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Home My WebLink AboutPROJECT WORKSHEETS AND PROJECT APPLICATION SUMMARY - 6/20/2007 I lie, /06. Fields of Opportunities STATE O F IOWA CHESTER J. CULVER DEPARTMENT OF PUBLIC DEFENSE GOVERNOR IOWA HOMELAND SECURITY AND EMERGENCY MANAGEMENT DIVISION PATTY JUDGE DAVID L.MILLER,ADMINISTRATOR LT.GOVERNOR t1;?: /, 64r1"1 1 ^' June 20, 2007 Ms. Nancy Eckert, City Clerk Disaster#: DR-1688-IA City of Waterloo PA ID#: 013-82425-00 715 Mulberry Street Package#(s): 57 Waterloo, IA 50703 Dear Ms. Eckert: Enclosed are copies of your Project Worksheets (PW's) and Project Application Summary (P.2), for your Public Assistance application. It is very important that you review each Project Worksheet for: • accuracy/completeness; • the scope of work to determine differences, if any, between the Project Worksheet and what was agreed upon when the site was inspected; • calculation errors and corresponding dollar amounts. If there are specific issues or discrepancies on a Project Worksheet you need to notify the Public Assistance Officer immediately. Remember, you have 30 days from the receipt of this letter to request to have any issue reconsidered for eligibility. When all of your small projects are 100% complete, or when any one of your large projects is 100% complete, please notify the Public Assistance Office of Iowa Homeland Security and Emergency Management Division so that we may begin the closeout process. Remember, in the event that your actual project costs exceed the approved amount shown on the project worksheet, you have 60 days from the date on which the project work was completed to officially request a project cost adjustment, which must include documentation of all project costs. Payments received from Iowa Homeland Security and Emergency Management Division should be redeemed upon receipt, regardless of the status of the respective project(s) they pertain to. The Catalog of Federal Domestic Assistance (CFDA) number may be found on the"Payment Voucher"form enclosed with each warrant. All records of work associated with the claimed costs on every project are to be maintained for a minimum of three (3) years from the closing date of the grant or sub-grant and are subject to State and Federal review under the "Single Audit Act, as amended"and the "Single Audit Act Amendments of 1996, as amended". The Office of Management and Budget Circular A-133, the "Single Audit Act, as amended", and the "Single Audit Act Amendments of 1996, as amended", require that Non-Federal entities that expend $500,000.00 or more in a year in Federal awards shall have a single audit conducted. A program specific audit may be conducted in place of a single audit if the auditee meets the terms specified in Office of Management and Budget Circular A-133 § .200, paragraph C. If there is a "finding" relating to a Federal program administered by Iowa Homeland Security and Emergency Management Division: A copy of the official audit must be submitted within nine (9) months of the end of the auditee's fiscal year to: State Fiscal Office Department of Public Defense 7105 NW 70th Avenue, Bldg B-61 Johnston, IA 50131 If there are no "findings" A copy of the audit report is not required, but the auditee shall provide written notification