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ENVIRONMENTAL JUSTICE
SMALL GRANTS PROGRAM
APPLICATION GUIDANCE
FY2010
Public Participation
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Environment
Access to Information
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United States Office of Enforcement and October 2009
Environmental Protection Compliance Assurance
Agency http://www.epa.gov/compliance/environmentaliustice/grants/ei smallgrants.htm
Office of Environmental Justice (2201 A)
FOR ADDITIONAL COPIES CONTACT YOUR
REGIONAL EJ COORDINATOR FOUND ON PAGES 24 - 26
Inside Front Cover
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Office of Environmental Justice Small Grants Program -Application Guidance FY 2010
OVERVIEW (OV) INFORMATION
AGENCY: U. S. ENVIRONMENTAL PROTECTION AGENCY
OFFICE OF ENVIRONMENTAL JUSTICE
TITLE: ENVIRONMENTAL JUSTICE SMALL GRANTS PROGRAM
TYPE: INITIAL ANNOUNCEMENT
FUNDING NO.: EPA-OECA-OEJ-10-01
CFDA NO: 66.604
DATES: ANNOUNCEMENT DATE: October 28, 2009
CLOSING DATE: January 8, 2010
EXECUTIVE SUMMARY: Historically, the Environmental Justice Small Grants Program (EJSG)
is designed to provide funding for eligible applicants working on, or planning to work on, a project
that addresses a local environmental and public health issue within an affected community. The
EJSG Program is a multi-statute program designed to help communities understand and address
their exposure to multiple environmental harms and risks.
What types of projects are eligible for funding?
The primary purposes of proposed projects should be to develop an understanding of
environmental and public health issues and to identify ways to address these issues at the
local level, and educate and empower the community. The long-term goals of the EJSG
Program are to help build the capacity of the communities with environmental justice concerns
and create self-sustaining, community-based partnerships that will continue to improve local
environments in the future.
There is a well-established scientific consensus that climate change will cause disproportionate
impacts upon vulnerable populations.1 Thus, the program is adding emphasis this year on
addressing the disproportionate impacts of climate change in communities with environmental
justice concerns. The goal is to recognize the critical role of grassroots efforts in helping shape
climate change strategies to avoid, lessen, or delay the risks and impacts associated with climate
change. An overarching goal of including this emphasis is to help increase the number of
underrepresented communities and ensure equitable green economic development in ways that
build healthy sustainable communities.
Who is eligible under the EJSG Program?
An eligible applicant MUST BE one of the following entities:
1 As stated in the Technical Support Document for the Endangerment and Cause or Contribute Findings for
Greenhouse Gases under Section 202(a) of the Clean Air Act (April 2009), "Within settlements experiencing
climate change, certain parts of the population may be especially vulnerable; these include the poor, the elderly,
those already in poor health, the disabled, those living alone, those with limited rights and power (such as recent
immigrants with limited English skills), and/or indigenous populations dependent on one or a few resources. Thus, the
potential impacts of climate change raise environmental justice issues."
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Office of Environmental Justice Small Grants Program -Application Guidance FY 2010
(1) a 501(c)(3) non-profit organization as designated by the Internal Revenue Service;
(2) a non-profit organization, recognized by the state, territory, commonwealth, or tribe in
which it is located;
(3) a city, township, county government and their entities; OR
(4) a Native American tribal government (Federally recognized)
AND
(5) located within the same state, territory, commonwealth, or tribe that the proposed
project will be located.
In addition, an eligible applicant must be able to demonstrate that it has worked directly with, or
provided services to, the affected community. An "affected community," for the purposes of this
assistance agreement program, is a vulnerable community that is disproportionately impacted by
environmental harms and risks and has a local environmental and public health issue that is
identified in the proposal.
The following entities are INELIGIBLE:
colleges and universities;
hospitals;
state governments and their entities;
quasi-governmental entities (e.g., water districts, utilities)*;
national, multi-state, or state-wide organizations and chapters of any of the
aforementioned organizations; and
non-profit organizations that engage in lobbying activities as defined in Section 3 of the
Lobbying Disclosure Act of 1995
* Generally, a quasi-governmental entity is one that: (1) has a close association with the government agency, but is not considered a
part of the government agency; (2) was created by the government agency, but is exempt from certain legal and administrative
requirements imposed on government agencies; or (3) was not created by the government agency but performs a public purpose and
is significantly supported financially by the government agency.
What is the amount of funding available?
The financial assistance obtained through this solicitation will be awarded as a one year grant.
The total estimated funding expected for all awards under this solicitation is approximately
$1,000,000. EPA anticipates awarding 1-4 grants per region in the amount of $25,000 per award.
The EJSG Program is very competitive. In the 2008 competition, 123 applications were received
and 40 projects were funded.
EPA reserves the right to increase or decrease (including to zero) the total number of grants
awarded. Such changes may be necessary as a response to the quality of applications received
by EPA, the amount of the funds awarded to the selected applicants, or budget availability.
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Office of Environmental Justice Small Grants Program -Application Guidance FY 2010
FULL TEXT ANNOUNCEMENT - Page
I. Funding Opportunity Description - 3
II. Award Information - 8
III. Eligibility Information - 9
IV. Application and Submission Information -10
V. Application Review Information -19
VI. Award Administration Information - 22
VII. Agency Contact - 24
VIM. Other Information /Appendices - 26
SECTION I - FUNDING OPPORTUNITY DESCRIPTION
A. DEFINITION OF ENVIRONMENTAL JUSTICE
The U.S. Environmental Protection Agency (EPA) defines "environmental justice" as the fair
treatment and meaningful involvement of all people regardless of race, color, national origin or
income with respect to the development, implementation, and enforcement of environmental laws,
regulations, and policies. Fair treatment means that no one group of people, including racial,
ethnic, or socioeconomic groups, should bear a disproportionate share of the negative
environmental consequences resulting from industrial, municipal, and commercial operations or
the execution of Federal, state, local, and tribal environmental programs and policies.
Meaningful involvement means that: (1) potentially affected community residents have an
appropriate opportunity to participate in decisions about a proposed activity that will affect their
environment and/or health; (2) the public's contribution can influence the regulatory agency's
decision; (3) the concerns of all participants involved will be considered in the decision-making
process; and (4) the decision-makers seek out and facilitate the involvement of those potentially
affected.
B. BACKGROUND
The EPA's Office of Environmental Justice (OEJ) established the Environmental Justice Small
Grants Program in fiscal year (FY) 1994. The purpose of this grant program is to support and
empower communities that are working on local solutions to local environmental and public health
issues. We continue to fund projects that support collaborative partnerships that address the
community's local environmental issues such as residents' and children's exposure to air toxins
and lead, farm worker and resident's exposure to pesticides and environmental stewardship and
youth involvement and education projects. Summaries of all the EJSG projects funded in FY 2009
and prior years are available on the OEJ website:
http://www.epa.gov/compliance/environmentaliustice/grants/ei-smgrants.html
All proposed projects should include a work plan that includes strategies for addressing local
environmental issues, educating and empowering the community about the issues, building
consensus, and setting community priorities. In addition, the work plan should also demonstrate
how the applicant will collaborate with other stakeholders (e.g., community-based organizations,
environmental groups, businesses, industry, Federal, tribal, state and local governments, and
academic institutions) to realize their project goals and objectives.
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Office of Environmental Justice Small Grants Program -Application Guidance FY 2010
Clean, Green and Healthy Sustainable Communities
There is a well-established scientific consensus that climate change will cause disproportionate
impacts upon vulnerable populations.2 Thus, the program is adding emphasis this year on
addressing the disproportionate impacts of climate change in communities with environmental
justice concerns. The goal is to recognize the critical role of grassroots efforts in helping shape
climate change strategies to avoid, lessen, or delay the risks and impacts associated with climate
change.
Strategies to deal with the risks and impacts associated with climate change are generally divided
in two categories. Mitigation strategies utilize creative and innovative ways to reduce
greenhouse gas emissions, and generally focus on energy efficiency, renewable energy,
agricultural practices and implementation of technologies to achieve greenhouse gas reductions.
Adaptation strategies recognize that because some degree of future climate change will occur
regardless of future greenhouse gas emissions, developing strategies to help vulnerable
communities adapt to or cope with climate change is a necessity. Some climate change
initiatives, such as green jobs and building a green economy, are critical elements of both
mitigation and adaptation strategies.
Applicants are encouraged to develop innovative projects that focus on climate change mitigation
and adaptation in communities with environmental justice concerns. The following is a non
exclusive list of examples of the types of climate change projects that would be consistent with
this intent.
Climate Change Mitigation Strategies (Clean- Renewable- Efficient Energy)
Clean energy generally encompasses forms of energy that have minimal environmental
impacts and zero to low greenhouse gas emissions. Clean energy refers to renewable
energy, and is also been used to refer to energy conservation and energy efficiency-
increased conservation and efficiency being the cleanest "sources" of additional energy
capacity Examples of activities that will reduce greenhouse gas emissions include:
Green Building and Infrastructure Design
Smart Growth
Equitable Development
Energy Conservation/Energy Efficiency in Homes and Commercial Buildings
Weatherization Programs
Home Residence Retrofits
Water Efficiency
Use of Renewable Energy
Climate Change Adaptation Strategies
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As stated in the Technical Support Document for the Endangerment and Cause or Contribute Findings for
Greenhouse Gases under Section 202(a) of the Clean Air Act (April 2009), "Within settlements experiencing
climate change, certain parts of the population may be especially vulnerable; these include the poor, the elderly,
those already in poor health, the disabled, those living alone, those with limited rights and power (such as recent
immigrants with limited English skills), and/or indigenous populations dependent on one or a few resources. Thus, the
potential impacts of climate change raise environmental justice issues."
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Office of Environmental Justice Small Grants Program -Application Guidance FY 2010
The Intergovernmental Panel on Climate Change states with very high confidence that "adaptive
capacity is uneven across and within societies." There are individuals and groups within all
societies that have insufficient capacity to adapt to climate change, making it particularly difficult
to reduce vulnerability for difficult to reach populations, such as the elderly, children, and the poor.
Applicants should demonstrate how their projects will increase the adaptive capacity of
communities with EJ concerns. Examples of projects in different sector areas include:
Human Health
* Financial and human public health resources, including training for emergency response,
prevention and control programs.
