BIOENGINEERING GROUP CDBG CHECKLIST River Wharf Realty Trust
2013 Compliance and InvoicTi
e .
i
Environmental Review P. 1
Statutory Checklist
Federal Laws and Authorities Listed at Sec 58.5
Business Loan — River Wharf Realty Trust (BioEngineering
Project Name and Identification No. Group)
76
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Area of Statutory or d 4) ° ¢c a .o Provide compliance documentation.
Regulatory Compliance m o o. "o m ¢ Additional material may be attached.
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Historic Properties X Not on Local historic district map &�
NR criteria on building survey form
Floodplain Management X Not-applicable per.FEMA maps
Not-application per Conservation
Wetlands Protection X Commission administrator.review
Coastal Zone Management X Salem does not have any coastal
barriers (file memo dated 8/3/06).
There are no EPA designated Sole
Water Quality—Aquifers X Source Aquifers in Salem per EPA
Region 1 map.
Endangered Species X Developed urban area - No endangered
species will be effected by this project.
Wild and Scenic Rivers X No wild and scenic rivers have been
designated in Salem.
Air Quality X No impact anticipated.
Farmlands Protection X Non - applicable. No farmlands will be
affected by this project.
Non-applicable. No increase in
dwellings; no known thermal/explosive
Manmade Hazards: X hazards will be created. Not near an
Thermal/Explosive operation handling conventional fuels or
chemicals of an explosive or flammable
nature.
The thresholds for railroads and airports
Noise X in the assessment guidelines will not be
exceeded. The project does not involve
deve lo ment of noise sensitive uses.
Airport Clear Zones X No airport clear zones are located in
Salem.
Attach evidence that required actions have been taken.
Environmental Review P. 2
Toxic Sites X Not an EPA/DEP designated toxic site.
Environmental Justice X The project is not likely to raise
environmental justice issues.
Statutory Checklist
Federal Laws and Authorities listed at Sec. 58.6 and Permits, Licenses, Forms of Compliances Under Other Laws
(Federal, State and Local Laws)
15
C N O
L d aO c p
Other Areas of Statutory ~ D D M 0 o
o C a E o E E Provide compliance documentation.
or Regulatory Compliance 4) o m 0 @ Additional material may be attached.
Applicable to Project 2 a3i o O
U ? E C N O U
Q M N N l6 :_. Q
Q O 0 O O
U no
Z Q O
Federal Requirements
Flood Insurance—58.6(a) X This property is not located within a
floodplain.
Coastal Barriers —58.6(b) X Salem does not have any coastal
barriers (file memo dated 8/3/06).
Airport Clear Zone X None in municipality
Notification —58.6(c)
Water Quality X Water quality will not be affected by this
project.
Any hazardous waste generated will be
Solid Waste Disposal X deposed of according to applicable
re ulations.
Fish and Wildlife X No known fish or wildlife will be affected
by this project.
State and LocaLStatutes, (to be added by Responsible Entity)
Prepared by: Andrew Shapiro Title: Economic Development Planner
Date: January 28, 2013
'Attach evidence that required actions have been taken.
CDBG PROJECT CHECKLIST
Put one co in Ct file and qlve one copy to Jane for Environmental Review rile
90W&N.P104 ROJECUINFQRMAT,10114`22' L
PROJECT NAME: LOCATION: PROJECT MANAGER:
Business Loan:Bio-Engineering Group/River 18 Commercial Street Tom Daniel
Wharf Realty Trust
CDBG BUDGET: NON-CDBG BUDGET&SOURCE: TOTAL BUDGET:
$63,925 City funds $75,925
N00
00 E
i om�.o*'A a',W-_'P&iJww"'i o Cow
LjLinuted Clientele(low/mod persons) ®Area Benefit(low/mod area) LIJob Creation(min 51%low/mod)
[I 51UM51811ght(Urban Renewal Area El Urgent Need this category is rarely used
PROJECT DESCRIPTION (attach separately Of needild)' Rprnp tA 7P.Ingn to prriv rip,wnrk nq r.Apitql And gi ippnrt inh rpntpntinn
Completed
Ellifinority Outreach—For HOME Affordable Housing Projects&CDBG Projects over$25,000
F-1
E]Section 3—For contracts of$100,000+
El
Davis Bacon Prevailing Wages
El Construction project over$2000 involving laborers or mechanics.