that: ♦ an audit was conducted, including - entity(auditee) name Catalog of Federal Domestic Assistance (CFDA) number(s) the period covered by the audit dollar amount expended ♦ the schedule of findings and questioned costs disclosed no audit findings relating to Federal award(s) administered by Iowa Homeland Security and Emergency Management Division ♦ the summary of schedule of prior audit findings did not report on the status of any audit findings related to Federal award(s) administered by Iowa Homeland Security and Emergency Management Division If you have any questions or concerns, please call the Public Assistance Office of Iowa Homeland Security and Emergency Management Division at(515) 725-3231. Sincerely, Pan-no rf't.rper Dennis Harper State Public Assistance Officer Enclosures 7105 NW 701h AVENUE/CAMP DODGE/ BLDG. W-4/JOHNSTON, IOWA 50131-1824/515-725-3231 WWW.IOWAHOMELANDSECURITY.ORG DATE: 06/19/2007 FEDERAL EMERGENCY MANAGEMENT AGENCY PROJECT APPLICATION SUMMARY(P.2) DISASTER#: 1688 PACKAGE NO: 57 P.A. ID: 013-82425-00 APPLICANT: WATERLOO,CITY OF PW# VSN CAT INF COST SHR PROJECTED COMPL DATE APPROVED PW AMOUNT 626 0 B N N 09/14/2007 $7,163.75 Site Number: 1 DAMAGED EMERGENCY PROTECTIVE MEASURES FACILITY: CITY WIDE FACILITY LOCATION: THE CITY POLICE DEPARTMENT PATROLLED THE STREETS UTILIZING MORE THAN 1,876 REGULAR TIME FORCE ACCOUNT LABOR AND 13,025 MILES OF FORCE ACCOUNT EQUIPMENT. SCOPE OF WORK: PW# VSN CAT INF COST SHR PROJECTED COMPL DATE APPROVED PW AMOUNT 633 0 B N N 09/14/2007 $8,853.99 Site Number: 1 DAMAGED EMERGENCY PROTECTIVE MEASURES FACILITY: CITY WIDE FACILITY LOCATION: THE FIRE DEPARTMENT RESPONDED TO OVER 345 EMERGENCY CALLS REQUIRING 2,116 REGULAR HOURS OF FORCE LABOR AND 178 HOURS OF FORCE EQUIPMENT DURING THE EVENT PERIOD. SCOPE OF WORK: Page 1 of 2 DATE: 06/19/2007 FEDERAL EMERGENCY MANAGEMENT AGENCY PROJECT APPLICATION SUMMARY(P.2) DISASTER#: 1688 PACKAGE NO: 57 P.A. ID: 013-82425-00 APPLICANT: WATERLOO,CITY OF PW# VSN CAT INF COST SHR PROJECTED COMPL DATE APPROVED PW AMOUNT 637 0 C N N 09/14/2008 $13,413.11 Site Number: 1 DAMAGED TRAFFIC SIGNAL CONTROL BOX FACILITY: CITY WIDE FACILITY LOCATION: DURING THE SEVERE WINTER STORM FROM 2-23-07 TO 3-2-07,LIGHTNING STRUCK AND DAMAGED, BEYOND REPAIR,A TRAFFIC SIGNAL CONTROL CABINET AND CONTROLLER MOUNTED INSIDE.THE CITY HAS DONE SOME WORK ON THIS SITE TO GET THE LIGHTS WORKING. SCOPE OF WORK: WORK TO BE COMPLETED; THE CITY HAS RECEIVED AN ESTIMATE FROM BROWN TRAFFIC PRODUCTS, INC. IN THE AMOUNT OF$9,925.00 FOR REPLACEMENT OF THE CABINET AND CONTROLLER. OTHER IN STOCK PARTS TO REPLACE ITEMS DAMAGE BRING THE TOTAL TO$10,668.82 TO REPLACE THE DAMAGED EQUIPMENT. 3 PWs $AMOUNT ELIGIBLE $FEDERAL SHARE PWs: $29,430.85 $22,073.13 SUBGRANTEE ADMIN EXP: $588.61 $588.61 TOTAL: $30,019.46 $22,661.74 GRAND TOTAL: 3 PWs $AMOUNT ELIGIBLE $FEDERAL SHARE PWs: $29,430.85 $22,073.13 SUBGRANTEE ADMIN EXP: $588.61 $588.61 GRANTEE TOTAL: $30,019.46 $22,661.74 ADMIN EXP: $113.31 APPROVED BY: DAVID TESKA DATE: 06/06/2007 PUBLIC ASSISTANCE OFFICER Page 2 of 2 PROJECT WORKSHEET REPORT DECLARATION NO. FEMA-IA-DR1688 PREPARED DATE 05/12/2007 FIPS NO. 013-82425-00 APPLICANT NAME WATERLOO,CITY OF REPORT DATE 06/19/2007 16:27 SUBDIVISION INF TYPE 0 INF • FEMA PW# 633 VSN 0 REF# RH-008 