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STATE SMALL BUSINESS STATIONARY SOURCE

TECHNICAL AND ENVIRONMENTAL COMPLIANCE

ASSISTANCE PROGRAM (SBTCP)

ANNUAL REPORTING FORM

FOR THE PERIOD January 01, 2014 TO December 31, 2014

(We are collecting objective information on each SBTCP. This report is not an evaluation of your program)

*** Completed forms are due by Friday, May 29, 2015***

This is the Annual Reporting Form for the State Small Business Stationary Source Technical and Environmental Compliance 

Assistance Programs (SBTCPs) under section 507 of the Clean Air Act (CAA) as amended in 1990. For over 20 years, these programs 

known as the state Small Business Ombudsman and Small Business Environmental Assistance Programs (SBO/SBEAP) have provided 

extensive, hands-on assistance to small businesses to help them understand and comply with environmental regulations. The 

programs also advocate with the Environmental Protection Agency (EPA) to issue regulations that are relatively simple to implement 

and clear and easy for small businesses to comply with. 

The public reporting and recordkeeping burden for this collection of information is estimated to average 4 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 completed form to this address.

NOTE: This survey captures data on the assistance efforts of diverse state programs and program data will 

differ based on the specific program structure and menu of services. Therefore, if you do not have all the 

information requested, you may leave sections blank.

INSTRUCTIONS FOR COMPLETING THIS FORM

1. Save this document (using the "Save As" function from the File menu) to your hard drive using the name of your 

State or Territory and the date as the document title before continuing.

2. Please complete this form in whatever version works best for you. You may complete this form in Microsoft 

Word, Adobe, or print out, complete in hardcopy, then scan it back into an electronic version to be returned by 

email. 

3. You should have already collected the requested information. If a question asks for data you do not have, please 

briefly explain why it is not available in the narrative box at the end of each section and/or at the end of this 

document. For future reports, you may need to revise the information that you track.

4. Each answer block (with the noted exceptions) must contain complete information. If part of the question does 

not apply, indicate "not applicable," "NA," “0,” or another appropriate answer. If you do not collect a particular item, 

you can enter “not tracked” or “not collected” or either abbreviation (NT or NC). 

5. Please do not answer questions by referring to attached documents or a previous SBTCP report. Whenever 

possible respond to the questions with the required data necessary to easily compile all the states information

cohesively. 

6. In the narrative section at the end of the form, you may cut and paste text from another file. Text will be autoformatted to fit the allocated space.

7. Once your form is complete please e-mail a copy of the document to Elnora Thompson thompson.elnora@epa.gov

and Paula Hoag, Hoag.paula@epa.gov.
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8. If you have questions, contact Paula Hoag at 202 566-2496 or hoag.paula@epa.gov.

ADDITIONAL SUGGESTIONS FOR COMPLETING THIS FORM

 Gathering information for this report is a team effort! Enlist the help of key contacts from the SBO, the 

SBEAP, and the CAP, and ask them to complete applicable sections.

 However, one person should take responsibility for completing and submitting this Form.

 Refer to last year's report when completing this year's Reporting Form.

1. PROGRAM INFORMATION

Name of State or Territory California

Report Contact Name

Contact Phone Number

What Components of the 507 Program does your state have?

 SBO 

 CAP

 SBEAP

 Dual SBO/SBEAP (combined role in one person)

Are all three components reporting on this form?  Yes  No 

Component(s) not reporting:

SBEAP

 Dual Role (SBO/SBEAP)

SBO

(Skip if dual role)

CAP Chair

Name Of Primary Contact

Title

Agency/Organization

Street Address

City, State, Zip

Telephone Number

Email Address

Web Site

Where is each 507 program component administered or 

housed? (for the CAP, check box of agency who provides the 

professional staffing for your CAP)

SBEAP SBO Dual Program

(SBO/SBEAP) CAP

State Regulatory Agency

Local Regulatory Agency
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Commerce/Economic Development Agency

Small Business Development Center

Private Contractor

College/University

Chamber of Commerce

Trade Group

Other __________________________________

2. STAFFING 

How many employees, measured as full-time equivalents (FTEs), support the SBO & SBEAP?

If the SBEAP function is not full-time for staff, indicate the fraction of FTE spent on the 507 program. If funding sources for a position 

include something other than dedicated for the 507 program (e.g., a pollution prevention grant), indicate the fraction of FTE

dedicated from other funds outside the SBO/SBEAP staff numbers, in the "Other staff" section. If a position was vacant at any point 

during the year, enter that information in the "If vacant, percent of year vacant" column. 

