HomeMy WebLinkAboutIowa Dept. of Economic Development-Financial Assistance Application-11.05.2007 I OW .:
Michael Tramontina, Director
life c h a n g i n g Iowa Department of Economic Development
Application for Financial Assistance
Section A — Applicant & Project Information
Business Development Division
Iowa Department of Economic Development
200 East Grand Avenue
Des Moines, Iowa 50309
www.iowalifechanging.com
Updated:April 19,2007
Instructions
1. All applicants shall complete Section A of the Application for Financial Assistance and attach only those section(s)for the
program(s)to which the applicant is applying.
Program Download and Complete
Community Economic Bettermeant Account(CEBA) Section B
Enterprise Zone Program (EZ) Section C
High Quality Job Creation Program(HQJC) Section D
Entrepreneurial Ventures Assistance Frogram (EVA) Section E
Value Added Agricultural Products&Processes
Financial Assistance Program (VAAPFAP) Section F
Economic Development Set-Aside Program (EDSA) Section G
2. Please visit the IDED Web site, http://www.iowalifechanginq.com/applications/bus dev/index.html or contact IDED at(515)
242-4819 to see if this version of the application is still current.
3. Before filling out this application form, please read all applicable sections of the 2005 Iowa Code and Iowa Administrative
Code(rules). http://www4.legis.state.ia.us/IAChtm1l261.htm
4. Only typed or computer-qenerated applications will be accepted and reviewed. Any material change to the format,
questions, or wording of questions presented in this application, will render the application invalid and it will not be
accepted.
5. Complete the applicable sections of the application fully; if questions are left unanswered or required attachments are not
submitted, an explanation must be included.
6. Use clear and concise language. Attachments should only be used when requested or as supporting documentation.
7. Any inaccurate information of a significant nature may disqualify the application from consideration.
8. Upon completion of the application, please submit the following to the Business Finance Team at IDED:
• The original, signed application form and all required attachments
• One copy of the application form and all required attachments from which additional copies can easily be made.
If electronic copies of the application and required attachments are available, please e-mail these documents to
businessfinance aniowalifechanging.com in addition to submitting the original plus one copy.
Business Finance Team
Iowa Department of Economic Development
200 East Grand Avenue
Des Moines IA 50309
Application Due Dates
IDED Board Meeting Application Due Date
April 19, 2007 March 26, 2007
May 17, 2007 April 23, 2007
June 13, 2007 May 21, 2007
July 19, 2007 June 25, 2007
August 16, 2007 July 23, 2007
September 20, 2007 August 27, 2007
October 18, 2007 September 24, 2007
November 15, 2007 October 22, 2007
December 20, 2007 November 26, 2007
*EVA applications will be acted upon every other month starting in March.
Section A—Applicant&Project Information 2
Public Records Policies
Information Submitted to IDED. The Iowa Department of Economic Development(IDED) is subject to the Open Records law
(Iowa Code, Chapter 22). Treatment of information submitted to IDED in this application is governed by the provisions of the
Open Records law. All public records are available for public inspection. Some public records are considered confidential and
will not be disclosed to the public unless ordered by a court, the lawful custodian of the record, or by another person duly
authorized to release the information.
Confidential Records. IDED automatically treats the following records as confidential and they are withheld from public
disclosure:
• Tax Records
• Quarterly Iowa Employer's Contribution and Payroll Report prepared for the Iowa Workforce Development Department
• Payroll Registers
• Business Financial Statements and Projections
• Personal Financial Statements
Other information supplied to IDED as part of this application may be treated as confidential under Iowa Code section 22.7.
Following are the classifications of records which are recognized as confidential under Iowa law and which are most frequently
applicable to business information submitted to IDED:
• Trade secrets[Iowa Code§22.7(3)]
• Reports to governmental agencies which, if released, would give advantage to competitors and serve no public purpose.