- Urban tree planting to moderate temperature increases
* Weather advisories to alert the public about dangerous heat conditions
Grain storage, emergency feeding stations
Coastal Areas and Sea Level Rise
- Developing county-scale maps depicting which areas will require shore protection (e.g. dikes,
bulkheads, beach nourishment) and which areas will be allowed to adapt naturally
* Analyzing the environmental consequences of shore protection
- Promoting shore protection techniques that do not destroy all habitat
* Identifying land use measures to ensure that wetlands migrate as sea level rises in some
areas
- Engaging state and local governments in defining responses to sea level rise
Improving early warning systems and flood hazard mapping for storms
Protecting water supplies from contamination by saltwater
Agriculture and Forestry
- Altering the timing of planting dates to adapt to changing growing conditions
- Altering cropping mix and forest species that are better suited to the changing climatic
conditions
- Breeding new plant species and crops that are more tolerant to changed climate condition
- Promoting fire suppression practices in the event of increased fire risk due to temperature
increases
Controlling insect outbreaks
Ecosystems and Wildlife
- Protecting and enhancing migration corridors to allow species to migrate as the climate
changes
* Identifying management practices that will ensure the successful attainment of conservation
and management goals
* Promoting management practices that confer resilience to the ecosystem
Water Resources
* Altering infrastructure or institutional arrangements
Changing demand or reducing risk
- Improving water use efficiency, planning for alternative water sources (such as treated
wastewater or desalinated seawater), and making changes to water allocation
Conserving soil moisture through mulching and other means
- Protecting coastal freshwater resources from saltwater intrusion
Energy
Increasing energy efficiency to offset increases in energy consumption due to warming
Protecting facilities against extreme weather events
Diversifying power supply in the event of power plant failures due to excess demand created
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Office of Environmental Justice Small Grants Program -Application Guidance FY 2010
by extreme heat, or by extreme weather events
Green Economy and Green Jobs Capacity Building.
In an effort to create a green economy that has enough jobs for those who have been
underemployed, unemployed, or faced other barriers to employment, it is important to target
green jobs to communities with EJ concerns. Green jobs provide healthy environments for
workers while helping build a clean economy.
Applicants would focus on developing effective strategies for promoting green economies that
build healthy sustainable communities in communities with environmental justice concerns.
Projects would help bridge the gap of knowledge and preparation in the green jobs sector, and
should connect with broader national programs such as DOL green jobs training, DOE
weatherization training, HUD retrofits to affordable housing and lead abatement.
Proposed training programs would target unemployed and underemployed individuals residing in
impacted communities, assisting in improving the participants' pre-employment skills and
increasing their ability to compete for and participate in larger more established programs.
Applicants would identify the ways in which the participants will be better equipped to compete for
employment in environmental work that involves green economy, energy efficiency or renewable
energy. Some examples of employment opportunities are:
Installing solar energy panels on rooftops,
Building wind turbines,
Retrofit homes for energy efficiency and much more.
For more information and examples of types of green economy activities go to
www.climatechange.org , www.greenforall.org
C. QUALIFIED ENVIRONMENTAL STATUTES
The EJSG Program is designed to address multi-statute environmental and public health
issues. For this reason, each project, including those with the added emphasis elements.
must include activities that are authorized by two or more of the following Federal
environmental statutes. The two or more environmental statutes that are involved in your
project must be clearly and precisely identified in your work plan. Any failure to clearly
and conclusively identify and cite the statutes in your work plan shall result in your project
not receiving the maximum points eligible under the Ranking Criteria.
1) Clean Water Act, Section 104(b) (3): conduct and promote the coordination of research,
investigations, experiments, training, demonstration projects, surveys, and studies relating to
the causes, effects, extent, prevention, reduction, and elimination of water pollution.
2) Safe Drinking Water Act, Section 1442(c)(3)(C): develop and expand the capability to carry
out a program (that may combine training, education, and employment) for occupations
relating to the public health aspects of providing safe drinking water.
3) Solid Waste Disposal Act, Section 8001 (a): conduct and promote the coordination of
research, investigations, experiments, training, demonstration projects, surveys, public
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Office of Environmental Justice Small Grants Program -Application Guidance FY 2010
education programs, and studies relating to solid waste (e.g., health and welfare effects of
exposure to materials present in solid waste and methods to eliminate such effects).
4) Clean Air Act, Section 103(b) (3): conduct research, investigations, experiments,
demonstration projects, surveys, and studies related to the causes, effects (including health
and welfare effects), extent, prevention, and control of air pollution.
5) Toxic Substances Control Act, Section 10(a): conduct research, development, monitoring,
public education, training, demonstration projects, and studies on toxic substances.
6) Federal Insecticide, Fungicide, and Rodenticide Act, Section 20(a): conduct research,
development, monitoring, public education, training, demonstration projects, and studies on
pesticides.
7) Marine Protection, Research, and Sanctuaries Act, Section 203: conduct research,
investigations, experiments, training, demonstration projects, surveys, and studies relating to
the minimizing or ending of ocean dumping of hazardous materials and the development of
alternatives to ocean dumping.
D. EPA STRATEGIC PLAN LINKAGE AND ANTICIPATED OUTPUTS AND OUTCOMES
1) Linkage to EPA Strategic Plan. Tasks under this project support the EPA's Strategic Plan
Goal 4: Healthy Communities and Ecosystems, Objective 4.2: Communities, Sub-objective
4.2.2: Restore Community Health. A copy of the EPA's Strategic Plan is available online at
http://www.epa.gov/ocfo/plan/plan.htm. Therefore, EJSG project activities must lead to
outputs and outcomes that will result in healthy communities and ecosystems.
2) Outputs. The term "output" means an environmental activity, effort, and/or associated work
product related to an environmental/public health goal and objective that will be produced or
provided over a period of time or by a specified date. Outputs may be quantitative or
qualitative but must be measurable during an assistance agreement funding period.
Here are examples of expected outputs for this program although they are not limited to the
following:
• The number of residents trained by an environmental/public health program to reduce
resident exposure to environmental/public health hazards (e.g., number of residents
trained on safe shellfish harvesting)
• Creation of an environmental/public health/climate change program to achieve and
sustain environmental/public health/climate change improvements (e.g., a
community-wide asthma coalition; community weatherization program)
• The number of homes/residents/communities reached or impacted by an
environmental/public health program/climate change (e.g., number of homes that
undergo a lead abatement program)
3) Outcomes. The term "outcome" means the result, effect, or consequence that will occur from
carrying out an environmental/public health program or activity that is related to an
environmental/public health programmatic goal or objective. Outcomes may be
environmental, behavioral, health-related, or programmatic in nature, but must be quantitative.
They may not necessarily be achievable within an assistance agreement funding period.
Here are some expected outcomes from the above output examples:
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• The number of residents that actually adopt safe shellfish harvesting
• The number of community members that utilize an asthma action plan to manage
asthma at home, work, and/or school
• The number of families that have reduced exposure to lead paint as result of their
homes undergoing a lead abatement program
• The number of residents that install home weatherization
• Reduction of energy used in buildings (school/apartment building/business/homes)
SECTION II - AWARD INFORMATION
A. FUNDING AVAILABILITY AND PROJECT PERIOD
The total estimated amount of funding available under this solicitation for FY 2010 is
approximately $1,000,000. Each award will be made in the form of a Federal grant in amounts up
to $25,000. All awards will be fully funded at the time of award. All projects should have a period
of performance of one year.
B. NUMBER OF ANTICIPATED AWARDS
EPA anticipates awarding 1-4 grants in each of EPA's ten regions, subject to the availability of
funds and the quality of the applications submitted. For a listing of EPA's ten regions and the
states for which they are responsible, please see Section VII. EPA reserves the right to reject all
applications and make no awards under this announcement. EPA reserves the right to make
additional awards under this announcement, consistent with Agency policy and guidance, if
additional funding becomes available after the original selections are made. Any additional
selections for awards will be made no later than six months after the original selection decisions.
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Office of Environmental Justice Small Grants Program -Application Guidance FY 2010
SECTION III - ELIGIBILITY INFORMATION
A. ELIGIBLE APPLICANTS BASED ON APPLICABLE CFDA
The applicable Catalog of Federal Domestic Assistance (CFDA) for this program is 66.604.
Assistance under this program is only available to the following types of applicants.
An eligible applicant MUST BE one of the following entities:
(1) a 501(c)(3) non-profit organization as designated by the Internal Revenue Service;
(2) a non-profit organization, recognized by the state, territory, commonwealth, or tribe in which it
is located;
(3) a city, township, county government and their entities; OR
(4) a Native American tribal government (Federally recognized)
AND
(5) located within the same state, territory, commonwealth, or tribe that the proposed project will
be located.
In addition, an eligible applicant must be able to demonstrate that it has worked directly with, or
provided services to, the affected community. An "affected community," for the purposes of this
assistance agreement program, is a community that is disproportionately impacted by
environmental harms and risks and has a local environmental and public health issue that is
identified in the proposal.
The following entities are INELIGIBLE:
colleges and universities;
hospitals;
state governments and their entities;
quasi-governmental entities (e.g., water districts, utilities)*;
national, multi-state, or state-wide organizations and chapters of any of the
aforementioned organizations; and
non-profit organizations that engage in lobbying activities as defined in Section 3 of the
Lobbying Disclosure Act of 1995
* Generally, a quasi-governmental entity is one that: (1) has a close association with the government agency, but is not considered a
part of the government agency; (2) was created by the government agency, but is exempt from certain legal and administrative
requirements imposed on government agencies; or (3) was not created by the government agency but performs a public purpose and
is significantly supported financially by the government agency.
B. THRESHOLD ELIGIBILITY CRITERIA
Before an application can be reviewed by a panel of EPA Staff (Review Panel), it must be
screened to ensure that the application meets the minimum eligibility requirements, or Threshold
Eligibility Criteria. EPA staff will screen all applications using the One-page Threshold Eligibility
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Office of Environmental Justice Small Grants Program -Application Guidance FY 2010
Form found in Appendix A. Applications must substantially comply with the application
submission instructions and requirements set forth in Section IV of this announcement or else
they will be rejected. However, where a page limit is expressed in Section IV with respect to the
application, pages in excess of the page limitation will not be reviewed.
