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DR-4539 Hazard Mitigation Program
CITY OF 111g• � . et Nancy Backus,Mayor WAS H I NGTON 25 West Main Street * Auburn WA 98001-4998* wwwauburnwa.gov* 253-931-3000 November 2, 2020 Hazard Mitigation Program Washington Military Department Emergency Management Division RE: Match Commitment To Whom it May Concern: The purpose of this letter is to confirm the City of Auburn's intent to apply for state and/or federal funding for hazard mitigation assistance under DR-4539 HMGP, and the City's commitment to provide 12.5% local funds. These funds will be cash match from the City's water utility fund. Sincerely, ` bk. Nancy Ba4a Mayor NB/sf/as ENG-163-ELH, Revised 12/19 AUBURN * MORE THAN YOU IMAGINED Resolution Designating Applicant Agent For the state of Washington Hazard Mitigation Grant Program Application and Grant: Susan Fenhaus,Water Utility Engineer BE IT RESOLVED THAT (Print Name and Title) Lisa Tobin, Utilities Engineering Manager OR HIS/HER ALTERNATE (Print Name and Title) Is hereby authorized to execute for and on behalf of City of Auburn _,a local government entity,state agency,special purpose district,federally recognized tribe or private nonprofit organization established under the laws of the state of Washington,this application,grant agreement,and payment requests to be filed with the Military Department, Emergency Management Division,for the purpose of obtaining and administering certain state and federal financial assistance under Section 404 of the Robert T. Stafford Disaster Relief and Emergency Act of 1988, P.L. 93-288, as amended. THAT Nancy Backus hereby authorizes its agent to provide to the Washington Military Department, Emergency Management Division assurances and agreements required for all matters concerning such state disaster mitigation. Passed and approved this day of , 20 61404.4 - Nancy Backus, Mayor ignature "� Print Name and Title \CL *Note:Applicant agent designation is made by a mayor, county executive or governing board.An individual cannot designate himself/herself as the Applicant Agent. FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B.No.3067-0206 SUMMARY SHEET FOR ASSURANCES AND CERTIFICATIONS Expires February 28,2007 FOR CA FOR (Name of Applicant) FY City of Auburn This summary sheet includes Assurances and Certifications that must be read,signed,and submitted as a part of the Application for Federal Assistance. An applicant must check each item that they are certifying to: Part I ❑X FEMA Form 20-16A,Assurances-Nonconstruction Programs Part II EX FEMA Form 20-16B,Assurances-Construction Programs Part III ❑X FEMA Form 20-16C,Certifications Regarding Lobbying; Debarment,Suspension,and Other Responsibility Matters;and Drug-Free Workplace Requirements Part IV ID SF LLL,Disclosure of Lobbying Activities (If applicable) As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the identified attached assurances and certifications. Nancy Backus Mayor Typed Name of Authorized Representative Title 11 .$s ZD Sign of Authorized Representative Date Signed NOTE: By signing the certification regarding debarment,suspension,and other responsibility matters for primary covered transaction,the applicant agrees that,should the proposed covered transaction be entered into,it shall not knowingly enter into any lower tier covered transaction with a person who is debarred,suspended,declared ineligible,or voluntarily excluded from participation in this covered transaction,unless authorized by FEMA entering into this transaction. The applicant further agrees by submitting this application that it will include the clause titled "Certification Regarding Debarment,Suspension,Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction," provided by the FEMA Regional Office entering into this covered transaction,without modification,in all lower tier covered transactions and in all solicitations for lower tier covered transactions. (Refer to 44 CFR Part 17.) Paperwork Burden Disclosure Notice "Public reporting burden for this form is estimated to average 1.7 hours per response. Burden means the time,effort and financial resources expended by persons to generate,maintain,retain,disclose,or to provide information to us. You may send comments regarding the burden estimate or any aspect of the form, including suggestions for reducing the burden to: Information Collections Management, Federal Emergency Management Agency,500 C Street,SW,Washington, DC 20472, Paperwork Reduction Project(3067-0206). You are not required to respond to this collection of information unless a valid OMB control number appears in the upper right corner of this form. Please do not send your completed form to the above address. FEMA Form 20-16,FEB 01 • FEDERAL EMERGENCY MANAGEMENT AGENCY ASSURANCES-NON-CONSTRUCTION PROGRAMS Note: Certain of these assurances may not be applicable to your project or program. If you have any questions,please contact the awarding agency. Further,certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case,you will be notified. As the duly authorized representative of the applicant,I certify that the applicant: 1. Has the legal authority to apply for Federal assistance, alcohol abuse or alcoholism;(g)Sections 523 and 527 of and the institutional,managerial and financial capability the Public Health Service Act of 1912(42 U.S.C.290-dd-3 (including funds sufficient to pay the non-Federal share of and 290-ee-3),as amended,relating to confidentiality of project costs)to ensure proper planning,management and alcohol and drug abuse patient records;(h)Title VIII of the completion of the project described in this application. Civil Rights Acts of 1968(42 U.S.C.Section 3601 et seq.), as amended,relating to nondiscrimination in the sale, 2. Will give the awarding agency,the Comptroller rental or financing of housing;(i)any other General of the United States,and if appropriate,the State, nondiscrimination provisions in the specific statute(s) through any authorized representative,access to and the under which application for Federal assistance is being right to examine all records,books,papers,or documents made;and(j)the requirements of any other related to the award;and will establish a proper accounting nondiscrimination statute(s)which may apply to the system in accordance with generally accepted accounting application. standards or agency directives. 7. Will comply,or has already complied,with the 3. Will establish safeguards to prohibit employees from requirements of Title II and III of the Uniform using their positions for a purpose that constitutes or Relocation Assistance and Real Property Acquisition presents the appearance of personal gain. Policies Act of 1970(P.L.91-646)which provide for fair and equitable treatment of persons displaced or whose 4. Will initiate and complete the work within the property is acquired as a result of Federal or Federally applicable time frame after receipt of approval of the assisted programs. These requirements apply to all awarding agency. interest in real property acquired for project purposes regardless of Federal participation in purchases. 5. Will comply with the Intergovernmental Personnel Act of 1970(42 U.S.C.Section 4728-4763) relating to 8. Will comply with provisions of the Hatch Act(5 prescribed standards for merit systems for programs U.S.C.Sections 1501-1508 and 7324-7328)which limit funded under one of the nineteen statutes or regulations the political activities of employees whose principal specified in Appendix A of OPM's Standards for a Merit employment activities are funded in whole or in part System of Personnel Administration)5 C.F.R.900, with Federal funds. Subpart F). 9. Will comply,as applicable,with the provisions of 6. Will comply with all Federal statutes relating to the Davis-Bacon Act(40 U.S.C.Sections 276a to 276a- nondiscrimination. These include but are not limited to: 7),the Copeland Act(40 U.S.C.Section 276c and 18 (a)Title VI of the Civil Rights Act of 1964(P.L.88-352) U.S.C.Sections 874),and the Contract Work Hours which prohibits discrimination on the basis of race,color and Safety Standards Act(40 U.S.C.Sections 327-333), or national origin;(b)Title IX of the Education Amendments regarding labor standards for federally assisted of 1972,as amended(20 U.S.C.Sections 1681-1683,and construction subagreements. 