[Iowa Code§22.7(6)]
• Information on an industrial prospect with which the IDED is currently negotiating. [Iowa Code§22.7(8)]
• Communications not required by law, rule or regulation made to IDED by persons outside the government to the extent that
IDED could reasonably believe that those persons would be discouraged from making them to the Department if they were
made available for general public examination. [Iowa Code§22.7(18)]
Information supplied to IDED as part of this application that is material to the application and/or the state program to
which the applicant is applying including, bui:not limited to the number and type of jobs to be created,wages for those
jobs, employee benefit information, and project budget, are considered open records and will not be treated as
confidential.
Additional Information Available. Copies of Iowa's Open Record law and IDED's administrative rules relating to public
records are available from the Department upon request or at
http://www.iowalifechanginq.com/downloads/chap169openrecords.doc.
Section A—Applicant&Project Information 3
Applicant Information
1. Name of Business: A-Line EDS, Inc.
Address: 808 Dearborn Avenue
City, State &Zip Code: Waterloo, IA 50703
Contact Person: Ben De Jong Title: Controller
Phone: 319.232.3889 Fax: 319.235.7032 Email: bdejong@alineeds.com
2. SIC or NAICS Code: NAICS Code 562920
3. Federal ID Number: 02-0624383
Does the Business file a consolidated tax return under a different tax ID number? n Yes X❑ No
If yes, please also provide that tax ID number:
4. Is the contact person listed above authorized to obligate the Business? ❑Yes X[No
If no, please provide the name and title of a company officer authorized to obligate the Business:
Ben Stroh, President
5. If the application was prepared by someone other than the contact person listed above, please complete the following:
Name: Title:
Organization:
Address:
City, State, &ZIP Code:
Phone: Fax: Email:
Sponsor Information
Please review the following table to determine who needs to sponsor this application. Depending on the programs being
applied for, more than one sponsor may be necessary.
Program Acceptable Sponsor
CEBA City or County or Community College in which the Project Site is Located
EZ Local Enterprise Zone Commission
HQJC City or County in which the Project Site is Located
EVA City or County in which the Project Site is Located; Local Development Entity;John Pappajohn Entrepreneurial
Center;a Small Business Development Center; Business Accelerator;or similar entity
VAAPFAP City or County in which the Project Site is Located or Local Development Entity
EDSA City or County in which the Project Site is Located
1. Sponsor Organization: City of Waterloo
Official Contact(e.g. Mayor, Chairperson, etc.): Timothy Hurley Title: Mayor
Address: 715 Mulberry Street
City, State &ZIP Code:Waterloo, IA 50703
Phone: 319.291.4301 Fax: 319.291.4262 E-mail:tim.hurley@waterloo-ia.org
2. If IDED needs to contact the sponsor organization with questions, should we contact the person listed above?
Yes 4-1 No, please contact the following person:
Name: Linda Laylin Title: Director of Business Services
Address: 10 West Fourth Street
City, State &ZIP Code: Waterloo, IA 50701
Phone: 319.232.1156 Fax: 319.232.1829 E-mail:Laylin@cedarvalleyalliance.com
If necessary, please list information on additional sponsors in an attachment.
Section A—Applicant&Project Information 4
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Certification&Release of Information "G. 1P f `?skis//
I hereby give permission to the Iowa Department of Economic Development(IDED)to research the Business'history,make
credit checks,contact the Business'financial institutions, insurance carriers,and perform other related activities necessary for
reasonable evaluation of this application. I also hereby authorize the Iowa Department of Revenue to provide to IDED state tax
information pertinent to the Business'state income tax,sales and use tax,and state tax credits claimed.
I understand that all information submitted to IDED related to this application is subject to Iowa's Open Record Law(Iowa Code,
Chapter 22).
I understand this application is subject to final approval by IDED and the Project may not be initiated until final approval is
secured. (High Quality Job Creation Program applications may be submitted up to 12 months following the completion of the
project.)
I understand that IDED reserves the right to negotiate the financial assistance. Furthermore, I am aware that financial
assistance is not available until an agreement is executed within a reasonable time period following approval.
