EPA Form XXXX
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**INSTRUCTIONS FOR COMPLETING BROWNFIELDS PROPERTY PROFILE FORM GENERAL INSTRUCTIONS**  **Overview:** As specified in the cooperative agreement terms and conditions, all Assessment, Cleanup, Revolving 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 Asse ssments (TBAs) must also report accomplishments as they occur. This Office of Management and Budget (OMB) and Environmental Protection Agency (EPA) approved reporting form (OMB Form XXXX
- XXXX , EPA Form XXXX
- XX), supplements your Progress Reports with speci fic property information. Please note that in most 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. Al l cooperative agreement recipients must develop and 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 in formation relating only to a specific property targeted by the cooperative agreement recipient. The Property

Profile Form is divided into four parts. Unless otherwise indicated, reporting 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 Regional Representative if you have any questions when completing thi s form. Le veraged Accomplishments Note : Several fields in the Property Profile Form refer to “ leveraged” activities or accomplishments. Typically, these leveraged activities and accomplishments 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 c onnection between the EPA
- funded activity and the leveraged activity /f unding/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 no t be reported as leveraged since the activity predates the award. In addition, the leveraged activity /f unding/accomplishment should be reported only when actually manifested (i.e., projected dates, acreage, and other data, including expected jobs or uncommitted funding, should not be 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 an eligible property .  For Assessment c ooperative a greements , this will typically mean when the cooperative agreement recipient has started an assessment at an 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.EPA Form XXXX
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 For RLF cooperative agreement s, this may mean when a subgrant or loan package is completed for an eligible property .  For TBAs, this will typically mean when an eligible property assessment has started us ing EPA funds.  For s tate and tribal voluntary response p rogram cooperative agreement s, this will typically mean when the cooperative agreement recipient has started using EPA funds at an eligible property for assessment or cleanup activities. Updated Property

Profile Forms : Property

Profile Forms must be updated as activities (e.g., ass essment, 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 upon: completion of a Phase II assessment , rec eipt 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 background information changes or if there are othe r 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 targeted 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 Property Profile Form may

also be submitted in hard copy with the next required Progress Report or submitted via e
- mail to the EPA Regional Representative. 

### 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 tribal property
- specific activities, enter the s tate or tribe name. **2. Co**  **operative 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 tribal property
- specific cooperative agreement s (e.g., RP 00000000). For TBAs, enter the Contract number.EPA Form XXXX
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**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 benefite d 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 Assessmen t, 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 Property Pro file 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 of land under 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 primary reference to the property, as well as any aliases. If multiple names are listed, indicate the primary name first followed by any aliases (separated by commas). **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.EPA Form XXXX
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**8 . Siz**  **e.** 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 property (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 property) , 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 Program 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 property 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. m ailing address or intersection and ACRES will automatically load the correct geographic data. 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 Profile Form , complete the following steps. Indicate the latitude and 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). After providing this information ACRES will automatically

update the address fields. There are six required data elements ( i.e., metadata associated with latitude and longitude) that are described below; however the EPA Office of Brownfields and Land Revitalization (OB LR) or its contractors will provide latitude/longitude and associated metadata 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 also available from your EPA Region al representative. **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 latitude are less than 10, leading zeros should be given (e.g., 09 degrees latitude). Latitude measures should be preceded by a plus (+) sy mbol for points on or north of the equator and a minus (
- ) sy mbol for points south of the equator. **11b . Longitude.**  Enter 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 degrees longitude are less than 100, leading zero(s) should be given (e.g., 006 or 089 degrees longitude). Longitude should alway s be preceded by