1685-1686),which prohibits discrimination on the basis of sex;(c)Section 504 of the Rehabilitation Act of 1973,as 10. Will comply,if applicable,with flood insurance amended(29 U.S.C.Section 794),which prohibits purchase requirements of Section 102(a)of the Flood discrimination on the basis of handicaps;(d)the Age Disaster Protection Act of 1973(P.L.93-234)which Discrimination Act of 1975,as amended(42 U.S.C. requires recipients in a special flood hazard area to Sections 6101-6107),which prohibits discrimination on the participate in the program and to purchase flood basis of age;(e)the Drug Abuse Office and Treatment Act insurance if the total cost of insurable construction and of 1972(P.L.92-255),as amended,relating to acquisition is$10,000 or more. nondiscrimination on the basis of drug abuse;(f)the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970(P.L.91-616),as amended,relating to nondiscrimination on the basis of FEMA Form 20-16A,JUN 94 11. Will comply with environmental standards which may 14. Will comply with P.L.93-348 regarding the be prescribed pursuant to the following: (a)institution protection of human subjects involved in research, of environmental quality control measures under the development,and related activities supported by this National Environmental Policy Act of 1969(P.L.91-190) award of assistance. and Executive Order(EO) 11514;(b)notification of violating facilities pursuant to EO 11738;(c)protection of wetlands 15. Will comply with the Laboratory Animal Welfare Act pursuant to EO 11990;(d)evaluation of flood hazards in of 1966(P.L.89-544,as amended,7 U.S.C.2131 et seq.) floodplains in accordance with EO 11988;(e)assurance of pertaining to the care,handling,and treatment of warm project consistency with the approved State management blooded animals held for research,teaching,or other program developed under the Coastal Zone Management activities supported by this award of assistance. Act of 1972 (16 U.S.C.Section 1451 et seq.);(f)conformity of Federal actions to State(Clean Air)Implementation 16. Will comply with the Lead-Based Paint Poisoning Plans under Section 176(c)of the Clean Air Act of 1955, Prevention Act(42 U.S.C.Section 4801 et seq.)which as amended(42 U.S.C.Section 7401 et seq.);(g)protection prohibits the use of lead based paint in construction or of underground sources of drinking water under the Safe rehabilitation of residence structures. Drinking Water Act of 1974,as amended,(P.L.93-523); and(h)protection of endangered species under the 17. Will cause to be performed the required financial Endangered Species Act of 1973,as amended, and compliance audits in accordance with the Single (P.L.93-205). Audit Act of 1984. 12. Will comply with the Wild and Scenic Rivers Act of 18. Will comply with all applicable requirements of all 1968(16 U.S.C.Section 1271 et seq.)related to other Federal laws,executive orders,regulations and protecting components or potential components of policies governing this program. the national wild and scenic rivers system. 19. It will comply with the minimum wage and maximum 13. Will assist the awarding agency in assuring hours provisions of the Federal Fair Labor Standards compliance with Section 106 of the National Historic Act(29 U.S.C.201),as they apply to employees of Preservation Act of 1966,as amended(16 U.S.C.470), institutions of higher education,hospitals,and other EO 11593(identification and protection of historic non-profit organizations. properties),and the Archaeological and Historic Preservation Act of 1974(16 U.S.C.469a-1 et seq.). FEMA Form 20-16A(BACK) FEDERAL EMERGENCY MANAGEMENT AGENCY ASSURANCES-CONSTRUCTION PROGRAMS NOTE: Certain of these assurances may not be applicable to your project or program. If you have any questions,please contact the awarding agency. Further,certain Federal assistance awarding agencies may require applicants to certify to additional assurances. If such is the case,you will be notified. As the duly authorized representative of the applicant,I certify that the applicant: 1. Has the legal authority to apply for Federal assistance, 9. Will comply with the Lead-Based Paint Poisoning and the institutional,managerial and financial capability Prevention Act(42 U.S.C.Sections 4801 et seq.)which (including funds sufficient to pay the non-Federal share of prohibits the use of lead based paint in construction or project costs)to ensure proper planning,management and rehabilitation of residence structures. completion of the project described in this application. 10. Will comply with all Federal statutes relating to 2. Will give the awarding agency,the Comptroller non-discrimination. These include but are not limited to: General of the United States,and if appropriate,the State, (a)Title VI of the Civil Rights Act of 1964(P.L.88-352) through any authorized representative,access to and the which prohibits discrimination on the basis of race,color right to examine all records,books,papers,or documents or national origin;(b)Title IX of the Education Amendments related to the assistance;and will establish a proper of 1972,as amended(20 U.S.C.Sections 1681-1683,and accounting system in accordance with generally accepted 1685-1686),which prohibits discrimination on the basis of accounting standards or agency directives. sex;(c)Section 504 of the Rehabilitation Act of 1973,as amended(29 U.S.C.Section 794),which prohibits 3. Will not dispose of,modify the use of,or change the discrimination on the basis of handicaps;(d)the Age terms of the real property title,or other interest in the site Discrimination Act of 1975,as amended(42 U.S.C. and facilities without permission and instructions from Sections 6101-6107),which prohibits discrimination on the the awarding agency. Will record the Federal interest in basis of age;(e)the Drug Abuse Office and Treatment Act the title of real property in accordance with awarding of 1972(P.L.92-255),as amended,relating to agency directives and will include a covenant in the non-discrimination on the basis of drug abuse;(f)the title of real property acquired in whole or in part with Comprehensive Alcohol Abuse and Alcoholism Prevention, Federal assistance funds to assure nondiscrimination Treatment and Rehabilitation Act of 1970(P.L.91-616),as during the useful life of the project. amended,relating to non-discrimination on the basis of alcohol abuse or alcoholism;(g)Sections 523 and 527 of 4. Will comply with the requirements of the assistance the Public Health Service Act of 1912(42 U.S.C.290 dd-3 awarding agency with regard to the drafting,review and and 290 ee-3),as amended,relating to confidentiality of approval of construction plans and specifications. alcohol and drug abuse patient records;(h)Title VIII of the Civil Rights Acts of 1968(42 U.S.C.Section 3601 et seq.), 5. Will provide and maintain competent and adequate as amended,relating to non-discrimination in the sale,rental engineering supervision at the construction site to ensure or financing of housing;(i)any other non-discrimination that the complete work conforms with the approved plans provision in the specific statute(s)under which application and specifications and will furnish progress reports and for Federal assistance is being made; and(j)the such other information as may be required by the requirements of any other non-discrimination statute(s) assistance awarding agency or state. which may apply to the application. 6. Will initiate and complete the work within the applicable 11. Will comply,or has already complied,with the time frame after receipt of approval of the awarding agency. requirements of Title II and III of the Uniform Relocation Assistance and Real Property Acquisition 7. Will establish safeguards to prohibit employees from Policies Act of 1970(P.L.91-646)which provide for fair using their positions for a purpose that constitutes or and equitable treatment of persons displaced or whose presents the appearance of personal or organizational property is acquired as a result of Federal or Federally conflict of interest,or personal gain. assisted programs. These requirements apply to all interest in real property acquired for project purposes 8. Will comply with the Intergovernmental Personnel Act regardless of Federal participation in purchase. of 1970(42 U.S.C.Sections 4728-4763) relating to prescribed standards for merit systems for programs funded under one 12. Will comply with provisions of the Hatch Act(5 U.S.C. of the nineteen statutes or regulations specified in Sections 1501-1508 and 7324-7328)which limit the Appendix A of OPM's Standards for a Merit System of political activities of employees whose principal employment Personnel Administration(5 C.F.R.900,Subpart F). activities are funded in whole or in part with Federal funds. FEMA Form 20-16B,JUN 94 M 13. Will comply,as applicable,with the provisions of the 20. It will comply with the minimum wage and maximum Davis-Bacon Act(40 U.S.C.Sections 276a to 276a-7), hours provisions of the Federal Fair Labor Standards the Copeland Act(40 U.S.C.Section 276c and 18 U.S.C. Act(29 U.S.C.201),as they apply to employees of Section 874),the Contract Work Hours and Safety institutions of higher education,hospitals,and other Standards Act(40 U.S.C.Sections 327-333)regarding non-profit organizations. labor standards for federally assisted construction subagreements. 