I hereby certify that all representations,warranties,or statements made or furnished to IDED in connection with this application
are true and correct in all material respect. I understand that it is a criminal violation under Iowa law to engage in deception and
knowingly make,or cause to be made,directly or indirectly,a false statement in writing for the purpose of procuring economic
develo assistance state agency or subdivision.
Forth zB siness.
b/22/07
Signature C I Date
tie.n jar`^i n -WON PI. 5 ce
Name and Title(typed or printed)
For the Sponsor s:
Signature Date
rY1 J Lit 12- -
Name and Title(typed or printed)
Please use the following if more than one sponsor is required. (For example, use this if a signature from the local Enterprise
Zone Commission is required in addition to the signature from the Mayor of the sponsoring city.)
Signature Date
Name and Title(typed or printed)
IDED will not provide assistance in situations where it is determined that any representation, warranty, or statement made in
connection with this application is incorrect, false, misleading or erroneous in any material respect. If assistance has already
been provided prior to discovery of the incorrect, false, or misleading representation, IDED may initiate legal action to recover
incentives and assistance awarded to the Business.
Section A—Applicant&Project Information 5
Project Information
1. Provide a brief description and history of the Business. Include information about the Business' products or services
and its markets and/or customers.
A-Line EDS, Inc. dismantles and decommissions high-voltage electrical equipment. The materials
from transformers are recycled. A-Line EDS, Inc. has two coppper wire incenerators on-site to recycle
the copper wire from the transformers.
A-Line EDS, Inc. has been in operation for approximately 9 years and is owned by Ben Stroh and Brad
Stroh. The majority of the work done by A-Line EDS, Inc. is commissioned out of state. A-Line
currently has 28 employees.
2. Business Structure:
❑ Cooperative ❑ Corporation ❑ Limited Liability Company ❑ Not for Profit
❑ Partnership X❑ S-Corporation ❑ Sole Proprietorship
State of Incorporation: Iowa
3. Identify the Business'owners.
Ben Stroh and Brad Stroh
Does a woman, minority,or person with a disability own the Business? ❑ Yes X❑ No
If yes, is the business certified as a Targeted Small Business? ❑ Yes ❑ No
4. List the Business' Iowa Locations and the Current Number of Employees at each Location.
808 Dearborn Ave, Waterloo, IA 50703 - 28 employees
5. What is the Business'worldwide employment? (Please include employees of parent company,subsidiaries,and other
affiliated entities in this figure.)28
6. Briefly describe the proposed project for which assistance is being sought. (Include project timeline with dates,facility
size, infrastructure improvements, proposed products/services,any new markets,etc.)
A-Line EDS, Inc. is is planning to expand their current market and services outside the State of Iowa.
This expansion project will make A-Line EDS, Inc. a full-service decommissioning company for their
current, as well as new customers. This expansion will allow A-Line to obtain distribution
transformer contracts with utility companies and will create 9 new positions. A-Line EDS, Inc. will be
a one-of-a-kind facility in the State of Iowa. The major competitors for A-Line are Celan Harbors
(Ohio and Texas) Solomon Corporation (Kansas), Transformers Disposal Services (Oklahoma), G&S
Technologies (New York) and TCI (Alabama and New York) and all of them currently have a facility
similar to what A-Line is proposing.
The new facility will be used to decommssion transformers up to 500 ppm PCB. Upon completion of
this expansion, the company will have the capacity to store 300-350 pole mount and pad mount
Section A—Applicant&Project Information 6
transformers. The company will also have oil storage capacity for 7,500 gallons of<2ppm oil and 7,500
gallons of 2-49 ppm oil.
This expansion requires construction of a new building between 10,000 - 13,000 square feet for a
decommissioning line for distribution transformers. The building wil include a receiving dock and
three shipping docks and will require an overhead crane and a PCB testing lab. Currently, there is not
a similar facility in the State of Iowa.
The facility will be permitted by the EPA, and the company is already taking the necessary steps to be
licensed by the EPA.
