Survey ID: ________________ OMB Control No. 20XX-XXXX Approval expires XX/XX/XX



## United States Environmental Protection Agency

Stormwater Discharges from Developed Sites

Owner/Developer Long Questionnaire

Survey ID: ________________

Please return the completed response no later than [date for returning questionnaire]

An Agency may not conduct or sponsor, and a pe rson is not required to respond to, a collection of information, unless it displays a currently valid OMB control number.

The public reporting and recordkeeping burden for th is collection of information is estimated to average 73 hours per response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the comp leted questionnaire to this address.

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## General Information

Purpose of the Questionnaire

Stormwater discharges from developed la nd can negatively impact water quality through
increases in stormwater volume and increased pollutant loads to the receiving waters. To strengthen its stormwater regulations, EPA’s Offi ce of Water (OW) is considering revisions to the current National Pollutant Discharge Elimin ation System (NPDES) re gulations including the establishment of standards for long term stor mwater discharges from developed sites.

To collect data to inform deci sions regarding how the nation’s st ormwater regulations should be strengthened and to support the technical and financial feasibility associated with this rulemaking, EPA is sending the following questionna ire to owners/develope rs of residential, non-residential, industrial, and commercial site s. This questionnaire will provide EPA with
information to:

 Characterize current building and real estate improveme nt projects including type, location, and size;

 Characterize the prevalence and type of stormwater controls implemented at new development and redevelopment sites to contro l long term stormwater discharges. These controls include, but are not limite d to, practices that retain or infiltrate stormwater onsite (commonly referred to as low impact de velopment practices, or LID) and more traditional stormwater practices (such as ponds); and,

 Characterize the operations and financial condition of owners and developers that could be subject to revised regulations.

Authority

EPA has the authority to administer this questio nnaire under section 308 of the Clean Water Act (Federal Water Pollution Control Act, 33 U. S.C. Section 1318). Participation in this questionnaire is mandatory, and you are require d to respond. You must retain a copy of the completed questionnaire for your files. EPA may contact you with follow-up questions to clarify your answers. Late filing of the questionnaire, or failure to follow any related EPA instruction, may results in civil penalties, criminal fines, or other sanctions provided by law including the possibility of fines and imprisonment as explai ned in Section 308 of the Clean Water Act (33 U.S.C., Section 1318).

When to Complete the Questionnaire

The response to this questionnair e m ust be received by EPA no mo re than 60 calendar days after receiving it.

If you wish to request an extens ion, you must do so in writing no later than one week prior to the due date of this questionnaire. Written reque sts may be e-mailed to Ms. Jan Matuszko at matuszko.jan@epa.gov

.

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Where to Return the Questionnaire

Af ter completing the questionnai re and certifying the informa tion that it contains, use the enclosed mailing label to mail the completed que stionnaire to:

U.S. Environmental Protection Agency Stormwater Owner/Developer Long Questionnaire c/o Eastern Research Group, Inc. 14555 Avion Parkway, Suite 200 Chantilly, VA 20151

Certification Statement

The individual responsible for di recting or supervising the prepar ation of the questionnaire m ust read and sign the Certification Statement liste d below. The certifying official must be a responsible corporate official or his/her authorized representative. The signed certification must be returned with the completed survey.

Where to Get Help

If you have any questions regarding com pletion of this questionnaire you can request assistance using EPA’s e-mail helpline provided below. Pl ease include the name of the survey to which you are responding, the question number along w ith your questions. Respondents who desire assistance by telephone should send an e-mail with “Please Call Me” in the subject line. Please provide the call-back phone number, contact name, and desired day a nd time to call. The return phone call will be free of charge to the respondent.

E-mail address for help line: _________________________________

Confidential Business Information

Regulations governing the confiden tiality of business information are contained in the Code of Federal Regulations (CF R) at Title 40 Part 2, Subpart B. You may assert a business confidentiality claim covering part or all of the information you submit. Information that is publicly available should not be claimed as confidential, as described in 40 CFR 2.203(b):

“(b) Method and time of asserting business confidentiality claim. A business which is submitting information to EPA may assert a business conf identiality claim covering the information by placing on (or attaching to) the information, at th e time it is submitted to EPA, a cover sheet, stamped or typed legend, or other suitable form of notice complying language such as ‘trade secret,’ ‘proprietary,’ or ‘com pany confidential.’ Allegedly c onfidential portions of otherwise nonconfidential documents should be clearly iden tified by the business, and may be submitted separately to facilitate identification and hand ling by EPA. If the business desires confidential treatment only until a certain date or until the occurrence of a certa in event, the notice should so

state.”

If no business confidentiality claim accompanie s the information when it is received by EPA, EPA may make the information availabl e to the public without further notice.

You may claim as confidential al l information included in the re sponse to a question by checking the Confidential Business Information (CBI) box ne xt to the question number. Note that you may be asked to justify any clai m of confidentiality at a late r time, for example if someone

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requests access to your data. Note also that in form ation claimed confidential cannot be accessed or used by the industry to evaluate data and analyses supporting the regulations.