El
El Wage Decision number in effect at time of bid lock date(provided to contractor with copy in project file):
Wage decision nurobar mod firpt on# Highway,Bu Id ng or HeP42
Actual Contract amount$
❑ Bid Lock Date(bid opening date,contract award or start of construct on)
E]Bid opening date ElContract award ElStart of Construction
El Copies of invoices,certified payroll form and proof of payment in file
Environmental Review
0 Flood-Plain Management Review—required for all projects
Each proiect must fall under one of the following 5 categories:
❑ Environment Review Exempt—No further review required
Included plans,studies, administrativelmanagement activities,inspections,testing,design, engineering,technical assistance,training and tools pure l ase.
Categorically Excluded NOT subject to 58.5—No further review required
Includes tenant based rental assistance,operating costs(including maintenance,security,operation, utilities,furnishings,equipment,supplies,
staff training and recruitment and other incidental costs),economic development costs(including equipment purchase,inventory financing,
interest subsidy,operating expenses and similar costs NOT associated with construction or expansion of existing operations),homebuyer
purchase assistance,affordable housing pre-development costs(legal,consulting,developer,project financing, administrative fees,zoning
approvals).
❑ Categorically Excluded subject to 58.5
Includes 1)acquisition,repair,improvement, reconstruction or rehabilitation of public facilities and improvements(other than buildings)when the
facilities and improvements are in place&will be retained in the same use without change in size or capacity of more than 20%, 2)removal of
architectural barriers, 3)rehab of buildings 3a)(1-4 units)provided density is not increased beyond 4 units and footprint not increased in a
Floodplain or wetland 3b)(multi-family)when unit density is not changed more than 20%, the project does not involve changes in land use from
residential to non-residential&the estimated cost of rehab is less than 75%of the total estimated cost of replacement after rehab 3c)(non-
residential)when the facilities and improvements are in place and will not be changed in size or capacity by more than 20%, the activity does not
involve change of land use,such as from non-residential to residential,commercial to industrial or one industrial use to another 4a)an individual
action on 1-4 family dwelling units where there is a maximum of 4 units on any one site(41-unit buildings, 14-unit building or any combo)4b)an
individual action on a project of 5+housing units developed on scattered sites when the sites are more than 2,000 feet apart and not more than 4
units on any one site 5)acquisition or disposition of an existing structure or acquisition of vacant land provided that the structure or land acquired
or disposed of will be retained for the same use. 6)combinations of above activities.
Z Historic Property Review—see Jane
Z Wetlands Protection Review—see T. Devine
Statutory Checklist
D 0 No compliance Actions Required—No further review required
El Compliance Actions Required
El
El El FONSI/RROF—see Jane (Must be done before any funds can be spent)
❑ Environmental.Assessment Required
Includes all other projects if not excluded above,
E:1 Statutory Checklist ❑
p iU
❑ Environmental Assessment Report
❑ Historic Property Review—see Jane
❑ Wetlands Protection Review—see Carey ❑
❑ FONSURROF—see Jane (Must be done before any funds can be spent)
❑ Environmental Impact Statement Required(for projects determined to have potentially significant impact on the human environment)
Prepared by, Signature
Date
ECONOMIC DEVELOPMENT ACTIVITY SUMMARY
To be submitted to Jane prior to creation of/p�urebase order.
Activity Name �rr t�a� tic _ t7+e� . Wre - tuTlQ� tJla,rQ �ne�gJ(
Site Address
Description
Eligible activity(select one):
Special Economic Development activity- acquiring, constructing, reconstructing,
rehabilitating or installing commercial or industrial buildings,structures or real property,
equipment and improvements (i.e. can be interior improvements, expansion of a plant or
factory, assistance to prevent closure)
o Must meet job creation/retention requirements (see sunnnary provided).
o Must meet public benefit standards - A minimum of one FTE job must be created or
retained for every$35,000 in CDBG funds.
❑Microenterprise activity- 5 or fewer employees, one of whom owns the business (&owner
is low/mod). Note: Owner does not have to be low/mod if business is located within and
serves a low/mod area. A micro-enterprise can also be "persons developing microenterprises"
(low/mod person actively working toward developing a microenterprise business).