7. Project Address(Street Address, City, and County): 808 Dearborn Avenue, Waterloo, IA 50703
8. Type of Business Project:
❑ Startup X❑ Expansion of Iowa Company ❑ New Location in Iowa
❑ Relocation from another State
9. Please identify the management at the project location and his/her/their experience.
Ben Stroh, President — 15 years experience in scrap metal reclamation. Has owned A-Line EDS,
Inc. since its beginning. Extensive knowledge in the transformer dismantling
Lynn Fritz, Sales Manager - Lynn Fritz worked at SD Myers that was in turn purchased by
Clean Harbors. He worked at the combination of the two for almost 30 years. He worked at SD
Myers for 21 years and Clean Harbors for 9 years.
10. Has any part of the project started? ❑Yes X❑ No
If yes, please explain.
Section A—Applicant&Project Information 7
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12. Employee Benefits: Please identify all employee benefits provided by and paid for(in full or in part) by the Business.
Employee Benefits Total Annual Cost Portion of Total Plan Provisions
Provided by the (show on a per Annual Cost Paid (Include deductibles,coinsurance%,office visit
co payments, annual out-of-pocket maximums,
Business employee basis) by the Business*
.a . face amounts,etc.
Employee Family Employee Family
2,940.00 7,944.00 81% 30% $500/$1,000 Deductible, Coinsurance
Medical/Health 10%30%, $25 office visit. Out of pocket
Insurance maximum$1,000/$2,000 Prescription
$10/$25/$40
228.00 804.00 50% 50% $25/$75 annual deductible, Coinsurance
Dental Insurance 20%/50%. Annual maximum$1,500
00.00 Vision included in Medical insurance
Vision Insurance package
Life Insurance
Short Term Disability
(STD)
Long Term Disability
(LTD)
* If the business's plan is self-insured, please use the amount paid by the business for costs associated with employee and family coverage
during the past three years and then,determine the business'average annual contribution per employee for that three year period.
Does the Business offer a pension plan, 401(k) plan, and/or retirement-plan? ❑ Yes X❑ No
If yes, please indicate the amount contributed or a per employee basis by the Business to the plan. For 401(k) plans, please
provide information on the company match and indicate the average annual match per employee(show average as a
percentage of salary).
Does the Business offer a profit-sharing plan? ❑ Yes X❑ No
If yes, please indicate total amount paid out each year for the past three years and then, determine the average annual bonus or
contribution per employee for that three year period.
Does the Business offer child care services? Yes X❑ No
Child care services include child care services on-site at the facility in which the project will occur or off-site child care
subsidized by the business at the rate of 50% or more of the costs incurred by an employee.
Section A—Applicant&Project Information 9
13. Identify the Business'competitors. If any of these competitors have Iowa locations,please explain the nature of the
competition(e.g.competitive business segment,estimated market share, etc.) and explain what impact the proposed
project may have on the Iowa competitor.
A-Line EDS, Inc.will be a one-of-a-kind facility in the State of Iowa. The major competitors for A-
Line are Celan Harbors (Ohio and Texas) Solomon Corporation(Kansas), Transformers Disposal
Services (Oklahoma), G&S Technologies (New York) and TCI (Alabama and New York) and all of
them currently have a facility similar to what A-Line is proposing.
14. Will any of the current Iowa employees lose their jobs if this project does not proceed in Iowa?
❑ Yes X❑ No
If yes, please explain why and identify those jobs as"retained jobs"in the following question.
Not immediately, However if the project would not move forward in Iowa, A-Line EDS, Inc. would
have to look elsewhere for this facility as it is much needed by the company. This process would take
1-2 years and at that time A-Line EDS would have to access what location to have its company offices.
If the company offices were located in another state,approximately 5 workers would have to be
relocated.
Section A—Applicant&Project Information 10
15. List the jobs that will be retained and/or created as the result of this project. (A retained job is an existing job that
would be eliminated or moved to another state f the project does not proceed in Iowa.) For retained jobs, include the current
hourly wage rate. For jobs to be created, including the starting hourly wage rate.