Total FTEs (FTE time/# staff)

[For example: 0.25 FTE/1 staff; 0.5 FTE/1.5 staff, etc.)

If vacant, percent of year vacant

[For example: 1 FTE vacant 75% year]

SBEAP Staff: 

SBO Staff:

SBO/SBEAP Dual program staff: 

Other staff: 

Staffing level:  Increased  Decreased  Remained the Same 

Change in staffing level was: Temporary  Permanent 

Comments on 

staffing changes:

3. MEDIA 

What formal media (air, water, waste, etc.) services does your 507 program provide? 

Only check multimedia if providing media services other than air is a required function of your program.

 Air Only
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 Multimedia

Check services in addition to air:  Water  Waste  Energy  P2  Other _____________________________

If your program does not offer a formal multimedia program, do you provide limited services in other areas like water, waste,

energy, etc.?  Yes  No

Comments on multimedia:

. 

Of the SBO/SBEAP activities within your program, please provide a rough estimate of the percentage of time spent on each media 

program or other programs. To estimate, programs may use such things as demands for services like “% of helpline calls”, training, 

tool development, or other initiatives focused on a particular media, or simply based off budgeted/work plan levels.

Program % Air % Waste % Water % Other (enter description of other)

SBEAP

SBO

Dual (SBO/SBEAP)

CAP

□ Do not have this information but mainly air

□ Do not have this information but conduct activities in all media

4. BUDGET

SBEAP (or Dual Program) BUDGET

Record the budget for your SBEAP for the calendar year. If your budget is by fiscal year (FY), report the FY budget that was in effect 

as of 12/31 of the calendar year used for reporting data. Explain any changes to the budget in the comments box.

SBEAP Current Budget (as of 12/31) 

 Dual (SBO/SBEAP reported here)

Contains CAP Funding  Yes  No

Direct Annual CAP expenditures (if known)

Budget Changes

 Increase  Decrease  No Change

If budget changed, was it:  Temporary  Permanent 

Budget Source(s) - check all that apply (if 

known)

 Air  Waste  Water 

 Other federal grants  Other state funds 

 Other (e.g., fees, SEP, donations; please list) 

____________________________
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SBO BUDGET

Record the budget for your SBO for the calendar year. If your budget is by fiscal year (FY), report the FY budget that was in effect as 

of 12/31 of the calendar year used for reporting data. Explain any changes to the budget in the comments box.

Comments/ Explanations (additional sources, if other funding or changes, describe)

5. COMPLIANCE ADVISORY PANEL (CAP)

Does your state have a 

CAP?  Yes  No 

Total number of positions : 

________

Number of vacant positions

________

Reason for any vacant 

positions in last FY  Reduced funding  Temporary vacancies 

 Not getting 

appointments 

 Other :

Is your CAP active 

(holding meetings or 

conference calls)?

 Yes  No  N/A # of meetings/calls held 

over the FY: 

Comments/ Explanations (describe any issues with CAP changes, appointments, etc)

.

6. OUTREACH AND TECHNICAL ASSISTANCE

SBO Current Budget (as of 12/31) 

(skip if Dual recorded above)

Contains CAP Funding  Yes  No

Direct Annual CAP expenditures (if known) $

Budget Changes (if known)

 Increase  Decrease  No Change

If budget changed, was it:  Temporary  Permanent 

Budget Source(s) - check all that apply (if 

known)

 Air  Waste  Water 

 Other federal grants  Other state funds 

 Other (e.g., fees, SEP, donations; please list) 

____________________________
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Check the box for the services or tools your state provides listed below according to the entity (SBO/SBEAP/CAP) that provides the 

service or tool. The service or tool should only be checked if the SBO/SBEAP/CAP staff provided the service directly. Any services or 

tools provided that are not listed below should be noted in the second table, "Other Services/Tools Not Captured Above." DO NOT 

enter counts of activities in this table; that data should be provided in the Compliance Assistance tables on page 7. 

Service/Tool Provided

(Check all provided by each component reporting here)

SBEAP SBO

Dual Role

(SBO/SBEAP) CAP

Toll-free Helpline

Web site

Newsletter

Outreach via Social Media (Facebook, Twitter, Linked In etc)

Face-to-face Meetings

Seminars/Workshops

On-site Compliance Assessments

Individual Client Advocacy/Meeting Facilitation with regulatory staff

General Industry Advocacy: comments on state and federal rule development, 

serving on workgroups, etc.

