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INSTRUCTIONS FOR COMPLETING BROWNFIELDS PROPERTY PROFILE FORM
GENERAL INSTRUCTIONS

Public reporting burden for this collection of information is estimated to average 1.5 hours per response, including the time for reviewing instructions, searching data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate, or any other aspect of thi s collection of information, including suggestions for reducing this burden, to the Environmental Protection Agency, Office of Environmental Information, Code 2822T, Washington, DC 20460; and to the Paperwork Reduction Project, Office of Management and Bud get, Washington, DC 20503. DO NOT RETURN your form to either of these addresses. Send your completed form to the address provided by the issuing office.

Overview: As specified in the cooperative agreement terms and conditions, all Assessment, Cleanup, R evolving Loan Fund (RLF), and State and Tribal Section 128(a) (for site

- specific work) cooperative agreement recipients must report to EPA as soon as an accomplishment has occurred

. Targeted Brownfields Assessments (TBAs) must also report accomplishments a s they occur. This Office of Management and Budget (OMB) and Environmental Protection Agency (EPA) approved reporting form (OMB

Form 2050

- 0192 , EPA Form 6200

- 03 ), supplements your Progress Reports with specific property

information. Please note that in mos t instances, all reported information is accessible to the public under the Freedom of Information Act (FOIA) and may be distributed by EPA to the public unless one of the FOIA exclusions is applicable.

All cooperative agreement recipients must develop a nd regularly maintain a Brownfields Property
Profile Form for each property benefiting from the EPA Brownfields cooperative agreement

. Compared to the Progress Reports, each Property Profile Form contains information relating only to a specific property targeted by the cooperative agreement recipient.

The Property Profile Form is divided into four parts. Unless otherwise indicated, r eporting in each section is mandatory for all cooperative agreement recipients. Use the following format when asked to enter a date: mm/dd/yyyy. Additional instructions and definitions for completing this form are provided below. Please contact your EPA Re gional Representative if you have any questions when completing this form.

Leveraged Accomplishments Note : Several fields in the Property Profile Form refer to “ leveraged ” activities or accomplishments. Typically, these leveraged activities and accomplis hments are natural

results/outcomes of the EPA

- funded activities (e.g., cleanup jobs/funding at a property assessed with EPA Brownfields Assessment grant funding; redevelopment jobs/funding at a property cleaned up with EPA Brownfields Cleanup or RLF grant funding). To be reportable, there must be a

demonstrable link or connection between the EPA

- funded activity and the leveraged activity/funding/accomplishment. Usually, activities/funding/accomplishments that occur prior to award of the EPA grant and have no demonstrable link or connection to EPA

- funded activity should not be reported as leveraged since the activity predates the award. In addition, the leveraged activity/funding/accomplishment should be reported only when actually manifested (i.e., projecte d dates, acreage, and other data, including expected jobs or uncommitted funding, should not beOMB Control No. 2050

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reported) . However, “ Planned Acres ” or “ Square Footage of the Future Use ” (Field 24) may be reported prior to redevelopment activity

.

When to Submit: Original Property Profile Form : A Property Profile Form must be submitted when the cooperative
agreement recipient starts using EPA funds at a n eligible property

.

 For Assessment c ooperative a greements , this will typically mean when the cooperative
agreement recip ient has started an assessment at a n eligible property.

 For Cleanup cooperative agreement s, this will typically be the first or second quarter of the cooperative agreement period as the funds are first spent on the property identified in the
selected proposal.

 For RLF cooperative agreement s, this may mean when a subgrant or loan package is completed for a n eligible property.

 For TBAs, this will typically mean when an eligible property assessment has started us ing
EPA funds.

 For s tate and t ribal v ol untary r esponse p rogram cooperative agreement s, this will typically
mean when the cooperative agreement recipient has started using EPA funds at a n eligible property for assessment or cleanup activities.

Updated Property Profile Forms : Property Profile F orms must be updated as activities (e.g., assessment, cleanup, and redevelopment) and accomplishments (e.g., cleanup completed, redevelopment underway, significant leveraged funding committed) occur. For example, a Property Profile Form should be updated u pon: completion of a Phase II assessment

, receipt of a no cleanup

action document or determination

, completion of cleanup activity

, and/or initiation/completion of redevelopment. In addition, a Property Profile Form should be updated as the property backgr ound information changes or if there are other anecdotal information and successes that the cooperative
agreement recipient wants to share with EPA. Cooperative agreement recipients should also revise and submit updated Property Profile Forms for all targe ted properties when the cooperative
agreement is being closed out. If you have data to report after the closeout of the cooperative agreement, please contact the ACRES Help desk at acres_help@epa.gov.

To Whom to Submit: Cooperative agreement recipients must submit Property Profile Forms to their EPA Regional Representative identified in the terms and conditions of the cooperative agreement. If data is entered

online it will automatically be delivered to the EPA Regional Representative

.

How to Submit: The Assessment, Cleanup, and Redevelopment Exchange System (ACRES) is available online and is the preferred method for all cooperative agreement recipients to enter and electronically submit the Property Profile Form. 

### The cooperative agreement recipient must utilize the ACRES system unless approval is obtained from the regional Project Officer to utilize and submit the Property Profile Form in hard copy or via e

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### DETAILED INSTRUCTIONS FOR COMPLETING EACH ITEM ON FORM

PART I

– PROPERTY INFORMATION (Mandatory for all cooperative agreement recipients)

COOPERATIVE AGREEMENT RECIPIENT INFORMATION
1. Cooperative Agreement Recipient Name. Enter the cooperative agreement recipient name. Use
the official name of the cooperative agreement recipient as written in the cooperative agreement documentation, unless otherwise directed by the EPA Regional Representative. For TBAs, indicate the requester name. For s tate and t ribal property

- specific activities, enter the s tate or t ribe name

.

2. Cooperative Agreement Number. Enter the number of the cooperative agreement as provided in
the cooperative agreement documentation (e.g., BF 00000000). Enter the response program number
for s tate and t ribal property

- specific cooperative agreement s ( e.g., RP 00000000). For TBAs, enter
the Contract number.

