+--------------------------------------------------------+-------------+
| ## U.S                                                 | ***O.M.B    |
| . DEPARTMENT OF HOMELAND SECURITY - FEDERAL EMERGENCY  | No.         |
| MANAGEMENT AGENCY RIVERINE HYDROLOGY & HYDRAULICS FORM | 1           |
|                                                        | 660-0016*** |
|                                                        |             |
|                                                        | *Expires:   |
|                                                        | **12        |
|                                                        | /31/2010*** |
+--------------------------------------------------------+-------------+

+-----------------------------------------------------------------------+
| # PAPERWORK REDUCTION ACT                                             |
|                                                                       |
| Public reporting burden for this form is estimated to average 3.25    |
| hours per response. The burden estimate includes the time for         |
| reviewing instructions, searching existing data sources, gathering    |
| and maintaining the needed data, and completing, reviewing, and       |
| submitting the form. 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. Send comments regarding the   |
| accuracy of the burden estimate and any suggestions for reducing this |
| burden to: Information Collections Management, U.S. Department of     |
| Homeland Security, Federal Emergency Management Agency, 500 C Street, |
| SW, Washington DC 20472, Paperwork Reduction Project (1660-0016).     |
| Submission of the form is required to obtain or retain benefits under |
| the National Flood Insurance Program. **Please do not send your       |
| completed survey to the above address.**                              |
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+-----------------------------------------------------------------------+
| Flooding Source:                                                      |
|                                                                       |
| **Note:** Fill out one form for each flooding source studied          |
+-----------------------------------------------------------------------+

A. HYDROLOGY

+-----------------+-----------------+-----------------+-----------------+
| 1.  Reason for  |                 |                 |                 |
|     New         |                 |                 |                 |
|     Hydrologic  |                 |                 |                 |
|     Analysis    |                 |                 |                 |
|     (check all  |                 |                 |                 |
|     that apply) |                 |                 |                 |
|                 |                 |                 |                 |
| Not revised     |                 |                 |                 |
| (skip to        |                 |                 |                 |
| section B) No   |                 |                 |                 |
| existing        |                 |                 |                 |
| analysis        |                 |                 |                 |
| Improved data   |                 |                 |                 |
|                 |                 |                 |                 |
| > Alternative   |                 |                 |                 |
| > methodology   |                 |                 |                 |
| > Proposed      |                 |                 |                 |
| > Conditions    |                 |                 |                 |
| > (CLOMR)       |                 |                 |                 |
| > Changed       |                 |                 |                 |
| > physical      |                 |                 |                 |
| > condition of  |                 |                 |                 |
| > watershed     |                 |                 |                 |
|                 |                 |                 |                 |
| 2\. Comparison  |                 |                 |                 |
| of              |                 |                 |                 |
| Representative  |                 |                 |                 |
| 1               |                 |                 |                 |
| %-Annual-Chance |                 |                 |                 |
| Discharges      |                 |                 |                 |
+-----------------+-----------------+-----------------+-----------------+
| Location        | Drainage Area   | Effective/FIS   | Revised (cfs)   |
|                 | (Sq. Mi.)       | (cfs)           |                 |
+-----------------+-----------------+-----------------+-----------------+
|                 |                 |                 |                 |
+-----------------+-----------------+-----------------+-----------------+
|                 |                 |                 |                 |
+-----------------+-----------------+-----------------+-----------------+
|                 |                 |                 |                 |
+-----------------+-----------------+-----------------+-----------------+
| 3\. Methodology |                 |                 |                 |
| for New         |                 |                 |                 |
| Hydrologic      |                 |                 |                 |
| Analysis (check |                 |                 |                 |
| all that apply) |                 |                 |                 |
|                 |                 |                 |                 |
| Statistical     |                 |                 |                 |
| Analysis of     |                 |                 |                 |
| Gage Records    |                 |                 |                 |
| Preci           |                 |                 |                 |
| pitation/Runoff |                 |                 |                 |
| Model           |                 |                 |                 |
|                 |                 |                 |                 |
| Regional        |                 |                 |                 |
| Regression      |                 |                 |                 |
| Equations Other |                 |                 |                 |
| (please attach  |                 |                 |                 |
| description)    |                 |                 |                 |
|                 |                 |                 |                 |
| > Please        |                 |                 |                 |
| > enclose all   |                 |                 |                 |
| > relevant      |                 |                 |                 |
| > models in     |                 |                 |                 |
| > digital       |                 |                 |                 |
| > format, maps, |                 |                 |                 |
| > computations  |                 |                 |                 |
| > (including    |                 |                 |                 |
| > computation   |                 |                 |                 |
| > of            |                 |                 |                 |
| > parameters)   |                 |                 |                 |
| > and           |                 |                 |                 |
| > documentation |                 |                 |                 |
| > to support    |                 |                 |                 |
| > the new       |                 |                 |                 |
| > analysis.     |                 |                 |                 |
|                 |                 |                 |                 |
| 4\.             |                 |                 |                 |
| Review/Approval |                 |                 |                 |
| of Analysis     |                 |                 |                 |
|                 |                 |                 |                 |
| > If your       |                 |                 |                 |
| > community     |                 |                 |                 |
| > requires a    |                 |                 |                 |
| > regional,     |                 |                 |                 |
| > state, or     |                 |                 |                 |
| > federal       |                 |                 |                 |
| > agency to     |                 |                 |                 |
| > review the    |                 |                 |                 |
| > hydrologic    |                 |                 |                 |
| > analysis,     |                 |                 |                 |
| > please attach |                 |                 |                 |
| > evidence of   |                 |                 |                 |
| > a             |                 |                 |                 |
| pproval/review. |                 |                 |                 |
|                 |                 |                 |                 |
| []{.mark}       |                 |                 |                 |
|                 |                 |                 |                 |
| 5\. Impacts of  |                 |                 |                 |
| Sediment        |                 |                 |                 |
| Transport on    |                 |                 |                 |
| Hydrology       |                 |                 |                 |
|                 |                 |                 |                 |
| > Was sediment  |                 |                 |                 |
| > transport     |                 |                 |                 |
| > considered?   |                 |                 |                 |
| > Yes No If     |                 |                 |                 |
| > yes, then     |                 |                 |                 |
| > fill out      |                 |                 |                 |
| > Section F     |                 |                 |                 |
| > (Sediment     |                 |                 |                 |
| > Transport) of |                 |                 |                 |
| > Form 3. If    |                 |                 |                 |
| > No, then      |                 |                 |                 |
| > attach your   |                 |                 |                 |
| > explanation   |                 |                 |                 |
| > for why       |                 |                 |                 |
| > sediment      |                 |                 |                 |
| > transport was |                 |                 |                 |
| > not           |                 |                 |                 |
| > considered.   |                 |                 |                 |
+-----------------+-----------------+-----------------+-----------------+

