Storage Tanks Program
520 Lafayette Road North
St. Paul MN 55155-4194
(Phone) 651-297-8583
(Fax) 651-296-9707
MISSISSIPPI
Walter Huff, Manager
MS Dept of Environmental Quality
Bureau of Pollution Control, UST Branch
P.O. Box10385
Jackson MS 39289-0385
(Phone) 601-961-5142
(Fax) 601-961-5093
MISSOURI
Edward Galbraith, Tank Section Chief
Missouri Dept of Natural Resources
POBox 176
Jefferson City MO 65102-0176
(Phone) 573-526-0971
(Fax) 573-526-8922
MONTANA
Jeffrey Kuhn, Section Manager
MT Dept of Environmental Quality
Remediation Division
Petroleum Release Section
P.O. 6ox 200901
Helena MT 59620-0901
(Phone) 406-444-5976
(Fax) 406-444-1901
15
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Appendix II: State USTImplementing Agency Contacts
NEBRASKA
David Chambers, Supervisor
Dept. of Environmental Quality
LUST/RA Section,
Atrium, Suite 400,
1200 N. Street PO Box 98922
Lincoln NE 68509-8922
(Phone) 402-471-4258
(Fax) 402-471-2909
NEVADA
Doug Zimmerman, Bureau Chief
NV Dept of Conservation and Natural
Resources
Div of Environmental Protection
Bureau of Corrective Action
333 W. Nye Lane , Room 138
Carson City NV 89706
(Phone) 702-687-4670 Ext 3127
(Fax) 702-687-6396
NEW HAMPSHIRE
Gary Lynn, Manager
NH Dept of Environmental Services
Oil Remediation & Compliance Bureau
P.O. Box 95, 6 Hazen Drive
Concord NH 03302-0095
(Phone) 603-271-8873
(Fax) 603-271-2181
NEW JERSEY
Terri Smith, Brownfields Coordinator
NJ Dept. of Environmental. Protection
Site Remediation Program
401 East State Street (CN-028)
P.O. Box 028
Trenton NJ 08625-0028
(Phone) 609-292-1250
(Fax) 609-777-1914
NEW MEXICO
Joyce Shearer, Manager
Remedial Action Program
Underground Storage Tanks Bureau
NM Department of Environment
1190 St. Francis Dr.
Harold Runnels Bldg., Rm. N2150
PO Box 26110
Santa FeNM 87502-6110
(Phone) 505-476-3779
(Fax) 505-827-0310
NEW YORK
Maris Tirums, Environmental Engineer 3
NY Dept. of Environmental Conservation
Bureau of Spill Prevention and Response
Special Projects Section
625 Broadway, 11th Floor
Albany NY 12233-7020
(Phone 518-402-9543
(Fax) 518-402-9577
NORTH CAROLINA
Burrie Boshoff, UST Section Chief
NC Dept. of Environ & Natural Resources
Div of Waste Management
1637 Mail Service Center
Raleigh NC 27699-1637
(Phone) 919-733-1300
(Fax) 919-733-9413
NORTH DAKOTA
Gary Berreth, UST Program Coordinator
ND Dept of Health
Div of Waste Management
Undreground Storage Tanks Program
PO Box 5520
1200 Missouri Ave
Bismarck ND 58506-5520
(Phone) 701-328-5166
(Fax) 701-328-5200
OHIO
Pete Chace, Program Manager
OH Department of Commerce
Bureau of Underground Storage Tank Regulations
6606 Tussing Road
P.O. Box 687
Reynoldsburg OH 43068-9009
(Phone) 614-995-4246
(Fax) 614-995-1626
OKLAHOMA
Richard Oppel, LUST/Trust Manager
Oklahoma Corp Commission ,
Petroleum Storage Tank Division
Jim Thorpe Bldg. P.O. Box 52000
2101 North Lincoln Blvd., Room 483
Oklahoma City OK 73152-2000
(Phone) 405-522-5264
(Fax) 405-521-4945
OREGON
Sheila Monroe, Manager
OR Dept of Environmental Quality
Underground Storage Tank Program
811 SW Sixth Ave 8th Floor
Portland OR 97204
(Phone) 503-229-6704
(Fax) 503-229-6954
PENNSYLVANIA
Charlie Swokel, Manager
PA Dept of Environmental Protection
Bur of Land Recycling & Waste Management
Storage Tank Cleanup Program
PO Box 8471
Harrisburg PA 17105-8471
(Phone) 717-783-7509
(Fax) 717-787-0884
PUERTO RICO
Katherine Batista, Manager
PR Environmental Quality Board
Commonwealth of Puerto Rico
Water Quality Control
Box 11488