3. Type of Brownfields Cooperative Agreement

. Indicate the type of EPA Brownfields cooperative
agreement to which all accomplishments reported on this Property Profile Form apply. If a property
has benefited from more than one EPA Brownfields cooperative agreement , submit separate Property Profile Forms to report accomplishments for each cooperative agreement at that property. The TBA selection is to be used by EPA Regional personnel only.

4. For Assessment, Cleanup, and RLF Cooperative A greement s, indicate type of Funding Used at the Property

. Indicate what type of funding is being used at the property (e.g., hazardous substances, petroleum, or a combination of both).

5 a . Initial or Updated Pro perty Profile Form. Indicate if this is the first Property Profile Form being submitted for the property or an updated version of a previously submitted Property Profile

Form.

5b

. If “Updated Form,” provide the ACRES Property ID. Enter the ACRES Property ID number as indicated on the property screen in ACRES. The ACRES Property ID is unique to the ACRES application only

.

PROPERTY BACKGROUND INFORMATION (Mandatory for all cooperative agreement recipients)

Property Background Information. Provide background information about the targeted property. Much of this information is historical (e.g., name, street address, latitude/longitude, size, description/history) and should be provided on the original Property Profile Form, with updates only

a s necessitated by changed circumstances.

For purposes of cooperative agreement recipient reporting, a “property” generally is the targeted site identified by the recipient as an eligible brownfield and is generally defined as a contiguous piece ofOMB Control No. 2050

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land u nder unitary ownership unless otherwise discussed with EPA. A property may contain several smaller components, parcels, or areas.

6 . Property Name. Enter the name of the property. The property name should include the pr imary reference to the property.

6 a. Property Alias . Enter any additional property aliases. . If multiple aliases are listed, separate by

comma s.

7 a. Street Address. Enter the address of the property. The street address provided should reflect the primary entrance to the property. If no street address is available, please report the names of the streets for the intersection closest to the primary property entrance.

7 b. City. Enter the name of the city in which the property is located.

7c. County. Enter the county in which the property is located.

7d . State. Enter the two

- letter abbreviation for the name of the state in which the property is located.

7 e . Zip Code. Enter the zip code (with plus four code, if available) for the property.

8 . Size. Enter the number of acres contained within the property’s boundary. Acreage for the entire property, not just the potentially contaminated portions, should be provided.

9 . Parcel Number(s). Enter the universal identification number for the proper ty (i.e., parcel number

, or tax map/block/lot number ). Please list all applicable parcel numbers for the property. If multiple parcel numbers are listed, indicate the primary parcel number first (i.e., that which encompasses the primary entrance for the pr operty), followed by any other parcel numbers (separated by commas).

STATE & TRIBAL BROWNFIELDS/VOLUNTARY RESPONSE PROGRAM
INFORMATION. Provide information on the status of the property within a state voluntary

response program.

10. State & Tribal Prog ram Enrollment. If the property is enrolled in a state B rownfields program or a state voluntary response program, indicate the date upon which the property was enrolled and the state identification number(s) the property received upon enrollment. If the pr operty is not enrolled in a state program, check “ This Property Is Not Enrolled in a State or Tribal Program.”

PROPERTY GEOGRAPHIC INFORMATION. If you are using ACRES to submit the Property Profile Form all you will need is a standard U.S. mailing address or intersection and ACRES will automatically load the correct geographic data for
11a and 11b below

.

If the property does not have a standard U.S. mailing address or an intersection or you are using the paper version of the Property Profil e Form

, complete the following steps. Indicate the latitude andOMB Control No. 2050

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longitude information for the property. The coordinates should be taken at the primary entrance to the property (i.e., at the street address listed in 7 a). If lacking a proper address and a pr oper entrance location, the primary entrance coordinates can be taken at a central location within the site’s property
boundaries. After providing this information ACRES will automatically update the address fields.

T he EPA Office of Brownfields and Land Revitalization (OB L R) or its contractors will provide latitude/longitude if cooperative agreement recipients are unable. Additional guidance regarding
EPA’s d ata s tandards for geographic information can be found at http://www.epa.gov/edr and is al so available from your EPA Regional r epresentative.

11a . Latitude. Enter the latitude coordinate for the property’s primary entrance. Please indicate, in degrees and decimal degrees (up to a maximum of six decimal positions), the measure of the angular distance on a meridian north or south of the equator. Where degrees la titude are less than 10, leading zeros should be given (e.g., 09 degrees latitude). Latitude measures should be preceded by a plus (+) symbol for points on or north of the equator and a minus (

- ) symbol for points south of the equator.

11b . Longitude. En ter the longitude coordinate for the property’s primary entrance. Please indicate, in degrees and decimal degrees (up to a maximum of six decimal positions), the measure of the angular distance on the meridian east or west of the prime meridian. Where degr ees longitude are less than 100, leading zero(s) should be given (e.g., 006 or 089 degrees longitude). Longitude should always be preceded by a minus (

- ) symbol for points west of the prime meridian and a plus (+) symbol for points on or east of the prime meridian. Longitude for places in the United States should be preceded by a minus (

- ) symbol.

PART II

– ENVIRONMENTAL ACTIVITIES

ENVIRONMENTAL ASSESSMENT INFORMATION ( Mandatory for Assessment Cooperative Agreements, State and Tribal Property

- Specific Assessments, and TBAs ; and

, if information is available

, for Cleanup and RLF cooperative agreement recipients

. )

In this section, the cooperative agreement recipient should provide information relating to assessment

activities conducted with EPA funds fro m the subject cooperative agreement . For Cleanup and RLF cooperative agreements, only assessment activities funded through non

- EPA sources should be

entered here.

Table A. Environmental Assessment Activity. Table A collects the assessment phase, assessment start and completion date(s), funding category, name of the entity(ies) providing funding, and the amount of funding. If there are multiple assessments, please use a separate line for each.

Activity. Indi cate the type of activity (e.g., Phase I or II Environmental Site Assessment (ESA)

, Supplemental Assessment, Cleanup Planning )

 Phase I Assessment

o Phase I Start Date(s). The date(s) on which the grant recipient authorizes the initiation of any Phase I activ ities on the property (e.g., historical property research,OMB Control No. 2050

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record review, site visit, etc.)