Information covered by a claim of confidentiality will be disclosed by EPA only to the extent of, and by means of, the procedures set forth in 40 CFR Part 2, Subpart B. In general, submitted information protected by a busin ess confidentiality claim may be disclosed to other employees, officers, or authorized representatives of the United States concerned with implementing the Clean Water Act. The authorized representatives include employees of other executive branch agencies, who may review CBI during the course of reviewing draft regulations.

Information covered by a claim of confidentiality will be made available to EPA contractors to enable the contractors to perf orm the work required by their contracts with EPA. All EPA contracts provide that contractor employees use the information only for the purpose of performing the work required by their contracts and will not disc lose any CBI to anyone other than EPA without prior written approval from each affected business or from EPA's legal office.

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## Detailed Instructions for Co mpleting the Questionnaire

Complete the questionnaire consid ering the following instructions:

 Personnel most knowledgeable about the subj ect areas covered by a specific section should complete that secti on of the questionnaire.

 For all questions and sections, read all in structions and definitions carefully. Pay particular attention to the distincti on between establishments and firms.

 Do not leave any entry blank. If the answer is zero, write “0" or “ze ro”. If a question is not applicable, write “NA.”

 Answer all of the questions in sequence unle ss you are directed to SKIP forward in the questionnaire. This is important since some que stions and/or sections are only applicable to some respondents.

 Use the units specified when responding to questions requesting measurement data (e.g., acres). If not specifie d and applicable, include units in your response

 The period of interest for the survey is calendar years 2005-2009 unless indicated
otherwise.

 Provide the requested information based on data you currently have. EPA is not requesting or recommending that respondents co llect new data to provide information for this survey. However, you may need to contac t other business estab lishments with which you were involved on individual projects, such as engineering or design firms, in order to answer some questions. Unless indicated othe rwise, provide estimates if actual values
are not available.

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## Certification Statement

The individual responsible for directing or supervising the preparation of the enclosed Stormwater Discharges from Developed S ites Owner/Developer Long Questionnaire must read and sign the Certification Statement below before returning both documents to the U.S. Environmental Protection Agency. The certifying official must be an official duly authorized representative. The Certification Statement must be completed and submitted in accordance with the requirements contained in the Code of Federal Regulations at 40. CFR 122.22.

I certify under penalty of law that the attached questionnaire was prepared under my direction or supervision in acco rdance with a system designed to ensure that qualified personnel properly gathered and evaluated the information submitted. The information submitted is, to the best of my knowledge and belief, accurate and co mplete. In those cases where we did not possess the requested information, we have provided be st engineering and/or financial estimates or judgment. I am aware that there are significa nt penalties for submitting false information, including the possibility of fines and imprisonmen t as explained in Se ction 308 of the Clean Water Act (33 U.S.C., Section 1318).

_____________________________ _________________________ Signature of Certifying Official Date

_____________________________ (______)_________________ Printed Name of Certifying Of ficial Telephone Number

_____________________________ Title of Certifying Official

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## Glossary of Terms

Term Definition

Bioretention A stormwater management practice that consists of an excavated
area that is filled with a mixture of soil and organic matter and that is planted with vegetation that is tolerant of inundation and
saturated soil conditions. Bioret ention includes rain gardens, sidewalk planters, curb extensions and other plant or soil systems designed to filter, infiltrate or evapotranspirate stormwater.

Cistern Large storage devices that ar e often built below ground, at ground level, or on rooftops, for stori ng captured stormwater and can be integrated with more sophisticated pumping devices. For example,
some cisterns collect stormwater that is subsequently used for nonpotable plumbing, such as flus hing of toilets, or irrigation applications.

Commercial/Institutional A project that includes structur es designed for use by retail, wholesale, office, hotel, or other service-providing facilities/businesses, including Fede ral, State, and local government
facilities.

Constructed Wetlands A man-made basin that contains wa ter, a substrate (soil, gravel, rock, organic materials, etc.), pl ants (vascular and non-vascular), and organisms similar to those usually found in natural wetlands. The number of plants and the biod iversity of a c onstructed wetland are greater than that of wet re tention pond. Constructed wetlands usually use a relatively impermeable subsurface layer to prevent water from seeping into the ground.

Construction Phase The project phase following land ac quisition and land development. Construction of structure(s) occurs during this phase. Activities in this phase also include any legal or marketing activities required to bring the project to completion. Also commonly called vertical
construction.

Detention Basin Practice which hold stormwater temporarily and discharge the stormwater over an extended pe riod of time (hours to days) generally by controlli ng the size of the discharge volume and flow

rate.

Developer A person, business, or partnership that controls project design and/or land development activities associated with a project. The developer may make improvements to land parcel(s) owned by the developer or on behalf of a separate owner-entity (e.g., the developer may be the land owner’s agent).

Establishment A single, permanent, physical office location where business is conducted and for which revenue, employment, and other records are kept.

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Term Definition

Final Project Value The value of the project at the tim e of completion. This value could be the project’s sales value or the recorded asset valu e of the project when has been completed.