❑Connnerrial rehabilitation in low/mod or Urban Renewal Area (exterior of building,
correction of code violations or removal of architectural barriers)
o Requires use of prevailing wages (Davis-Bacon)
❑Wage Decision number in effect at time of bid lock date (provided to contractor with
copy in project file
❑Bid Lock Date (bid opening date,contract award or start of constnrction):
❑Copies of invoices, certified payroll form and proof of payment in file
Proposed Accomplishments (select one):
Nate- Reportb-ng on Yol s"z ill rt itrire nnnitnir�
Direct Financial Assistance to For-Profits
[]Businesses (check if Commercial rehab only)
,fobs (check if Special Economic Development) # Units proposed:
Micro-enterprise Assistance
❑Businesses
[]People
❑Jobs
Total !\mount of CDBG $ ) vc-llo
Grant: ❑No ❑Yes If yes: Amount $
Loan: ❑No�2ves If yes: Amount $
,Armortized or ❑Deferred Payment/Forgivable Loan
Interest rate: y qn Amortization Peno m months: Ll8
,kms � d �, 3 .
Proposed Leveraged Funds: Pr 1 L
Section 108 Loan Guarantee
Other Consolidated Plan Funds (HOME, ESG, HOPWA)
OtheE-F,ederal Funds
Stat Local mds
Private Funds
Other (25 Characters max):
Nat nal objective (must meet one)
Benefit to Low and moderate income persons
❑Area benefit (must be primarily residential): Census tract#
o If Special Economic Development or Microenterprise activity, the business must
provide a service that primarily serves the residents of a substantially residential
low/mod area.
❑Limited clientele activities (must provide low/mod income documentation). Only applicable
for Microenterprises and only the owner needs to qualify; if the owner does not,job
creation/retention criteria can be used.
(ob creation or retention activities — Not applicable for commercial rehabilitation.
❑Aide in the prevention or elimination of slums or blight (Urban Renewal area only)
❑Urgent need — Use of this category is extremely rare. It is designed only for activities that
alleviate emebencyconditions. U bent need activities must meet the following qualifying criteria
and documentation of how the application meets this criteria must be submitted:
❑The existing conditions must post a serious and immediate threat to the health or welfare of
the conurtunity
❑The existing conditions are of recent origin or recently became urgent (generally, within the
past 18 months);
[]The recipient is unable to finance the activity on its own; and
❑Other sources of funding are not available.
Job Creation/Retention (if applicable)
Miriirnrm 1 FTE jab for,or y$35,000 in CDBG f tar Pani hi(p#r 2 jobs for ezvy$35,000))
Total Job Count Total Weekly Hours
F/T F/T-LM P/T P/T-LM
Expect to Create
Expect to Retain
q
2
City of Salem
Non-Housing Activities
Environmental Review — Compliance Documentation
Activit .address: �;b -
Program: y S�
FLOODPLAIN MANAGEMENT (Guidance)
I D the project involve the acquisition, construction or rehabilitation of structures, buildings or mobile homes?
, Nosflood insurance is not required. Review completed.
❑ Yes; continue.
Is the property located in a FEMA designated Special Flood Hazard Area?
❑ No. Flood insurance is not required.
❑ Yes; Flood Insurance must be obtained and maintained for the economic life of the project,
in the amount of the total project cost. A copy of the flood insurance policy declaration must be kept the
Environmental Review Record.
Source: FEMA/FIRM Community-Panel Numbers 250102 0001 B-0005B Date: August 5, 1985
), 1�,tn,,, I t LAA . ad l
Preparer Signature Name Date
WETLANDS PROTECTION
1. Does this project include any construction or alteration of land within 100 feet of wetlands or a waterway?
/ONo.
❑ Yes; Request for Determination of Applicability to the Conservation Commission
2. Is this activity going to take place within 200 feet of a river?
❑ No.
ZNot applicable to Wetlands Protection Act
❑ Yes; Request for Determination of Applicability to the Conservation Commission
3. Will this project take place in a waterway or resource area?
,Rr—No.