. A Phase I is equivalent to an environmental assessment
conducted in accordance with the A ll A ppropriate I nquiries final rule standard set
forth in 40 C.F.R. 312, o r an Environmental Site Assessment Conducted in compliance with the ASTM E1527

- 05 standard.

o Phase I Report Completion Date(s). The date(s) on which any Phase I reports (e.g., the written report required under 40 CFR 312.21(a) of the A ll A ppropriate I nquir ies final rule) were completed. A Phase I report is final when an environmental professional or state official has signed and dated the report as required in the final rule (see 40 CFR 312.21(c) )

.

 Phase II Assessment

o Phase II Start Date(s). The date(s) on which any Phase II activities (e.g., sampling analysis plan is approved or field mobilization occurs on the property) begin

.

o Phase II Report Completion date(s). The date(s) on which any Phase II reports (e.g., supplement assessment, site investigation) we re completed. A Phase II report is final when an environmental professional or state official has prepared an environmental assessment report that has been accepted by the grant recipient.

 Supplemental Assessment

o Supplemental Assessment Start Date. Enter the date on which a Supplemental Assessment activity starts. A Supplemental Assessment is defined as any additional environmental activity that is required in order to complete a site characterization,
define the nature and extent of contamination and/or f ill any environmental data gap necessary to identify and/or perform cleanup activities.

o Supplemental Assessment Completion Date. Enter the date on which a Supplemental Assessment is completed. A Supplemental Assessment is considered completed whe n the Supp lemental Assessment report has been accepted by the cooperative agreement recipient.

 Cleanup Planning

o Cleanup Planning Start date. The date(s) on which cleanup planning activities began leading up to the completion of one or more cleanup planning documents that were prepared by an environmental professional and accepted by the cooperative agreement recipient. Planning documents could include an Analysis of Brownfields of Cleanup Alternatives (ABCA), Community Relations Plan, cleanup workplan, etc. Cleanup planning may also include such activities as: environmental data analysis, risk assessment, the establishment of remedial action o bjectives, or the identification
of cleanup levels as required by the applicable state or tribal response program.

o Cleanup Planning Completion date. The date(s) on which cleanup planning activities are completed, most likely marked as the date in which the cooperative agreement recipient accepts completed cleanup planning documents.

Source of Funding. Use the check boxes to indicate the category of funding, and check only one funding source box per line. The categories of funding include:

 This U.S. EPA Co operative A greement

. Select if U.S. EPA (see Field 2 on the Property Profile Form) funds from the subject cooperative agreement were used to perform assessment activities at the property (including TBA funding for EPA regional personnel)

.

 Other Federal. S elect if other federal funds were used to perform assessment activities at the property (e.g., U.S. Department of Housing and Urban Development Brownfields EconomicOMB Control No. 2050

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Development Initiative grant, U.S. Economic Development Administration grant, EPA Smart
Gro wth grant).

 State/Tribal Funding. Select if any state and tribal funds (exclusive of s tate and t ribal
property

- specific 128(a) funds) were used to perform assessment activities at the property (e.g., state economic development grant, state brownfields ass essment grant).

 Local Government. Select if any local funds were used to perform assessment activities at the property (e.g., local bond/tax increment financing, city community development grant).

 Private/Other. Select if any private funds were used to p erform assessment activities at the property (e.g., company X, developer Y, non

- profit Z).

Name of Entity Providing Funds. Indicate the name of the entity that provided funding for assessment activity, unless it is from this U.S. EPA Cooperative Agreemen t

.

Amount of Funding Expended on this Activity

. Enter the amount of funding committed by the specified entity providing funds for the assessment activity.

12 a

. Indicate Whether Cleanup is Necessary

. Indicate whether cleanup is required as soon as sufficient assessment has been conducted to make such a determination. An “environmental cleanup” is defined as any action that is required at a property as a result of contamination by any hazardous

substanc e, petroleum product, controlled substance, or solid waste to address levels that pose a threat to human health and the environment. The “no cleanup necessary ” determination is generally made by the cooperative agreement recipient or property owner

— typical ly in conjunction with state voluntary response program officials and/or certified environmental professionals following an environmental assessment of the property

— to indicate that the property does not have any contaminants at levels that pose a threat t o human health or the environment. In this instance, proceed to #16 or provide an explanation in #2 5

. A cooperative agreement recipient may not know whether cleanup is required, if additional assessment work is required, if the cleanup level is dependent on the future use, or if a future use has not been determined. In these instances, indicate “unknown” and update this section when a determination is made. A “cleanup is necessary ” determination may include situations where a n invasive cleanup does not occur but use of either engineering controls (e.g., capping) or institutional controls (e.g., land use restrictions) ensures that any residual contamination left on the property does not pose a threat to human health or the

environment.

12b. Unknown Reason. If it is unknown whether cleanup is necessary, select the reason why. If the appropriate answer is not available, select Othe r and use the text field to provide the reason. Additional information can provided in Field 25

– Property Highlights.

Make sure to complete INSTITUTIONAL CONTROLS INFORMATION before submitting

this Property Profile Form to your EPA Regional Representative

.

CONTAMINANTS AND MEDIA AFFECTED INFORMATION (Assessment information (i.e., types of contaminants revealed, Recognized Environmental Conditions ( REC ) found and media affected) is mandatory for Assessment cooperative agreement recipients,

s tate and t ribal property

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and

, if information is available

, for Cleanup and RLF cooperative agreement recipients. Cleanup information (i.e., types of contaminants cleaned up and media cleaned up) is mandatory for Cleanup, RLF, and State and Tribal property

- specific cooperative agreement recipients ; and

, if information is
available

, for Assessment cooperative agreement recipients.)

Table B . Contami nants and Media Affected. Provide information relating to the results from the environmental assessment activities performed at the property, including information on the types of contaminants found/cleaned up and the media impacted/cleaned up. Update this section as additional

information becomes available. Recognized Environmental Conditions

. Indicate the presence or likely presence of any hazardous
substances or petroleum products in, on, or at a property following a Phase I report : ( 1 ) due to any
release to the environment ; ( 2 ) under conditions indicative of a release to the environment ; or ( 3 ) under conditions that pose a material threat of a future release to the environment as defined in
ASTM 

### E1527

- 13

. Include controlled recognized environmental conditions, historical recognized environmental conditions, and any applicable non

- scope considerations that may need to be considered in future land use or development

. De minimis conditions are not recognized
environmental conditions

.