Job Title Skills,Education,or Experience Number of Retained(R)or Starting or Current Hourly
Required Jobs Created(C) Wage Rate
Year 1 of the Project
Crew laborer Torching/Mechanical experience 2 C $30,500
Sales assistant/manager College degree preferred 1 C $30,500
Communication/organization skills
Year 1 Subtotal 3
Year 2 of the Project
Plant Manager College degree,environmental and 1 C $75,000
supervisory experience
Transportation Manager College degree,logistics experience 1 C $40,000
Crew laborer Torching and mechanical experience 1 C $30,500
Lab Technician 2 year degree or equivalent 1 C $32,000
experience
Year 2 Subtotal 4
Year 3 of the Project
Crew laborer Torching and mechanical experience 1 C $30,500
Asst.Crew Foreman Dismantling and equipment 1 C $36,000
experience,2 year c'egree or
equivalent experience
Year 3 Subtotal 2
Total Number of Retained Jobs:
Total Number of Created Jobs: 9
Section A—Applicant&Project Information 11
16. Discuss each of the following items with respect to the proposed project:
a) the current employment conditions in the community, include any business closures, unemployment rates, etc.
and if applicable,the community's need for assistance in attracting the Business.
The area's unemployment rate for August 2007 was 3.6%. While the area's economic recovery continues to improve,
there is still a tremendous need in the area for more jobs and higher wages.
A labor shed study was recently completed for the area, and reflected significant numbers of individuals working in the
Cedar Valley and surrounding communities who were interested in finding employment or willing to change
employment. The positions at A-Line will offer excellent alternative employment with quality benefits.
A local Discovered Resources Job Fair was held on October 10, 2007. Approximately 1,000 job seekers attended
demonstrating a need for more job opportunities in the area.
b) impact of the proposed project on the community and the state, include projections that reflect the impact on local
and state tax revenue and any additional costs the community will incur as the result of the proposed project;
The project would add nine employees to the workforce. Over 85%of the revenue generated by A-Line EDS is
generated from other states. The project would create no sales tax revenue as all of the companies sales are
recycling/resale of scrap metal. The community would have no additional costs as A-Line EDS receives no local
or state funding. The owners Ben and Brad Stroh are residents of the state of Iowa and pay personal income
taxes to the state of Iowa. All profits of the business flow through to the owners as A-Line EDS, Inc. is a
Subchapter S Corporation,thus creating additional state income taxes.
c) impact the proposed project will have on current employees, including the potential for increased skills and wages;
and
A-Line EDS, Inc will have the ability to add extra benefits as the company becomes more profitable. The first
benefit that we would like to add would be a 401k plan. We anticipate if everything goes according to plan, we
would add some sort of retirement mechanism within the next two years. This may or may not be a 401k plan.
Bonuses to employees are routinely paid out based on individual and company performance. Each of the
employees at the location would have an added potential for increased bonuses.
d) impact the investment will have on the ability of the business to expand, upgrade,or modernize its capabilities.
The investment is needed by A-Line EDS to be able to compete in the marketplace. All of our major competitors
have a facility similar to what we are proposing. If the project does not move forward,there would be no
expansion of the A-Line EDS facility and no need to upgrade or modernize. The facility that we are proposing,will
be to our knowledge, the only facility in the State of Iowa.
17. Is the Business actively considering locations outside of Iowa? X❑ Yes ❑ No
If yes, where and what assistance is being offered?
As A-Line considers expansion of their markets and services, they have evaluated locations in other states, but prefer to do this
expansion in Waterloo, IA, if possible.
18. There are three general justifiable reasons for assistance. Check the box next to the reason why assistance is needed
to complete this project
❑ Financing Gap - The Business can only raise a portion of the debt and equity necessary to complete the
project. A gap between sources and uses exists and state and/or federal funds are needed to fill the gap.
❑ Rate of Return Gap — The Business can raise sufficient debt and equity to complete the project, but the
returns are inadequate to motivate an "economic person" to proceed with the project. Project risks outweigh the
rewards.