The form will address the following areas:
1) Applicant Eligibility:
You must be able to demonstrate that you:
a) are an eligible applicant as defined above in Section III. A;
b) have worked directly with, or provided services to, the affected community; and
c) do not belong to the list of excluded organizations in Section III A.
2) Qualified Environmental Statutes:
You must have two or more qualified environmental statutes associated with your project.
See Section I. C for more information on the requirements for environmental statutes.
3) Complete Application Package. You must have a complete application package.
Congress has prohibited the use of federal funds to award grants to the Association of Community
Organizations for Reform Now (ACORN) or any of its affiliates, subsidiaries, or allied
organizations and therefore in order to be eligible for funding consideration under this competition
all applicants must affirmatively indicate in their proposal that they are not subject to this
prohibition. In addition, since this funding prohibition applies to subawards/subgrants and
contracts awarded by grantees, applicants must consider it when preparing proposals.
In addition, applications must be date stamped by the courier or postmarked by as specified in
Section IV of this announcement on or before the application submission deadline published in
Section IV of this announcement. Applicants are responsible for ensuring that their proposal [or
application] reaches the designated person/office specified in Section IV of the announcement by
the submission deadline.
Applications date stamped by the courier or postmarked after the submission deadline listed in
Section IV will be considered late and returned to the sender without further consideration unless
the applicant can clearly demonstrate that it was late due to EPA mishandling. For hard copy or e-
mailed submissions, where Section IV requires application receipt by a specific person/office by
the submission deadline, receipt by an agency mailroom is not sufficient. Applicants should
confirm receipt of their application with Sheila Lewis at lewis.sheila@epa.gov as soon as possible
after the submission deadline—failure to do so may result in your application not being reviewed.
Applicants deemed ineligible for funding consideration as a result of the threshold eligibility review
will be notified within 15 calendar days of their ineligibility determination.
C. COST-SHARING OR MATCHING FUNDS
No cost-sharing or matching is required.
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Office of Environmental Justice Small Grants Program -Application Guidance FY 2010
SECTION IV-APPLICATION AND SUBMISSION INFORMATION
A. ADDRESS TO REQUEST APPLICATION FORMS REQUIRED FOR THIS SOLICITATION
All required forms and optional templates are available at:
http://www.epa.gov/compliance/environmentaliustice/grants/index.html.
You can also receive a hard-copy through a regional or Headquarter (HQ) contact listed in
Section VII.
B. CONTENT AND FORM OF APPLICATION SUBMISSION
Applications submitted via U.S. Postal or courier service must contain the original application and
two copies. Applications submitted electronically via emailed PDF documents do not require two
copies. No matter how you submit your application, it MUST include the following required forms
and documents:
1) One-Page Threshold Eligibility Form (Appendix A)
2) SF-424 Application for Federal Assistance (Appendix B)
3) Key Contacts List EPA Form 5700-54 (Appendix C)
4) Workplan (Optional template in Appendix D)
5) Detailed Budget (Optional logic model template and example in Appendices E and F)
6) Resumes of the PI/PM and other key personnel (Principal Investigator/Project
Manager).
7) Project Performance Measures (Optional template and example in Appendices G & H)
8) Proof of Non-Profit Status
The following is a detailed description of all the required forms and documents.
1) SF-424 APPLICATION FOR FEDERAL ASSISTANCE, with original signature (Form is
available in Appendix B)
The SF-424 is the official form for all Federal grants and cooperative agreements. It requests
basic information about your organization and the proposed project. To complete this form
you must provide a Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS)
number. You can receive a DUNS number, at no cost, by calling the dedicated toll-free DUNS
number request line at 1-800-627-3867, or visiting the D&B website at http://www.dnb.com.
2) KEY CONTACTS LIST, EPA Form 5700-54 (Attached as Appendix C)
3) Workplan (Optional template is available in Appendix D):
The workplan is the most important part of your application package because it describes your
project. Workplans that are focused and succinct are stronger than ones that try to address
too many issues. The workplan should not exceed ten (10), single-spaced typewritten pages.
Anything over ten (10) pages will not be read by the Review Panel. The pages of the
workplan should be letter-size (8 1/2X11 inches), single-spaced, with normal type size (10 or
12 characters per inch), and at least 1 inch margins. There will be no penalty for using a
different page size or font type, but it is strongly discouraged. Do not use spiral binding,
separation tabs, or plastic covers. You may bind your paperwork with a staple. Do not
include videos or DVDs.
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The workplan must contain the following components and must be identified by the
headings in the exact order as listed below. The headings correspond with the criteria in
Section V that will be used to evaluate each eligible application.
I. Project Title and Project Purpose Statement (approximately 1/2 page). Provide the
following information:
• A title for your project; and
• A summary description of the proposed project.
II. Environmental. Public Health and Climate Change (if applicable) Information about the
affected Community (approximately 2 pages).
Please describe the following:
• The local environmental, public health and climate change (if applicable) issue that you
seek to address;
• The affected community that you work directly with, or provide services to;
• How the affected community is disproportionately impacted by environmental harms
and risks;
• How the affected community is impacted by climate change (if applicable); and
• How the affected community will benefit from the results of your project.
You must include relevant information such as demographics, geographic location, and
community history.
III. Organization's Historical Connection to the Affected Community (approximately (1
page). Describe the following:
• The history of your organization's involvement with the affected community, including the
length of your involvement and how you became involved;
• How you have worked with the affected community's residents and/or organizations to
address local environmental and public health issues;
• How the affected community residents and/or organizations are part of your decision-
making process;
• How your efforts have increased the community's capacity to address local environmental
and public health issues; and
• How you maintain and sustain an ongoing relationship with the affected community's
residents and/or organizations.
IV. Project Description (approximately 4 to 5 pages).
The Project Description is your opportunity to describe your project goals, all of the
components of the project, the timeframe to accomplish the proposed activities and the
evaluation process for determining success. Also included should be the key roles and
responsibilities of key organizations involved.
It MUST address the following items:
i) A concise description of the activities the project will undertake during the year to
examine and address the environmental and public health issue(s)/climate change.
e.g., training, education/outreach programs, capacity-building efforts, etc. Please
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describe the following:
• The local environmental, public health and climate change (if applicable) results your
projects seeks to achieve; and
• How your project will achieve these results.
• How your project is related to the environmental statutes you identified in your Threshold
Eligibility Form (see Section I.C and Appendix A). Please note each project must include
activities that are authorized by two or more of the Federal environmental statutes listed in
Section I.C.
ii) A concise description of how you and your partners) will work together during the
year to address the local issue(s). Please describe the following:
• The role of your partner(s) in addressing the local environmental, public health and
climate change (if applicable) issues;
• The nature of the organization(s), and what resources they bring to the partnership;
• How the partner has a vested interest in working with this partnership [other than just
getting income], commitments made, and specific activities it will be responsible for; and
• How you plan to maintain and sustain the partnerships.
V. Organizational Capacity and Programmatic Capability (approximately 1/2 page).
Please provide the following information:
• The organizational and administrative systems (e.g., accounting programs) that you have
in place that will be used to appropriately manage, expend, and account for Federal funds;
• How you have successfully managed these projects in the past;
• How you plan to effectively manage and successfully complete this proposed project; and
• If you have been a recipient of an EPA and/or other Federal grant/cooperative agreement
in the last five years, please indicate your past performance in meeting reporting
requirements (e.g., progress reports, financial status). Please also include the name of
the Project Officer overseeing the grant/cooperative agreement and the assistance
agreement number associated with the project(s);
If you do not have prior experience in managing federal funds please indicate this in
the proposal, you will receive a neutral score in this area. Failure to do so will result
in receiving a score of 0 for this element.
VI. Qualifications of the Principal Investigator or Project Manager (PI/PM) (approximately
1 page). Please describe the following:
• Why the PI/PM is qualified to undertake the project;
• How the PI/PM has ties to the community and/or organization; and
• Past activities that the PI/PM has worked on with the community.
VII. Past Performance in Reporting on Outputs and Outcomes (approximately 1/2 page).
Provide the following information:
• A list of any Federal or non-Federal grants or cooperative agreements (not Federal
contracts) of similar size, scope, and relevance to the proposed project that you
worked on within the past three (3) years (no more than five (5) agreements, ad
preferably EPA agreements). Please include the grant or cooperative agreement
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number, title of the project, the amount of funding, funding agency or organization, and
point-of-contact;
• A description of how you have documented and/or reported on progress towards
achieving the expected outputs and outcomes under prior and/or current assistance
agreements; and
• If you did not make any progress towards achieving the expected outputs and
outcomes, describe whether you have documentation and/or reports satisfactorily
explaining why.
If you do not have prior experience in reporting outputs and outcomes please indicate
this in the proposal, you will receive a neutral score in this area. Failure to do so will
result in receiving a score of 0 for this element.
VIM. Quality Assurance Project Plan (QAPP) Information (1 to 2 sentences). Please
describe the following:
• Indicate whether you believe that your project will involve the use of existing
environmental data or the collection of new data (use the checklist in Appendix I to assist
you in making this determination). For more information about Quality Assurance
Project Plans, please consult the following website http://www.epa.gov/quality/qs-
docs/q5-final.pdf.
You are not required to develop a QAPP at this point. You are only being asked to determine
whether or not you will need a QAPP if your project is selected for funding. If required, then an
approved QAPP must be in place prior to the initiation of activities.
5) Detailed Budget (5 pts) (Optional template and example are available in Appendices E
and F).
You must include a detailed budget breakdown that does the following:
• Shows how the funds will be specifically used in terms of personnel, fringe
benefits, travel, equipment, supplies, contractor costs, other costs, and indirect
costs; and
• Itemizes each cost.
Funding Restrictions. EPA grant funds can only be used for the purposes set forth in the
grant and must be consistent with the statutory authorities for the award. The recipient cannot
use these funds for the following activities under this grant program:
• Litigation against the Federal government or any other government entity;
• Construction;
• Lobbying;
• Matching funds for other Federal grants;
• Travel for Federal employees;
• Human health studies (taking blood or other information from humans).