. Contaminant (s) Found. Indicate wh at types of contaminants have been identified or detected through the assessment activities at levels that are actionable under state, tribal, and/or federal
standards following a Phase II assessment

. To the extent that the future reuse plans impact whether the contamination in the media is actionable, consider providing a brief description in Part VII, Anecdotal Property Information. Mark the boxes for each and every type of contaminant that has been detected. The eight specific classes listed are defined in Appendix A, Types of Contaminants . If

contaminants are identified that do not fall into one of the types , please indicate “other” and provide a brief description of the contaminant(s) identified during the assessment activities. If contaminants were not detected during assessment, indicate “no contaminants.” If the types of potential contaminants have not ye t been determined for the property, indicate “unknown.” Please consult with your EPA Regional Representative if you need additional assistance in classifying the contaminants at your targeted properties.
Contaminant (s) Cleaned Up. Indicate which type s of contaminants have been cleaned up. Mark the

boxes for each and every type of contaminant that has been cleaned up. Contaminants are considered cleaned up when a “clean” or “no further action” letter (or its equivalent) has been issued by the state

or tribe under its voluntary response program (or its equivalent) for cleanup activities at the property;

or the cooperative agreement recipient or property owner, upon the recommendation of an environmental professional, has determined and documented that on

- prop erty work is finished. On

going operation and maintenance activities or monitoring may continue after a cleaned up designation has been made.
Media Affected. Indicate which types of media (e.g., soil, air, building materials, indoor air, surface
water, gr ound water, drinking water, sediments) are impacted by the identified contaminants.

Contaminants must be identified before the media can be indicated. Mark the boxes for each and

every media impacted at levels that are actionable under state, tribal, and/or federal standards. To the extent that the future reuse plans impact whether the contamination in the media is actionable, consider providing a brief description in Part VII, Anecdotal Property Information. If no media were affected by contaminants, indicate “no media affected.” If the assessment activity is preliminary inOMB Control No. 2050

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nature and does not report potential affects by media, indicate “unknown.” When the media affected become known, pl ease update this section. Media Cleaned Up. Indicate which types of media (e.g., soil, air, surface water, ground water, drinking water, sediments) are impacted by the identified contaminants that have been cleaned up.

Contaminants must be identified befo re the media can be indicated. Mark the boxes for each and

every media impacted at levels that are actionable under state, tribal, and/or federal standards and have been cleaned up. Contaminants are considered cleaned up when a “clean” or “no further acti on” letter (or its equivalent) has been issued by the state or tribe under its voluntary response program (or its equivalent) for cleanup activities at the property; or the cooperative agreement recipient or property owner, upon the recommendation of an en vironmental professional, has determined and

documented that on

- property work is finished and any needed institutional or engineering controls are in place and functional. On

- going operation and maintenance activities or monitoring may

continue after a cle aned up designation has been made.

ENVIRONMENTAL CLEANUP INFORMATION (Mandatory for Cleanup, RLF, and State and Tribal property

- specific cooperative agreements ; and

, if information is available

, for Assessment cooperative agreement recipients and Targeted Brownfield Assessments

. )

In this section, the cooperative agreement recipient should provide information relating to cleanup activities funded by the EPA cooperative agreement and basic information relating to the cleanup activity and results. For Assessment cooperative agreements , information included in this section is assumed to be conducted with funding from other sources.

13 . Cleanup Activity Start Date. This is the date that the cleanup contractor mobilizes to the site and starts cleanup activities. Examples of cleanup acti vities include :

 Site preparation

 Clearing & grubbing

 Soil excavation

 Soil, water, and ground water treatment

 Removal of tanks

 Disposal of cleanup

- generated waste streams

 Hazardous building materials abatement

 Demolition needed to allow cleanup to sa fely proceed

 Operation and maintenance activities

14 a . Cleanup Activity Completion Date. This is the date when a property's cleanup activities are completed to a regulatory risk

- based standard. It typically occurs when:

 A "clean" or "no further action" letter (or its equivalent) has been issued by the state or tribe under its voluntary response program (or its equivalent) for cleanup activities at the property

,
or ;

 The grant recipient or property owner, upon the recommendation of an environmental professional, has determined and documented that on

- property work is finished. OngoingOMB Control No. 2050

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operation and maintenance activities or monitoring may continue after a cleanup completion designation has been made.

14b. Cleanup Completion Documentation. Select t he type of documentation used to determine the cleanup completion date.

(1) A “clean” or “no further action” letter (or its equivalent) has been issued by the state or tribe under its voluntary response program (or its equivalent) for cleanup activities a t the property; or

(2) The cooperative agreement recipient or property owner, upon the recommendation of an environmental professional, has determined and documented that on

- property work is finished. Ongoing operation and maintenance activities or monit oring may continue after a cleanup completion designation has been made.

15 . Acres Cleaned Up. Enter the number of acres that have been cleaned up. Provide only the acreage for the portion of the property that has been addressed by environmental cleanup activities. A property is considered cleaned up when it is made available for reuse as a result o f the environmental cleanup activity.

16. Date No Further Action/Cleanup Completion Document Issued

. If the property has received a No Further Action Letter or equivalent cleanup completion documentation, indicate the date upon which this documentation was issued. If the property is not enrolled in a state program such that this documentation does not app ly, leave this field blank.

17 . Number of Cleanup Jobs Leveraged. Provide information relating to jobs leveraged during the cleanup at the property. This number includes short

- term jobs (i.e., with a duration of less than one year) typically leveraged d uring the cleanup stage. Only actual jobs should be reported; planned or expected jobs should not be reported until they are realized. Cleanup jobs directly paid for by a U.S. EPA cooperative agreement should not be reported here, only jobs leveraged as a result of a U.S. EPA cooperative agreement.
To calculate the number of jobs, use the formula:

Full Time Equivalent FTE = Cumulative Hours Worked/Cumulative Hours in a Full

- Time Schedule *

*total number of cumulative hours in a full

- time schedule (i.e., 52 0 hours per quarter, 2080 per year)

If payroll records or the exact hours worked are not available, leveraged jobs can be estimated by multiplying the average cleanup crew size by the fraction of a year worked. For example, if a cleanup
crew of six worked for six months (half a year), there would be three cleanup jobs leveraged.