NON-INF REC CATEGORY B.Protective Measures COUNTY BLACK HAWK FUNDING OPTION COST SHARE 0.75 STD PROJECT NO. 299 PROJECT TITLE EMERGENCY PROTECTIVE MEASURES PROJECTED CMPLTN DT09/14/2007 ACTUAL CMPLTN DT WORK COMPLETE AS OF 04/24/2007 100 % ELIGIBILITY Yes AMOUNT ELIG$8,853.99 FEDERAL SHARE $6,640.49 PRIORITY Normal BEGIN DESIGN DT BEGIN CONSTR DT —PW REVIEWER DATA -- END DESIGN DT END CONSTR DT REVIEWER NAME DATE INITIAL REVIEW CHINN,PAUL 05/28/2007 PREPARER HUDSON, RAY FINAL REVIEW TESKA,DAVID 06/06/2007 ROLE PO DATA SOURCE Paper STATE DEAN,MARK MT PROP O Yes• No VALIDATED • Yes 0 No DATE OBLGTD 06/06/2007 PACKAGE DATE 06/06/2007 PNP QUESTIONS 0 Yes• No STATE RVWD 0 Yes• No PACKAGE ID 57 ATTACH • Yes O No Does the Scope of Work change the pre-disaster conditions at the site? 0 Yes • No 0 Unsure Special Considerations issues included? O Yes • No 0 Unsure Is there insurance coverage on this facility? 0 Yes • No O Unsure Hazard Mitigation proposal included? O Yes • No 0 Unsure Page 1 of 6 PROJECT WORKSHEET REPORT DECLARATION NO.FEMA-IA-DR1688 PREPARED DATE 05/12/2007 FIPS NO. 013-82425-00 REPORT DATE 06/19/2007 16:27 APPLICANT NAME WATERLOO,CITY OF INF TYPE 0 INF SUBDIVISION • NON-INF FEMA PW# 633 VSN 0 REF# RH-008 0 REC SITE NUMBER 1 of 1 FACILITY NAME EMERGENCY PROTECTIVE MEASURES Latitude 42.50217 ADDRESS Longitude-92.33601 CITY WATERLOO STATE IA ZIP Was this site previously damaged?0 Yes 0 No • Unsure SITE NUMBER 1 -LOCATION CITY WIDE SITE NUMBER 1 -DAMAGE DIMENSIONS AND DESCRIPTION SEVERE WINTER STORMS DURING THE EVENT PERIOD 2-23-07 TO 3-2-07 CAUSED ICE ACCUMULATION ON THE TREES, POWER LINES AND STREETS CAUSING DOWNED POWER LINES AND EXTREMELY DANGEROUS ROAD CONDITIONS.THE FIRE DEPARTMENT RESPONDED TO OVER 345 EMERGENCY CALLS FOR SERVICE UTILIZING 2,116 REGULAR HOURS FORCE LABOR AND 178 HOURS OF FORCE EQUIPMENT. THERE ARE NO CODES AND STANDARDS OR MITIGATION ISSUES WITH THIS PROJECT. SITE NUMBER 1 -SCOPE OF WORK THE FIRE DEPARTMENT RESPONDED TO OVER 345 EMERGENCY CALLS REQUIRING 2,116 REGULAR HOURS OF FORCE LABOR AND 178 HOURS OF FORCE EQUIPMENT DURING THE EVENT PERIOD. Page 2 of 6 PROJECT WORKSHEET REPORT DECLARATION NO.FEMA-IA-DR1688 PREPARED DATE 05/12/2007 FIPS NO. 013-82425-00 REPORT DATE 06/19/2007 16:27 APPLICANT NAME WATERLOO,CITY OF INF TYPE 0 INF SUBDIVISION • NON-INF FEMA PW# 633 VSN 0 REF# RH-008 0 REC COST ESTIMATE [ITEM VSNI CODEII MATERIAL AND/OR DESCRIPTION I L UOM 1 L (STY J L UNIT PRICE 1 COST 1 0 0000 WORK COMPLETED 0 0 8.00 $0.00 2 0 9008 EQUIPMENT LS 1 $8,853.99 38,853.99 Eligible Amounts: Total(this version) $8,853.99 Total Oblig To Date $8,853.99 Unobligated+Obligated $8,853.99 Federal Share for Obligated and Unobligated $6,640.49 SPECIAL CONSIDERATIONS 1 Does the damaged facility or item of work have insurance coverage and/or is it an insurable risk 0 Yes • No 0 Unsure (e.g.,buildings,equipment,vehicles,etc.)? 2 Is the damaged facility located within a floodplain or coastal high hazard area and/or does it have 0 Yes • No 0 Unsure an impact on a floodplain or wetland? 3 Is the damaged facility or item of work located within or adjacent to a Coastal Barrier Resource 0 Yes • No 0 Unsure System Unit or an Otherwise Protected Area? 4 Will the proposed facility repairs/reconstruction change the pre-disaster conditions(e.g.,footprint, 0 Yes • No 0 Unsure material, location,capacity,use or function)? 