Firm A business organization or entity consisting of one or more
domestic establishment locatio ns under common ownership or
control.

Green Roof A vegetative system installed on top of and in addition to the traditional roof system. A green roof includes engineered soil layers (e.g., a waterproof memb rane, drainage, high inorganic growing media), and appropriate pl ant species. Green roofs reduce surface runoff from the rooftop by absorbing stormwater and slowing stormwater flow rates, a nd provide ancillary benefits such as summer cooling, lowered urban heat island effect, and improved air quality.

Impervious Surface Low-permeability material such as asphalt or concrete. Common impervious areas include, but ar e not limited to, roads, rooftops, walkways, patios, driveways, parking lots or storage areas, concrete or asphalt paving, or other surfaces which similarly impede the
natural infiltration of storm water.

Industrial A project that includes structures designed for industrial purposes including, producing, processi ng, or assembling goods (for example, manufacturing, agricultu ral, and mining structures).

Infiltration Basin A shallow rock-filled trench or depression with no outlet intended to detain and then infiltrate stormwater into the underlying soil. Typically stormwater first passes through a swale or other stormwater control before reaching this device.

Land Acquisition An initial project phase, preceding land development and construction. In this stage, financ ing is assembled to purchase raw, vacant, un-zoned land parcel(s). This phase may also include project design and planning elements using e.g., architectural services. For redevelopment project s the land has previously been developed and zoned. However, the property made need to be rezoned for a new purpose, and proj ect will require designing and planning as well.

Land Development The second project phase, followi ng land acquisition and preceding construction. During this phase, raw land is converted into permitted, buildable lot(s) in a process that requires site approvals, hearings, etc. This process can take months to years. Costs incurred during this phase may include “sof t” costs for architectural and engineering services, legal work, permits, fees, and testing; and “hard” costs, such as land clea ring, installing utilities and roads, and preparing foundations or pads.

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Term Definition

Low Impact Development (LID) Development that is designed to be hydrologically functional by mimicking pre-development hydrology or hydraulic conditions. This is achieved by using design techniques that infiltrate, filter, evaporate, and store runoff close to its source (e.g. bioretention, rain gardens, cisterns, green roofs).

Manufactured Device Manufactured devices include a va riety of proprietary and nonproprietary stormwater management practices that are available from various suppliers and vendors and are designed to remove pollutants through a combination of filtration, gravity separation, flotation and hydrodynamic processe s. Examples include catch basin inserts, filtration units, vaults and separators.

Media Filter Filters that stormwater passes through for removal of solids. Filters can be made out of sand, peat, foam , crushed glass, textile, or other
suitable material.

Mixed Use Project A project that is designed for more than one land use category (for example, Single-Family Housing and Multi-Family housing, Residential and Commercial, or Commercial and Industrial).

Multi-Family Residential A project where multiple separate housing units for residential (i.e., non-commercial) inhabitants are c ontained within one building; also known as multi-dwelling unit. Does not include attached single-family homes, such as townhouses.

New Development Development that occurs on land where generally no or minimal structures or other impervious su rfaces, such as buildings, parking lots, and roads exist, including agricultural, forested, and open/barren land. These are common ly referred to as Greenfield
sites.

Owner The firm, individual, or instituti ons for which the project is being built. The owner may also act as the developer for a project, or may hire or partner with a separate developer.

Pervious Paving Pavement composed of a permeab le pavement material, which
allows distributed infiltration in to the underlying soil. There may also be an underlying stone reser voir that temporarily stores the surface runoff before it infiltrates into the underlying soil. Examples include; porous asphalt, permeable concrete, permeable block pavers.

Project New development or redevelopmen t of buildings or other real estate improvements on a contiguous site, which may be undertaken by a single entity or an entity partnership/team. A project generally consists of three phases: land acquisition, land development, and construction. It is possible that each entity or partnership actively involved in a project might only co ntrol one or two of the project phases, while another entity or partnership may control the other project phase(s).

Remodel Remodeling is alterations to the inte rior of a structure, and does not
involve the installation of a ny new impervious surface.

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Term Definition

Redevelopment Development of sites with exis ting structures or impervious surfaces. Redevelopment does not include projects that are solely remodeling or alterations to th e interior of a structure.

Retention Basin A retention basin, also called a we t pond, is an impoundment that is designed to maintain a permanen t pool of stormwater between
storm events. A retention basin di ffers from a detention basin, which is designed to empty between storm events and does not maintain a permanent pool.

Retention Practices Stormwater techniques that mana ge stormwater on-site through infiltration, evapotranspiration or harvesting.

Single-Family Residential A project in which housing units are designed and maintained for occupancy by only one family. This includes both attached and detached single-family homes.

Stormwater Post
Construction Controls Practices that are installed a nd maintained to control post construction stormwater discharges.