❑ Not applicable to Wetlands Protection Act
❑ Yes; Request for Determination of Applicability to the Conservation Commission
Source: Department of Environmental Protection Wetlands Map & Salem Conservation Agent
Prepared by: Reviewed b V,
Tom e Date
Con rvation Agent
:1 s
HISTORIC PROPERTIES PROTECTION (36 CFR PART 800)
1. Does the project involve property repair, rehabilitation of an existing structure, conversion of use, demolition, new
construction or acquisition of undeveloped land?
.E�rNo
❑ Yes—Proceed to questions 2-4
2. Is the project located within a local historic district?
Sou ce: Salem Historical Commission local historic district maps &address listings
No.
❑ Yes, within a local historic district. Name of Historic District:
❑ No Exterior Work.
❑ Exterior work replaces existing condition or is not visible from a public way.
Obtain Certificate of Non-Applicability.
❑ Work alters structure's exterior. Obtain Certificate of Appropriateness or Hardship.
3. Is the structure listed or eligible for listing on the National Register?
XSo ce: National Register maps & building survey forms
No.
❑ Yes, listed or eligible for listing on National Register. Name of Historic District:
❑ No Exterior Work or work replaces existing condition
❑ Work is exempt. The following rehabilitation activities are exempt: electrical work, plumbing, installation of a
new furnace, painting in a complementary or in-kind color, repair of roof, porches or cornices when the repair is done
in-kind to match existing materials and form, caulking, improvements to existing streets and sidewalks provided that
all work is confined to the existing street layout, flower/shrubbery/tree planting programs within existing traffic
islands or sidewalk greenspaces.
❑ Work alters structure's exterior.-
❑ Properties to be rehabilitated will be rehabilitated in accordance with the recommended approaches in
the Seeretaiy of the Interior's Standards for Rehabilitation and Guidelines for Rehabilitating Historic
Buildings. If the standards cannot be met, forward project information to Massachusetts Historical
Commission for consultation.
❑ Consult Salem Historical Commission for comment prior to bid.
❑ Work involves demolition of structure(s)
Apply for Waiver of Demolition Delay from Salem Historical Commission
Prepare Project Notification Form and submit to Massachusetts Historical Commission
4. Does the Area of Potential Effect include NR properties or eligible properties?
So ce: National Register maps &building survey forms.
o.
Yes. List of potentially effected properties (attach map):
Prepare Project Notification Form and submit to Massachusetts Historical Commission
Copy PNF to Salem Historical Commission and get comment
ARCHAEOLOGICAL REVIEW
Does the project involve subsurface disturbance, including filling, grading, or excavation? If so, is the project located
with n any archaeological sensitivity zones? Source: Archaeological sensitivity maps.
No
❑ Yes—Prepare Project Notification Form and submit to Massachusetts Historical Commission
Prepared by: Reviewed b .
,lane A. GV— 4HC Cle k Date
Environmental Review P. 1
Statutory Checklist
Federal Laws and Authorities Listed at Sec 58.5
Project Name and Identification No. _j,b1 �Q
L N > N
F j O
O =p 0 m
Area of Statutory or c a� � ° Q Z .4 Provide compliance documentation.
Regulatory Compliance m o 5 a_ o @ Q Additional material may be attached.
O C C
C
@ O O .O
Q wE C m -o m
Z d U X a U d U
Historic Properties / {10 0.c •�r'�W' r cf^"�fi"`""1`"' "� "O '
a c q
Floodplain Management ,
Wetlands Protection
Coastal Zone Management X Salem does not have any coastal
barriers (file memo dated 8/3/06).
There are no EPA designated Sole
Water Quality — Aquifers X Source Aquifers in Salem per EPA
Region 1 map.
Endangered Species X Developed urban area - No endangered
species will be effected by this project.
Wild and Scenic Rivers X No wild and scenic rivers have been
designated in Salem.
Air Quality X No impact anticipated.
Farmlands Protection X Non - applicable. No farmlands will be
affected by this project.
Non-applicable. No increase in
dwellings; no known thermal/explosive
Manmade Hazards: X hazards will be created. Not near an
Thermal/Explosive operation handling conventional fuels or
chemicals of an explosive or flammable
nature.
The thresholds for railroads and airports
Noise X in the assessment guidelines will not be
exceeded.