Santurce San Juan PR 00910
(Phone) 787-767-8181
(Fax) 787-767-1962
RHODE ISLAND
Bruce Catterall, Manager
Rl Dept. of Environmental Management
UST/LUST Section
235 Promenade St
Providence Rl 02908-5767
(Phone) 401-222-2797
(Fax 401-222-3813
16
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Appendix II: State USTImplementing Agency Contacts
SOUTH CAROLINA
Stanley L. Clark, Assistant Bureau Chief
SC Dept. of Health & Environmental Control
Bureau of Land & Waste Management
2600 Bull Street
Columbia SC 29201
(Phone) 803-898-4358
(Fax 803-898-4330
SOUTH DAKOTA
Douglas Miller, Team Leader
SD Dept. of Env. and Natural Resources
Ground Water Quality Program
Storage Tanks Section
523 East Capitol Joe Foss Bldg
Pierre SD 57501
(Phone) 605-773-3296
(Fax) 605-773-6035
TENNESSEE
Wayne Gregory, Director
TN Dept of Environment & Conservation
Div of USTs, 4th Floor, L & C Tower
401 Church St
Nashville TN 37243-1541
(Phone) 615-532-0730
(Fax) 615-532-9759
TEXAS
David L. Howell, Manager
TX Natural Resources Conservation
Commission
PST Reimbursement and Technical Services
Section
PO Box 13087 Bldg D, MC:
139 Austin TX 78711-3087
(Phone) 512-239-5370
(Fax) 512-239-1422
UTAH
Dale Marx, Manager
UT Dept of Environmental Quality
Div of Environmental Response and
Remediation
UST Branch
PO Box 144840
Salt Lake City UT 84114-4840
(Phone) 801-536-4131
(Fax) 801-359-8853
VERMONT
Chuck Schwer, Manager
VT Agency of Natural Resources
Department of Environmental Conservation
Leaking Underground Storage Tank Program
103 South Main St West Bldg
Waterbury VT 05671-0404
(Phone) 802-241-3876
(Fax) 802-241-3296
VIRGIN ISLANDS
Cecil Williams, Manager
VI Dept of Planning and Natural Resources
1118 Water Gut Homes
Christiansted St. Croix VI 00820
(Phone) 340-773-0565
(Fax) 340-773-9310
VIRGINIA
David Chance, Manager
VA Dept. of Environmental Quality
Underground Storage Tanks
PO Box 10009
Richmond VA 23240-0009
(Phone) 804-698-4288
(Fax) 804-698-4266
WASHINGTON
Barry Rogowski, Manager
WA Department of Ecology
Toxics Cleanup Program
PO Box 47600
Olympia WA 98504-7600
(Phone) 360-407-7236
(Fax) 360-407-7154
WEST VIRGINIA
Mr. Leslie Mullins, Office Manager
WV Div of Environmental Protection
Office of Waste Management
UST/LUST Section
1356HansfordSt
Charleston WV 25301
(Phone) 304-558-2508
(Fax) 304-558-3998
WISCONSIN
Darsi Foss, Chief
Wl Dept of Natural Resources
Brownfields Section
PO Box 7921
Madison Wl 53707-7921
(Phone) 608-267-6713
(Fax) 608-267-7646
WYOMING
LeRoy Feusner, Manager
WY Dept. of Environmental Quality
Water Quality Division
Herschler Bldg-4Wr
122 West 25th Street
Cheyenne WY 82002
(Phone) 307-777-7096
(Fax) 307-777-5973
17
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Appendix III: EPA Evaluation Criteria Rating Form
USTfields Pilots Evaluation Criteria Rating Form (Page 1)
State/Tribe/Intertribal Consortium:
USTfields Pilot Name:
Summary Rating Table For This Review
Evaluation Criteria
Total Points Available Total Points Awarded
#1 Resource Use and Leveraging
#2 Community Involvement
#3 Communication and Outreach
#4 Corrective Action Challenge
#5 Project Planning and Schedule
Total
35
30
15
10
10
100
18
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USTfields Pilots Evaluation Criteria Rating Form (Page 2)
State/Tribe/Intertribal Consortium:
USTfields Pilot Name:
Eligibility and Threshold Requirements (no points)
This element of the evaluation process is intended to gauge if the proposal meets the
eligibility requirements.