21. It will obtain approval by the appropriate Federal agency of the final working drawings and specifications 14. Will comply with the flood insurance purchase before the project is advertised or placed on the market requirements of Section 102(a)of the Flood Disaster for bidding;that it will construct the project,or cause it to Protection Act of 1973(P.L.93-234)which requires be constructed,to final completion in accordance with the recipients in a special flood hazard area to participate in application and approved plans and specifications; that it the program and to purchase flood insurance if the total will submit to the appropriate Federal agency for prior cost of insurable construction and acquisition is$10,000 approval changes that alter the cost of the project,use of or more. space,or functional layout,that it will not enter into a construction contract(s)for the project or undertake other 15. Will comply with environmental standards which may activities until the conditions of the construction grant be prescribed pursuant to the following: (a)institution program(s)have been met. of environmental quality control measures under the National Environmental Policy Act of 1969(P.L.91-190) 22. It will operate and maintain the facility in accordance and Executive Order(EO) 11514;(b)notification of violating with the minimum standards as may be required or facilities pursuant to EO 11738;(c)protection of wetlands prescribed by the applicable Federal,State,and local pursuant to EO 11990;(d)evaluation of flood hazards in agencies for the maintenance and operation of such floodplains in accordance with EO 11988;(e)assurance of facilities. project consistency with the approved State management program developed under the Coastal Zone Management 23. It will require the facility to be designed to comply Act of 1972(16 U.S.C.Section 1451 et seq.);(f)conformity with the"American Standard Specifications for Making of Federal actions to State(Clean Air)Implementation Buildings and Facilities Accessible to,and Usable by, Plans under Section 176(c)of the Clean Air Act of 1955, the Physically Handicapped," Number A117.- 1961,as as amended(42 U.S.C.Section 7401 et seq.);(g)protection modified(41 CFR 101-17.703). The applicant will be of underground sources of drinking water under the Safe responsible for conducting inspections to ensure Drinking Water Act of 1974,as amended,(P.L.93-523); compliance with these specifications by the contractor. and(h)protection of endangered species under the Endangered Species Act of 1973,as amended,(P.L.93-205). 24. If any real property or structure thereon is provided or improved with the aid of Federal financial assistance 16. Will comply with the Wild and Scenic Rivers Act of extended to the applicant,this assurance shall obligate 1968(16 U.S.C.Section 1271 et seq.) related to the applicant,or in the case of any transfer of such protecting components or potential components of the property,any transfer,for the period during which the national wild and scenic rivers system. real property or structure is used for a purpose for which the Federal financial assistance is extended or for 17. Will assist the awarding agency in assuring another purpose involving the provision of similar compliance with Section 106 of the National Historic services or benefits. Preservation Act of 1966,as amended(16 U.S.C.470), EO 11593(identification and preservation of historic 25. In making subgrants with nonprofit institutions properties),and the Archaeological and Historic under this Comprehensive Cooperative Agreement,it Preservation Act of 1974(16 U.S.C.469a-1 et seq.). agrees that such grants will be subject to OMB Circular A-122,"Cost Principles for Non-profit Organizations" 18. Will cause to be performed the required financial included in Vol.49,Federal Register,pages 18260 and compliance audits in accordance with the Single Audit through 18277(April 27, 1984). Act of 1984. 19. Will comply with all applicable requirements of all other Federal laws,Executive Orders,regulations and policies governing this program. FEMA Form 20-16B(BACK) FEDERAL EMERGENCY MANAGEMENT AGENCY CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS Applicants should refer to the regulations cited below to determine the certification to which they are required to attest. Applicants should also review the instructions for certification included in the regulations before completing this form. Signature on this form provides for compliance with certification requirements under 44 CFR Part 18,"New Restrictions on Lobbying;and 28 CFR Part 17,"Government-wide Debarment and suspension(Nonprocurement)and Government-wide Requirements for Drug-Free Workplace(Grants)." The certifications shall be treated as a material representation of fact upon which reliance will be placed when the Federal Emergency Management Agency(FEMA)determines to award the covered transaction,grant,or cooperative agreement. 1. LOBBYING (b) Have not within a three-year period preceding this application been convicted of ar had a civilian judgment rendered against them for A. As required by section 1352,Title 31 of the U.S.Code,and commission of fraud or a criminal offense in connection with implemented at 44 CFR Part 18,for persons entering into a grant obtaining,attempting to obtain,or perform a public(Federal,State, or cooperative agreement over$100,000,as defined at 44 CFR or local)transaction or contract under a public transaction;violation Part 18,the applicant certifies that: of Federal or State antitrust statutes or commission of embezzlement, theft,forgery,bribery,falsification or destruction of records, (a) No Federal appropriated funds have been paid or will be paid, making false statements,or receiving stolen property; by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of any agency,a (c) Are not presently indicted for or otherwise criminally or civilly Member of Congress.an officer or employee of congress,or an charged by a govemmental entity(Federal,State,or local)with employee of a Member of Congress in connection with the making commission of any of the offenses enumerated in paragraph(1)(b) of any Federal grant,the entering into of any cooperative agreement, of this certification,and and the extension,continuation,renewal,amendment,or modification of any Federal grant or cooperative agreement; (d) Have not within a three-year period preceding this application had one or more public t ransactions(Federal,State,or local) (b) If any other funds than Federal appropriated funds have been terminated for cause or default;and paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency,a Member of B. Where the applicant is unable to certify to any of the statements Congress,an officer or an employee of Congress,or employee in this certification,he or shall shall attached an explanation to this of a member of Congress in connection with this Federal grant or application. cooperative agreement,the undersigned shall complete and submit Standard Form LLL,"Disclosure of Lobbying Activities,"in 3. DRUG-FREE WORKPLACE accordance with its instructions; (GRANTEES OTHER THAN INDIVIDUALS) (c) The undersigned shall require that the language of this certification As required by the Drug-Free Workplace Act of 1988,and be included in the award documents for all subawards at all tiers implemented at 44 CFR Part 17,Subpart F,for grantees,as defined (including subgrants,contracts under grants and cooperative at 44 CFR Part 17,Sections 17.615 and 17.620: agreements,and subcontract(s)and that all subrecipients shall certify and disclose accordingly. A. The applicant certifies that it will continue to privide a drug- free workplace by: ElStandard Form LLL,"Disclosure of Lobbying Activities"attached. (This form must be attached to certification if nonappropriated funds (a) Publishing a statement notifying employees that the unlawful are to be used to influence activities.) manufacture,distribution,dispensing,possession,or use of a controlled substance is prohibited in the grantee's workplace and 2. DEBARMENT,SUSPENSION,AND OTHER specifying the actions tht will be taken against employees for RESPONSIBILITY MATTERS violation of such prohibition; (DIRECT RECIPIENT) (b) Establishing an on-going drug free awareness program