Airport Clear Zones X No airport clear zones are located in
Salem.
Toxic Sites X Not an'EPA/DEP designated toxic site.
Attach evidence that required actions have been taken.
Environmental Review P. 2 .
Environmental Justice X The project is not likelyao raise
environmental justice issues..,,.
Statutory Checklist
Federal Laws and Authorities listed at Sec. 58.6 and Permits, Licenses, Forms of Compliances Under Other Laws
(Federal, State and Local Laws)
O O C
O C NO
O ;D N C @
� N C p
Other Areas of Statutory o .= o
o P o E Provide compliance documentation.
or Regulatory Compliance o c Additional material may be attached.
Applicable to Project mq n_ o
° Q
n c a E
Q o 0 0
U o
Z O Q U
Federal Requirements
Flood In u once - 58.6(a)
Coastal Barriers — 58.6(b) X Salem has no designated coastal
barriers
Airport Clear Zone X None in municipality
Notification — 58.6(c)
Water Quality X Water quality will not be affected by this
project.
Any hazardous waste generated will be
Solid Waste Disposal X deposed of according to applicable
reclulations.
Fish and Wildlife X No known fish or wildlife will be affected,
by this project.
State and Local Statutes (to be added by Responsible Entity)
Prepared by: n( Title:
Date: - _ �� �✓5
Attach evidence that required actions have been taken.
r _r� CDBG PROJECT CHECKLIST
Put one copy in ro ect file and ive one copy to Jane for Environmental Review file
ROJECTINFORMATION:
PROJECT NAME: LOCATION: PROJECT MANAGER:
Business Loan:Bio-Engineering Group/River 18 Commercial Street Tom Daniel
Wharf Realty Trust -
CDBG BUDGET: NON-CDBG BUDGET&SOURCE: TOTAL BUDGET:
$63,925 City funds $75,925
12 000
z,-
LLimited Clientele(low/mod persons). ®Area eenefrf pow/mod area) ❑Job Creation(min 51%low/mod)
❑Slums Bli hf Urban Renewal Area ❑urgent Need this category is rarely used
PROJECT DESCRIPTION (attach separately if nPPdPdl)' Rprnlp r f a innn to nrnv'r a wnrk nq cap tai and support Ah rpntpntinn
Completed
❑Minority Outreach-For HOME Affordable Housing Projects&CDBG Projects over$25,000
El
❑Section 3-For contracts of$100,000+
Davis Bacon Prevailing Wages
❑ Construction project over$2000 involving laborers or mechanics.
❑ Wage Decision number in effect at time of bid lock date(provided to contractor with copy in project file):
Wage decision number mndification# Highway,Building or Hpaw9 -
Actual Contract amount$
❑ Bid Lock Date(bid opening date,contract award or start of construction)
[]Bid opening date ❑Contract award ❑Start of Construction
❑ Copies of invoices,certified payroll form and proof of payment in file
Environmental Review
®Flood Plain Management Review-required for all projects ❑
Each project must fall under one of the following 5 categories:
❑ Environment Review Exempt-No further review required
Included plans,studies,administrative/management activities,inspections,testing,design,engineering,technical assistance,training and tools purct ase.
® Categorically Excluded NOT subject to 58.5-No further review required
Includes tenant based rental assistance,operating costs(including maintenance,security,operation,utilities,furnishings,equipment,supplies,
staff training and recruitment and other incidental costs), economic development costs(including equipment purchase,inventory financing,
interest subsidy,operating expenses and similar costs NOT associated with construction or expansion of existing operations),homebuyer
purchase assistance,affordable housing pre-development costs(legal,consulting,developer,project financing, administrative fees,zoning
approvals).