Swale A swale, sometimes called a biofilte r, is a grass-lined channel that is designed to convey stormwat er in shallow flow. Pollutant removal is accomplished through fi ltration through the vegetation and swales are frequently designed to allow for infiltration of

stormwater.
Stormwater controls that direct stormwater discharges to a treebox, where it can be filtered by the so il and vegetation. Some tree boxes may drain to a channel below, wh ich conveys stormwater to the selected collection system. Transportation A project that includes uses such as highways and bridges

Underground Detention Underground vaults, storage cells, or water piping systems used for
stormwater flow rate and volume cont rol. This is an alternative to storage above ground (e.g., pond).

Underground Infiltration Underground infiltrati on includes a variety of proprietary and nonproprietary practices that are us ually placed under parking lots and streets that temporarily store and infiltrate stormwater. Common materials include corrugated meta l pipe, pre-cast concrete and polyvinyl chloride (PVC).

Utility A project that includes uses such as water and/or gas pipelines, or electricity transmission lines.

Water Body A water body includes waters of the state, waters of the U.S., and for purposes of this survey, gene rally includes any surface water such as a stream, river, lake, bay or ocean.

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## General Information

1. Provide contact informa tion for your establishment.

Establishment’s Full Legal Name Address

Phone/Fax Number Website

Email

2. Provide contact information for the person to who m EPA should direct follow up calls concerning your responses to this questionnaire if necessary.

Name Email

Title Best Time to Contact

Phone/Fax Number

This questionnaire will ask a series of questi ons about your operations and the projects in which you participated during 2005 – 2009. Prior to responding to each question, please carefully review the Glossary of Terms for applicable definitions

.

3. Many of the following questions will ask for information for each year that you were in business during 2005 – 2009. Unless specified othe rwise, EPA is requesting that you provide information for calendar years 2005-2009. However, for the financial questions only (e.g., revenue, project value), you may respond for the calendar year or your fiscal year. Please indicate whether you are reporting financial information for the calendar year or your fiscal year by checking one box below.

□ Calendar year (Skip to Question 4)

□ Fiscal year

If you checked “Fiscal Year”, please indicate the first month of your fiscal year.

□ January □ July

□ February □ August

□ March □ September

□ April □ October

□ May □ November

□ June □ December

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4a. Did your establishment complete one or mo re phases of at leas t one construction, land developm ent or redevelopment project during calendar years 2005 – 2009? If the only work you completed during calendar years 2005 – 2009 wa s alteration or remodeling of an existing structure or structures, then you s hould answer “No” to this question.

□ Yes

□ No ( You have completed the survey. Thank y ou for your input. Si gn the certification
statement on page 6 and return to the address indicated on page 3 ).

4b. During calendar years 2005 – 2009, was your establ ishment the owner or developer for at least one project or a phase/portion of at least one project (either as the so le responsible party or as a participant in a joint venture or other multiple party structure)?

□ Yes

□ No ( You have completed the survey. Thank y ou for your input. Si gn the certification
statement on page 6 and return to the address indicated on page 3 ).

4c. During calendar years 2005 – 20 09, did your establishm ent complete at least one project that
resulted in one or more acres of land disturba nce AND/OR that resulted in the installation of 5,000 square feet or more of new impervious surfaces (roads, roofs, etc.)?

□ Yes

□ No ( You have completed the survey. Thank y ou for your input. Si gn the certification
statement on page 6 and return to the address indicated on page 3 ).

4c. Were all of your projects completed dur ing calendar year 2005 th rough 2009 projects for
which the area was reclaim ed and no impervious surfaces were installed? Examples would be water, gas or utility pipelines or undergr ound electric or teleco mmunications cables.

□ Yes ( You have completed the survey. Thank y ou for your input. Si gn the certification
statement on page 6 and return to the address indicated on page 3 ).

□ No

5. Indicate the state(s)/territori es where your establishm ent has pa rticipated in projects at any time during calendar year 2005 thro ugh 2009 (check all that apply).

□ AL □ CO □ GA □ IN □ MD □ MO □ NC □ NY □ RI □ VA

□ AK □ CT □ HI □ KS □ ME □ MT □ ND □ OH □ SD □ VT

□ AR □ DE □ IA □ KY □ MI □ NM □ NH □ OK □ TN □ WA

□ AZ □ DC □ ID □ LA □ MN □ SC □ NJ □ OR □ TX □ WI

□ CA □ FL □ IL □ MA □ MS □ NE □ NV □ PA □ UT □ WV

□ Puerto
Rico □ Other U.S. Territory (specify):______________ □ WY

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6. Is your establishment independently owned and operated (i.e., the establishm ent is the same entity as the firm)?

□ Yes (skip to Question 10)

□ No (continue to the next question)

7. Provide contact information for the firm th at owns and operates this establishm ent.

Firm’s Full Legal Name Address

Phone/Fax Number Website

8. In what state is your parent firm organized as a legal entity?

__________________________________________

9. □ CBI. Complete the table below with your parent firm’s total annual revenue for 2005-2009.
Provide values in dollars and fill in all values; you may round values to the nearest thousand dollars. If your firm was not in business for one or more of the years, enter “N/A” for those

years.