5 Does the applicant have a hazard mitigation proposal or would the applicant like technical 0 Yes • No 0 Unsure assistance for a hazard mitigation proposal? 6 Is the damaged facility on the National Register of Historic Places or the state historic listing?Is it 0 Yes • No 0 Unsure older than 50 years?Are there more,similar buildings near the site? 7 Are there any pristine or undisturbed areas on,or near,the project site?Are there large tracts of 0 Yes • No O Unsure forestland? 8 Are there any hazardous materials at or adjacent to the damaged facility and/or item of work? 0 Yes • No 0 Unsure g Are there any other environmental or controversial issues associated with the damaged facility 0 Yes • No 0 Unsure and/or item of work? Page 3 of 6 PROJECT WORKSHEET REPORT DECLARATION NO.FEMA-IA-DR1688 PREPARED DATE 05/12/2007 FIPS NO. 013-82425-00 APPLICANT NAME WATERLOO,CITY OF REPORT DATE 06/19/2007 16:27 SUBDIVISION INF TYPE O INF • FEMA PW# 633 VSN 0 REF# RH-008 NON-INF O REC ENVIRONMENTAL-All Environmental Review is complete. Laws and Executive Orders Review-All Other Laws/EOs complete.-PCHINNI Laws/EOs Status Coastal Barriers Resources Act(CBRA) Gen Revw/NA Clean Water Act(CWA) Gen Revw/NA Coastal Zone Management Act(CZMA) Gen Revw/NA Endangered Species Act(ESA) Gen Revw/NA Fish and Wildlife Coordination Act(FWCA) Gen Revw/NA National Historic Preservation Act(NHPA) Gen Revw/NA Clean Air Act(CAA) Gen Revw/NA E.O. 11988: Floodplains Gen Revw/NA E.O. 11990:Wetlands Gen Revw/NA E.O. 12898:Environmental Justice for Low Income and Minority Populations Gen Revw/NA NEPA Level of Review-06/19/2007 16:27:37-This project is statutorily excluded from the requirements of the National Environmental Policy Act and no other environmental review or documentation is required.-PCHINNI Page 4 of 6 PROJECT WORKSHEET REPORT DECLARATION NO. FEMA-IA-DR1688 PREPARED DATE 05/12/2007 FIPS NO. 013-82425-00 REPORT DATE 06/19/2007 16:27 APPLICANT NAME WATERLOO,CITY OF INF TYPE 0 INF SUBDIVISION • NON-INF FEMA PW# 633 VSN 0 REF# RH-008 0 REC Standard Conditions 1. Any change to the approved scope of work will require re-evaluation for compliance with NEPA and other Laws and Executive Orders. 2. This review does not address all federal,state and local requirements.Acceptance of federal funding requires recipient to comply with all federal,state and local laws. Failure to obtain all appropriate federal,state and local environmental permits and clearances may jeopardize federal funding. 3. If ground disturbing activities occur during construction,applicant will monitor ground disturbance and if any potential archeological resources are discovered,will immediately cease construction in that area and notify the State and FEMA. GENERAL COMMENTS EMERGENCY PROTECTIVE MEASURES THIS PROJECT IS AN EMERGENCY ACTION OF SEARCH AND RESCUE, EMERGENCY CARE, ISSUES OF LIVE SAFETY,CONSTRUCTION OF TEMPORARY MEASURES TO REDUCE IMMEDIATE THREATS TO LIFE,PROPERTY AND PUBLIC HEALTH OR SAFETY. EMERGENCY ACTIONS ARE STATUTORILY EXCLUDED FROM FURTHER REVIEW UNDER THE NATIONAL ENVIRONMENTAL POLICY ACT. THE APPLICANT HAS IDENTIFIED NO ENVIRONMENTAL ISSUES WITH THIS PROJECT. PAUL CHINN 05/25/2007 RECORD MAINTENANCE