a minus (
- ) symbol for points west of the prime meridian and a plus (+) sy mbol for points on or east of the prime meridian. Longitude for places in the United States should be preceded by a minus (
- ) sy mbol.EPA Form XXXX
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**11c . Horizontal Collection Method.**  Enter the method used to determine the latitude and longitude coordinates (e.g., an address, an intersection, a Global Positi oning System (GPS) device, a census block centroid, etc.). **11d . Source Map Scale Number (only if a map/photo was used).**  Unless a GPS was used to determine the coordinates, please indicate the scale of the map/photo used to determine the latitude and long itude coordinates (i.e., the number that represents the proportional distance on the ground for one unit of measure on the map or photo). **11e . Reference Point.**  Enter the point of reference. Please indicate the place for which the latitude and longitude c oordinates were established (e.g., Center of Facility or Station, Entrance Point of Facility or Station, Plant Entrance). **11f . Horizontal Reference Datum.**  The Horizontal Reference Datum is the coordinate reference system to which the latitude/longitude data in 1 1 a and 1 1 b relate. Per EPA's Latitude/Longitude Data Standard, there are three possible values associated with horizontal reference datum:

 North American Datum of 1927 (NAD27): This datum was based on the ground survey in Europe and North America in the 19th century. NAD27 was the standard for many years because the USGS published its topographic maps in this datum. If you are reporting a location using a USGS 7.5
- minute map, NAD27 is your default datum.

 North American Datum of 1983 (NAD83): NAD 83 updated NAD 27 with current measurements using radio astronomy and satellite observations. When the USGS began publishing digital data, the NAD83 was used, which provided a more accurate representation of the earth’s shape and a more accurate depiction of the location of objects on the earth.

 World Geodetic System of 1984 (WGS84): This datum was developed from the measurements calculated in the North American Datum of 1983. If you used a GPS to calculate your latitude/longitude coordinates, WGS84 is th e default datum. **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 from 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.EPA Form XXXX
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**Activity.** Indicate 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 activities on the property (e.g., historical property research, record review, site visit, etc.)
. A Ph ase I is equivalent to an environmental assessment conducted in accordance with the A ll Appropriate Inquiries final rule standard set forth in 40 C.F.R. 312, or an Environmental Site Assessment Conducted in compliance with the ASTM E1527
- 05 standard. o **Phas e 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 Appropriate Inquiries final rule) were completed. A Phase I report is final when an environmental professional or s tate 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 analy sis 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) were 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 fill any environmental data gap necessary to identify

and/or perform cleanup activities. o **Supple mental Assessment Completion Date.**  Enter the date on which a Supplemental Assessment is completed. A Supplemental Assessment is considered completed whe n the Supplemental 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 objectives, 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:EPA Form XXXX
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 **This U.S. EPA Cooperative 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.** Select if other federal funds were used to perform assessment activities at the property (e.g., U.S. Department of Housing and Urban Development Brownfields Economic Development Initiative grant, U.S. Economic Development Administration grant, EPA Smart Growth grant).  **State/Tribal Funding.** Select if any state and tribal funds (exclusive of s tate and tribal property- specific 128(a) funds) were used to perform assessment activities at the property (e.g., state economic de velopment grant, state brownfields assessment 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.** Sele ct if any private funds were used to perform 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 f rom this U.S. EPA Cooperative Agreement
. **Amount of Funding Ex**  **pended 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

—ty pical 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 to 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 an 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 Other and use the text field to provide the reason. Additional information can provided in Field 25

–Property High lights. **Make sure to complete INSTITUTIONA L CONT**  **ROLS INFORMATION before submitting**

**this Property**

**Profile Form to y our EPA**  **Regional Representative .**  **CONTAMINANTS AND MEDIA AFFECTED INFORMATION**EPA Form XXXX
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(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 tribal property