6) Resumes of the Principal Investigator or Project Manager (PI/PM) and Other Key
Personnel. You must attach a resume of the PI/PM and any other key personnel named on the
Key Contacts List. (See Appendix C for EPA Form 5700-54)
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7) Project Performance Measures (Optional logic model template and example are
available in Appendices G and H). The ability to measure project progress is critical to
achieving your desired goals. Targeting work toward specific project outcomes can help you
manage your project to achieve these results. Measurement can tell you what is working with
your project and what is not, and when it may be necessary to adapt your approach. It will tell
you whether your efforts are having a positive impact on your community.
Please list and describe the following:
• Resources/Inputs. What resources are you and your partner(s) putting forward to
further the project's goals? Resources may include but are not limited to staff time, in-
kind contributions, monetary contributions, etc.
• Activities: What activities will you and your partners conduct under your workplan?
• Outputs and Outcomes: Describe the outputs and outcomes that will result from your
project (potential outputs and outcomes are listed in Section I. D). The following are
items to consider when developing output and outcome measures:
For projects involving training, possible outputs are the number of people trained and/or
the number of training sessions held. Possible outcomes are the number of people who
increase their awareness of the environmental and public health issue(s) and/or the
number of people who adopt or change certain behaviors to reduce their exposure to
environmental hazards as a result of the training.
For projects involving meetings or forums, an output may be the number of people
attending the meetings or forums, the number of meetings or forums held, and any
product (strategy or outreach plan, brochure, pamphlet, etc.) that was produced as a
result of the meeting or forum. If your proposed project wants to affect change among
the participants in the meeting or forum, possible outcomes are the number of meeting
or forum attendees who have increased awareness of the environmental and public
health issue(s) or the number of meeting or forum attendees who adopt or change
certain behaviors as a result of the meeting or forum.
If the purpose of the meetings or forums is to develop a product (strategy or outreach
plan, brochure, pamphlet, etc.) in order to reach a target population, e.g., people,
businesses, organizations, etc. outside of the meeting or forum attendees, a possible
outcome may include the number of those in your target population who have made
changes as a result of the implementation or dissemination of the product.
When developing performance measures, it's important to consider the following:
1) What are the measurable short term and longer term results the project will achieve?
2) How will my project measure progress in achieving the expected results (including
outputs and outcomes) and how will the approach use resources effectively and
efficiently?
In order to determine whether your project has achieved its intended outputs and outcomes, you
will need think about what your data source will be (e.g., people, existing records, observation,
etc.) and how you will collect the data (e.g., observing behavior changes, administering pre- and
post-tests). You will need to do this for each performance measure you develop. For example,
for projects involving training, the possible source for your data would be the participants who
receive the training and a possible way to collect data would be administering pre- and post-
tests to training participants to measure their changes in attitude or increased knowledge. A
follow-up survey could be conducted at a later point in time to measure any behavior changes
as a result of the training. You will need to think carefully about your data collection process in
order to get quality information from your project and to achieve your projects' intended results.
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In addition to articulating how an applicant intends to incorporate climate change mitigation
strategies in communities with environmental justice concerns, applicants should also highlight
any co-benefits associated with reductions in greenhouse gases (e.g. green job creation,
improved transit access for disadvantaged communities, reduced stormwater runoff, reduction
of co-pollutants produced concurrent with greenhouse gases, benefits to improved public
health). Examples of such outcomes include, but are not limited to: number of people who
adopted initiatives to reduce emissions of other air toxics or water pollution, number of people
that utilized an action plan to make improvements in air or water quality, number of people who
made changes to make a reduction in fossil energy use, number of trainings toward green jobs
created, number of cost savings, or number of community members participating in or benefiting
from a program
One tool that may useful to you in developing output and outcome measures is a "logic model."
A logic model is a visual model that shows the relationship between your work and your desired
results. It communicates the performance story of your project, focusing attention on the most
important connections betweens your actions and the results. A logic model can serve as a
basic road map for the project, explaining where you are and where you hope to end up. An
optional logic model template and example are available in Appendices I and J.
The following websites provide information on developing a logic model, performance
measures, and other tools to measure project outcomes:
The Kellogg Foundation guide to developing logic models:
http://www.wkkf.org/Pubs/Tools/Evaluation/Pub3669.pdf
An EPA Region 10 Web Page with measurement information and tools:
http://yosemite.epa.gov/R10/ECOCOMM.NSF/webpage/measuring+environmental+results
A University of Wisconsin Extension Service online course on enhancing performance using
logic models: http://www.uwex.edu/ces/lmcourse/
A page with National Fish and Wldlife Foundation logic framework examples:
http://www.nfwf.org/evaluation/logicframework.cfm
A website that provides information on developing surveys:
http://www.survevmonkey.com
8) Proof of Non-profit Status for non-governmental organizations. An eligible nonprofit
organization applicant must attach the certificate that shows it is either: (1) a 501(c)(3) non-profit
organization as designated by the Internal Revenue Service; OR (2) a non-profit organization,
recognized by the state, territory, commonwealth, or tribe in which it is located.
C. SUBMISSION DATES AND TIMES
All completed applications must be postmarked by USPS, date-stamped by courier service, or
received via Email by 11:59 pm, January 8, 2010. For instructions on submitting applications
electronically, please see Section IV. I. Depending on your choice of delivery method, paper
applications should be sent to either one of the addresses below:
Courier/Delivered Address
Sheila Lewis
U.S. EPA/Office of Environmental Justice
U.S. Postal Service Address
Sheila Lewis
U.S. EPA/Office of Environmental Justice
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Office of Environmental Justice Small Grants Program -Application Guidance FY 2010
1200 Pennsylvania Avenue NW, Room 2232E
Washington, DC 20004
Phone: 202-564-0152
E-Mail: lewis.sheila@epa.gov
Mail Code 2201A
Washington, DC 20460
Phone: 202-564-0152
E-Mail: lewis.sheila@epa.gov
Applications that are not postmarked by the U.S. Postal Service, date-stamped by courier service,
or submitted electronically via Email, by 11:59 pm, January 8, 2010 will not be considered for an
award.
D. PARTNERSHIPS. CONTRACTORS AND SUBAWARDS
The EJSG program supports the development of collaborative partnerships dedicated to
identifying and understanding the multiple local environmental and public health issues in
communities, educating communities about the issues, and setting priorities to address the
issues. EPA encourages establishing and building collaborative partnerships with other
stakeholders who share a desire to address the local environmental and public health issues
affecting their community. Establishing partnerships with a wide array of different stakeholders is
a necessary component of collaborative problem-solving.
EPA awards funds to one eligible applicant as the recipient even if other eligible applicants are
named as partners or co-applicants or members of a coalition or consortium. The recipient is
accountable to EPA for the proper expenditure of funds. The following questions and answers
provide additional information on Federal regulations governing partnerships, contractors and
subaward recipients.
Contracts and Subawards:
a. Can funding be used for the applicant to make subawards, acquire contract services, or
fund partnerships?
Funding may be used to provide subgrants or subawards of financial assistance, which includes
using subawards or subgrants to fund partnerships, provided the recipient complies with
applicable requirements for subawards or subgrants including those contained in 40 CFR Parts 30
or 31, as appropriate. Applicants must compete contracts for services and products, including
consultant contracts, and conduct cost and price analyses, to the extent required by the
procurement provisions of the regulations at 40 CFR Parts 30 or 31, as appropriate. The
regulations also contain limitations on consultant compensation. Applicants are not required to
identify subawardees/subgrantees and/or contractors (including consultants) in their
proposal/application. However, if they do, the fact that an applicant selected for award has
named a specific subawardee/subgrantee, contractor, or consultant in the proposal/application
EPA selects for funding does not relieve the applicant of its obligations to comply with
subaward/subgrant and/or competitive procurement requirements as appropriate. Please note
that applicants may not award sole source contracts to consulting, engineering or other firms
assisting applicants with the proposal solely based on the firm's role in preparing the
proposal/application.
Successful applicants cannot use subgrants or subawards to avoid requirements in EPA grant
regulations for competitive procurement by using these instruments to acquire commercial
services or products from for-profit organizations to carry out its assistance agreement. The
nature of the transaction between the recipient and the subawardee or subgrantee must be
consistent with the standards for distinguishing between vendor transactions and subrecipient
assistance under Subpart B Section .210 of OMB Circular A-133 , and the definitions of subaward
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at 40 CFR 30.2(ff) or subgrant at 40 CFR 31.3, as applicable. EPA will not be a party to these
transactions. Applicants acquiring commercial goods or services must comply with the
competitive procurement standards in 40 CFR Part 30 or 40 CFR Part 31.36 and cannot use a
subaward/subgrant as the funding mechanism.
b. How will an applicant's proposed subawardees/subgrantees and contractors be
considered during the evaluation process described in Section V of the announcement?
Section V of the announcement describes the evaluation criteria and evaluation process that will
be used by EPA to make selections under this announcement. During this evaluation, except for
those criteria that relate to the applicant's own qualifications, past performance, and reporting
history, the review panel will consider, as appropriate and relevant, the qualifications, expertise,
and experience of:
(i) an applicant's named subawardees/subgrantees identified in the proposal/application if the
applicant demonstrates in the proposal/application that if it receives an award that the
subaward/subgrant will be properly awarded consistent with the applicable regulations in 40 CFR
Parts 30 or 31. For example, applicants must not use subawards/subgrants to obtain commercial
services or products from for-profit firms or individual consultants.
(ii) an applicant's named contractor(s), including consultants, identified in the proposal/application
if the applicant demonstrates in its proposal/application that the contractor(s) was selected in
compliance with the competitive Procurement Standards in 40 CFR Part 30 or 40 CFR 31.36 as
appropriate. For example, an applicant must demonstrate that it selected the contractor(s)
competitively or that a proper non-competitive sole-source award consistent with the regulations
will be made to the contractor(s), that efforts were made to provide small and disadvantaged
businesses with opportunities to compete, and that some form of cost or price analysis was
conducted. EPA may not accept sole source justifications for contracts for services or products
that are otherwise readily available in the commercial marketplace.
EPA will not consider the qualifications, experience, and expertise of named
subawardees/subgrantees and/or named contractor(s) during the proposal/application evaluation
process unless the applicant complies with these requirements.
E. INTERGOVERNMENTAL REVIEW
All applications submitted are subject to Executive Order 12372, "Intergovernmental Review of
Federal Programs." Applicants should contact their State's Single Point of Contact (SPOC) to find
out how to comply with the State's process. The names and addresses of the SPOC's are listed
in the Office of Management Budget's website: http://www.whitehouse.gov/omb/grants/spoc.html.