Total Firm Revenue (Dollars; may round to nearest thousand)

Year

2005 2006 2007 2008 2009

10 Are you a publicly traded company?

□ Yes

□ No

11. Indicate your type of business organization.

□ Sole proprietorship

□ Partnership

□ Corporation (standard, “C” corporation)

□ Subchapter S Corporation

□ Lim ited Liability Corporation

□ Other: _______________________________________

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## Establishment Financial Information

12. □ CBI. Complete the table below with your es tablishment’s annual revenue for 2005-2009.
Provide values in dollars and fill-in all values; you may round values to the nearest thousand
dollars.

Establishment Revenue (Dollars; may round to nearest thousand)

Year
Revenue Type 2005 2006 2007 2008 2009 Revenue from projects that
meet the Question 4 Criteria

All other revenue*

Total Revenue**

* Including, for example, new or redevelopment projects that do not meet the Question 4 Criteria, and expansions or alterations of existing structures. **The previous two rows in the table should sum to this value.

13. □ CBI. How much of your establishment’s annual revenue was generated by performing each of the following roles? Provide values in dollars and fill in all values, indicating not applicable categories with a “0”; you may round values to the nearest thousand dollars.

Revenue (Dollars; may round to nearest thousand)

Year Project Role 2005 2006 2007 2008 2009
Owner Only
Developer Only
Owner & Developer

14. □ CBI. How much of your establishment’s annual revenue was generated from the following types of activity at any time during 2005 through 2009? Provide values in dollars and fill in all values, indicating not app licable categories with a “0”; you may round values to the
nearest thousand dollars.

Revenue (Dollars; may round to nearest thousand)

Year Type of Project 2005 2006 2007 2008 2009
New Development
Redevelopment
Alterations and Expansions

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15. □ CBI. How much of your establishment’s annual revenue was generated from the following types of projects during the period from 2005 through 2009? Provide values in dollars and fill in all values, indicating not applicable ca tegories with a “0”; you may round values to the
nearest thousand dollars.

Revenue (Dollars; may round to nearest thousand)

Year
Type of Project 2005 2006 2007 2008 2009
Single-Family Residential

Multi-Family Residential

Commercial/ Institutional

Industrial

Transportation

Mixed Residential (single-family and multi-family)

Mixed Residential and
Commercial/Institutional

Mixed Commercial/Institutional
and Industrial

Other Mixed Use

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## Project Information: Part 1

16. □ CBI. How many projects that meet the Question 4 Criteria was your establishment participating in on the last day of 2009?

_______________

17. □ CBI. How many total projects did your establ ishment finish participating in during calendar years 2005-2009? For projects meeting the Question 4 Criteria enter the number of projects that fall into each in each of the following size and type categories. For those projects
that do not meet the Question 4 Criteria, enter the number that fall into each type category.

Number of Projects

Project Size Range for Projects Meeting the Question 4 Criteria

Type of Project Less than 1

Acre 1 – 9.9

Acres 10 – 24.9

Acres 25 – 49.9

Acres 50 – 99.9

Acres 100 Acres

or More Projects not Meeting the Question 4

Criteria
Single-Family
Residential

Multi-Family Residential

Commercial/
Institutional

Industrial

Transportation

Mixed Residential(single-family and multifamily)

Mixed Residential and
Commercial/Institutional

Mixed
Commercial/Institutional
and Industrial

Other Mixed Use

Total

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18. □ CBI . For your residential projects that meet the Question 4 Criteria , how many projects did your establishment finish part icipating in at any time dur ing calendar years 2005-2009 in each of the following categories?

Number of Projects that Satisfy the Question 4 Criteria

Group Projects by Number of Housing Units in Project Type of Project 1-10 Units 10 – 25 Units 25 – 50 Units 50 – 100 Units >100 Units

Single-Family Residential

Multi-Family Residential

Mixed Residential (singlefamily and multi-family)

Mixed Residential and
Commercial/Institutional

Other Mixed Use

Total

19. To your knowledge, how many projects that you participated in at any time during calendar year 2005 – 2009 that meet the Question 4 Criteria incorporated low impact development (LID) practices for post-construction stormwater management?

________

20. □ CBI. Complete the table below with the total value of all projects:

1. Where your participation in the projec t ended in the year indicated; and,

2. That satisfy the Question 4 Criteria

. The project value is the final value at the time when your participation in the project
ended. This value could be the project’s sales value (whether as a project completed for
retail sale or for sale to anot her party for performance of th e next project phase), or the recorded asset value of the project when tr ansferred from work-in-progress status to completion of your establishment’ s participation in the project. Provide values in dollars and fill in all values; you may round values to the nearest thousand dollars.