18 . EPA Funding Category and Amount. Cleanup activities conducted and funded prior to the awarding of the cooperative agreement should typically not be provided (i.e., pre

- award a ctivities are not considered leveraged and should not be reported). Funding for activities used to prepare the property for redevelopment (e.g., demolition, property clearing) should be reported in this table. Supplemental narrative information about the c leanup funding may be further described in Part VII,OMB Control No. 2050

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Anecdotal Property Information (e.g., describe use of innovative funding sources, use of loans and/or insurance mechanisms to facilitate cleanup). The categories of funding include:

 U.S. EPA

– Brownfields Cleanup Cooperative Agreement. For Cleanup cooperative agreement recipients, indicate the amount of brownfield funds from the subject cooperative
agreement used to perform environmental cleanup activities at the property.

 U.S. EPA

– Brownfields RLF Loan. For RLF cooperative agreement recipients, indicate the date signed and the amount of the loan used to perform environmental cleanup activities at the property. Loan amounts should be reported when the loan is issued to the borrower (i.e.,
when th e loan document is signed and legally binding).

 U.S. EPA

– Brownfields RLF Subgrant. For RLF cooperative agreement recipients, indicate the date signed and the amount of the subgrant used to perform environmental cleanup activities at the property. Subgrant amounts should be reported when the subgrant is awarded (i.e., when the subgrant is signed and legally binding).



###  U.S. EPA

– Section 128 State and Tribal. For s tate and t ribal property

- specific cooperative agreements, indicate the amount of the Section 128 s tate and t ribal funds used to perform environmental cleanup activities at the property.

Table C. Environmental Cleanup Leveraged Funding Detail. Table C collects the leveraged funding source(s), name of entity providing leveraged funds, and the amount o f funding leveraged for cleanup. If multiple leveraged funding sources were used for cleanup, please use a separate line
for each source.

Source of Funding. Use the check boxes to indicate the source of funding, and check only one funding source box per line. Provide the name of the entity providing the funding and the amount of leveraged funding. The categories of funding include:

 Other Federal. Select if any federal funds other than this U.S. EPA Cooperative Agreement
were used t o perform environmental cleanup activities at the property (e.g., U.S. Department of Housing and Urban Development Community Development Block Grant, U.S. Department of Housing and Urban Development Brownfields Economic Development Initiative grant).

 Stat e/Tribal Funding. Select if any state and tribal funds (exclusive of s tate and t ribal
property

- specific 128(a) funds) were used to perform environmental cleanup activities at the property (e.g., state brownfields cleanup grant, state economic development g rant).

 Local Government. Select if any local funds were used to perform environmental cleanup activities at the property (e.g., local bond/tax increment financing).

 Private/Other. Select if any private funds were used to perform environmental cleanup activities at the property (e.g., company X, developer Y, non

- profit Z).

 Cost Share. Provide the amount of the Cost Share applied to this cleanup activity.

Name of Entity Providing Fu nds. Indicate the name of the entity that provided funding for the cleanup activity.

Activity Funded. Briefly describe the activity that was funded.

Amount of Funding. Enter the amount of funding committed by the specified entity.OMB Control No. 2050

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INSTITUTIONAL CONTROLS and ENGINEERING CONTROLS INFORMATION (Mandatory for all cooperative agreement recipients

. )

In this section, the cooperative agreement recipient should provide information relating to the use of institutional controls on the proper ty.

19a . Institutional Controls Required. Indicate whether institutional controls are requ ired as part of cleanup or containment activities to help minimize the potential for exposure to contamination and/or
restrict land or resource use.

19b . Category of Institutional Controls Required. Indicate which category(ies) of institutional controls are required. Mark the boxes for each and every category of institutional control that is required. Although the definitions of institutional controls vary across l ocalities and states, there are four general categories: proprietary controls (e.g., easements, covenants); governmental controls (e.g., zoning, building codes, drilling permit requirements); informational devices (e.g., state registries, deed notices, adv isories) ; and enforcement/permit tools (e.g., orders, permits, consent decrees). If the information about the institutional control (e.g., specific type of control) is available online, please provide the World Wide Web address or URL. Please use the provi ded text box to enter any additional information on institutional controls at the property. For more details on institutional controls, please refer to EPA guidance (the most recent February 2003 draft guidance is
entitled “Institutional Controls: A Guide to Implementing, Monitoring and Enforcing Institutional Controls at Superfund, Brownfields, Federal Facility, UST and RCRA Corrective Action Cleanups”) or contact your EPA Regional Representative.

19c . Institutional controls are in place, and operating as intended. Appropriate institutional controls should reflect the specific contamination and exposure potential circumstances of a given property, including consideration of reasonably anticipated futur e uses, and mechanisms in place to modify institutional controls, if necessary, based on future changes in use. Depending on the type of institutional control(s) to be implemented at a property the term “ in place ” could include

, for example: the enactment of ordinances (e.g., ground water use restrictions), codes, and/or regulations by local government; recording of legal instruments in the chain of title for a property; issuance by a regulatory authority of enforcement tools or permit s ; listing of property on state registry of contaminated sites; and/or recording of deed notices or hazard advisories in local land records. Indicate the date that the final required institutional control was enacted, recorded, issued or listed, as appropriate.

20a

. Engineeri ng Controls Required

. Indicate whether engineering controls are r equired as a part of cleanup or containment activities to help minimize the potential for exposure to contamination.

20b

. Category(ies) of Engineering Controls Required. Indicate which category(ies) of engineering controls are required. Mark the boxes for each and every category of engineering control that is required. Although the definitions of engineering controls may vary across localities and states, there are four general categori es: cover technologies (capping); Engineered Barrie r s (i.e., slurry walls, sheet, piling, synthetic membranes); Immobilization Process es (i.e., in

- situ solidification, in

- situ stabilization, encapsul ation); Security (guard, fences, public notices), and Other (please enter anyOMB Control No. 2050

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other engineering control not previously covered). If the information about the engineering control (e.g., specific type of control) is available online, please provide the World Wide Web addres s or URL. Please use the provided text box to enter any additional information on engineering controls at the property. For additional information please contact your EPA Regional Representative.