You should submit your application to your SPOC at the same time as you submit your
application to the EPA in order to prevent delay. The intergovernmental review process
can be lengthy, so it is encouraged that applicants submit application packages to their
designated SPOCs as early as possible.
F. CONFIDENTIAL BUSINESS INFORMATION
In accordance with 40 CFR 2.203, applicants may claim all or a portion of their application as
confidential business information. EPA will evaluate confidentiality claims in accordance with 40
CFR Part 2. Applicants must clearly mark applications/proposals or portions of
applications/proposals they claim as confidential. If no claim of confidentiality is made, EPA is not
required to make the inquiry to the applicant otherwise required by 40 CFR 2.204(c)(2) prior to
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disclosure. However, competitive applications are considered confidential and protected from
disclosure prior to the completion of the competitive selection process.
G. PRE-APPLICATION ASSISTANCE
Applicants are invited to participate in conference calls with EPA to address questions about the
EJSG Program. The following are the conference call dates and times. Please call or send an e-
mail to Sheila Lewis at lewis.sheila@epa.gov and provide the following information: (1) your
name; (2) the name of your organization; (3) the address of your organization; (4) your phone
number; (5) and the preferred date for the call. If you cannot reply by e-mail, you can also register
by calling your regional EJ Coordinator listed in Section VII.
Date
November 10, 2009
December 03, 2009
Time (Eastern)
1:30-2:30 p.m.
1:30 -2:30 p.m.
In accordance with EPA's Assistance Agreement Competition Policy (EPA Order 5700.5A1), EPA
staff will not meet with individual applicants to discuss draft proposals, provide informal comments
on draft proposals, or provide advice to applicants on how to respond to ranking criteria.
Applicants are responsible for the contents of their applications/proposals. However, consistent
with the provisions in the announcement, EPA will respond to questions from individual applicants
regarding threshold eligibility criteria, administrative issues related to the submission of the
proposal, and requests for clarification about the announcement.
H. MANAGEMENT FEES
When formulating budgets for proposals/applications, applicants must not include management
fees or similar charges in excess of the direct costs and indirect costs at the rate approved by the
applicant's cognizant audit agency, or at the rate provided for by the terms of the agreement
negotiated with EPA. The term "management fees or similar charges" refers to expenses added
to the direct costs in order to accumulate and reserve funds for ongoing business expenses,
unforeseen liabilities, or for other similar costs that are not allowable under EPA assistance
agreements. Management fees or similar charges may not be used to improve or expand the
project funded under this agreement, except to the extent authorized as a direct cost of carrying
out the scope of work.
I.ELECTRONIC SUBMISSION PROCEDURES
E-mail submissions must be submitted to ej_small_grants@epa.gov and be received by the
submission deadline stated in Section IV.C. of this announcement. All required documents listed
in Section IV. B. of the announcement must be attached to the e-mail as separate Adobe PDF
files. Please note that if you choose to submit your materials via e-mail, you are accepting all risks
attendant to e-mail submission including server delays and transmission difficulties. E-mail
submissions exceeding 15MB will experience transmission delays which will affect when they are
received by the Agency. For these size submissions, applicants should submit their application
materials via hardcopy because if they are sent via e-mail they may be received late and not
considered for funding. Applicants submitting their application materials through e-mail should
confirm receipt of the materials with Sheila Lewis at lewis.sheila@epa.gov as soon as possible
after submission.
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SECTION V-APPLICATION REVIEW INFORMATION
A. CRITERIA
1) Threshold Evaluation Criteria. Before an application is reviewed by a panel of EPA staff
(Review Panel), it must be screened to ensure that the application meets the Threshold
Eligibility Criteria (See Section III.B). Please note an application will not be reviewed and
scored if the application does not meet the Threshold Eligibility Criteria.
2) Ranking Criteria. Applications meeting the Threshold Evaluation Criteria will be reviewed
and scored by the Review Panel. Each criterion has corresponding points that range from 2
points (lowest) to 25 points (highest). Your score for each criterion will be based on how well
you address each criterion. The maximum total points you can obtain is 100. Please note
that certain sections are given greater weight than others. The application will be scored on
the following Ranking Criteria:
Criteria
Environmental, Public Health and Climate Chanqe (if applicable) Information.
You will be evaluated on your ability to clearly describe the local issue(s) you propose
to address and the community that is impacted. This will be determined through your
description of the following areas (Maximum of 3 points each):
(1) the local environmental, public health and climate change (if applicable) issue that
you seek to address;
(2) the local environmental and public health and climate change (if applicable) results
your project seeks to achieve;
(3) the affected community that you work directly with, or provide services to:
(4) how the affected community is disproportionately impacted by environmental
harms and risks/climate change;and
(5) how the affected community will benefit from your project's intended local
environmental, public health and climate change (if applicable) results.
You must include relevant information such as demographics, geographic location,
and community history.
Orqanization's Historical Connection to Affected Community. You will be
evaluated on your ability to demonstrate a strong connection between your
organization and the affected community. In scoring this section, reviewers will
consider the strength of the organization's historical involvement with the affected
community and the on-going communications between you and the affected
community residents and/or organizations. In addition, reviewers will consider the
extent of the affected community's active participation in the project and in the
decision-making process. This will be determined through your description of the
following areas (Maximum of 3 points each):
(1) history of your organization's involvement with the affected community, including
duration of involvement and circumstances that led to your involvement;
(2) how you have worked with the affected community's residents and/or organizations
to address local environmental and public health issues;
(3) how the affected community's residents and/or organizations are part of the
decision-making process;
(4) how your efforts have led to increased capacity on the part of local community-
based organizations to address local environmental and public health issues; and
(5) how you maintain and sustain an ongoing relationship with the affected
community's residents and/or organizations.
Project Description. You will be evaluated on your ability to describe the activities
the project will undertake to examine and address the environmental and public health
issue(s) and how you and your partner(s) will work together to address the local
environmental and public health issue(s). The reviewers will give more consideration
Maximum Points
per Criterion
15 points total
15 points total
25 points
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to a description that is focused, succinct rather than one that tries to address too many
issues. You will be evaluated on the clarity of your write-up in addressing the following
areas (Maximum of 5 points each):
(1) the local environmental and public health (including climate change if applicable)
results your projects seeks to achieve;
(2) how your project will achieve these results;
(3) The role of your partners) in addressing the local issue(s) and how you plan to
maintain and sustain the partnerships;
(4) The nature of the organization, what resources it brings to the partnership, how it
has a vested interest in working with this partnership [other than just getting income],
commitments made, and specific activities it will be responsible for; and
(5). How your project is related to the environmental statutes you identified in your
Threshold Eligibility Form.
Organizational Capacity and Programmatic Capability. You will be evaluated on
your ability to demonstrate how your organization has the organizational capacity and
programmatic capability to undertake this project. This will be determined through
your description of your past performance in successfully completing and managing
assistance agreements similar in size, scope, and relevance to the proposed project
performed within the last 5 years, your history of meeting reporting requirements under
these agreements, and how you plan to effectively manage and successfully complete
this proposed project .organizational experience and plan for timely and successfully
achieving the objectives of the proposed project, and (iv) staff expertise/qualifications,
staff knowledge, and resources or the ability to obtain them, to successfully achieve
the goals of the proposed project.. In evaluating your organization for programmatic
capability purposes under this criterion, OEJ will consider information provided by you
and may consider information from other sources, including Agency files. Applicants
who have no relevant or available past performance reporting must indicate this
in the narrative and will receive a neutral score for this factor. A neutral score in
this case is 5 points. Failure to do so will result in receiving a score of 0 for this
element.
10 points total
Qualifications of Principal Investigator/Project Manager. You will be evaluated on
your ability to clearly demonstrate that the PI/PM selected to lead this project is the
most qualified. This will be determined through your description of the following:
(1) why the PI/PM is qualified to undertake the project; (2 points)
(2) how the PI/PM has ties to the community and/or organization; and (6 points)
(3) past activities that the PI/PM has worked on with the community. (2 points)
10 points total
Past Performance in Reporting on Outputs and Outcomes. Under this criterion,
applicants will be evaluated on how well you have demonstrated prior experience in
reporting outputs and outcomes. This will be determined through your description of
how you have documented and/or reported on progress towards achieving the
expected outputs and outcomes under prior and/or current assistance agreements,
and if you did not make such progress towards achieving the expected outputs and
outcomes, whether the documentation and/or reports satisfactorily explain why not.
Note: In evaluating applicants under this criterion, the Agency will consider the
information provided by the applicant and may also consider relevant information from
other sources including agency files and prior/current grantors (e.g., to verify and/or
supplement the information supplied by the applicant). If you do not have any
relevant or available past performance or past reporting information, please
indicate this in the proposal and you will receive a neutral score for these
subfactors (a neutral score is half of the total points available in a subset of
possible points). If you do not provide any response for these items, you may
receive a score of 0 for these factors.
5 points total
Detailed Budget. You will be evaluated on the reasonableness of the costs and how
the budget relates to the activities under the project. You will receive a score of "zero"
for this criterion if you include costs that are restricted under Section IV. B "Workplan
5 points total
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(Detailed Budget)."
Project Performance Measures/Milestones. You will be evaluated on vour ability to
formulate concrete, well-developed performance measures on a semi-annual and
annual basis. Performance measures are ways to determine whether or not your
project meets your target. Measures should relate directly to the local climate change
(if applicable) and environmental and public health results your projects seeks to
achieve. You will be evaluated on your approach for determining how and whether
progress is made in achieving the expected project outcomes and outputs.
Total Maximum Points Available
15 points total
100
B REVIEW AND SELECTION PROCESS
All applications will be reviewed and scored under a two-step process.
1) Threshold Screening Process - All applications will be screened for Threshold Eligibility (see
Section III. B) at EPA headquarters. EPA staff will screen all applications using the One-Page
Threshold Eligibility Form found in Appendix A.
2) Panel Review Process - All applications believed to successfully meet the Threshold
Eligibility after the initial review will be forwarded to the appropriate EPA Region. For a listing
of EPA's ten regions and the states that they serve, go to Section VII. Each Region will
convene a panel to review, score and rank the applications based on the Ranking Criteria
(see Section V. A. 2) published in this RFA. Applications will not be scored against any
unpublished criteria. After the individual projects are reviewed, scored and ranked, the
regional official will make the final selection. EPA reserves the right to reject all applications
and make no awards under this announcement.