• Does the proposal meet all of the eligibility requirements on pages 4, 5, and 6? Yes
No (If the answer is "no," the proposal does not qualify for further evaluation.)
If the proposal meets all the eligibility requirements on pages 4, 5, and 6, does it meet these
additional threshold requirements?
• Are all the required portions of the written proposal provided? Yes No
• Is the budget described in sufficient detail? Yes No
• Does the budget include only eligible or allowable costs? Yes No
• Does the budget describe how EPA funds will be used, broken down by tasks/activities?
Yes No
• Does the budget seek $ 100,000 or less in USTfields Pilot LUST Trust funds from EPA?
Yes No
Any "no" responses to these additional threshold requirements should be explained below and
the Regional evaluation panel leader should be notified as soon as possible of any inadequacy(ies)
noted above.
Applicants should be given five (5) calendar days to resolve and submit information to address
the inadequacy (ies). After applicants have remedied the inadequacy(ies) and all answers above are
"Yes," the application evaluation may proceed. If applicants do not remedy the inadequacies)
within the given time frame, the application does not pass the threshold requirements and is
ineligible for further consideration.
If the proposal has failed any item, please explain here.
USTfields Review Panel Member (signature): Date:
19
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USTfields Pilots Evaluation Criteria Rating Form (Page 3)
State/Tribe/Intertribal Consortium:
USTfields Pilot Name:
Evaluation Criteria # 1: Resource Use and Leveraging (potential 35 points)
This element of the evaluation is intended to gauge how well a proposed project will utilize
potential USTfields Pilot LUST Trust funds, including how it will leverage existing infrastructure.
Scoring should reflect the desired factors listed below.
Factors to be considered are the extent to which the proposal can demonstrate:
• That the pilot will take advantage of existing infrastructure and existing reuse plans similar
to EPA Brownfields Pilots to clean up and reuse the properties. Preference will be given to
proposed pilots that have previously participated in an EPA cleanup program (i.e.,
Brownfields Assessment Demonstration Pilot or RCRA Brownfields Pilot). Refer to
www. epa. gov/swerosps/bf/pilotlst.htm for a list of all Brownfields Assessment
Demonstration Pilots.
• A commitment from state, tribal, intertribal consortium, local, or private entities to provide
funding or other resources for cleanup of listed properties. Preference will be given to
pilots that target USTfields Pilot LUST Trust funds for the assessment and characterization
of properties and that use other public/private funding and resources for site cleanup.
• The adequacy of potential USTfields Pilot LUST Trust funds and other funding described
in the proposal to complete the pilot. Preference will be given to proposals that
demonstrate sufficient funds to complete the project.
Strengths of this proposal:
Weaknesses of this proposal:
Summary:
Total points for this criteria:
USTfields Review Panel Member (signature): Date:
20
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USTfields Pilots Evaluation Criteria Rating Form (Page 4)
State/Tribe/Intertribal Consortium:
USTfields Pilot Name:
Evaluation Criteria # 2: Community Involvement (potential 30 points)
This element of the evaluation is intended to gauge how well a proposed pilot is supported
by its community and the benefits to that community. Scoring should reflect the desired factors
listed below.
Factors to be considered are the extent to which the proposal can demonstrate:
• Evidence of the community's current and long-term involvement and interest in the pilot.
Preference will be given to pilots with community involvement throughout the life of the
pilot.
• Support from the state, tribal, intertribal consortia, and local environmental, economic
development, and/or health agencies. Preference will be given to pilots that have
documented proof of support from state, tribal, intertribal consortia, and local governmental
agencies.