to As required by Executive Order 12549,Debarment and Suspension, inform empoyees about and implemented at 44 CFR Part 67,for prospective participants in primary covered transactions,as defined at 44 CFR Part 17, (1) The dangers of drug abuse in the workplace; Section 17.510-A. The applicant certifies that it and its principals. (2) The grantee's policy of maintaining a drug-free workplace; (3) Any available drug counseling,rehabilitation,and (a) Are not presently debarred,suspended,proposed for debarment, employee assistance programs,and declared ineligible,sentenced to a denial of Federal benefits by a State (4) the penalties that may be imposed upon employees for or Federal court,or voluntarily excluded from covered transactions by drug abuse violations occurring in the workplace; any Federal department or agency; FEMA Form 20-16C,JUN 94 (c) Making it a requirement that each employee to be engaged in (2) Requiring such employee to participate satisfactorily in a the performance of the grant to be given a copy of the statement drug abuse assistance or rehabilitation program approved for required by paragraph(a); such purposes by a Federal,State,or local health,law enforcement, or other appropriate agency. (d) Notifying the employee in the statement required by paragraph(a)that,as a condition of employment under the grant, (g) Making a good faith effort to continue to maintain a drug free the employee will: workplace through implementation of paragraphs(a),(b),(c),(d),(e). and(f). (1) Abide by the terms of the statement;and 8. the grantee may insert in the space provided below the site(s)for (2) Notify the employee in writing of his or her conviction for a the performance of work done in connection with the specific grant: violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction Place of Performance(Street address,City,County,State,Zip code) (e) Notifying the agency,in writing,within 10 calendar days after receiving notice under subparagraph(d)(2)from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice,including position title, to the applicable FEMA awarding office,i.e.,regional office or FEMA office. Check Oil there are workplaces on file that are not identified here. (f) Taking one of the following actions,within 30 calendar days of receiving notice under subparagraph(d)(2),with respect to any employee who is so convicted: Section 17.630 of the regulations provide that a grantee that is a State may elect to make one certification in each Federal fiscal year. A copy (1) Taking appropriate personnel action against such an employee, of which should be included with each application for FEMA funding. up to and including termination,consistent with the requirements States and State agencies may elect to use a Statewide certification. of the Rehabilitation Act of 1973,as amended;or FEMA Form 20-16C(BACK) DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348-0046 (See reverse for public burden disclosure) 1. Type of Federal Action: '2. Status of Federal Action: 3. Report Type: a.contract X a. bid/offer/application X a. initial filing b.grant b.initial award b.material change c.cooperative agreement c. post-award For Material Change Only: d. loan year quarter e. loan guarantee date of last report f.loan insurance 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No.4 is Subawardee, Enter Name Prime Subawardee and Address of Prime: Tier ,if known: Congressional District,if known: Congressional District,if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: Hazard Mitigation Grant CFDA Number,if applicable: 8. Federal Action Number,if known: 9. Award Amount,if known: 10. a. Name and Address of Lobbying Registrant b. Individuals Performing Services(including address if (if individual,last name, first name, Ml) different from No. 10a) (last name. first name.Ml): Not applicable Not applicable 11. Information requested through this form is authorized by title 31 U.S.C.section 1352. This disclosure of lobbying activities is a material Signature: representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This Print Name: Nancy Backus disclosure is required pursuant to 31 U.S C. 1352. This information will be reported to the Congress semi-annually and will be Title: Mayor available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less Telephone No.: Date: than S10.000 and not more than$100.000 for each such failure. Federal Use Only: Authorized for Local Reproduction Standard Form LLL(Rev 7-97) DR-4539 HMGP PROJECT SUBAPPLICATION CITY OF AUBURN RESERVOIR 4 AND 8 MITIGATION PROJECT APPLICATION PREPARED BY: Susan Fenhaus, Water Utility Engineer PHONE: 253-804-5061 E-MAIL:Sfenhaus@auburnwa.gov Washington State Emergency Management Division I Hazard Mitigation Assistance Grants www.mil.wa.gov/HMAGrants I HMA@mil.wa.gov 1111 � F Project Application DR-4539 HMGP Contents Application Summary 4 Applicant Information 4 Mitigation Plan Information 4 Project Funding Information 4 Project Summary 5 Scope of Work 6 Project Q&A 6 Budget and Funding Sources 9 Estimated Total Costs 9 Funding Source—Non-Federal Match 10 Schedule of Work 11 Project Alternatives 12 Alternative Project 12 No Action Alternative 13 Environmental Data 14 State Q&A 14 Growth Management Act Compliance—WA Dept. of Commerce and WA Dept.of Ecology 14 National Flood Insurance Program (NFIP)Compliance—WA Dept. of Ecology 14 Federal Q&A 14 National Historic Preservation Act 14 Endangered Species Act and Fish and Wildlife Coordination Act 15 Clean Water Act, Rivers and Harbors Act, and Executive Order 11990(Protection of Wetlands) 15 Executive Order 11988 (Floodplain Management) 15 Coastal Zone Management Act 15 Farmland Protection Policy Act 16 RCRA and CERCLA(Hazardous and Toxic Materials) 16 Executive Order 12898, Environmental Justice for Low Income and Minority Populations 16 2 ( Page Other Environmental/Historic Preservation Laws or Issues 16 Summary and Cost of Potential Impacts 17 Environmental Review Attachments 18 Required Attachments 20 Acquisition 20 Elevation 20 Equipment Purchases 20 Wildfire Mitigation 20 Seismic Retrofits Error! Bookmark not defined. Flood Control 21 Optional, but encouraged 21 Open Space Acquisition Project Supplemental 22 Additional Acquisition Attachments 22 Elevation Project Supplemental 23 Resolution Designating Applicant Agent 23 31 Page Application Summary NOTE: THIS SECTION OF THE APPLICATION REVIEWS BASIC ELIGIBILITY REQUIREMENTS. FOR MORE INFORMATION ON ELIGIBILITY PLEASE SEE HMA Unified Guidance Part III(PAGE 25). Applicant Information Applicant Organization/Agency: City of Auburn Type of Organization/Agency: Local Government If Private Non-Profit, describe legal status and function: N/A County: King-033 Congressional District: 8th Legislative District: 30th Federal Tax ID#: 91-6001228 UBI#: 171-000-010 DON'T KNOW YOUR UBI?LOOK IT UP here. DUNS#:032942575 WHAT ISA DUNS Number? CID#: ADD 2 DIGIT STATE CODE. RENAME FIELD Primary Contact for this application (The individual directly involved in overseeing the grant) Name: Susan Fenhaus Title: Water Utility Engineer Phone: 253-804-5061 Email Address: sfenhaus@auburnwa.gov Mailing Address: 25 West Main Street City:Auburn State: Washington Zip: 98001 Application Prepared by- Name: Susan Fenhaus Title:Water Utility Engineer Phone: 253-804-5061 Email Address: sfenhaus@auburnwa.gov Mitigation Plan Information Does the jurisdiction have a current FEMA-Approved multi-hazard mitigation plan? © Yes ❑ No ❑ Pending Approval—Please explain status: N/A If yes, what is the title of the plan? King County Regional Hazard Mitigation Plan FEMA Approval Date: 10/1/2020 Expiration Date: 10/1/2025 Project Funding Information Was any version of this application previously submitted under another FEMA Program or Funding Opportunity? Yes © No If yes, explain status: N/A Does another Federal entity have primary funding authority for this project? No 41Page Project Summary Project Title: Reservoir 4 and 8 Mitigation Project Project Cost Estimate:$ 1,655,750 Primary hazard the project will mitigate: Earthquake Benefit-Cost Ratio (from FEMA's required BCA Tool): 3.65 PCB, CRMA, BCA Tool, Landslide? BCA Tool Project Synopsis (summary) Limit to a high-level couple of paragraphs. Very much a summary, not an SOW: Install 4 seismic control valves at City of Auburn's 4 reservoir sites. With the completion of this project,the installed and functional seismic control valves will automatically close in case of an earthquake and therefore keep the stored water in the reservoirs and preventing it from escaping and causing local flooding emergency. SIPage Scope of Work Project Q&A What problem will be mitigated and what