Project Value (Dollars; may round to nearest thousand)

Year
Type of Project 2005 2006 2007 2008 2009

Single-Family Residential

Multi-Family Residential

Commercial/ Institutional

Industrial

Transportation

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Project Value (Dollars; may round to nearest thousand)

Year
Type of Project 2005 2006 2007 2008 2009
Mixed Residential (single-family and multi-family)

Mixed Residential and
Commercial/Institutional

Mixed Commercial/Institutional
and Industrial

Other Mixed Use

Total

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## Project Information: Part 2 Detailed Information

The next set of questions is meant to help EPA to develop a profile of projects performed during the last five years. Rather th an ask each respondent for inform ation on all the projects they participated in during the 2005-2009 time peri od, EPA has assigned each respondent a random date during this period, and is asking respondents to de scribe the projects they participated in that were on-going on the specified date. An on-going pr oject is one that was in the land acquisition, land development, or construction phas e on the date identified below.

Complete one copy of this section (covering Ques tions 21- 50) for each project that meets the Question 4 Criteria and that was on-going on ___________________. ( this is a randomly generated date between January 1, 2005 and December 31, 2009 ) In the event that you were not responsible for the entire project, provide an swers for the phases or portions for which you were directly involved and for general proj ect questions that you know the answer to.

Project Technical Information

21. Project Name or other identifier you use to describe this project:

__________________

22. Were you the Owner/Developer for the entire dur ation of the project or just a phase/portion of the project?

□ I was the owner/developer for the entire project. (Skip to 24)

□ I was the owner/developer for onl y a portion of the whole project.

23. Please indicate what portions of the project you were the owner/developer for.

□ General Site Clearing/Grubbing

□ Grading

□ Infrastructure (roads, utilities, etc.) Installation

□ Lot Development/Vertical Construction

24. If the property is non-residential and you did not retain ownership after project completion, who did you transfer ownership to?

________________________________________________________________

25. Please provide the location of the project.

Street Nam e & Address: Town/City:

State: ZIP Code:

Latitude: Longitude:

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26. Did you file for coverage under a state or federal general construction perm it?

□ Yes

□ No (Skip to 30)

27. What was the permit number assigned to you by the State or EPA when you filed for an NOI/NOC for the project?

__________________

28. What were the project start and end dates as listed on the NOI/NOC?

Start Date _____________ End Date _____________ (MM/DD/YYY) (MM/DD/YYY)

29. What was the actual project start and end date?

Start Date _____________ End Date _____________ (MM/DD/YYY) (MM/DD/YYY)

30. Indicate the project type and approxim ate size. If more than one type of developed area exists within this project, specify by area.

Developed Area Type Area of the Project (acres)

Total Newly Developed Area Single-Family Residential detached Single-Family Residential attached Multifamily Residential

Commercial

Industrial

Institutional

Government Transportation Non-Building Redeveloped Area Single-Family Residential detached Single-Family Residential attached Multifamily Residential

Commercial

Industrial

Institutional

Government Transportation Non-Building

31. How many residential dwellings units were constructed as a pa rt of this project? (If none enter 0) ___________________

Owner/Developer Long Questionnaire Page 20 of 28Survey ID: ________________ OMB Control No. 20XX-XXXX Approval expires XX/XX/XX

32. PRE-Construction Land Cover

Indicate what the land cover of the project area was prior to your developm ent activity. In the event of that you were only responsible for developing a portion of the project, indicate what the land use was when you bega n your construction activity. Check all that apply.

□ Developed (includes buildings, roads, pa rking lots, etc.). Specify the types of developed areas present below.

□ Residential

□ Commercial

□ Industrial

□ Parking Lot

□ Brownfield Area

□ Barren/Open

□ Forested/Woods

□ Shrubland

□ Grassland

□ Pasture

□ Cropland/Farm

□ Wetlands

□ Other ( Specify __________)

□ Don’t Know

33. POST-Construction Land Cover

Indicate th e area occupied by each of the follo wing site components. Fill in information for each site component. If not applicable write “NA”. If information is not available or unknown for a particular site co mponent, please provide your best estimate or indicate
“NK” for Not Known.

(a) Indicate the area occupied by each of the following impervious site components. Do not include the footprint of buildings that ha ve a green roof or di sconnected spout leading to an infiltration BMP or transportation areas which are constructed of pervious pavers or other pervious materials. Ra ther, include these areas in response to part (b).

Acres Covered by Impervious Site Components

Site Component Area (Acres or % of Total Project Area)

Building Areas/ Rooftops (house, garage, storage structure etc.)

Roads

Driveways

Parking area

Other Impervious Area, Specify:_______________________

Owner/Developer Long Questionnaire Page 21 of 28Survey ID: ________________ OMB Control No. 20XX-XXXX Approval expires XX/XX/XX

(b) Indicate the area occupi ed by each of the following pervious site com ponents.