B. HYDRAULICS

+-----------------+-----------------+----------+----------+------------+
| 1\. [Reach to   |                 |          |          |            |
| be              |                 |          |          |            |
| Revis           |                 |          |          |            |
| ed]{.underline} |                 |          |          |            |
+-----------------+-----------------+----------+----------+------------+
|                 | Description     | Cross    | Water    |            |
|                 |                 | Section  | -Surface |            |
|                 |                 |          | El       |            |
|                 |                 |          | evations |            |
|                 |                 |          | (ft.)    |            |
+-----------------+-----------------+----------+----------+------------+
|                 |                 |          | E        | Propos     |
|                 |                 |          | ffective | ed/Revised |
+-----------------+-----------------+----------+----------+------------+
| Downstream      |                 |          |          |            |
| Limit           |                 |          |          |            |
+-----------------+-----------------+----------+----------+------------+
| Upstream Limit  |                 |          |          |            |
+-----------------+-----------------+----------+----------+------------+
| 2\. [Hydraulic  |                 |          |          |            |
| Method/Model    |                 |          |          |            |
| Us              |                 |          |          |            |
| ed]{.underline} |                 |          |          |            |
|                 |                 |          |          |            |
| >               |                 |          |          |            |
+-----------------+-----------------+----------+----------+------------+

B. HYDRAULICS (CONTINUED)

+-----------------------------------------------------------------------+
| 3\. [Pre-Submittal Review of Hydraulic Models]{.underline}            |
|                                                                       |
| DHS-FEMA has developed two review programs, CHECK-2 and CHECK-RAS, to |
| aid in the review of HEC-2 and HEC-RAS hydraulic models,              |
| respectively. These review programs may help verify that the          |
| hydraulic estimates and assumptions in the model data are in          |
| accordance with NFIP requirements, and that the data are comparable   |
| with the assumptions and limitations of HEC-2/HEC-RAS. CHECK-2 and    |
| CHECK-RAS identify areas of potential error or concern. **These tools |
| do not replace engineering judgment.** CHECK-2 and CHECK-RAS can be   |
| downloaded from <http://www.fema.gov/plan/prevent/fhm/frm_soft.shtm>. |
| We recommend that you review your HEC-2 and HEC-RAS models with       |
| CHECK-2 and CHECK-RAS. Review of your submittal and resolution of     |
| valid modeling discrepancies may result in reduced review time.       |
|                                                                       |
| 4\. [Models Submitted]{.underline} [Natural Run]{.underline}          |
| [Floodway Run]{.underline} [Datum]{.underline}                        |
|                                                                       |
| Duplicate Effective Model\* File Name:       Plan Name:       File    |
| Name:       Plan Name:       [     ]{.underline}                      |
|                                                                       |
| Corrected Effective Model\* File Name:       Plan Name:       File    |
| Name:       Plan Name:       [     ]{.underline}                      |
|                                                                       |
| Existing or Pre-Project Conditions Model File Name:       Plan Name:  |
|       File Name:       Plan Name:       [     ]{.underline}           |
|                                                                       |
| Revised or Post-Project Conditions Model File Name:       Plan Name:  |
|       File Name:       Plan Name:       [     ]{.underline}           |
|                                                                       |
| Other - (attach description) File Name:       Plan Name:       File   |
| Name:       Plan Name:       [     ]{.underline}                      |
|                                                                       |
| \* For details, refer to the corresponding section of the             |
| instructions.                                                         |
|                                                                       |
| Digital Models Submitted? (Required)                                  |
+-----------------------------------------------------------------------+