are the current conditions and/or history of the problem? Potential loss of the stored drinking water in the reservoirs and local flooding are the problems to be mitigated. Current conditions and/or history of the problem is that this potential water loss and local flooding will always exist without the proposed mitigation effort and project. What is the intended outcome of the proposed project and how will it reduce or eliminate the long-term risk of future damage, hardship, loss,or suffering resulting from natural hazards? The intended outcome of the proposed project is 4 seismic control valves installed on the City's 4 reservoir sites.Once they are installed and functional,they'll automatically shutoff should an earthquake occur and therefore eliminating the long-term risk of lossing the stored drinking water, and therefore reducing or eliminating local flooding and future damage and hardship to the City, the adjacent and downstream homeowners and properties resulting from natural hazards such as earthquakes. What members of the community will benefit from the proposed project? Positive and negative effect to the community. Overall demographics. Population. Socioeconomic make up. Number of people who will benefit from the project. All of the retail and wholesale customers of the City's water system will benefit from the proposed project. Negative effect to the community might be the potential financial burden and cost. The positive effect is the City's water system will be safer and more resilient and robust. The project sites are located at City owned reservoir property sites which are gated and fenced with restricted access. The sites are covered by grass with no fish or streams or shoreline nearby. The Lea Hill reservoir sites (4A and 4B) are in the residential area with a new elementary school soon to be built in its vicinity. The Academy reservoir sites(8A and 8B)are also in the residential neighborhood and currently serves the Smoke Shop, Bingo Hall as well as the Casino of the Muckshoot Indian Tribe and Auburn Adventist Academy and the FAA Auburn facility. A new multi-use, multi-phased commercial development project and a new elementary school project have been proposed in its close vicinity. City of Auburn itself is centrally located between Seattle and Tacoma and in both King and Pierce County, Washington. Two rivers, Green River and White River flows through the City which encompasses 29.8 square miles and with an estimated 2020 population of 87,135. Its adjacent cities include: Pacific, Algona, Bonney Lake, Federal Way, Kent, Sumner and Covington. Large employers include Boeing, Outlet Collection Mall, Auburn School District, Auburn Medical Center and Muckleshoot Indian Tribe. The number of people who will benefit from this project is estimated to be around 65,000. What specific work activities or components are involved in the proposed project, how will each one be implemented, and who will be responsible for completing them? The specific work activities or components involved in the proposed project include consultant selection/retaining for conducting the design work, permitting, project advertising/bidding/awarding and construction as well as project management. The project will be implemented and managed by the City's internal capital project engineering group. Permitting, project advertising/bidding/awarding will also be the City's responsibility. A consultant will be retained to perform the design work(preparing design plans and specifications). A contractor will be hired through open public project bidding process and be responsible for completing the construction aspect of the project. City staff will be responsible for 6IPage inspecting the work performed by the contractor and coordinating the pipe and electronic connections between City's maintenance and operation division and the contractor. Which tasks will contractors be responsible for, if any? Please explain their expected products and/or deliverables. The contractors will be responsible for completing the actural field construction of the 4 proposed seismic valves. Temporary staging yard will be used by the contractor on the project sites to perform the construction work which includes constructing the 4 vaults that will house the seismic control valves and integrating them into the City's SCADA system. The contractor is expected to excavate the project site, install the precast concrete vault, install the valve and appurtenances inside the vault, install the associated electrical control panel and equipment, cut the existing pipes and make the existing and new pipe connections as well as electrical connection to the City's SCADA system. Which tasks will the jurisdiction be responsible?Who will manage the project? City staff will be responsible for managing the project, performing the necessary administrative work related to the project and grant, financing, reporting, etc. and construction observation and inspecting the work performed by the contractor and the coordination between the contractor and the City and other jurisdictions. Has the proposed project's construction or implementation phase already started? No. However, the preliminary engineering design drawings and photos for the proposed project are attached which demonstrate the feasibility and effectiveness of the project. Pre award costs question and explanation? Pre award costs are the estimated cost associated with City's staff in reviewing and preparing this grant application. What design specification will this project be built to? City of Auburn design specification. Will the proposed project use unproven technology? O Yes ❑x No If yes, please explain: N/A How will the proposed project be coordinated with neighboring entities(including counties,cities,states, tribal nations,fire, police, public works, utilities,etc.)? Timely coordination and communication will be conducted with City of Algona, the City's wholesale customer,Valley Regional Fire Authority and Muckleshoot Indian Tribe as the reservoir 8A and 88 site are close to the Tribe territory. How is the proposed project related to or consistent with the jurisdiction's FEMA-approved Hazard Mitigation Plan? The state plan identifies earthquakes as a hazard within the state. It further states Goal 2, Objective 2.1 as "Protect assets, particularly critical assets". Water reservoirs are critical assets that directly contribute to Goal 1, "Protect Life". 71 Page Demographics. Will this project need to be phased? How much design and engineering has been completed. Have any studies been completed or will need to be completed in the future? Are there any challenges that may delay the project(homeowner buy-in, public concerns?) This project will not be phased. Detailed design and engineering has not been completed yet. However, The preliminary engineering design drawing and photos for the proposed project are attached which demonstrate the feasibility and effectiveness of the project. No studies have been completed and no future ones are anticipated. Not aware of any challenges that may delay the project. Potential roadblocks? Funding. Wage Budget and Funding Sources Estimated Total Costs Total Project Costs $ Estimate Pre-Award Costs (4/21/2017 through grant award date) $0 Project Management Costs, Legal Expenses, etc. $45,750 Land, Structures, Rights-of-way,appraisals, etc. $0 Relocation Expenses and Payments $0 Architectural, Engineering, Geotechnical, etc. $390,000 Project Inspection Fees $180,000 Site Work $0 Demolition and Removal $0 Construction $1,040,000 Equipment(trackable assets costing$5,000 or more) $0 Miscellaneous(Personnel, Fringe Benefits, Travel, Supplies, etc.) $0 Total Project Costs $1,655,750.00 * *To update total of all categories, right click the cell above and select Update Field Attach backup documentation to explain how the cost estimates were determined (spreadsheets, vendor quotes,engineer/design estimates, in-house worksheets,correspondence,etc.) Insert a by property table for acquisition,elevation, or multi-site mitigation. N/A Describe the expenses included in each of the above budget categories: N/A Consultations: USACE, DFW,SHPO,WSDOT, Wage Funding Source — Non-Federal Match The Hazard Mitigation Grant Program offers cost-share grants payable on a reimbursement basis. Jurisdictions must have sufficient resources to provide the required non-federal match and cover any cost overruns related to completing the proposed Scope of Work. The maximum federal share is 75%of the total,eligible costs.The minimum non-federal cost share is 25%. In some instances, the state will split the non-federal share between the state (12.5%) and the applicant (12.5%). If this state match is available, applicants will be notified during the Pre-Application step of the HMGP round. Source of Funds Estimates Federal 75% $ 1,241,812.5 State 12.5% $ 206,968.75 Local 12.5% $ 206,968.75 Total: $1,655,750.00 , *To update the total, right-click the cell above and select Update Field Local(applicant)Cash Match $ 206,968.75 Other Eligible Local (applicant) Non-Cash Match Sources: Local (applicant)Staff Time $0 Local (applicant) Materials and/or Supplies $0 Local (applicant) Equipment Use $0 Third Party In-Kind Donations* $ 0 Other Eligible non-federal match sources $ 0 Total applicant Cost Share (at least 12.5%of project budget): $206,968.75 *To update the total, right-click the cell above and select Update Field *Third Party In-Kind Contributions: The applicant's required cost share can include another entity's donations of staff time and/or volunteers, equipment use, materials, etc. These Third Party In-Kind Contributions must be identified in this table to be eligible for consideration as a cost-share match source. 