❑ Categorically Excluded subject to 58.5
Includes 1)acquisition,repair,improvement, reconstruction or rehabilitation of public facilities and improvements(other than buildings)when the
facilities and improvements are in place&will be retained in the same use without change in size or capacity of more than 20%, 2)removal of
architectural beaters,3)rehab of buildings 3a)(1-4 units)provided density is not increased beyond 4 units and footprint not increased in a
floodplain or wetland 3b)(multi-family)when unit density is not changed more than 20%,the project does not involve changes in land use from
residential to non-residential&the estimated cost of rehab is less then 75%of the total estimated cost of replacement after rehab 3c)(non-
residential)when the facilities and improvements are in place and will not be changed in size or capacity by more than 20%, the activity does not
involve change of land use,such as from non-residential to residential,commercial to industrial or one industrial use to another 4a)an individual
action on 1-4 family dwelling units where there is a maximum of 4 units on any one site(41-unit buildings, 1 4-unit building or any combo)4b)an
individual action on a project of 5+housing units developed on scattered sites when the sites are more than 2,000 feet apart and not more than 4
units on any one site 5)acquisition or disposition of an existing structure or acquisition of vacant land provided that the structure or land acquired
or disposed of will be retained for the same use. 6)combinations of above activities.
® Historic Property Review-see Jane
® Wetlands Protection Review-see T. Devine
❑ ® Statutory Checklist ❑
❑ No compliance Actions Required-No further review required
❑ Compliance Actions Required
❑ FONSI/RROF-see Jane (Must be done before any funds can be spent)
❑ Environmental Assessment Required
Includes all otherprojects if not excluded above.
❑ Statutory Checklist ❑
`�❑ Environmental Assessment Report
El
❑ Historic Property Review—see Jane
❑ Wetlands Protection Review—see Carey ❑
❑ FONSURROF-see Jane (Must be done before any funds can be spent)
❑ Environmental Impact Statement Required(for projects determined to have potentially significant impact on the human environment)
Prepared ® �\?7
p by, t Signature,
Date
CDBG PROJECT CHECKLIST
Put one eWZ/n egect file and /ye one copy to Jane for Environmental Review file
:-,1%W%PROJEcT,IN : rasmB ;..
PROJECT NAME: LOCATION: PROJECT MANAGER:
,d e n M 4-f—C-1v
CDB9 BUDGET: NON-CDBG BUDGET&SOURCE: TOTAL BUDGET:
n. - .
_ ,. .. a* ik?GDBG ELIGIBILITY:;�x
❑Limited Ciente/e(low/mod persons) ❑Area Benefit(low/mod area) b Creation(min SZ%low/mod)
❑Slums1811 ht Urban Rene wa/Area ❑Urgent Need this cat o is rare/ used
PROJECT DESCRIPTION (attach separately if needed): Caw ct7(a",�
Dari, n Oterai/ing Wager [amplend
❑ [onstr ion project over$2000 involving laborers or mechanics. ❑
❑ Wa Decision number in effect at time of bid lock date (provided to contractor with copy in project file):
Wage Sionnumber modification # Highway, Building or Heavy,
Actual Con ct amount$
❑ Bid Lock Date d opening date, contract award or start of construction):
❑Bid opening da ❑Contract award ❑Start of Construction
❑ Copies of invoices, certi i payroll form and proof of payment in file
fnrironmental Review
® flood Plain Management Review—required for all projects s�
Each project must fall under one of the following 5 categories:
❑ Environment Review Exempt— No further review required
lndoded plans,studies admiairtntiee/management acurioer, inrpertiour, testing, design, eupneenng, technical arrirtanre, training and tools purchase
/ .
fCategorically Excluded NOT subject to 58.5 — No further review required
/nrluder tenant bared rental amrmnce, operating cart,(including maintenance, serunty, operation, utilities Lumuhugr, equipmen4 supplies naN ttainmg and recruitment
and other fnadenta/corer, eronomir development rusty(including equipment purchase, inventory Atanting, interest mbsidy, opereling expenses and similar arts NOT
associated with courenvenon or expansion of existing epemtionr),homebuyer purchase assistance affordable housing pr denvcpment costy(legal, consulting, developer,
project hnannng, administrative fees,zoning approalt)
❑ Categorically Excluded subject to 58.5
lnduder l)acquisition, repair, improvement reconstruction or rehabilitation of pOfiir bcilitfes and fmproremmis(other than buildings)when the fariliies and fmprove"wer are
in place 6 will be retained in the same use without change in size or rapacity of more than 10% 1)remoa/of architectural hametr J)rehab of buildings Ja)(/-0 units)
provided deurity it not increased beyond 4 unity and footprint not increased in a Ooodp/a/n or wetland J6)(multi=family)when unit density is not changed more than 10Y,
the projert doer not tredve changer in land use from residential to non-residential B the estimated cost of rehab is leu than IS%of the teal estimated tort of replacement
after rehab Jr)(non-re lucflurl when the briliues and improaments are in place and will not be changed in size or rapacity by more than 10% the activity doer not involve
change of land use, such as,fmm non-residential to raridential, commerefal to fndustna/or one fndurufa/me to another 42)an individual action on 1-4 family dwelling units
where there is a maximum of 4 units on any one site(4/-unit bai/dfngr l 4-unit bm7ding or any combo)46)an individual adieu on a projert of S+housing units
demloped on scattered,iter when the rifer are more than 1,000 feet apart and not more than 4 units on any one rite SJ acquisition or dupmitfon of an exfrung structure of
acquisition of scant land pronded that the structure or land acquired or disposed of will be retained for the tame use. 6J combinations of aboa activities.