Acres Covered by Pervious Site Components

Site Component Area (Acres or % of Total Project Area) Pervious paving (includes porous asphalt, pervious concrete, modular block pavers or similar practices)

Grass lawns, turf grass or other open green space

Infiltration BMPs (such as bioretention, rain gardens and swales) Water bodies including natural ponds and stormwater ponds

Cropland/Pasture

Natural vegetation and undisturbed areas (forest, shrubland, grassland, etc)

Wetlands

Other pervious area, specify:______________________

34. Is a waterbody located adjacent to the property, or does a waterbody pass through the property?

□ Yes □ No (SKIP to Question 36)

35. Was there a vegetative buffer zone that was eith er preserved and/or creat ed at the shoreline?

□ Yes □ No

36. Has a soils survey been conducted at the site?

□ Yes

□ No (Skip to 39)

□ Don’t Know (Skip to 39)

37. Indicate the approximate distribut ion of soil types at this site

Type % Coverage

Clayey soils (clay, clay loam)

Silty soils (silt, silt loam)

Loamy soils (loam, sandy loam)

Sandy soils (sand, loamy sand)

Owner/Developer Long Questionnaire Page 22 of 28Survey ID: ________________ OMB Control No. 20XX-XXXX Approval expires XX/XX/XX

38. Indicate the approximate distributi on of hydrologic soil groups at the site

Soil Group % Coverage

Group A

Group B

Group C

Group D

39. To what does the site discharge stormwater (check a ll that apply)?

□ a MS4 owned and operated by a local government, sewer dist rict or other public body

□ direct discharge to surface water

□ storm sewer/control structure (pond) owned by a private entity

□ other, specify: ______________

40. Indicate which specific or numeric stormwater performance standards and/or design criteria requirements apply to this proj ect. (Check all that apply.)

□ Post-development peak runoff/discharge rate must match pre-development peak runoff/discharge rate for a specified st orm return interval or intervals.

□ 1 year □ 25 year

□ 2 year □ 100 year

□ 5 year □ Other ( Specify ) __________

□ 10 year

□ Detention of a specified storm depth or vol ume (such as 0.5 inch per acre or 1 inch per impervious acre). ( Specify ) __________

□ Detention of a specified storm volume (suc h as 1,800 cubic feet pe r acre or 3,600 cubic feet per impervious acre). ( Specify ) __________

□ Detention of a specified percen tile storm event (such as the 80 th percentile storm). ( Specify ) __________

□ Retention of a specified storm depth or vol ume (such as 0.5 inch per acre or 1 inch per impervious acre). ( Specify ) __________

□ Retention of a specified storm volume (suc h as 1,800 cubic feet pe r acre or 3,600 cubic feet per impervious acre). ( Specify ) __________

□ Retention of a specified percen tile storm event (such as the 80 th percentile storm).

Owner/Developer Long Questionnaire Page 23 of 28Survey ID: ________________ OMB Control No. 20XX-XXXX Approval expires XX/XX/XX

( Specify ) __________

□ Pollutant reduction requirem ent (for exampl e, stormwater control practices must be installed to remove 80% of the post-cons truction TSS loading and 40% of the postconstruction nitrogen loading) Specify : ____________

□ Channel protection measures (such as a maximum allowable discharge velocity or other metric) Specify : ____________

□ Infiltration/groundwater recharge requireme nt (for example, maintain predevelopment groundwater recharge levels or infilt rate the first 0.5 inch of runoff) Specify : ____________

□ Limits for effluent concentr ations of specific pollutants Specify : ____________

□ Requirements for control of temperature Specify : ____________

□ Flood control requirements other than the peak discharge rate control and on-site detention/retention requirements specified above. Specify : ____________

□ Stream buffer requirements (for exampl e, a 50 foot vegetated buffer must be maintained/implemented adjacent to waters of the state) Specify : ____________

□ Limits on the maximum percent imperviousness for the site, or maximum directly connected impervious surface or other limits on impervious surfaces. Specify : ____________

□ Other Standards Not Identified Above, Specify: ___________________

41. Did your firm perform a cost comparison betw een traditional stormwater post construction controls (i.e. basins) and stormw ater post construction controls that retain runoff onsite (also known as low impact development practices whic h include bioretention, rain gardens, etc) for this project?

 Yes  No

42. Were stormwater post construc tion controls that retain runof f onsite planned for this site?

□ Yes □ No

43. Were stormwater post construc tion controls that retain runof f onsite implemented on this
site?

□ Yes □ No

Owner/Developer Long Questionnaire Page 24 of 28Survey ID: ________________ OMB Control No. 20XX-XXXX Approval expires XX/XX/XX

44. What, if any, challenges did your establishmen t encounter in implem enting stormwater post construction controls that retain runoff onsite? Or if the controls/practices were planned but not implemented, what prevented your establishment from implementing them? Check all that apply.

□ No stormwater controls/practices that retain runoff onsite planned or implemented

□ Zoning ordinances

□ Expense

□ Local stormwater regula tions/permit requirements

□ Site limitations

□ Financing requirements

□ Lack of local providers w ith retention practic e experience (site designers/engineers, architects, subcontractors and installation, etc.)

□ Lack of desirability by site owner or other project participant

□ Other ____________________________________________

□ Not Applicable

□ None

45. If on-site stormwater post cons truction controls had not been im plemented at the site, how would the additionally available land most likely been used? Check all that apply.