X❑ Locational Disadvantage (Incentive)—The Business is deciding between a site in Iowa (site A) and a site in
another state (site B) for its project. The Business argues that the project will cost less at site B and will require a
Section A—Applicant&Project Information 12
subsidy to equalize costs in order to Iccate at site A. The objective here is to quantify the cost differential between site
A and site B.
What measures were analyzed to determine the amount and form of assistance needed
Cash Flow and profit were the key measures we looked at when determining the cost of the project and how the
project were to be funded.
Physical location is the most important measurable. Our location in Iowa will allow us to serve the Chicago
marketplace nicely. However a facility in Nevada, would allow us to serve the Los Angeles market nicely. We have
chosen to expand our location in Iowa as we feel our relationship with clients in Chicago is greater than our relationship
with the Los Angeles market.
Property taxes, income taxes and fund ng sources were also compared.
19. What amount of state assistance is requested based on the above-identified need?
$45,000 in direct financial assistance, but investment tax credits and sales tax refunds will also impact financial
decision.
What type/form of assistance is preferred (e.g. loans,forgivable loans, tax incentives,etc.)?
Forgivable loan, tax incentives
20. Please indicate what program(s)the Business is applying to and download and submit those applicable sections:
X❑ CEBA (Complete Section B)
EZ (Complete Section C)
I1 HQJC (Complete Section D)
❑ EVA (Complete Section E)
❑ VAAPFAP (Complete Section F)
❑ EDSA (Complete Section G)
The Department reserves the right to review this application and determine, based on the proposed project and available
program funds, which financial assistance program(s)is best suited for the Business'project. The actual program(s)utilized
may vary from the programs indicated above.
Section A—Applicant&Project Information 13
21. Return on Investment Information—Business Taxes
IDED is required to calculate the return on state and local government investments in this project. Data from other parts of the
application will be combined with the estimates requested below to calculate the required return on investment information.
Instructions for Question 21
- IDED is asking for a best estimate on the increase in taxes associated with this project.
- Estimates should only include the expected increase in tax liability resulting from this project.
- At minimum, IDED needs estimates for the first three years of the project.
- Show data as if no tax abatements or tax credits awarded for this project were taken.
- For partnership forms of ownership(e.g. limited partnerships, s-corporations, LLC,etc.), please estimate the
partners' increase in Iowa tax liability due to this project.
- Sales and use taxes refer to the taxes paid on materials, etc.that the Business purchases, not taxes you
collect from sales to your customers.
- Applicants will not be held to these numbers with respect to any award from or contract with IDED.
- This page of the application will automatically be treated as confidential.
Increase in Tax Collections Associated with this Project
State Business Taxes Year 1 Year 2 Year 3 Year 4 Year 5
State Corporate Income Tax* $10,000 $45,000 $50,000 $60,000 $75,000
State Business Sales and Use Tax $ $ $ $ $
* Insurance Companies: Provide State Insurance Premium Tax
Local Business Taxes Year 1 Year 2 Year 3 Year 4 Year 5
Local Real Estate Property Tax $4,000 $4,000 $4,000 $4,000 $4,000
Local Option Sales Tax $ $ $ $ $
Section A—Applicant&Project Information 14
Attachments
Please attach the following documents:
Al Business Plan
At a minimum, include:
• marketing study,
• feasibility study,
• projected profit and loss statements for three years into the future,
• project budget,
• production operations,
• management structure,
• personnel needs,
• descriptions of product or process,
• status of product/process development, and
• patent status(if applicable).
(Any information outlined above not included in the business plan should be submitted as supplemental information via
a separate attachment.)
A2 Copies of the Business' Quarterly Iowa Employer's Contribution and Payroll Report Summary Page(Page 1)for the
past year and a copy of the most recent payroll report for one pay period.