❑ Historic Property Review—see Jane - ❑
❑ Wetlands Protection Review—see Carey ❑
❑ Statutory Checklist ❑
❑ No compliance Actions Required— No further review required
❑ Compliance Actions Required ❑
❑ FONSI/RROF —see Jane (Must be done before any funds can be spent) ❑
❑ Environmental Assessment Required
lndudes all other projects if not excluded above.
❑ Statutory Checklist ❑
❑ Environmental Assessment Report ❑
❑ Historic Property Review—see Jane ❑
❑ Wetlands Protection Review—see Carey ❑
❑ FONSI/RROF —see Jane (Must be done before any funds can be spent) ❑
❑ Environmental Impact Statement Required (for projects determined to have potentially significant impact on the human environment) ❑
Prepared by: Signature: Date
Environmental Review P. 1
Statutory Checklist
Federal Laws and Authorities Listed at Sec 58.5
Project Name and Identification No. Bioengineering Group
«
> a
H « « o « u
Area of Statutory or a � m ° ¢ c o Provide compliance documentation.
Regulatory Compliance o a o m ¢ Additional material may be attached.
�cm
0 0 0
Q ami of 3 N E ,N ._
c > 2E c .m
ZIt. U X a OUd U2
Property is not a historic property.
Historic Properties X Project does not include acquisition,
construction or rehabilitation.
Floodplain Management X Project does not include acquisition,
construction or rehabilitation.
Wetlands Protection X Project does not include acquisition,
construction or rehabilitation.
Coastal Zone Management X Salem does not have any coastal
barriers (file memo dated 8/3/06).
There are no EPA designated Sole
Water Quality—Aquifers X Source Aquifers in Salem per EPA
Re on 1 map.
Endangered Species X Developed urban area - No endangered
species will be effected by this project.
Wild and Scenic Rivers X No wild and scenic rivers have been
designated in Salem.
Air Quality X No impact anticipated.
Farmlands Protection X Non - applicable. No farmlands will be
affected by this project.
Non-applicable. No increase in
dwellings; no known thermal/explosive
Manmade Hazards: X hazards will be created. Not near an
Thermal/Explosive operation handling conventional fuels or
chemicals of an explosive or flammable
nature.
The thresholds for railroads and airports
Noise X in the assessment guidelines will not be
exceeded.
Airport Clear Zones X No airport clear zones are located in
Salem.
Toxic Sites X Not an EPA/DEP designated toxic site.
*Attach evidence that required actions have been taken.
`A,
Environmental Review `' P. 2
Environmental Justice X The project is not likely to raise.
environmental justice issues.
Statutory Checklist
Federal Laws and Authorities listed at Sec. 58.6 and Permits, Licenses, Forms of Compliances Under Other Laws
(Federal, State and Local Laws)
O C N O «
O "O N c -
N � a 'a ami cr.....
t o U O
Other Areas of Statutory o N `o �
or Regulatory Compliance o L' o v a) 2 Provide compliance documentation.
C 4) c Additional material may be attached.
Applicable to Project m s a o
8 > E m
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OL c d E >
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Federal Requirements
Flood Insurance — 58.6(a) X Project does not include acquisition,
construction or rehabilitation
Coastal Barriers —58.6(b) X Salem has no designated coastal
barriers
Airport Clear Zone X None in municipality
Notification —58.6(c)
Water Quality X Water quality will not be affected by this
project.