C. ANTICIPATED ANNOUNCEMENTS AND AWARD DATES
Below is a tentative schedule of important dates for the EJSG Program. Please note dates are
subject to change.
Date
October 28, 2009
October 28 -January 08,
2010
January 08, 2010
January 08-12, 2010
January 13-15, 2010
January 15-30, 200
January 15, 2010-
February 28, 2010
March 1,2010
May 2010
Activity
EJSG Program is announced and published.
Eligible applicants develop, complete and submit their applications.
Applications must be date-stamped by courier service, postmarked by
U.S. Postal Service, or submitted through Grants.gov by 1 1 :59pm, Dec.
15, 2008. Applications received after this date will not be reviewed.
Staff at EPA headquarters will review applications for Threshold
Eligibility Criteria.
Letters to ineligible applicants will be sent. Letters will provide brief
explanations on the reason(s) for ineligibility.
Ineligible applicants must request a debriefing by midnight, January 30,
2010
EPA Review Panel reviews, scores, and ranks all eligible applications.
The EPA Regional Selection Official will make the final selections for
awards. All applicants will be notified of the selection results by mail.
The Director of EPA's Office of Environmental Justice will release a
national announcement of the recipients.
SECTION VI - AWARD ADMINISTRATION INFORMATION
A. AWARD NOTICES
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After all applications are received, acknowledgments will be mailed to applicants. Once
applications have been recommended for funding, EPA will notify the finalists and request any
additional information necessary to complete the award process. The finalists will be required to
complete additional government application forms prior to receiving a grant, such as the EPA
Form SF-424B (Assurances - Non-Construction Programs). The Federal government requires all
grantees to certify and assure that they will comply with all applicable Federal laws, regulations,
and requirements.
B. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS
A listing and description of general EPA regulations applicable to the award of assistance
agreements may be viewed at: http://www.epa.gov/ogd/grants/regulations.htm.
C. REPORTING
1) Progress Report - The Project Manager/Principal Investigator will be required to submit at
least a semi-annual progress report to update the EPA Regional Project Officer on the project's
progress.
2) Final Report Requirement - The Project Manager/Principal Investigator must submit a Final
Technical Report for EPA approval within ninety (90) days after the end of the project period.
A draft of this report should be submitted within sixty (60) days after the end of the project
period. A Financial Status Report is also required and will be described in the award
agreement. The EPA may collect, review, and disseminate those final reports that can serve
as models for future projects.
D. DISPUTE RESOLUTION
Any applicant deemed ineligible because its application did not meet the conditions required
under the Threshold Eligibility Criteria (see Section III. B and Section V. A. 1.) will be notified of
the reason for ineligibility no later than 15 calendar days from the date of completion of the
Threshold Eligibility Review. The applicant will have 15 calendar days from the date of the
notification to request a debriefing on the decision. Responses can be sent via e-mail, postal, or
courier but must be dated within the 15 calendar day period for dispute resolution.
Assistance agreement competition-related disputes will be resolved in accordance with the
dispute resolution procedures published in 70 FR (Federal Register) 3629, 3630 (January 26,
2005) which can be found at http://www.epa.gov/ogd/competition/resolution.htm. Copies of these
procedures may also be requested by contacting Sheila Lewis at (202) 564-0152 or
lewis.sheila@epa.gov.
E. DATA ACCESS AND INFORMATION RELEASE
The Office of Management and Budget (OMB) Circular A-110 has been revised to provide public
access to research data through the Freedom of Information Act (FOIA) under some
circumstances. Data that are (1) first produced in a project that is supported in whole or in part
with Federal funds and (2) cited publicly and officially by a Federal agency in support of an action
that has the force and effect of law (i.e., a regulation) may be accessed through FOIA. If such
data is requested by the public, the EPA must ask for it, and the grantee must submit it, in
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Office of Environmental Justice Small Grants Program -Application Guidance FY 2010
accordance with A-110 and EPA regulations at 40 C.F.R. 30.36.
F. NON-PROFIT AWARD ADMINISTRATIVE CAPABILITY
Non-profit applicants that are recommended for funding under this announcement are subject to
pre-award administrative capability reviews consistent with Section 8b, 8c and 9d of EPA Order
5700.8 - Policy on Assessing Capabilities of Non-Profit Applicants for Managing Assistance
Awards (http://www.epa.gov/ogd/grants/award/5700 8.pdf). In addition, non-profit applicants that
qualify for funding, depending on the size of the award, may be required to fill out and submit to
the Grants Management Office the Administrative Capabilities Form with supporting documents
contained in Appendix A of EPA Order 5700.8.
SECTION VII - AGENCY CONTACTS
For further information about this grant program, please contact the following:
Courier/Delivered Address
U.S. Postal Service Address
Sheila Lewis
U.S. EPA/Office of Environmental Justice
1200 Pennsylvania Avenue NW, Room 2232E
Washington, DC 20004
Phone: 202-564-0152
E-Mail: lewis.sheila@epa.gov
Sheila Lewis
U.S. EPA/Office of Environmental Justice
Mail Code 2201A
Washington, DC 20460
Phone: 202-564-0152
E-Mail: lewis.sheila@epa.gov
SEND YOUR APPLICATION TO MS. LEWIS AT THE ABOVE ADDRESS.
The names below reflect the contact person in each region and the states for which the region
serves.
Region
Contact Information
Region I:
Connecticut
Maine
Massachusetts
New Hampshire
Rhode Island
Vermont
USEPA Region 1 (RAA)
One Congress Street - 11th Floor
Boston, MA 02203-0001
Primary Contact:
AmyBraz (617)918-1346
Braz.amy @epa.gov
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Office of Environmental Justice Small Grants Program -Application Guidance FY 2010
Region 2:
New Jersey
New York
Puerto Rico
U.S. Virgin Islands
USEPA Region 2
290 Broadway, 26th Floor
New York, NY 1007
Primary Contact:
Terry Wesley (212) 637-5027
Weslev.terrv@epa.gov
Secondary Contact:
Tasha Frazier (212) 637-3861
Frazier.tasha@epa.gov
Region 3:
Delaware
District of Columbia
Maryland
Pennsylvania
Virginia
West Virginia
USEPA Region 3 (3DAOO)
1650 Arch Street
Philadelphia, PA 19103-2029
Primary Contact:
Reginald Harris (215) 814-2988
Harris.reggie@epa.gov
Region 4:
Alabama
Florida
Georgia
Kentucky
Mississippi
North Carolina
South Carolina
Tennessee
USEPA Region 4
61 Forsyth Street
Atlanta, GA 30303-8960
Primary Contact:
Elvie Barlow (404) 562-9650
Barlow.elvie@epa.gov
Secondary Contact:
Ella Mclendon (404) 562-8316
Mclendon.ella@epa.gov
Region 5:
Illinois
Indiana
Michigan
Minnesota
Ohio
Wisconsin
USEPA Region 5 (DM7J)
77 West Jackson Boulevard
Chicago, IL 60604-3507
Primary Contact:
Margaret Millard (312) 353-1440
Millard.margaret@epa.gov
Region 6:
Arkansas
Louisiana
New Mexico
Oklahoma
Texas
USEPA Region 6
Fountain Place, 13th Floor
1445 Ross Avenue (RA-D)
Primary Contact:
Shirley Quinones (214) 665-2713
Quinones.shirley@epa.gov
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Office of Environmental Justice Small Grants Program -Application Guidance FY 2010
Region 7:
Iowa
Kansas
Missouri
Nebraska
USEPA Region 7
901 North 5th Street (RGAD/ECO)
Kansas City, KS 66101
Primary Contact:
Althea Moses (913) 551-7649
Moses.althea@epa.gov
Secondary Contact:
Kimberly Jones (913) 551-7280
iones.kimberly@epa.gov
Region 8:
Colorado
Montana
North Dakota
South Dakota
Utah
Wyoming
USEPA Region 8 (8ENF-EJ)
1595 Wynkoop
Denver, CO 80202-2466
Primary Contact:
Nancy Reish (303) 312-6040
Reish.nancv@epa.gov
Secondary Contact:
Jean Belille (303) 312-6556
Belille.iean@epa.gov
Region 9:
Arizona
California
Hawaii
Nevada
American Samoa
Guam
USEPA Region 9 CED-1
75 Hawthorne Street
San Francisco, CA 94105
Primary Contact:
Karen Henry (415) 972-3844
Henrv.karen@epa.gov
Region 10:
Alaska
Idaho
Oregon
Washington
USEPA Region 10 (CRE-164)
1200 Sixth Avenue
Seattle, WA 98101
Primary Contact:
Running Grass (206)553-2899
Grass.running@epa.gov
SECTION VIM - OTHER INFORMATION
See Appendices
-26-
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APPENDIX A
EJSG One-page Threshold Eligibility Form
This form will be used to determine if you meet all the eligibility requirements. You must address
the following areas:
1) Applicant Eligibility.
501(c)(3) non-profit organization as designated by the Internal Revenue Service OR a non-profit
organization, recognized by the state, territory, commonwealth, or tribe in which we are located . n
City, township, county government and their entities n
Native American tribal government (Federally recognized) n
My organization is located within the same state, territory, commonwealth, or tribe that the
proposed project will be located n
Please specify where the project is located:
State Territory Commonwealth Tribe
My organization is not an ineligible entity (See Section III.A) n
My organization has worked directly with, or provided services to, the affected community as
demonstrated in the work plan n
2) Qualified Environmental Statutes. Below is a list of qualified environmental statutes. You
must have two or more qualified environmental statutes associated with your project.
Please check the applicable boxes.
• Clean Water Act, Section 104(b) (3) n
• Safe Drinking Water Act, Section 1442(c)(3)(C) n
• Solid Waste Disposal Act, Section 8001 (a) n
• Clean Air Act, Section 103(b) (3) n
• Toxic Substances Control Act, Section 10(a) n
• Federal Insecticide, Fungicide, and Rodenticide Act, Section 20(a) n
• Marine Protection, Research, and Sanctuaries Act, Section 203 n
3) Required Documents. Use this checklist to ensure that you have submitted all required
documents. You must submit all the items below. Please check each box upon completing
each form.