Conflict Resolution/Regulatory Complaints

Direct Permit Application Preparation

Guidance Publications

Recordkeeping Tools

Regulatory Forms Development

Electronic Tools Development (web-based training, spreadsheets, etc.)

Individual Regulatory Applicability Assistance

Industry Notification of New Rules

Return-to-compliance Assistance (referrals through enforcement action)

Environmental Results Program (ERP)

Listing of Environmental Consultants

Mentor Programs (SCORE, etc.)

Energy Assessments

P2 Assessments

Loan Programs

Grant Programs

Tax Credits

Referrals to other providers

Other Services/Tools Not Captured Above SBEAP SBO Dual Role

(SBO/SBEAP) CAP
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Other Services/Tools Not Captured Above SBEAP SBO Dual Role

(SBO/SBEAP) CAP

Compliance Assistance

For the questions below, enter data for each compliance assistance activity provided directly by the SBO or SBEAP for the calendar 

year. If your program does not provide that service, enter N/A. In cases in which an SBO and SBEAP work independently, identify 

efforts engaged by each one as appropriate. The “Dual” column is for programs that have staff holding both roles. 

Compliance assistance includes activities, tools, and technical assistance that help small businesses understand and meet their 

obligations under environmental regulations. Compliance assistance may also help small businesses find cost-effective solutions 

and/or go beyond compliance through pollution prevention, environmental management practices, and innovative technologies.

The first column, “Amount of Effort”, counts the number of assistance activities provided, (for example, number of face to face 

meetings held) not the number of individual businesses assisted. The second column, "Number of Small Businesses Assisted by this 

Effort," counts the number of individual businesses for each assistance type. Thus the same business may be counted in several 

assistance categories. In contrast, the following table asks for the overall total number of individual businesses assisted and is not a 

summation of the data in the second tables under each question. If you do not track activities exactly as described, estimate the 

data to the best of your ability. If you find you are unable to include data in a particular area please note that in the narrative 

section at the end of the main survey. 

Activities AMOUNT OF EFFORT NUMBER OF SMALL BUSINESSES 

ASSISTED BY THIS EFFORT

SBO SBEAP Dual Role SBO SBEAP Dual Role

DIRECT CONTACTS

Phone calls or emails exchanged, and/or face-to-face 

meetings with businesses, trade associations, federal 

offices, the general public, or internal contacts to answer 

questions regarding environmental issues or assistance 

in understanding environmental regulations. Include 

hotline calls in total. These may duplicate other 

activities below. [Note: Where the data is available, if 

you make several contacts with or on behalf of one 

business, it counts as one business assisted even if it was 

for multiple issues. Count each “Confidential” or 

“Anonymous” contact as a separate business in this 

column.]

ON-SITE VISITS

One-on-one meetings at the business's work site to 

answer questions about environmental issues, assist 

with self audit activities, or present information about 

environmental programs. Does not include enforcement 

inspections. [Effort = total number of site visits made.]

REGULATORY APPLICABILITY

Any type of assistance provided to a business relating to 

rules or permit/exemption applicability. This may include 

compliance requirements, permit applications or 

questions, notification/reporting forms, other regulatory 

determinations, or directing business owners or 

managers to contacts for additional assistance. 
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Activities AMOUNT OF EFFORT NUMBER OF SMALL BUSINESSES 

ASSISTED BY THIS EFFORT

SBO SBEAP Dual Role SBO SBEAP Dual Role

REGULATORY PUBLICATIONS/ 

DOCUMENTS DISTRIBUTED TO 

SMALL BUSINESS

The number of regulatory publications 

distributed directly or indirectly (i.e., 

through trade associations, etc.) to 

small businesses. Do not count web 

distribution.

Tools 

Developed

Copies 

Distributed

WORKSHOPS AND SEMINARS

Workshops and seminars that were 

provided to small businesses for the 

purpose of compliance assistance. 

Attendees

Events

ADVOCACY

Activities to advocate on behalf of 

small businesses; include inquiries or 

investigation of complaints or disputes 

between a small business and any 

government body related to 

environmental issues. Also included 

are any activities advocating for small 

businesses in the rulemaking process, 

such as writing letters to regulation 

agencies, attending related hearings, 

and commenting on proposed rules.