-specific cooperative agreement s, and Targeted Brownfield Assessments ; , and , if informatio n 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**  **. Contaminants 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 su bstances or petroleum products on the property under conditions that indicate an existing release, a past release, or a material threat of a release of any hazardous substances or petroleum products into structures on the property or into the soil, ground water or surface water of the property as defined in ASTM
- 1527
. **Contaminant (s)**  **Found.** Indicate what ty pes of contaminants have been identified or detected through the assessment activities. Mark the boxes for each and every ty pe of contaminant that has bee n 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 ty pes , 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 ty pe s of contaminants have been cleaned up. Mark the boxes for each and every ty pe 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, ground water, drinking water, sediments) are impacted by the identified contaminants. 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 in nature and does not report potential affects by media, indicate “unknown.” When the media affected become known, please 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. 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 aEPA Form XXXX
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“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 o r property owner, upon the recommendation of an environmental 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 **cleaned 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 activities include :  Site preparation  Clearing & grubbing  Soil excavation  Soil, water, and ground water treatment  Removal of tanks  Disposal of cleanup
- generated waste s treams  Hazardous building materials abatement  Demolition needed to allow cleanup to safely 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. Ongoing operation and maintenance activities or monitoring may continue after a cleanup compl etion designation has been made. **14b. Cleanup Completion Documentation.** Select the ty pe 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 trib e under its voluntary response program (or its equivalent) for cleanup activities at the property; orEPA Form XXXX
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(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 monitoring 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 acreag e 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 of 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 s tate program such that this documentation does not apply, 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 ye ar) ty pically leveraged during 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., 520 hours per quarter, 2080 per year) If pay roll 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 activities 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 cleanup funding may be further described in Part VII, 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 . L oan amounts should be reported when the loan is issued to the borrower (i.e., when the 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 cleanupEPA Form XXXX
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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**

**– S**  **ection 128 State and Tribal.** For s tate and tribal 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 Lev eraged Funding Detail.**  Table C collects the leveraged funding source(s), name of entity providing leveraged funds, and the amount of 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 tribal property- specific 128(a) funds) were used to perform environmental cleanup activities at the property (e.g., state brownfields cleanup grant, state economic development grant).  **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 Funds.** 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. **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 property. **19a . Institutional Controls Required.**  Indicate whether institutional controls are required as part of the cleanup or containment activity 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 control s are required. Mark the boxes for each and every category of institutional control that isEPA Form XXXX
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required. Although the definitions of institutional controls vary across localities and states, there are four general categories: proprietary controls (e.g., easem ents, covenants); governmental controls (e.g., zoning, building codes, drilling permit requirements); informational devices (e.g., state registries, deed notices, advisories) ; and enforcement/permit tools (e.g., orders, permits, consent decrees). If the in formation 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 provided 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 future 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 .**  **Engineering Controls Required .**  Indicate whether engineering controls are required as a part of the cleanup or containment activity 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 categories: cover technologies (capping); Engineered Barrier s (i.e., slurry walls, sheet, piling, sy

nthetic membranes); Immobilization Process es (i.e., in
- situ solidification, in
- situ stabilization, encapsul ation); Security (guard, fences, public notices), and Other (please enter any other engineering control not previously covere d). If the information about the engineering control (e.g., specific ty

pe of control) is available online, please provide the World Wide Web address 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 intended** 
. 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 controls, if n ecessary , 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 stabilization, an d/or completion of the construction of the fence. Indicate the date that the final required engineering control was implemented.EPA Form XXXX
- XX (X
- XXXX ) 

### 13

**REDEVELOPMENT AND OTHER LEVERAGED ACCOMPLISHMENTS** (Mandatory for Assessment, Cleanup and RLF c ooperative agreement s ; and , if information is available, for s tate and tribal 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 agreeme nt 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 activity, or where the EPA cooperative agreement
- funded activity was a cataly st 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 tribal p roperty specific 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 information 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., change 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 redevelopment 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). **Table D. Redevelopment Leveraged Fundi ng 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 funds 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 furthe r described in 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, greenspaces, 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 purpos e uses (e.g., courthouse, public health clinic). Redevelopment activities conducted and funded prior to the awarding of the cooperative agreementEPA Form XXXX
- XX (X
- XXXX ) 

### 14

should not be provided (i.e., pre
- award activities are not considered leveraged and should not be reported). L everaged funds 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, p roperty preparation, 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 o f activity funded, 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 multip le funding sources 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/Tribal Funding.**  Select if any state and tribal funds (exclusive of s tate and tribal property- specific 128(a) cooperative agreement funds) were leveraged to perform redevelopment activities at the property (e.g., state brownfields grant, state economic development 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 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 the redevelopment activity. **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 cooperative agreement at the property. This number includes short
- ter m 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 o ne 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 cal culate number of jobs, use the formula: FTE=Cumulative Hours Worked/Cumulative Hours in a Full
- Time Schedule *EPA Form XXXX
- XX (X
- XXXX ) 