10IPage Schedule of Work List the major milestones in the proposed project and provide an estimated timeline for each activity. Projects must be completed within the established period of performance. MILESTONE # of Months to Description of Activity/Task Complete Consultant selection 2 Contract negotiation/execution 3 Preliminary Design 3 Detailed Design 4 Permitting 2 Project Bid 1 Project Construction 3 Click to enter milestone Enter # Click to enter milestone Enter # Click to enter milestone Enter # Click to enter milestone Enter # Click to enter milestone Enter # Click to enter milestone Enter # Click to enter milestone Enter # Click to enter milestone Enter # Click to enter milestone Enter # Click to enter milestone Enter # Click to enter milestone Enter # Click to enter milestone Enter # Total Months Required to Complete This Project: No more than 36 months 18 �� II 11IPage Project Alternatives Alternative Project This section is intended to demonstrate that project alternatives were seriously considered and that the proposed project is the most beneficial, cost-effective mitigation activity reasonably available to the applicant. The questions below ask for information regarding the next best mitigation action that was considered during the process of developing the proposed mitigation activity. Scope of Work—Summarize an alternative course of action considered by your organization that would mitigate the same hazard. Include any appropriate diagrams, sketch maps, materials and equipment quantities, scale of the project, amount of time required to complete, etc. 1) Investigate, evaluate and compare different city or privately owned property sites for best and optimal locations of placing additional, new reservoirs 2) Prepare a RFP and select a consulting firm to: a. Conduct topographic survey b. Conduct a geotechnical investigation c. Prepare a project report to meet DOH requirements d. Prepare a preliminary and final design report e. Assist with public relations including neighborhood meetings or workshops f. Prepare detailed, final design and construction documents g. Assist with construction support as needed 3) Detailed design including 30%, 60%, 90%and final construction documents 4) Engineering services during construction: a. Bid period assistance b. Construction support, including inspection, as needed c. Permit and environmental compliance d. Closeup including final inspection support e. Record documentation Hazard Mitigation— How would the alternate project reduce or eliminate the hazard's effects and risks, and the need for future state or federal disaster assistance? The new reservoir will have seismic control valve installed and therefore reduce or eliminate the hazard's effects and risks and eliminate the need for future state or federal disaster assistance resulted from this aspect of earthquake hazard. Environmental Considerations—How would the alternate project positively and/or negatively affect the surrounding environment? Include information regarding both natural (fish, wildlife,streams, soils, plant life)and social (public services, utilities, land/shoreline use, population density)environments. As the new reservoir site location has not been determined, it is hard to determine or predict how would it positively or negatively affect the surrounding environment. For the time being and at this very early planning stage, information regarding both the natural and social environments are not available for this alternative yet. Total Estimated Cost for Alternate Project: $ 12.5 million 12IPage Additional Comments:The City has limited financial resources available for capital improvement projects of this type and must use its available resources as wisely as possible. The alternative of replacement of the entire reservoirs is an excellent but very expensive solution. It would cost an estimated $12.5 million. While this would significantly reduce the risk of failure during a seismic event, its return on investment ($1,655,750/$12.5 million) ratio is 0.13; it is not the most cost effective solution. It would also require a large capital investment by the City which would likely not able to support it without significant external financial assistance or rate increases.This alternative is therefore, not financially viable. Thus the seismic retrofit project can best leverage available funds and funding sources to the maximum extent possible while addresses the source of the problem and risk faced and can provide an effective, practical and engineering sound long-term solution. No Action Alternative What are the potential impacts if no action is taken? a)The"no action"option is not viable from a risk management perspective given the identification of a known seismic threat. It's not a proactive approach for dealing and solving problems. b)The loss of the storage facility would significantly hinder the City's domestic water and fire flow capabilities. c)Given that the City's water supply is a primary component of the emergency management network, "no action" option would not reduce or eliminate the disaster potential to the City's facilities/operational capabilities, the adjacent public roadway and/or residential structures. d)The need for future city, state or federal assistance would therefore not be reduced (if not completely eliminated). e)lt would also result in higher lost revenue for the City during the repair/replacement of the system. Is there a potential for degradation of already poor environmental conditions? ❑ Yes 0 No If Yes, please describe: N/A Additional Comments: As shown,this mitigation project will increase the City's level of protection against earthquakes and is technically feasible and cost effective and is consistent with the City's adopted hazard mitigation plan. 13IPage Environmental Data Is there potential to violate any federal, state, local, or tribal law or code to protect the environment? ❑ Yes ❑x No If yes, please explain: N/A State Q&A Growth Management Act Compliance—WA Dept. of Commerce and WA Dept. of Ecology 1. Is the jurisdiction in compliance with state Growth Management Act Requirements? a. ❑x Yes ❑ No ❑ Not Applicable (Tribes, Non-Profits) b. If yes, provide the date the jurisdiction's Comprehensive Land Use Plan (if required) and the Critical Areas Ordinances(CAos)were approved and adopted. i. Land Use 12/14/2015 CAOs 11/4/2019 c. If no, explain the identified non-compliance issues and how the jurisdiction is resolving them. N/A 2. Is the proposed project in any Critical Area classifications identified in Washington State's Growth Management Act? These areas include but are not limited to: Wetlands, Aquifer Recharge Areas, Frequently Flooded Areas, Geologically Hazardous Areas, and Fish and Wildlife Habitat Areas. ❑ Yes ❑ No a. If yes, please identify the Critical Area categories: N/A b. If yes, how will this project comply with protection requirements of these areas? N/A National Flood Insurance Program (NFIP) Compliance—WA Dept. of Ecology 1. Is the project located in a Special Flood Hazard Area (SFHA) as defined by the NFIP? ❑ Yes ® No 2. The date of your most recent NFIP Community Assistance Visit(CAV) 8/30/2007 3. Did your community have any CAV/NFIP issues or violations from this visit? ❑ Yes ❑x No a. If yes, please explain: N/A Federal Q&A National Historic Preservation Act Historic Buildings and Structures Does your project affect or is it near any buildings or structures 45 years or more in age? Allowing for application review time lI Yes ❑ No El Unknown If yes,explain how the project design will minimize adverse effects on known or potential historic buildings or structures. Please address and note associated costs in your project budget. Most of those reservoir structures are 45 years or more in age Archeological Resources 14IPage Does your project involve disturbance of ground? 