Rules 

commented 

on:

Businesses 

potentially 

impacted 

Individual 

businesses 

assisted, 

through 

advocacy 

7. PROMOTIONAL ACTIVITIES

Provide information on promotional activities for the calendar year. Spaces have been left open to add additional types of activities 

not represented here.

Promotional activities are activities whose primary purpose is to increase awareness of the program and its services. This can 

include informational presentations, newsletters with contact information, public service announcements, radio talk shows, news 

print, special events, state fairs, or other forms of advertisement.

Promotional Activity Number Estimated Audience

SBO SBEAP Dual Role SBO SBEAP Dual Role

PUBLICATIONS AND NEWSLETTERS DISTRIBUTED

Publications created to increase the visibility of the 

organization. For the "Number," provide the number of 

publications created; for the "Estimated Audience," 

provide the number of publications distributed, either 

in print or electronically.

SEMINARS, PRESENTATIONS, AND MEETINGS

Events created and/or attended to increase a program’s 

visibility and understanding of what the program does 

for small businesses.

Radio Talk Shows

Other

Other
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Promotional Activity Number Estimated Audience

SBO SBEAP Dual Role SBO SBEAP Dual Role

Other

Total Promotional Activities

8. WEB SITE ACTIVITY

Number of times your web site was accessed.

Web site “visits” or “views” are recorded every time a web page is viewed. The terms used may differ slightly among web analytical 

software packages.

Do not report “hits” as in previous reports, because this captures the number of times images on that page were viewed rather 

than the number of times the page itself was viewed. Do your best to capture the numbers that represent activity for your 

SBO/SBEAP program pages, through views or visits, however your software tracks the number. If you are confused about what to 

count/track for web sites, please contact Audrey Zelanko with the Small Business Environmental Home Page.

Your Web Site Address Number of Web Site Pages Total Number of Visits/Views

SBO only

SBEAP only

Dual (SBO/SBEAP)

Do you use other Social Media outlets?  Yes  No

If yes, which ones?  Facebook  LinkedIn  Twitter  Other ________________________________ 

9. OUTCOME MEASURES

Outcomes are measures that capture desired results, such as emission reductions, cost savings, or even improvement of compliance 

rates or changes in understanding among businesses assisted.

Does your state measure outcomes?  Yes  No

If you answer “No”, but have other less quantitative outcomes to highlight you can use the tables provided in section 10.

If you answer “Yes”, complete the table below as best you can based on outcome data you collect. Only report outcomes achieved 

through SBO/SBEAP efforts, as opposed to other pollution prevention or toxics reductions programs. 

 Compliance improvement rate can include things such as percent of notification forms provided by SBEAP and returned to 

state/EPA; improved test scores from before and to after training provided; average number of illegal dumping instances 

eliminated; etc. You can report any similar efforts that improved performance.

 The number of facilities assisted/impacted should directly relate to the results reported, whether the number that 

measured reductions/savings or the number tested for compliance improvement rates.

EXAMPLE

Activity (what did you do): 
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Sector: 

Media (air, water, waste, other): 

Universe: 

Response rate: 

Metric (how do you measure results): 

Results:

Comments

Activity (what did you do): 

Sector: 

Media (air, water, waste, other): 

Universe (who are you collecting 

information from): 

Response rate: 

Metric (how do you measure results): 

Results:

Comments:

Activity (what did you do): 

Sector: 

Media (air, water, waste, other): 

Universe(who are you collecting 

information from): 

Response rate: 

Metric (how do you measure results): 

Results:

Comments

Activity (what did you do): 

Sector:

Media (air, water, waste, other): 

Universe(who are you collecting 

information from): 

Response rate: 

Metric (how do you measure results): 

Results:

Comments:

[Copy and paste empty tables if you have multiple efforts to summarize.]

10. OTHER PROGRAM HIGHLIGHTS
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Include information about your program that you would like to highlight. To help tell the story about the value of our programs, 

include enough detail to address the following:

 Provide descriptions of the most successful initiatives and activities over the year (workshops, new partnerships, outreach 

activities).

 Describe any successes over the year (awards, positive feedback, new initiatives, success stories, etc.)

 Describe specific issues that you resolved or found solutions to during the year Is there anything that makes your program 

or services unique?

SBO

SBEAP

Dual

(SBO/SBEAP)

CAP

Other

YOU HAVE COMPLETED THE REPORT. THANK YOU!