### 15

*total number of cumulative hours in a full
- time schedule (i.e., 520 hours per quarter, 2080 per year) If pay roll 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 worked for six months (half a year), there would be three cleanup jobs leveraged.
**24 .**  **Future Use (s)**  **and Estimated Acreage Amount(s).** Indicate the type and amount of planned vs. actual acreage of future use(s). For properties with more than one future use (i.e. , mixed use), check all c ategories that apply and indicate the proportional acreage of each future use. The total amount of future 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. Future use categories for targeted properties include:  Greenspace : Agricultural site, field, forest, nature trails, park, playing fields, playground, pond, recreational area , stormwater management areas , green roof, urban forest canopy, wetland, wildlife refuge;  Residential : Housing;  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, laundry, recycling, retail, service station, storage, public services, places of wo rship, schools, transportation center (bus, rail, etc.)
. Additional information on actual reuse and redevelopment progress can entered in Field 25

– Property Highlights. **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 Efficiency, 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 or unique issues, activities, technolo gies, 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 ceremonies, 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 through the cooperative agreement at the targeted property. Any such activities that are not linked directly 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.EPA Form XXXX
- XX (X
- XXXX ) 

### 16

**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 with the anecdotal narrative, EPA will use any photographs to illustrate the progress and successes of e ach 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 dep icting 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. **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 th an 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:

 Greenspace : Agricultural site, field, forest, nature trails, park, playing fields, playground, pond, recreational area , stormwater management areas , green roof, urban forest canopy, wetland, wildlife refuge;  Residential : Housing;  Industrial : Chemical plant, foundry, machine shop, incineration, landfill, manufacturing (g eneral), 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, laundry, recycling, retail, service station, storage, public services, places of worship, schools, transportation center (bus, rail, etc.)
. **OWNERSHIP AND SUPERFUND LIABILITY** (Mandatory for Cleanup and RLF c ooperative agreement s .)EPA Form XXXX
- XX (X
- XXXX ) 

### 17

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., tribal, 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 considered 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) liability protection provided in t

he Brownfields Amendments to the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA or Superfund) was a factor in the property 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.** Ty pe 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.** Ty pe or print the name of the EPA Regional representative. The EPA representative should also **sign and date** the reviewed Property Profile Form.EPA Form XXXX
- XX (X
- XXXX ) 

### 18 **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 Services (CAS) numbers are also provided. Please consult with your EPA Regi onal representative 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, natural gas liquids, liquefied natural gas, or synthetic gas usable for fuel (or mixture s 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 contaminated 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, p etroleum
- contaminated properties must not be subject to a corrective action order under Resource Conservation and Recovery Act (RCRA) Section 9003(h). **Controlled Substances** (CAS Number: None)

– The Brownfields Law refers to Section 102 of the Controlled Substances Act (21 USC Section 802) to define a “controlled substance” as “ a drug or other substance, or immediate precursor, included in schedule I, II, III, IV, or V of part B of this title (21 USC Section 812). The term does not include distilled spirit s, 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 the 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 grayi sh, noncombustible fibrous material. It consists primarily of impure magnesium silicate minerals.” The Agency for Toxic Substances and Disease Registry further defines asbestos 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 issued 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

combination of substances which contains such substance.” Please note that the Brownfi elds 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).EPA Form XXXX
- XX (X
- XXXX ) 

### 19

**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 variety 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 above room temperature. Semi
- volatile organic compounds include phenols and poly nuclear aromatic hydrocarbons (PAH s ). **Lead** (CAS Number: 7439
- 92
- 1)

– T he Agency for Toxic Substances and Disease Registry defines lead as “a naturally occurring bluish
- gray metal 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 chemicals that are formed during the incomplete burning of coal, oil and gas, garbage, or other organic substances like t obacco or charbroiled meat. PAHs are usually found as a mixture containing two or more of these compounds, such as soot. Some PAHs are manufactured. 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 Number: None)

– The Environmental Protection Agency defines a pesticide as a chemical used to prevent, destroy, or repel pe sts. 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.