0 Yes 0 No ❑ Unknown If yes, describe the ground disturbance by giving the dimensions (area, volume, depth, etc.) and location. Basically excavating the ground with a dimension of about 15' long x 10' wide x 10' deep (150 square foot, 1,500 cubic foot) to construct the vault that will house the seismic valve. Their locations are adjacent and very close to the reservoir itself. Describe the past use of the area to be disturbed, noting the extent of previously disturbed ground. It's reservoir sites, mainly for installing pipes to get water to/from the reservoirs. Additional Information:These sites basically are the City's Reservoir sites. Endangered Species Act and Fish and Wildlife Coordination Act Are federally listed threatened or endangered species or their critical habitat present in the area affected by the project? ❑ Yes 0 No 0 Unknown Does your project remove or affect vegetation? 0 Yes El No ❑ Unknown If yes,describe the amount(area and type of vegetation to be removed or affected.Very minimal, will be limited to the area of the vault where the seismic control valve will be installed. About 15'x10'(150 square foot)for each of the 4 project sites,vegitation type is the typical and regular grass cover on all the 4 sites. Is your project in, near(within 200 feet),or likely to affect any type of waterway or body of water? 0 Yes El No ❑ Unknown Clean Water Act, Rivers and Harbors Act, and Executive Order 11990 (Protection of Wetlands) 1. Will the project involve dredging or disposal of dredged material,excavation, adding fill material, or result in any modification to water bodies or wetlands designated as "waters of the U.S." as identified by the US Army Corps of Engineers or on the National Wetland Inventory? 0 Yes 0 No ❑ Unknown If yes, include USACE correspondence in Environmental Review Attachments. Executive Order 11988 (Floodplain Management) 1. Does a Flood Insurance Rate Map (FIRM), Flood Hazard Boundary Map (FHBM), hydrologic study or some other source indicate that the project is located in or will affect a 100-year floodplain, a 500 year floodplain is a critical facility, an identified regulatory floodway, or an area prone to flooding? ❑ Yes 0 No 0 Unknown If yes,complete the 8 Step Process,confirm with science and barry. Possibly only for SFHA 2. Does the project alter a watercourse, water flow patterns, or a drainage way, regardless of its floodplain designation? ❑Yes I] No ❑ Unknown Coastal Zone Management Act 1. Is the project located in the State's designated Coastal Zone? Note: the Coastal Zone includes projects located anywhere within a county that has a shoreline, regardless of whether or not the project itself is located on that shoreline. Cl Yes ❑x No ❑ Unknown 15IPage Farmland Protection Policy Act 1. Will the project convert more than 5 acres of"prime or unique" farmland outside city limits to a non-agricultural use? ❑ Yes ❑D No ❑ Unknown 2. Additional Information: N/A RCRA and CERCLA (Hazardous and Toxic Materials) 1. Is there a reason to suspect there are contaminants from a current or past use on the property associated with the proposed project? ❑ Yes EI No ❑ Unknown 2. Are there any studies, investigations, or enforcement actions related to the property associated with the proposed project? ❑ Yes ❑x No 0 Unknown 3. Does any project construction or operation activities involve the use of hazardous or toxic materials?0 Yes ® No ❑ Unknown 4. Do you know if any of the current or past land uses of the property affected by the proposed project or of the adjacent properties are associated with hazardous or toxic materials? ❑Yes No ❑ Unknown 5. Additional Information: N/A Executive Order 12898, Environmental Justice for Low Income and Minority Populations 1. Are there low income or minority populations in the project's area of effect or adjacent to the project area? El Yes❑ No ❑ Unknown 2. If yes, describe any disproportionate or adverse effects to these populations. The low income or minority population adjacent to 2 of the project sites (reservoir 8A and 8B) is Muckshoot Indian Tribe. Not aware of any disproportionate or adverse effects to the Muckleshoot Indian Tribe. 3. If yes, describe the affected population and the portion of the population that would be disproportionately and adversely affected. Please include specific efforts to address the adverse impacts.The affected population is Muckleshoot Indian Tribe. Not aware of any disproportionate or adverse impacts to the Tribe. As a matter of fact, it'll have positive effects on the Tribe. Other Environmental/Historic Preservation Laws or Issues 1. Are there other environmental/historic preservation requirements that are associated with this project that you are aware of? ❑ Yes © No ❑ Unknown a. If yes, please explain: N/A 2. Are there controversial issues associated with this project? ❑ Yes ❑x No 0 Unknown a. If yes, please explain: N/A 3. Have you conducted any public meeting or solicited public input or comments on your specific proposed mitigation project? ❑ Yes ❑x No ❑ Unknown a. If yes, please explain: N/A If you answered yes to any of the above questions in the Environmental Review, additional documentation will be required as listed in Environmental Review Attachments. 16IPag ? Summary and Cost of Potential Impacts Having answered the above questions, have you identified any aspects of your proposed project that have the potential to impact environmental or historic properties? ❑x Yes ❑ No ❑ If yes,confirm that you have completed the following: ® Evaluated these potential effects and provided the required materials in attachments that identify the nature and extent of potential impacts to environmental resources and/or historic properties. ® Consulted with appropriate parties to identify any measures needed to avoid or minimize these impacts. ® Considered alternatives that could minimize both the impacts and the cost of the project. ® Made certain that the costs of any measures to treat adverse effects are realistically reflected in the project budget estimate. Additional information: None End of Main Application-See Attachments and Supplemental Sections Below 17IPage Environmental Review Attachments State Environmental Review ❑ SEPA Compliance Checklist NFIP ❑ Documentation from Washington State Department of Ecology NFIP State Coordinator that you are currently in compliance National Historic Preservation Act ❑ State historic preservation Officer(SHPO)concurrence letter Correspondence from State or Tribal Historic Preservation Officer regarding CIany structures or buildings that are eligible for listing on the National Register of Historic Places or within or near a National Historic Register listed or eligible historic district Explanation of how project design will minimize adverse effects on known or ❑ potential historic buildings or structures, and any alternatives considered or implemented to avoid or minimize effects on historic buildings or structures For acquisition/demolition projects affecting historic buildings or structures, ❑ any data regarding the consideration and feasibility of elevation, relocation,or flood proofing as alternatives to demolition Archeological Resources ❑ Dept. of Archeological and Historic Preservation (DAHP)concurrence letter ❑ A description of the ground disturbance by giving the dimensions (area, volume, depth,etc.)and location ❑ The past use of the area to be disturbed, noting the extent of ground disturbance ❑ A USGS 1:24,000 scale sale or other site map showing the location and extent of ground disturbance Any information about potential historic properties, including archeological ❑ sites in the project area Endangered Species Act and Fish and Wildlife Coordination Act ❑ 01. Any information obtained to identify species in or near the project area. Provide the source and date of the information cited. Q1.Any request for information and associated response from the USFWS,the ❑ National Marine Fisheries Services (NMFS) (for affected ocean-going fish), or State Wildlife Agencies, regarding potential listed species present and potential of the project to impact those species ❑ Q2. A description of the amount (area) and type of vegetation to be removed or affected ❑ Q2.A site map showing the project area and the extent of vegetation affected ❑ 02. Photographs or digital images that show both the vegetation affected and the vegetation in context of its surroundings Q3. Evidence of any discussions with the USFWS, and/or State Wildlife ❑ Agencies concerning any potential impacts if there is the potential for the project to affect any water body 18IPage ❑ Q3. A photograph or digital image of the site showing both the body of water and the project area Q3. Any information about the type of water body nearby including: its ❑ dimensions, the proximity of the project activity to the water body, and the expected and possible changes to the water body, if any. Identify all water bodies regardless whether you think there may be an effect/ CIQ3.A 1:24,000 scale quadrangle map showing the project activities in relation to all nearby water bodies (within 200 feet). Clean Water Act, Rivers and Harbors Act, Executive Order 11990 Documentation of the project location on a USGS 1:24,000 scale topographic ❑ map or image and a copy of the National Wetlands Inventory map or other available wetlands mapping information Request for information and response letter from the USACE and/or State ❑ resource agencies regarding the potential for wetlands, and applicability of permitting requirements ❑ Evidence of alternatives considered to eliminate or minimize impacts to wetlands Executive Order 11988 (Floodplain Management) ❑ 01. 