Any hazardous waste generated will be
Solid Waste Disposal X deposed of according to applicable
re ulations.
Fish and Wildlife X No known fish or wildlife will be affected
by this project.
State and Local Statutes (to be added by Responsible Entity)
Prepared by Title:
Date:
Attach evidence that required actions have been taken.
v�' o-b� � /J
I
ECONOMIC DEVELOPMENT ACTIVITY SUMMARY
0 ,
To be submitted to Jane prior to creation offppurc¢hase order.
Activity Name �kS,� ess leu �. +bIIn2 f7,ae^R��vn^n1^f h^�^^�p I ?IWPr
Site Address
M A
Description -e w
Eligible activity (select one):
Zpecial Economic Development activity- acquiring, constructing, reconstructing,
rehabilitating or installing commercial or industrial buildings, structures or real property,
equipment and improvements (i.e. can be interior improvements, expansion of a plant or
factory, assistance to prevent closure)
o Must meet job creation/retention requirements (see summary.provided).
o Must meet public benefit.standards - A minimum of one FTE job must be created or
retained for every$35,000 in CDBG funds.
❑Microenterprise activity- 5 or fewer employees, one of whom owns the business (&owner
is low/mod). Note: Owner does not have to be low/mod if business is located within and
serves a low/mod area. A micro-enterprise can also be "persons developing microenterprises"
(low/mod person activelyworking toward developing a microenterprise business).
❑Commercial rehabilitation in low/mod or Urban Renewal Area (exterior of building,
correction of code violations or removal of architectural barriers)
o Requires use of prevailing wages (Davis-Bacon)
❑Wage Decision number in effect at time of bid lock date (provided to contractor with
copy in project file):
❑Bid Lock Date (bid opening date, contract award or start of construction):
❑Copies of invoices,certified payroll form and proof of payment in file
Proposed Accomplishments (select one):
Now Reporting on Dohs"will require nu itonng
Direct Financial Assistance to For-Profits
❑Businesses (check if Commercial rehab only)
Oobs (check if Special Economic Development) # Units proposed:
Micro-enterprise Assistance
❑Businesses
❑People
❑Jobs
1
Total Amount of CDBG$ 3S ou o
Grant: FZNo ❑Yes If yes: Amount $
Loan: ❑No [,2Yes If yes: Amount $
,❑"Amortized or ❑Deferred Payment/Forgivable Loan
Interest rate: �( '�� Amortization Period in months:
Proposed Leveraged Funds:
Section 108 Loan Guarantee
Other Consolidated Plan Funds (HOME, ESG, HOPWA)
Other Federal Funds
State Local Funds I(oS.oao
Private Funds
Other (25 Characters max):
National objective (must meet one)
0-enefit to Low and moderate income persons
❑Area benefit (must be primarily residential): Census tract#
o If Special Economic Development or Microenterprise activity,the business must
provide a service that primarily serves the residents of a substantially residential
low/mod area.
❑Limited clientele activities (must provide low/mod income documentation). Only applicable
for Microenterprises and only the owner needs to qualify; if the owner does not,job
creation/retention criteria can be used.
Zob creation or retention activities - Not applicable for commercial rehabilitation.
❑Aide in the prevention or elimination of slums or blight (Urban Renewal area only)
❑Urgent need- Use of this category is extremely rare. It is designed only for activities that
alleviate emergency conditions. Urgent need activities must meet the following qualifying criteria
and documentation of how the application meets this criteria must be submitted:
❑The existing conditions must post a serious and immediate threat to the health or welfare of
the community:
❑The existing conditions are of recent origin or recently became urgent (generally, within the
past 18 months);
F-1 The recipient is unable to finance the activity on its own; and
❑Other sources of funding are not available.
r ; Job Creation/Retention (if apphcahie)
R+ Mamrraah 1)F M pob f r ezery$3S,000 an CDBG fi�ufs p "i"(prefer Z lobs far ezery$35,0000
..._ ... r.�...... ._ . ., , . ,..
Total Job Count Total Weekly Hours
F/T F/T-LM P/T P/T-LM
Expect to Create S -3 3
Expect to Retain Sy 5
2