C. MAPPING REQUIREMENTS

+-----------------------------------------------------------------------+
| A **certified topographic map** must be submitted showing the         |
| following information (where applicable): the boundaries of the       |
| effective, existing, and proposed conditions 1%-annual-chance         |
| floodplain (for approximate Zone A revisions) or the boundaries of    |
| the 1%- and 0.2%-annual-chance floodplains and regulatory floodway    |
| (for detailed Zone AE, AO, and AH revisions); location and alignment  |
| of all cross sections with stationing control indicated; stream,      |
| road, and other alignments (e.g., dams, levees, etc.); current        |
| community easements and boundaries; boundaries of the requester\'s    |
| property; certification of a registered professional engineer         |
| registered in the subject State; location and description of          |
| reference marks; and the referenced vertical datum (NGVD, NAVD,       |
| etc.).                                                                |
|                                                                       |
| Digital Mapping (GIS/CADD) Data Submitted                             |
|                                                                       |
| Note that the boundaries of the existing or proposed conditions       |
| floodplains and regulatory floodway to be shown on the revised FIRM   |
| and/or FBFM must tie-in with the effective floodplain and regulatory  |
| floodway boundaries. Please attach **a copy of the effective FIRM     |
| and/or FBFM,** annotated to show the boundaries of the revised 1%-    |
| and 0.2%-annual-chance floodplains and regulatory floodway that       |
| tie-in with the boundaries of the effective 1%- and                   |
| 0.2%-annual-chance floodplain and regulatory floodway at the upstream |
| and downstream limits of the area of revision.                        |
|                                                                       |
| Annotated FIRM and/or FBFM (Required)                                 |
+-----------------------------------------------------------------------+

**D. COMMON REGULATORY REQUIREMENTS\***

+-----------------------------------------------------------------------+
| 1\. For LOMR/CLOMR requests, do Base Flood Elevations (BFEs)          |
| increase? Yes No                                                      |
|                                                                       |
| > a\. For CLOMR requests, if either of the following is true, please  |
| > submit **evidence of compliance with Section 65.12 of the NFIP      |
| > regulations**:                                                      |
|                                                                       |
| -   The proposed project encroaches upon a regulatory floodway and    |
|     would result in increases above 0.00 foot.                        |
|                                                                       |
| -   The proposed project encroaches upon a SFHA with or without BFEs  |
|     established and would result in increases above 1.00 foot.        |
|                                                                       |
| b\. For LOMR requests, does this request require property owner       |
| notification and acceptance of BFE increases? Yes No                  |
|                                                                       |
| > If Yes, please attach **proof of property owner notification and    |
| > acceptance (if available)**. Elements of and examples of property   |
| > owner notification can be found in the MT-2 Form 2 Instructions.    |
|                                                                       |
| 2.  Does the request involve the placement or proposed placement of   |
|     fill? Yes No                                                      |
|                                                                       |
| > If Yes, the community must be able to certify that the area to be   |
| > removed from the special flood hazard area, to include any          |
| > structures or proposed structures, meets all of the standards of    |
| > the local floodplain ordinances, and is reasonably safe from        |
| > flooding in accordance with the NFIP regulations set forth at 44    |
| > CFR 60.3(a)(3), 65.5(a)(4), and 65.6(a)(14). Please see the MT-2    |
| > instructions for more information.                                  |
|                                                                       |
| 3\. For LOMR requests, is the regulatory floodway being revised? Yes  |
| No                                                                    |
|                                                                       |
| If Yes, attach **evidence of regulatory floodway revision             |
| notification**. As per Paragraph 65.7(b)(1) of the NFIP Regulations,  |
| notification is required for requests involving revisions to the      |
| regulatory floodway. (Not required for revisions to approximate       |
| 1%-annual-chance floodplains \[studied Zone A designation\] unless a  |
| regulatory floodway is being added. Elements and examples of          |
| regulatory floodway revision notification can be found in the MT-2    |
| Form 2 Instructions.)                                                 |
|                                                                       |
| 4\. For LOMR/CLOMR requests, does this request have the potential to  |
| impact an endangered species? Yes No                                  |
|                                                                       |
| > If Yes, please submit documentation to the community to show that   |
| > you have complied with Sections 9 and 10 of the Endangered Species  |
| > Act (ESA). Section 9 of the ESA prohibits anyone from "taking" or   |
| > harming an endangered species.  If an action might harm an          |
| > endangered species, a permit is required from U.S. Fish and         |
| > Wildlife Service or National Marine Fisheries Service under Section |
| > 10 of the ESA.                                                      |
| >                                                                     |
| > For actions authorized, funded, or being carried out by Federal or  |
| > State agencies, please submit documentation from the agency showing |
| > its compliance with Section 7(a)(2) of the ESA.                     |
+-----------------------------------------------------------------------+

\* Not inclusive of all applicable regulatory requirements. For details,
see 44 CFR parts 60 and 65.