8 Step Process for Floodplains& Wetlands Q2. Hydrologic/hydraulic information from a qualified engineer to ❑ demonstrate how drainage and flood flow patterns will be changed and to identify down and upstream effects ❑ _ Evidence of any consultation with the USACE if not already included elsewhere ❑ Request for information and response letter from the State water resource agency, if applicable,with jurisdiction over modification of waterways Coastal Zone Management Act Information resulting from contact with the appropriate State agency that I=1implements the coastal zone management program regarding the likelihood of the project's consistency with the State's coastal zone plan and any potential requirements affecting the cost or design of the proposed activity Coastal Zone Management Form RCRA and CERCLA (Hazardous and Toxic Materials) Results of any consultations with State or local agencies to obtain permit with ❑ requirements for handling,disposing of or addressing the effects of hazardous or toxic materials related to project implementation ❑ Any studies, investigations, or enforcement actions related to the properties associated with the project Other ❑ Documentation of Public Notices and/or public meetings related to the proposed project ❑ Any available Agency consultations and correspondence not previously included Any available Environmental Assessments or Biological Opinions related to the project 19 ) Page Required Attachments General Signed Certificate of Assurances —please print and sign Resolution Designating Applicant Agent -please print and sign Cost Estimate Summary Spreadsheet Map of area with project site limits clearly identified FIRM and/or FIRMETTE of Project Site(s) Pictures of existing conditions at Project site(s)-at least 3 different sides or angles Copy of FEMA Approval Letter for the reference Hazard Mitigation Plan BCA Report(exported PDF from FEMA-Approved BCA software) Local Funds Commitment Letter BCA.zip file-includes full access to the project's BCA inputs and assumptions Acquisition List of Properties and their addresses(include Lat& Long and total square footage) Documentation of the Valuation Estimate of the Property Signed assurances that the subapplicant will implement the project grant award in compliance 44 CFR Part 80 Property Acquisition and Relocation for Open Space If applicable: Documentation that verifies that Structure Relocation Costs Identify the Value of the Land to be Acquired in Addition to other Eligible Costs Signed Voluntary Interest form from all Property Owners Elevation List of Properties and their addresses(include Lat& Long, structure type, foundation type, original date of construction, elevation of lowest finished floor and total square footage) List of first floor elevation of the proposed elevation, proposed foundation type, proposed elevation methodology and standard, and Base Flood Elevation (BFE)or Advisory BFE (ABFE). Signed statement from the Appropriate Local Official or qualified professional that the Structure Appears to be Capable of Elevation and a Model Acknowledgement of Conditions for Mitigation of Property in a Special Flood Hazard Area Equipment Purchases Vendor Quotes Manufacturer's Product Data Wildfire Mitigation Defensible Space: Maps clearly showing targeted properties(include square footage) and an approximation of the total vegetation to be removed Map clearly showing that the wildfire project activity will fall within a Wildland Urban Interface Area Building Replacement Value (BRV)and Project Useful Life/Projected Lifespan for structures to be protected A draft operations and maintenance plan Signed agreement from the property owner to maintain the defensible space for a structural protection project 20IPage Seismic Retrofits Seismic studies and/or reports establishing existing conditions, needed retrofits, and post- mitigation seismic performance goal (target seismic code level) List of Properties and their addresses(include Lat& Long, soil type,construction type, original date of construction, building type, number of stories, use,occupancy, and total square footage) Assessment of the vulnerabilities(seismic)of the existing building conditions A Model Acknowledgement of Conditions for Mitigation of Property in a Special Flood Hazard Area Proposed Structural Retrofit Methodology and Applicable Engineering Standard Building replacement value (BRV) ($/square foot) and supporting documentation Flood Control Excerpts of flood studies and hydrology reports Optional, but encouraged Recent aerial image of the project site via Google, MapQuest,ArcGIS or similar NFIP-CAV Letter confirming community is in good standing per CRS Project relevant excerpts from the Local Hazard Mitigation Plan 21IPage Open Space Acquisition Project Supplemental 1. Will the intended use of the property comply with 44 CFR Part 80, FEMA Property Acquisition and Relocation for Open Space and the current Hazard Mitigation Assistance Unified Guidance, February 27, 2015. ❑ Yes ❑ No 2. Upon consultation with the US Army Corps of Engineers (USACE), are any of the proposed properties under consideration for the use of the construction of a levee system (including berms, floodwalls,and dikes)? ❑ Yes ❑ No 3. Upon consultation with the Washington State Department of Transportation (WSDOT),are any of the proposed properties under consideration for use for future, planned improvements or enhancements to the Federal Aid Systems, or other State transportation projects? ❑ Yes N No *If yes,the affected property will not be eligible for this grant 4. Is the pre-event market value being used in the proposed property valuations? ❑ Yes ❑ No Additional Acquisition Attachments ❑ Copies of any relevant letters/emails concerning consultation with USACE regarding consideration of levee systems, berms floodwalls, and dikes ❑ Copies of any relevant letters/emails concerning consultation with WSDOT regarding planned improvements of federal aid systems or state transportation projects. ❑ A completed Property Site Inventory.Template provided by WA EMD. For each property to be acquired include the following: ❑ Signed copy of the Statement of Assurances ❑ Copy of the sample deed restriction that will be recorded at closing. The sample must be consistent with FEMA's model. O Documentation of voluntary interest signed by each homeowner using either individual signed statements. ❑ Certification on FEMA Form 009-0-3 (formerly 90-69B) that the property owners are Nationals of the United States or qualified aliens. ❑ For each property that has been substantially damaged also include documentation provided to the property owner from the appropriate local official ❑Property owner's NFIP Policy Documentation 22IPage Elevation Project Supplemental For each structure to be elevated include the following: O Documentation of voluntary interest signed by each homeowner using either individual signed statements. OElevation certificate (FEMA Form 81-31) or equivalent information/data used to determine the first floor elevation ❑A completed Property Site Inventory.Template provided by WA EMD. ❑Property owner's NFIP Policy Documentation Resolution Designating Applicant Agent Subapplicants must provide a completed copy of the Resolution Designating Applicant Agent form found on the HMA grants website https://mil.wa.gov/hazard-mitigation-grants. 23IPage