20c

. Engineering controls are in place, and operating as in tended

. Appropriate engineering controls should reflect the specific contamination and exposure potential circumstances of a given property, including consideration of reasonably anticipated future uses, and mechanisms in place to modify engineering contro ls, if necessary, based on future changes in use. Depending on the type of engineering control(s) to be implemented at a property the term “ in place ” could include

, for example: the completion of construction of the cap, completion of the in

- situ stabiliza tion, and/or completion of the construction of the fence. Indicate the date that the final required engineering control was implemented.

REDEVELOPMENT AND OTHER LEVERAGED ACCOMPLISHMENTS (Mandatory for Assessment, Cleanup and RLF c ooperative a greement s ; and

, if information is
available

, for s tate and t ribal p roperty s pecific a ctivities and TBAs

. )

In this section, provide information relating to redevelopment activities and other non

assessment/cleanup accomplishments leveraged by the EPA cooperative ag reement and basic information relating to the leveraged activities. The term "leveraged" refers to those non

- EPA

brownfields cooperative agreement funds and activities that have some link or nexus to the efforts of

an EPA cooperative agreement

- funded activ ity, or where the EPA cooperative agreement

- funded activity was a catalyst for the leveraged accomplishments. This section is mandatory for Assessment, Cleanup and RLF c ooperative a greement s and as available for s tate and t ribal p roperty s pecific

a ctivities and TBAs where targeted properties undergo subsequent redevelopment activities; but should only be updated when real accomplishments are realized (e.g., anticipated leveraged funding should not be reported until it is committed to the property). This section should be updated by all cooperative agreement recipients as redevelopment activities are undertaken or leveraged funds are committed for the property during the term of the cooperative agreement

.

Redevelopment Information. Provide informati on relating to redevelopment activities leveraged by
the EPA cooperative agreement

.

21 . Redevelopment Start Date. Enter the date upon which redevelopment activities began at the property. The start date can be triggered by a variety of events (e.g., chan ge in property ownership, infrastructure preparation, property preparation, groundbreaking ceremony). Conceivably, the redevelopment start date can precede the date of cleanup completion when portions of the property are undergoing simultaneous cleanup and redevelopment activities. However, environmental cleanup activities necessary to prepare the property for redevelopment should not be considered a trigger for the redevelopment start date.

22

. Redevelopment Completion Date

. Enter the date upon which re development activities were concluded at the property. The completion date can be triggered by a variety of events (e.g., completion of the project, ribbon

- cutting events, grand opening ceremonies).OMB Control No. 2050

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Table D. Redevelopment Leveraged Funding Detail. Describe all funds linked to and leveraged by the cooperative agreement to support additional, related activities at the property, and check only one funding source box per line. Only funding committed to the property should be reported (e.g.

, committed fu nds may include

, but are not limited to : tax increment financing, mortgages, bank documents, and contracts); anticipated funding should not be reported. Supplemental narrative information about the leveraged redevelopment funding may be further described i n Part VII, Anecdotal Property Information (e.g., describe innovative funding sources/uses, additional details on what each funding source was used for).

Redevelopment may include non

- commercial reuses (e.g., parks, wildlife refuges, nature trails,

green spaces, a non

- profit community health care facility), as well as commercial or industrial uses (e.g., the expansion or remodeling of an existing manufacturing facility, the construction of a new retail space), and residential and public purpose uses (e.g., courthouse, public health clinic). Redevelopment activities conducted and funded prior to the awarding of the cooperative agreement should not be provided (i.e., pre

- award activities are not considered leveraged and should not be reported). Leveraged fund s may be used to support allowable activities (e.g., inventory, assessment, cleanup) as captured in the previous sections (Tables A and C, respectively) and activities that cannot be funded by the EPA cooperative agreement (e.g., demolition, property prepa ration, redevelopment construction, transportation improvements) that should be reported in this section.

To the extent that funding for program/grant

- level activities and/or redevelopment activities have been leveraged but cannot be discretely allocated to one or more targeted properties, the leveraged funding should only be described in the Progress Report (i.e., not in the Property Profile Form). In addition to describing the amount leveraged, use the Progress Report to identify the type of activity

fu nded, funding source, and which specific properties or areas (if any) benefit from the funding. Table D collects the funding category, name of the entity(ies) providing funding, and the amount of funding leveraged for redevelopment. If multiple funding so urces were leveraged for redevelopment, please use a separate line for each funding category used for redevelopment. The categories of funding include:

 Other Federal. Select if any federal funds were leveraged to perform redevelopment activities at the property (e.g., U.S. Department of Housing and Urban Development Community Development Block Grant, U.S. Economic Development Administration Public Works grant).

 S tate/T ribal Funding. Select if any state and tribal funds (exclusive of s tate and t ribal
property

- specific 128(a) cooperative agreement funds) were leveraged to perform redevelopment activities at the property (e.g., state brownfields grant, state economic
devel opment grant).

 Local Government. Select if any local funds were leveraged to perform redevelopment activities at the property (e.g., local bond/tax increment financing).

 Private/Other. Select if any private funds were leveraged to perform redevelopment

a ctivities at the property (e.g., company X, developer Y, non

- profit Z).

Name of Entity Providing Funds. Indicate the name of the entity that provided funding for the redevelopment activity.OMB Control No. 2050

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Activity Funded. Briefly describe the activity that was funded.

Amount of Funding. Enter the amount of funding committed by the specified entity providing

funds.

23 . Number of Redevelopment Jobs Leveraged. Provide information relating to the jobs leveraged by the EPA c ooperative agreement at the property. This number includes short

- term jobs (i.e., with a duration of less than one year) typically but not limited to leveraged during the construction stage and long

- term jobs that typically occur as a result of the new or enhanced reuse at the property (i.e., with a duration of more than one year). Other examples of redevelopment jobs leveraged are assessment activities, new businesses’ employees on the redeveloped property. Only actual jobs should be reported; planned or expected jobs should not be reported until they are realized. To calculate number of jobs, use the formula:

FTE=Cumulative Hours Worked/Cumulative Hours in a Full

- Time Schedule *
*total number of cumulative hours in a full

- time schedule (i.e., 520 hours per quarter, 2080 per year)

If payroll records or the exact hours worked are not available, leveraged jobs can be estimated by multiplying the average redevelopment crew size by the fraction of a year worked. For example, if a redevelopment crew of six wo rked for six months (half a year), there would be three cleanup jobs leveraged.