• One-Page Threshold Eligibility Form n
• SF-424, Application for Federal Assistance (Form in Appendix B) n
• Key Contacts Form (Form in Appendix C) n
• Workplan (Optional template in Appendix D) n
• Detailed Budget (Optional template and example in Appendices E and F) n
• Performance Measures (Optional template and example in Appendices G and H) n
• Resumes of the PI/PM and Other Key Personnel n
• Quality Assurance Project Plan Questionnaire (Appendix I) n
• Proof of Nonprofit Status n
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APPENDIX B
OMB Number: 4040-0004
Expiration Date: 01/31/2009
Application for Federal Assistance SF-424
Version 02
*1. Type of Submission:
D Preapplication
D Application
HH Changed/Corrected Application
*2. Type of Application * If Revision, select appropriate letter(s)
D New
D Continuation *Other (Specify)
n Revision
3. Date Received: 4. Applicant Identifier:
5a. Federal Entity Identifier:
*5b. Federal Award Identifier:
State Use Only:
6. Date Received by State:
7. State Application Identifier:
8. APPLICANT INFORMATION:
*a. Legal Name:
*b. Employer/Taxpayer Identification Number (EIN/TIN):
*c. Organizational DUNS:
d. Address:
*Street 1:
Street 2:
*City:
County:
*State:
Province:
*Country:
*Zip / Postal Code
e. Organizational Unit:
Department Name:
Division Name:
f. Name and contact information of person to be contacted on matters involving this application:
Prefix:
*First Name:
Middle Name:.
*Last Name:
Suffix:
Title:
Organizational Affiliation:
Telephone Number:
*Email:
Fax Number:
Page Iof6
-------
OMB Number: 4040-0004
Expiration Date: 01/31/2009
Application for Federal Assistance SF-424 Version 02
*9. Type of Applicant 1: Select Applicant Type:
Type of Applicant 2: Select Applicant Type:
Type of Applicant 3: Select Applicant Type:
"Other (Specify)
"10 Name of Federal Agency:
11. Catalog of Federal Domestic Assistance Number:
CFDA Title:
*12 Funding Opportunity Number:
*Title:
13. Competition Identification Number:
Title:
14. Areas Affected by Project (Cities, Counties, States, etc.):
*15. Descriptive Title of Applicant's Project:
Page 2 of 6
-------
OMB Number: 4040-0004
Expiration Date: 01/31/2009
Application for Federal Assistance SF-424
Version 02
16. Congressional Districts Of:
*a. Applicant: *b. Program/Project:
17. Proposed Project:
*a. Start Date:
*b. End Date:
18. Estimated Funding ($):
*a. Federal
*b. Applicant
*c. State
*d. Local
*e. Other
*f. Program Income
*g. TOTAL
*19. Is Application Subject to Review By State Under Executive Order 12372 Process?
D a. This application was made available to the State under the Executive Order 12372 Process for review on .
D b. Program is subject to E.O. 12372 but has not been selected by the State for review.
D c. Program is not covered by E. O. 12372
*20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes", provide explanation.)
D Yes D No
21. *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements
herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to comply
with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject
me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001)
D ** I AGREE
** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or
agency specific instructions
Authorized Representative:
Prefix:
*First Name:
Middle Name:
*Last Name:_
Suffix:
*Title:
*Telephone Number:
Fax Number:
Email:
*Signature of Authorized Representative:
*Date Signed:
Authorized for Local Reproduction
Standard Form 424 (Revised 10/2005)
Prescribed by OMB Circular A-102
Page 3 of 6
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OMB Number: 4040-0004
Expiration Date: 01/31/2009
Application for Federal Assistance SF-424 Version 02
'Applicant Federal Debt Delinquency Explanation
The following should contain an explanation if the Applicant organization is delinquent of any Federal Debt.
Page 4 of 6
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INSTRUCTIONS FOR THE SF-424
Public reporting burden for this co ection of information is estimatec to average 80 IT, notes per response, including trie to* reviewr-g nstructions, sesrc-h r\g
existing data sources, gathering and maintaining the data needed, anc competing and revetting the eollecticf of informal or. Send comments regarding fre
ixirden estinate or any otter aspect of this GO lection of infornalion. including suggestions for reducing this tureen, to the Office of Management ana Budget,
Paperwork Reaction Project (0348-0043), Washington. DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET SEND IT TO THE ADDRESS PROVIDED
BY THE SPONSORING AGENCY.
This is a snuidajd form (including the coarinaatiac sheer.) required for use as a cover sheet for submission of pre&pphcaaous and appUcsnoM aad
related infonnation ucder discretionary programs. Some of the items are required and iome are optional at the discretion of the applicant or the Federal
agency (agency). Required items are identified with ac asterisk OK the form and are specified hi the instructions below. la addition to the instructions
provided betom'. applicants must consul; agency invtnsctians to teenaiae specific requirements
ken
1.
^
3.
4.
5a
5b.
g.
7.
6.
Entry:
Type of Submission: ;Requ rec): Select one type of subrniss on in
accordance with agency rstructions.
• Preapplicalicn
• Ape cation
» Changed.'Correded Applicator - If requested by the agency, check
i? this submission s to change or correct a prevously submitted
aps- cation. Unless requestec by the agency. applicants may not
use this to submit changes after the closing date.
Type of Application: (Required) Select one type of application in
accordance with agency r-structions.
» New - An application t*at is being sac-mittee to an agency for the
first time.
• Cont nuaton - An extens on for an acditcnai funding/budge: period
for a prc.ect with a projected camp etion date. ~">! s cap include
renewals.
» Revsicn -Any change rt the Fede'3 Government's franca
cb galicf or contingent lability from an existing obligation, f a
revison, enter the appropriate etterisi. Moretfian cne may be
selected. If ''Other" is selectee, please specfy in text box prov oed.
A Increase Award 3. Decrease Aware
C. Increase Duraton D Decrease Durat on
E. Other ['specify;
Date Received: Leave tin is fee blank. This date will be assigned fay frig
Fedes'a agency.
Applicant Identifier: Enter the entity identif er assgrred fey the Federal
agency, if arty, or appi cant'5 control number, if ape- cab e.
Federal Entity Identifier: Enter the number assigned to your
organization by the Federal Agency, if any.
Federal Award Identifier: For new applicators leave blank. Fora
continuation or revison to an existing award, enter the previous, y
assigned Federal award identif e>' number f a changei'correctec
application, enter Vs Federal Identifier in accordance witn agency
nstructicns.
Date Received by State: Leave this f eld &ank. This date wi be
assigned by the State, if applicable.
State .Application Identifier: Leave this ;ield blank. ~hs denffier w
be assgned fry the State, if applicable.
Applicant Information: Enter the following n accoroance wth agency
nstructicns:
a. Legal Name: (Requires): Enter the egal name of ape cant that will
undertake tie ass stance actvity. This is the nane that fe ergs- nation
has registered witr the Central Ccntraetcr Registry. In'orratc" on
registering wth CCR may be obtained bvv siting the G'ants aov websie
b. EmploywiTaxpayer Numbw (EINfTIN): (Required; E-lert"e
tnp oyer or Taxpayer denticaton Number ;t!N or TIN 1 as assigned by
the Intema Revenue Service. If your crganizatici is net -. tr.e JS, e,°ter
444444444.
e. Organizational DUNS: (Required) Enter the organizaton's DUNS or
DUNS+4 number received from Dun and B^adstreet. Infornaticn on
obta n ng a DUNS "unber may be obtained by vsitng the Grants.gov
website.
d. Address: Enter the complete address as follows: Street address ;_ne
1 neo-j red). City ;Requ rec). County, State (.Required., f country is USi,
Prov nee. Country ('Required';. Zip/Postai Cose (Requires, if c«"1ry s
us;.
e. Organizational Unit: Enter the name of the primary organ zational
unit (and department or cMsion. if apc-iica&el that will undertake the
tern
10.
11.
12.
13.
14.
15.
16.
17.
13.
19.
Entry:
Name Of Federal Agency: ('Required; Enter the fane of the
Federal agency from til oh assistance s being requestec with
this application.
Catalog Of Fedecal Domestic Assistance NumberfTitle:
Enter the Catalog of Federa Conest c Assistance mincer anc
title of the program, uncer which ass stance is recyested, as
found in the program announcement, '' ape sab e.
Funding Opportunity Number/Title: ;Req:j red) Enter the
Funding Opportunity Number and ttle of Ire opportunity under
which assistance is requested, as found in the program
annojncement.
Competition Identification Number/Title: Enter fre
C-orpc«1ition Identification Number and title of the competition
unde' which ass stance is requested, i* app cab e.
Areas Affected By Project: List the areas or entities using
the categories (e.g., cities, cc^lies, states, etc.) seec.fied in
agency instructions. Use the continuation sheet to enter
add tional areas, if neecec.
Descriptive Title of Applicant's Project: ;Requ ,'edi Enter a
brief Descriptive ttle of t/ie prc.ect. f appropriate, atacft a
map shewing project location (e.g., construction e»r rea
prcjoerty projects). Fcr preapp cations, attach a summary
desc'C'tic"1 of the projeci.
Congressional Districts Of: (Required; 16a. Enter the
app cant's Congressional District, anc 18&. Enter ali D stric.t(s)
affected by the program or prqecc. Enter in tie format: 2
characters State Abbrevaticr - S characters Distrct Nurrcer,
e g.. CA-OC5 for Cali'ornia 5"" distrct. CA-C'1 2 for Ca fornia 12*1
distrct, NC-103 fa' North Carolina's 103"1 o strict
« If a congresi ortal disfrcts in a state are affesed, enter
"all" for the disfct number e.g , MD-all fo' all
congressional distncts in Mar/ and.
• If nationwide, .e. ai districts within all states are affected,
enter US-all
• If the program.'project s outside the US, enter CC-OOD.
Proposed Project Start and End Dates: (Recuired; Enter the
proposed start date and end cate of the pro ea.
Estimated Funding: (Requires ) Enter the amount requested
or to be contributed during the frst funding.'budget period by-
each contributor. Value of in-kind contributions should be
included on appropriate nes, as applicable f t?ie act:Cfi will
result in a collar change to an existing aware, ndicaie only the
amount cf the change. For decreases, encose fre amounts in
parentheses.