• Expected benefits for the community, such as how the pilot will advance existing state,
tribal, intertribal consortium, and local efforts to address other abandoned tank properties.
Preference will be given to projects that demonstrate potential benefits to the community
from completing the pilot.
Strengths of this proposal:
Weaknesses of this proposal:
Summary:
Total points for this criteria:
USTfields Review Panel Member (signature): Date:
21
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USTfields Pilots Evaluation Criteria Rating Form (Page 5)
State/Tribe/Intertribal Consortium:
USTfields Pilot Name:
Evaluation Criteria # 3: Communication and Outreach (potential 15 points)
This element of the evaluation is intended to gauge how well a proposed pilot will be able
to convey "lessons learned" and the progress and results from conducting the project. Scoring
should reflect the desired factors listed below.
Factors to be considered are the extent to which the proposal can demonstrate:
• A commitment to voluntarily share information about the pilot (exclusive of confidential
information), such as photographs, maps, and descriptions of the factual, historical,
demographic, economic, and geographical context of the properties. Preference will be
given to proposals that commit to voluntarily sharing information.
• A commitment to address the items in Appendix V and to document "lessons learned" from
the pilot. Preference will be given to proposals that commit to address the items listed in
Appendix V.
• A commitment to use the Internet and/or other user-friendly methods to communicate pilot
information, progress, and results to public and private entities who may want to undertake
similar pilots. Preference will be given to proposals that commit to use of the Internet or
other user-friendly methods to communicate pilot information, progress, and results.
Strengths of this proposal:
Weaknesses of this proposal:
Summary:
Total points for this criteria:
USTfields Review Panel Member (signature): Date:
22
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USTfields Pilots Evaluation Criteria Rating Form (Page 6)
State/Tribe/Intertribal Consortium:
USTfields Pilot Name:
Evaluation Criteria # 4: Corrective Action Challenge (potential 10 points)
This element of the evaluation is intended to gauge how well a proposed pilot will address
the corrective action challenges. Scoring should reflect the desired factors listed below.
Factors to be considered are the extent to which the proposal can demonstrate:
• That properties near potentially impacted residential neighborhoods, sensitive sub-
populations (e.g., children), and environmental receptors (e.g. potentially impacted drinking
water wells) will be addressed. Preference will be given to proposed pilots that address
properties in close proximity to residential neighborhoods, sensitive sub-populations, and
environmental receptors.
• That properties with expected MTBE contamination will be addressed. Preference will be
given to proposals that will assess the properties for MTBE contamination.
• That multiple properties and multiple abandoned tanks will be addressed. Preference will
be given to pilots assessing/cleaning up multiple properties and tanks.
Strengths of this proposal:
Weaknesses of this proposal:
Summary:
Total points for this criteria:
USTfields Review Panel Member (signature): Date:
23
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USTfields Pilots Evaluation Criteria Rating Form (Page 7)
State/Tribe/Intertribal Consortium:
USTfields Pilot Name:
Evaluation Criteria # 5: Project Planning and Schedule (potential 10 points)
This element of the evaluation is intended to gauge how comprehensive the plans are for
completing the proposed pilot and how soon the pilot will be completed. Scoring should reflect the
desired factors listed below.
Factors to be considered are the extent to which the proposal can demonstrate:
• Project plans for each of the phases of the pilot (e.g., assessment, remedy selection,
cleanup, and reuse). Preference will be given to pilots with project plans that will enable
the pilot to move through each phase efficiently and with minimal disruptions.
• Time frames for assessing the properties, selecting the remedy, and initiating and
completing the cleanup and reuse of the properties. Preference will be given to pilots with
shorter time frames.
Strengths of this proposal:
Weaknesses of this proposal:
Summary:
Total points for this criteria:
USTfields Review Panel Member (signature): Date:
24
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i®°To Be Used For Either an Amendment to an Existing Application OR For a New USTflelds Pilot Application
APPLICATION FOR
FEDERAL ASSISTANCE
1. TYPE OF SUBMISSION
Application
n Construction
• Non-Construction
Appendix IV
Preapplicatbn
n Construction
n Non-Construction
2. DATE SUBMITTED
3. DATE RECEIVED BY STATE
4. DATE RECEIVED BY FEDERAL AGENCY
5. APPLICANT INFORMATION
Legal Name:
Address (give city, county, state, and zip code):
6. EMPLOYER IDENTIFICATION (BIN):
8. TYPE OF APPLICATION:
n New n Continuation n Revision
If Revision, enter appropriate letter(s) in box(es): n n
A. Increase Award B. Decrease Award
C. Increase Duration D. Decrease Duration
Other Specify:
10. CATALOG OF FEDERAL
DOMESTIC ASSISTANCE NUMBER: 6 6 .