A3 Affidavit that states the Business has not, within the last five years,violated state or federal statutes, rules, and
regulations, including environmental and worker safety regulations, or, if such violations have occurred,that there were
mitigating circumstances or such violations did not seriously affect public health or safety or the environment.
A4 Financial Information (Existing Businesses Only)
• Profit and loss statements and balance sheets for past three year-ends;
• Current YTD profit and loss statement and balance sheet;
• Schedule of aged accounts receivable;
• Schedule of aged accounts payable; and
• Schedule of other debts.
Application Checklist
Section A—Applicant&Project Information 15
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Section B — CEBA
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1. Which program component is the Business applying for?
❑ Small Business Gap Financing
X❑ New Business Opportunity
Li New Product Development
E Modernization Component
2. Funding Information:
Total Amount Requested: $45,000
Loan Amount: $
Forgivable Loan Amount: $45,000
See Chapter 53, Section 261 in the CEBA Administrative Rules for maximum funding amounts. The CEBA program is
not designed to provide 100% funding for any project and limits assistance based on the type of project submitted.
3. Security:
Corporate Guaranty [1 Surety Bonds
X[1 UCC Financing Statement fl Mortgage on Real Estate
n Irrevocable Letter of Credit Escrow Account
❑ Personal Guarantee ❑ Other:
All awards secured by Personal Guarantees will require a current financial statement from each of the personal
guarantors, which must be attached to the application.
4. Does the business certify that at least 10% of the positions to be created will be made available to qualified Promise
Job Participants? XYes ❑ No
5. Are underground tanks(whether or not in current use)for the storage of petroleum products, agricultural or other
chemicals, waste oil or other liquid waste or any other inflammable, corrosive, reactive or explosive liquid or gas
located on the project site?
n Yes NoX If yes, please explain:
Will the Business be storing above-grog nd,on or about the project site, in tanks or otherwise, any liquid or gas (as
described above)or any inflammable, corrosive, reactive or explosive solid,for any length of time or any purpose?
n X Yes No If yes, please specify:
The transformers that will be brought or-site will have transformer oil in them. They facility will be approved by the
EPA to handle PCB's up to 500 ppm.
Will the Business be treating, transporting or disposing of any liquid,gas,or solid (described above)either on or about
the project site or at a landfill or other treatment facility or upon any public street or highway, or on any waterway or
body of water, or in any aircraft?
Section B—CEBA 12/21/2006 1
I X Yes No
If yes, please specify the substance and what the Business will be doing with it.
Transformer oil less than 50 ppm will be sold as recyclable material to a local oil company. Transformer oil greater
than 50 ppm will be treated on-site and then recycled. If the material can not be recycled it will be disposed of by either
using Waste Management out of Alabama or US Ecology out of Nevada.
6. Does the Business generate solid or hazardous waste? E Yes X No
If yes, please describe and provide a copy of the Business'solid and hazardous waste reduction plans.
7. Does the project include the initial construction of any building or facility? XE Yes No
If yes, does the local jurisdiction have a local building code in place which it enforces through a system of plan reviews
and inspections? X❑ Yes ❑ No
Attachments
Please attach the following documents:
B3 Community resolution authorizing the submission of the application
To be submitted immediately following Council approval. Tentative date: November 5,2007.
Section B—CEBA 12/21/2006 2
Attachment A3
Affidavit
State of Iowa
County of Black Hawk
I, Benjamin B Stroh,depose and say that I have examined the following statement and have found
it to the best of my knowledge to be accurate and true.
A-Line EDS, Inc.has not,within the last five years,violated state or federal statutes,rules,and
regulations, including environmental and worker safety regulations,or,if such violations have
occurred,that there were mitigating circumstances or such violations did not seriously affect public
health or safety or the environment✓ ,7
I further depose that the sire be own proper signature.
Dated: 10/22/07 _
Signature
Subscribed and sworn to before me on
t _2,21v' day of Oc ZOO7 = COMMISSKON N0.735997
1&-/ otary P iblic) rev c()trstPT 1��2ooe RES
County PANNE BAILE
My commission expires on �ii/00