24

. Planned and Actual Acreage Amount(s). Indicate the type and amount of planned vs. actual acreage of property. For properties with more than one use (i.e.

, mixed use), che ck all categories that apply and in dicate the proportional acreage. The total amount of acreage can NOT be greater than the property size indicated in Field # 8

. For properties with multi

- story buildings only, check the
“multi

- story building” box and indicate the total square footage. C ategories for targeted properties
include:

 Residential : Housing

 Greenspace : Agricultural site, field, forest, nature trails, park, playing fields, playground, pond, recreational area , stormwater management areas , green r oof, urban forest canopy, wetland, wildlife refuge;

 Industrial : Chemical plant, foundry, machine shop, incineration, landfill, manufacturing (general), mill (general), mining, petroleum (distribution/storage), power generating plant, utility, warehouse, w ater treatment/sewage plant, wood products site; and

 Commercial : Automotive (dealership), dry cleaning facility, bank, museum, office, laundry, recycling, retail, service station, storage, public services, places of worship, schools, transportation center (bus, rail, etc.)

. ;

 Multi

- Story : I ndicate the total square footage , and then include individual use square footage
in the uses above.

Additional information on actual reuse and redevelopment progress can entered in Field 25

– Property Highlights.OMB Control No. 2050

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ANECDOTAL PROPERTY INFORMATION ( If available for all cooperative agreement recipients)

25 . Property Highlights. Briefly describe anecdotal information about the property. Information relating to the cooperative agreement award criteria (e.g., community benefit , sustainable reuse/brownfields prevention, reduction of environmental threats, use of existing infrastructure, and community involvement ; implementing EPA initiatives such as Clean Energy/Energy Efficiency,

Water Ef ficiency, Diesel Emission Reduction, Construction & Demolition Materials Recycling, Low Impact Development

, and/or Green Remediation ) should be highlighted as much as possible. The cooperative agreement recipient may also want to highlight any innovative o r unique issues, activities, technologies, or approaches; any disenfranchised or sensitive populations impacted; planned or actual reuse(s); and/or any other significant accomplishments or upcoming events, such as groundbreaking or ribbon cutting ceremonie s, associated with the targeted property. In addition, the cooperative agreement recipient should provide information relating to any allowable, but non

assessment/cleanup activities (e.g., health monitoring studies, insurance) funded and/or leveraged

thro ugh the cooperative agreement at the targeted property. Any such activities that are not linked

d irectly to a single property should be described in the Progress Report. EPA will use this additional

information for use in its evaluation of the success of the cooperative agreement and for its use in developing communications materials to promote the B rownfields P rogram and grants.

PROPERTY PHOTOGRAPH INFORMATION. Provide information on the availability of photographs and/ or video footage depicting pre

- cooperative agreement property conditions, cooperative agreement funded activities, redevelopment activities, and/or the property after redevelopment has been completed. As w ith the anecdotal narrative, EPA will use any photographs to illustrate the progress and successes of each cooperative agreement recipient in communications

materials.

2 6 . Availability of Photographs. Indicate whether still photographs depicting the property have
been taken and are available.

2 7 . Availability of Video. Indicate whether video footage depicting the property has been taken and
is available.

PART III

– ADDITIONAL PROPERTY INFORMATION

PROPERTY HISTORY INFORMATION ( If available for all cooperative agreement recipients

. )

Provide information about the property, such as description, past uses, and ownership history. If

additional space is needed, please attach an additional sheet. If one has already completed assessment activities prior to receiving EPA funding, please provide that information in Table A

, Environmental Assessment Activity.OMB Control No. 2050

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2 8 . Property Description/History/Past Ownership. Provide a brief narrative description about the history of the property

, including past owners and past uses leading to any real or perceived
environmental contamination.

29 . Predominant Past Uses(s). Indicate the type and amount of acreage of predominant past use(s). For properties with more than one predominant past use (i.e.

, mixed use), check all categories that apply and indicate the proportional acreage of each past use. The total amount of predominant past use acreage can NOT be greater than the property size indicated in Field # 8

. For properties with
multi

- story buildings only, check the “multi

- story building” box and indicate the total square footage

. Predominant past use categories for targeted properties include:

 Residential : Housing;

 Greenspace : Agricultural site, field, fore st, nature trails, park, playing fields, playground, pond, recreational area , stormwater management areas , green roof, urban forest canopy, wetland, wildlife refuge;

 Industrial : Chemical plant, foundry, machine shop, incineration, landfill, manufacturing (general), mill (general), mining, petroleum (distribution/storage), power generating plant, utility, warehouse, water treatment/sewage plant, wood products site; and

 Commercial : Automotive (dealership), dry cleaning facility, bank, museum, office, laundr y, recycling, retail, service station, storage, public services, places of worship, schools, transportation center (bus, rail, etc.)

.

 Multi

- Story : I ndicate the total square footage , and then include individual use square footage
in the uses above.

OWNERS HIP AND SUPERFUND LIABILITY (Mandatory for Cleanup and RLF c ooperative agreement s

. )

Indicate if ownership has changed over the life of the cooperative agreement and if Superfund federal landowner protections factored into the ownership change.

3 0 a . Ownership Entity. Indicate whether the property is currently owned by a government (i.e.,

t ribal, s tate, l ocal) or private entity.

3 0 b . Current Owner. Enter the name of the current owner of the targeted property. If ownership changes during the term of the cooperative agreement , provide the new owner’s name.

3 1 a . Ownership Change. Indicate if during the term of the cooperative agreement , ownership for the property has changed. For reporting purposes, a property “ ownership change ” is defined as a property transaction that is recorded in a deed of sale or other equivalent sales contract that legally transfers the property from one entity to another. In addition, a transaction involving a long

- term lease (e.g., 99 years) should be co nsidered as a property ownership change (i.e., the landlord would be considered the seller and the tenant would be considered the buyer).