805
Amendment: TITLE: LEAKING UNDERGROUND STORAGE TANKS
New Application: TITLE: LEAKINGUNDERGROUND STORAGE TANKS USTFIELDS
PILOTS FOR STATES, TRIBES, AND INTERTRIBAL
CONSORTIA
12. AREAS AFFECTED BY PROJECT (cities, counties, states, etc.):
13. PROPOSED PROJECT:
Start Date End Date
15. Estimated Funding:
a. Federal
b. Applicant
c . State
d. Local
e. Other
f. Program Income
g. TOTAL
Applicant Identifier
State Application Identifier
Federal Identifier (select one):
Am endm ent: LS
New Application: LP
Organizational Unit:
Name and telephone number of the person to be contacted on matters involving this
application (give area code)
7. TYPE OF APPLICANT: (enter appropriate
A. State H. Independent Sc
B. County I. State Controllec
C. Municipal J. Private Universi
D . Townsh ip K . Indian Tribe
E. Interstate L. Individual
F. Intermunicipal M. Profit Organiz
G. Special District N. Other (Specify
etterhere) A
hool District
Institution of Higher Learning
ty
ation
9. NAME OF FEDERAL AGENCY:
11. DESCRIPTIVE TITLE OF APPLICANT'S PROJECT:
Am endm ent: LUST Trust Fund Cooperative Agreement (Statewide Remedial
Actions for Leaking Underground Storage Tanks)
New Application: Leaking Underground Storage Tanks USTfields Pilots for State, Tribes,
and Intertribal Consortia
STATUTORY AUTHORITY: 137
14. CONGRESSIONAL DISTRICT OF:
a. Applicant:
$
$
$
$
$
$
0.00
16. IS APPLICATION SUBJECTTO REVIEW
12372 PROCESS?
a. YES. THIS APPLICATION WAS MADE A
EXECUTIVE ORDER 12372 PROCESSES
DATE
b. NO.
n PROGRAM IS NOT COVERED BY E.O
n OR PROGRAM HAS NOT BEEN SELE
b. Project
BY STATE EXECUTIVE ORDER
VAILABLE TO THE STATE
FOR REVIEW ON:
. 12372
CTED BY STATE FOR REVIEW
17. IS THE APPLICANT DELINQUENT ON ANY FEDERAL DEBT?
n Yes If "Yes" attach an explanation.
n No
18. TO THE BEST OF MY KNOWLEDGE AND BELIEF. ALL DATA IN THIS APPLICATION ARE TRUE AND CORRECT, THE DOCUMENT HAS BEEN DULY AUTHORIZED
BY THE GOVERNING BODY OF THE APPLICANT AND THE APPLICANT WILL COMPLY WITH THE ATTACHED ASSURANCES IF THE ASSISTANCE IS AWARDED.
a. Typed Name of Authorized Representative.
b. Title:
d. Signature of Authorized Representative
c. Telephone Number
e. Date Signed
AUTHORIZED FOR LOCAL REPRODUCTION
Standard Form 424A (REV 4-88)
Prescribed by OMB Circular A-l 02
25
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Appendix V: The Final Report
Below is a list of potential topics for the final performance report required under 40 CFR
31.40. EPA is not requiring that these elements of information be provided; however, this
information would provide a foundation for communicating "success stories" about the pilots.
Any information voluntarily provided or obtained through regular cooperative agreement
monitoring will be compiled by EPA along with other outreach materials to communicate the
progress and success of this initiative.
Before and after photographs
List of types of contamination identified and remediated, particularly MTBE
List of affected media or receptors
List of remedial activities
Descriptions of obstacles to assessment, cleanup, and monitoring
Information on how the funding facilitated cleanup activities
26
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