Is Application Subject to Review by Slat* Under Executive
Order 12372 Process? App cants should contact the State
Singe Point of Contact (SPOC) for Fecerai Exeeutve Order
12372 to determine wether fre application is sucect to the
Page 5 of 6
-------
8.
assistance activity, -f applicable.
f. Nam* and contact information of person to b* contacted on
matters involving this application: Enter t^e name (F nt and last name
required';, organizaticna affiliation fif affiliated with an organization other
than t*w app cant organization), telephone number (Required;, fax
n unbar, and ena. address (Required) cf'the person to contact on
matters related to this application.
Type of App cant: (Required;
Select up to three applicant type-is! in accordance wiBi agency
rtst ructions.
A. State Government
B. County Government
C. City or Township Government
0- Special D strict Government
E. Regional Organ zatton
F, U.S. "err lory cr Possession
G. ndepenoerrt School District
H. Pub e/Staie Ccmrellec
nstituticfi of Higher Education
1 ndian/NatitfB American Triba
Government (Federa y
Reoognizeo)
J. ndianVNalive American Triba
Government (Other than
Federally Recognized)
K. ndianYNaiive American
Tribally Desgnated
Organisation
L. P-jfe Cilnc-an Housing
Authority
M. Nonproft with HHC3 IRS
Status -lOther than Institutes
of Higher Education )
N. Nonproft without 5C1C3 IRS
Status iOther than Instituton
of Higher Educatiofi J
0 . Private In strtulion of H -gher
Educaton
P, ificiwQyal
Q . For-Prof t Drganizaton
(Other than Small 9ysin*ss)
R. Small Business
S. Hspano-servng nslitutio™
T. H storically Black Co eges
and Unversites (HBCUs;
U. Tr bally Confro led Colleges
and Unversrtes f~CCUs)
V. Alaska Native and Natve
Hawai a« Seeing Institutions
W. Non-domescic (non-JS'l
Entity
X. Other ispecify)
20.
21.
State intergovernmenta review process- Se ea the
appropriate box. If 'a." s se eeted, enter the date the
app cation was submitted to tine Stats
is the Applicant Delinquent o
-------
APPENDIX C
Form Approved OMB No:2030-0020 Approval Expires 12/3/02
<>EPA
KEY CONTACTS FORM
Authorized Representative: Original awards and amendments will be sent to this individual for
review and acceptance, unless otherwise indicated.
Name:
Title:
Complete Address:
Phone Number
Payee: Individual authorized to accept payments.
Name:
Title:
Mail Address:
Phone Number:
Administrative Contact: Individual from Sponsored Program Office to contact concerning
administrative matters (i.e., indirect cost rate computation, rebudgeting requests etc.)
Name:
Title:
Mailing Address:
Phone Number:
FAX Number:
E-Mail Address:
Principal Investigator: Individual responsible for the technical completion of the proposed
work.
Name:
Title:
Mailing Address:
Phone Number:
FAX Number:
E-Mail Address:
Web URL:
EPA Form 5700-54 (Rev 4-02)
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APPENDIX D
EJSG Workplan Template (Optional)
A. Project Title and Project Purpose Statement (approximately 1/2 page)
[ADD NARRATIVE HERE]
B. Past Performance in Reporting on Outputs and Outcomes
(approximately 1/2 page)
[ADD NARRATIVE HERE]
C. Affected Community and Environmental and Public Health Information
(approximately 2 pages)
[ADD NARRATIVE HERE]
D. Organization's Historical Connection to Affected Community
(approximately 1 page)
[ADD NARRATIVE HERE]
E. Organizational Capacity and Programmatic Capability (approximately 1/2 page)
[ADD NARRATIVE HERE]
F. Project Description (approximately 4 to 5 pages)
[ADD NARRATIVE HERE]
G. Qualifications of the Principal Investigator or Project Manager
(approximately 1 page)
[ADD NARRATIVE HERE]
H. Quality Assurance Project Plan (QAPP) Information (approximately 1-2 sentences)
[ADD NARRATIVE HERE]
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APPENDIX E
EJSG Budget Detail Template (Optional)
Personnel
Fringe Benefits
Travel
Equipment
Supplies
Contractual
Construction
Other
Description
Total
$25,000
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APPENDIX F
EJSG Detailed Budget Example
Description
Total
Personnel
Project Manager @ $30,000 annual
salary X 10% of time on project =
$3,000 per year
Outreach worker @ $25,000 annual
salary X 20% of time on project =
$5,000
Community support leader @
$20,000 annual salary X 15% =
$3,000
$11,000
Fringe Benefits
Project Manager 15% of salary
(includes medical, dental, life
insurance) = $450 per year
Outreach worker 10% of salary
(includes medical, dental, life
insurance) = $500
Community support leader 10% of
salary (includes medical, dental, life
insurance) = $500
$1,250
Travel
Local mileage for Project Manager for
partner meetings: 25 miles @
$0.30/mi. X 16 meetings = $120.00
Local mileage for Outreach worker for
community outreach efforts: 10 miles
@ $0.30/mi. X 30 times X 12 months
= $1,080
Travel to 2 regional seminars: Per
diem - $30 per day X 2 days = $60;
Airfare = $1,360
$2,560.00
Equipment (purchase
greater than $5,000)
None
$0
Supplies
20 reams of copy paper @ $4.00 for
outreach materials = $80
Laptop computer for Outreach worker
to work off-site on community $1,500
Miscellaneous supplies for staff on
this project = $1,500
$3,080
Contractual
Bookkeeper/Accountant $10/hr @ 3
hrs/week @ 52 weeks = $1,560
$1,560
Construction
None
Other
Sub-grant = $4,050
Outreach materials/Postage = $1,500
$5,550
$25,000
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Appendix G
EJSG Logic Model Template for Performance Measures/Milestones
PROJECT TITLE:
Semi-Annual
(six months after
beginning of
project)
Resources/Inputs
Activities
Outputs
Outcomes
Annual
fat tha and nf
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Appendix H
Sample of Performance Measures/Milestones
Creating Partnerships to Develop Inter-agency Air Quality Guidance
Semi-Annual
(six months after
beginning of
project)
Annual
(at the end of
the project)
Resources/Inputs
Staff time
In-kind contributions
Additional grants
Volunteers
Partnering
Organizations
Staff time
In-kind contributions
Additional grants
Volunteers
Partnering
Organizations
Activities
• Identify potential partners
in city, county, state
government, public health
office, universities to draft
and implement air quality
guidance
• Partner meetings to
discuss how to formulate
an interagency air quality
guidance
• Conduct door knocking to
solicit resident support and
input
• Generate report and
brochures on air quality
data
Outputs
Developing a
comprehensive
understanding
8 meetings on quarterly
basis to formulate air
quality guidance
Draft air quality guidance
Educating the
Community
Create one report on the
status of air quality, 4
brochures on specific
neighborhood data
Reach 250 residents in
community through door
knocking
Disseminate report and
brochures to 250 residents
Outcomes
Creating Partnerships
Increase # of various
stakeholders participating to
address issues concerning air
quality
Educating the Community
Increase in # of stakeholders
who are informed of the
immediate impacts of poor air
quality in target community
Increase in # of residents who
participate in the partner
meetings
Educating the Community
Increase in # of residents aware
of air quality issues in
community
Increase in # of residents
actively participating in the
project
Improved air quality
Page 1 of 2
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Sample of Performance Measures/Milestones
Diesel Best Practices Manual
Semi-Annual
(six months after
beginning of
project)
Annual
(at the end of
the project)
Resources/Inputs
Staff time
In-kind contributions
Additional grants
Volunteers
Partnering
Organizations
Staff time
In-kind contributions
Additional grants
Volunteers
Partnering
Organizations
Activities
• Identify potential partners
in city, county, state
government, public health
office, universities to draft
and implement air quality
guidance
• Partner meetings to
discuss how to formulate
an interagency air quality
guidance
• Conduct door knocking to
solicit resident support and
input
• Generate report and
brochures on air quality
data
Outputs
Developing a
comprehensive
understanding
8 meetings on quarterly
basis to formulate
guidance
Draft diesel best practices
guidance
Educating the
Community
Create manual and 4
brochures on specific
neighborhood data
Reach xx of stakeholder in
community through ...
Disseminate manual and
brochures to xx operators.
Outcomes
Creating Partnerships
Increase # of operators
participating to address issues
concerning diesel best
practices and air quality
Educating the Community
Increase in # of stakeholders
who are informed of the
immediate impacts of diesel
reduction and poor air quality in
target community
Increase in # of operators and
stakeholders who participate in
the partner meetings
Educating the Community
Increase in # of operators
aware of air quality issues in
community
Increase in # of operators
actively participating in the
project
Improved air quality and
reduction of greenhouse gases
Climate Change co-benefit:
greenhouse gases
reduction of co-pollutants produced concurrent with
Page 2 of 2
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APPENDIX I
Office of Environmental Justice
Quality Assurance Project Plan Requirement (QAPP)
Check Yes or No for each of the items provided below as it applies to your specific project.
1. Your project will involve the collection of groundwater, soil, sediment, surface water, air, biota or fauna
samples for chemical or biological analysis.
Yes D No D
2. Your project will use existing computer databases containing analytical data or personal information
previously collected.
Yes D No D
3. Your project will use existing historical research pertaining to this project or proposal.
Yes D No D
4. Your project will implement deed searches for current property or site.
Yes D No D
5. Your project will conduct medical records search for the population covered in the grant.
Yes D No D
6. Your project will compile meteorological data to determine weather trends or air mixing trends.
Yes D No D
7. Your project will use existing statistical studies or will conduct these studies as part of the project.
Yes D No D
8. Your project will create a new database based on the information gathered.
Yes D No D
9. Your project will use this information for litigation purposes.
Yes D No D
10. Your project will use this information to make recommendations on environmental decisions.
Yes D No D
If you answered Yes to any of the items listed above, you ARE REQUIRED TO SUBMIT a
Quality Assurance Project Plan in accordance with EPA Requirements and an approved QAPP
must be in place prior to the initiation of activities. You will be contacted with information on how to
prepare your QAPP. In the meantime you can visit the website
http://www.epa.gov/ogd/grants/assurance.htm which provides guidance on what must be
submitted for grants/cooperative agreements.
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