3 1 b . Superfund Federal Landowner Liability Protection. For any ownership changes during the

term of the cooperative agreement , indicate whether the bona fide prospective purchaser (BFPP)OMB Control No. 2050

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liability protection provided in the Brownfields Amendments to the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA or Superfund) was a factor in the proper ty transfer. Check the “unknown” box if you do not know whether the BFPP liability protection had an impact on the property transfer.

PART IV

– APPROVALS

3 2

. Cooperative Agreement Recipient Project Manager. Type or print the name of the cooperative
agreement recipient project manager. The project manager should also sign and date the completed Property Profile Form before submission.

3 3 . U.S. EPA Regional Representative. Type or print the name of the EPA Regional r epresentative. The EPA representat ive should also sign and date the reviewed Property Profile Form.OMB Control No. 2050

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Appendix A: Types of Contaminants The eight specific types of contaminants pertinent to the Property Profile Form are defined below. To the extent available, the Chemical Abstract Servic es (CAS) numbers are also provided. Please consult with your EPA Regional r epresentative if you need additional assistance in classifying the contaminants at your targeted properties.

Petroleum/Petroleum Products (CAS Number: 8002

- 05

- 9)

– Petroleum is defined under CERCLA

as “ crude oil or any fraction thereof which is not otherwise specifically listed or designated as a hazardous substance under subparagraphs (A) through (F) of this paragraph, and the term does not include natural gas, natu ral gas liquids, liquefied natural gas, or synthetic gas usable for fuel (or mixtures of natural gas and such synthetic gas) ” (40 USC Section 9601).

Please note that the Brownfields Law restricts eligibility for EPA B rownfields funding to petroleum

conta minated properties that EPA or the state determines: (1) are of "relatively low risk" compared with other "petroleum

- only" properties in the state; and (2) for which there is no viable responsible party and will be assessed, investigated, or cleaned up by a person that is not potentially liable for cleaning up the property. In addition, petroleum

- contaminated properties must not be subject to a corrective action order under Resource Conservation and Recovery Act (RCRA) Section 9003(h).

Controlled Substanc es (CAS Number: None)

– The Brownfields Law refers to Section 102 of the Controlled Substances Act (21 USC Section 802) to defi ne a “controlled substance” as “ a drug or other substance, or immediate precursor, included in schedule I, II, III, IV, or V of p art B of this title (21 USC Section 812). The term does not include distilled spirits, wine, malt beverages, or tobacco
as those terms are defined or used in subtitle E of the Internal Revenue Code of 1954 (26 USC Section 5001 et seq.).”

Please note that properties eligible for B rownfields funding include real property, including residential property, which is contaminated by a controlled substance. For example, properties eligible for B rownfields funding may include private residences formerly used for th e manufacture and/or distribution of methamphetamines or other illegal drugs where there is a presence or potential presence of controlled substances or pollutants, contaminants, or hazardous substances (e.g., red phosphorous, kerosene, acids).

Asbestos (CAS Number: 1332

- 21

- 4)

– EPA’s Substance Registry System defines asbestos as “a grayish, noncombustible fibrous material. It consists primarily of impure magnesium silicate minerals.” The Agency for Toxic Substances and Disease Registry further defines as bestos as “a group of six different fibrous minerals (amosite, chrysotile, crocidolite, and the fibrous varieties of tremolite, actinolite, and anthophyllite) that occur naturally in the environment.”

PCBs (CAS Number: 1336

- 36

- 3)

– The regulations issue d under the Toxic Substances Control Act (TSCA, 15 USC 2601 et seq.), 40 CFR Section 461.3, define polychlorinated biphenyls (PCB s ) as “any chemical substance that is limited to the biphenyl molecule that has been chlorinated to varying degrees or any comb ination of substances which contains such substance.”OMB Control No. 2050

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Please note that the Brownfields Law excludes from funding eligibility portions of facilities where there has been a release of PCBs that are subject to remediation under the Toxic Substances Control Act (TSCA).

VOCs (CAS Number: None)

– Organic compounds are chemicals composed of carbon. Volatile organic compounds (VOCs) produce vapors readily. At room temperature and normal atmospheric pressure, vapors escape easily from volatile liquid chemicals. Volatile organic compounds include a

var iety of chemicals such as gasoline, benzene, toluene, xylene, formaldehyde, tetrachloroethylene, and perchloroethylene.

SVOCs (CAS Number: None)

– Organic compounds are chemicals composed of carbon. The Environmental Protection Agency defines a semi

- volatile organic compound (SVOC) as an organic compound which has a boiling point higher than water and which may vaporize when exposed to
temperatures a bove room temperature. Semi

- volatile organic compounds include phenols and polynuclear aromatic hydrocarbons (PAH s ).

Lead (CAS Number: 7439

- 92

- 1)

– The Agency for Toxic Substances and Disease Registry defines lead as “a naturally occurring bluish

- gray met al found in small amounts in the earth’s crust.”

Other Metals (CAS Number: None)

– A metal is an element characterized by a tendency to give up electrons and by good thermal and electrical conductivity. These chemical elements cannot be broken down by any chemical or biological process and include arsenic, mercury, cadmium, and chromium.

PAHs (CAS Number: 1340489

- 29

- 2)

– The Agency for Toxic Substances and Disease Registry defines polycyclic aromatic hydrocarbons (PAHs) as “a group of over 100 different c hemicals that are formed during the incomplete burning of coal, oil and gas, garbage, or other organic substances like tobacco or charbroiled meat. PAHs are usually found as a mixture containing two or more of these compounds, such as soot. Some PAHs are m anufactured. These pure PAHs usually exist as colorless, white, or pale yellow

- green solids. PAHs are found in coal tar, crude oil, creosote, and roofing tar, but a few are used in medicines or to make dyes, plastics, and pesticides.”

Pesticides (CAS Num ber: None)

– The Environmental Protection Agency defines a pesticide as a chemical used to prevent, destroy, or repel pests. Pests can be insects, mice and other animals, weeds, fungi, or microorganisms such as bacteria and viruses. Some examples of pests are termites causing damage to homes, dandelions in the lawn, and fleas. Pesticides also are used to kill organisms that
can cause diseases.