□ Additional building units

□ Larger building footprint

□ Additional connected impervious area su ch as parking, driveway, or garage

□ Additional disconnected imperv ious area such as a shed

□ Additional green space such as lawn

□ Additional natural vege tation/undisturbed land

□ Stormwater management techni que did not have a footprint

□ Other _________________________________________

□ Not Applicable (No on-site stormwater post construction c ontrols/practices)

□ Unknown

46. Indicate which of the following stormwat er post construction controls have been installed for this project. Check all that apply.

□ Detention/retention basins

□ Curbs and Gutters

□ Storm Sewers

□ Catch Basins

□ Swales

□ Constructed Wetlands

□ Wetland Channels

□ Underground Detention

□ Underground Infiltration

□ Manufactured Devices, specify: ____________________

□ Tree Boxes

□ Green Roofs

□ Bioretention/Rain Gardens

□ Infiltration basins/trenches/dry wells

Owner/Developer Long Questionnaire Page 25 of 28Survey ID: ________________ OMB Control No. 20XX-XXXX Approval expires XX/XX/XX

□ Porous asphalt

□ Perm eable concrete

□ Permeable modular block pavers

□ Sand filters or other types of media filters

□ Cisterns

□ Rain barrels

□ Other _________________________________________

□ None

47. Provide an estimate of the final value of the pr oject and the estim ated co st of the stormwater post construction controls associated with this project. If your partic ipation in the project ended prior to the completion of the constr uction phase, provide your best approximation.

Project value: $ __________________ Stormwater Post Construction Costs $ __________________

If costs of stormwater controls are unknown, provide an estimate of the percentage of the total construction costs: ________%

Project Financial Information

48. □ CBI. Please complete the table below regarding your participation in the phases of this project.

Land Acquisition Land Development Project
Construction Check all phases in which your establishment actively participated □ □ □

Indicate your establishment’s percent share of ownership in the project (%) ____% ____% ____%

49 □ CBI. Provide the following financial information for each phase of the project in which you were an active participant.

Land Acquisition and Initial Pr oject Planning and Design

Item Cost ($)

Raw Land Cost
Fees - Legal, Accounting, Financi ng, and Permitting incurred during land acquisition phase
Project Design, Architectural Services, etc.

Interest or other financing co sts incurred during this phase

Establishment’s Overhead

Other Costs

Owner/Developer Long Questionnaire Page 26 of 28Survey ID: ________________ OMB Control No. 20XX-XXXX Approval expires XX/XX/XX

Land Development

Item Cost ($)
Acquisition value (if your business participation in the project began at Land Development, what was the cost of purchasing partially developed land). Land Development (includes site prep aration, site improvements such as paving, water and sewer conn ections, erosion and sediment control, land preservation and planting etc.)
Fees - Legal, Accounting, Impact Analysis, Other

Interest or other financing co sts incurred during this phase

Establishment’s Overhead

Other Costs

Project Construction

Item Cost ($)
Acquisition value (if your business participation in the project began at Project Construction, what was the cost of purchasing partially developed land)
Fees - Legal, Accounting, Building Permit and Inspection, Other

Cost of Construction – Material s, Labor, Services, Construction Contracts, etc.
Interest or other financing co sts incurred during this phase

Establishment’s overhead
Sale or Other Completion Dis position Costs (e.g., legal fees, accounting fees, marketing fees)

Other Costs

50. □ CBI. Provide information on the financial struct ure and financing terms for each phase of the project in which you were an active particip ant. If you were not a participant in that phase
leave blank.

Financing Information for Each Project Phase

Item Land Acquisition Land Development Construction Primary Debt Financing (first or senior debt)

Fraction Financed (%):

Interest Rate, if a fixed rate (%):

Interest Terms, if not fixed:

Base Rate (check box): 

### □ Prime Rate



### □ LIBOR



### □ Other: 

### □ Prime Rate



### □ LIBOR



### □ Other: 

### □ Prime Rate



### □ LIBOR



### □ Other:

Increment to Base Rate (%):

Owner/Developer Long Questionnaire Page 27 of 28Survey ID: ________________ OMB Control No. 20XX-XXXX Approval expires /XX/XX

Owner/Developer Long Questionnaire Page 28 of 28 XX

Secondary Debt or Other Fixed Repayment Term Financing

Description:

Fraction Financed (%):

Interest Rate, if a fixed rate (%):

Interest Terms, if not fixed:

Base Rate (check box): 

### □ Prime Rate



### □ LIBOR



### □ Other: 

### □ Prime Rate



### □ LIBOR



### □ Other: 

### □ Prime Rate



### □ LIBOR



### □ Other:

Increment to Base Rate (%):

Equity Financing (Owner’s Financing or other Non-Debt, Non-Fi xed Repayment Term Financing)

Fraction Financed (%):

Other Equity Financing or other Non-Debt, Non-Fixed Repayment Term Financing (e.g., joint venture partner financing or limited partner financing)

Description:

Fraction Financed (%):

Once you have completed a copy of this section for all projects described in the associated instructions on page 19, you have completed the questionnaire. Sign the Certification Statement and refer to instruc tions for mailing the questionna ire back to the United States Environmental Protection Agency. Thank you.