COMPLETE RECORDS AND COST DOCUMENTS FOR ALL APPROVED WORK MUST BE MAINTAINED FOR AT LEAST 3 YEARS FROM THE DATE THE LAST PROJECT WAS COMPLETED OR FROM RECEIPT OF FINAL PAYMENT,WHICHEVER IS LATER. ALL APPROVED PWS WITHIN A PROJECT APPLICATION ARE SUBJECT TO RANDOM AUDITS. QUARTERLY REVIEWS ARE CONDUCTED ON ALL APPROVED PW'S WHICH EQUAL OR EXCEED$59,700 AND HAVE NOT RECEIVED FINAL PAYMENT. ANY JURISDICTION RECEIVING$500,000 OR MORE IN TOTAL FEDERAL FINANCIAL ASSISTANCE IN A FISCAL YEAR MUST SUBMIT A COPY OF ITS SINGLE AUDIT(AS REQUIRED BY THE SINGLE AUDIT ACT OF 1984)TO THE STATE.-PAUL CHINN 05/25/2007 Page 5 of 6 PROJECT WORKSHEET REPORT DECLARATION NO. FEMA-IA-DR1688 PREPARED DATE 05/12/2007 FIPS NO. 013-82425-00 APPLICANT NAME WATERLOO,CITY OF REPORT DATE 06/19/2007 16:27 SUBDIVISION INF TYPE 0 INF • FEMA PW# 633 VSN 0 REF# RH-008 NON-INF REC PW REQUIRED REVIEWS REVIEW ASSIGNED DATE DATE REVIEW STATUS RECOMMENDATION REVIEWER REVIEWER SUBMITTED REVIEWED Initial Complete Eligible pchinn1 05/25/2007 05/28/2007 STATE Complete Eligible hall p 05/28/2007 06/06/2007 Final Complete Eligible dteska 06/06/2007 06/06/2007 Page 6 of 6 PROJECT WORKSHEET REPORT DECLARATION NO.FEMA-IA-DR1688 PREPARED DATE 05/16/2007 FIPS NO. 013-82425-00 REPORT DATE 06/19/2007 16:27 APPLICANT NAME WATERLOO,CITY OF INF TYPE 0 INF SUBDIVISION • NON-INF FEMA PW# 626 VSN 0 REF# RH-005 0 REC CATEGORY B. Protective Measures COUNTY BLACK HAWK FUNDING OPTION COST SHARE 0.75 STD PROJECT NO. 299 PROJECT TITLE EMERGENCY PROTECTIVE MEASURES PROJECTED CMPLTN DT09/14/2007 ACTUAL CMPLTN DT WORK COMPLETE AS OF 04/25/2007 100 % ELIGIBILITY Yes AMOUNT ELIG$7,163.75 FEDERAL SHARE $5,372.81 PRIORITY Normal BEGIN DESIGN DT BEGIN CONSTR DT DPW REVIEWER DATA REVIEWER NAME DATE END DESIGN DT END CONSTR DT INITIAL REVIEW CHINN,PAUL 05/28/2007 PREPARER HUDSON, RAY FINAL REVIEW TESKA,DAVID 06/06/2007 1 ROLE PO DATA SOURCE Paper STATE DEAN,MARK MT PROP 0 Yes• No VALIDATED • Yes 0 No DATE OBLGTD 06/06/2007 PACKAGE DATE 06/06/2007 PNP QUESTIONS 0 Yes• No STATE RVWD 0 Yes• No PACKAGE ID 57 ATTACH • Yes 0 No Does the Scope of Work change the pre-disaster conditions at the site? 0 Yes • No 0 Unsure Special Considerations issues included? 0 Yes • No 0 Unsure Is there insurance coverage on this facility? 0 Yes • No 0 Unsure Hazard Mitigation proposal included? 0 Yes No 0 Unsure Page 1 of 6 PROJECT WORKSHEET REPORT DECLARATION NO.FEMA-IA-DR1688 PREPARED DATE 05/16/2007 FIPS NO. 013-82425-00 REPORT DATE 06/19/2007 16:27 APPLICANT NAME WATERLOO,CITY OF SUBDIVISION INF TYPE 0 INF • NON-INF FEMA PW# 626 VSN 0 REF# RH-005 0 REC SITE NUMBER 1 of 1 FACILITY NAME EMERGENCY PROTECTIVE MEASURES Latitude 42.49891 ADDRESS Longitude-92.33238 CITY STATE IA ZIP Was this site previously damaged?0 Yes 0 No • Unsure SITE NUMBER 1 -LOCATION CITY WIDE SITE NUMBER 1 -DAMAGE DIMENSIONS AND DESCRIPTION SEVERE WINTER STORMS DURING THE EVENT PERIOD 2-23-07 TO 3-2-07 REQUIRED THE USE OF OVER 1,876 HOURS OF REGULAR TIME POLICE FORCE ACCOUNT LABOR AND 13,025 MILES FORCE ACCOUNT EQUIPMENT TO PATROL THE ROADS LOOKING FOR DOWNED ELECTRICAL WIRES AND TREE LIMBS,ACCIDENTS,CITIZENS IN DANGER, INOPERATIVE TRAFFIC LIGHTS AND RESPONDED TO 49 EMERGENCY CALLS. THERE ARE NO CODES AND STANDARDS OR MITIGATION ISSUES WITH THIS PROJECT. SITE NUMBER 1 -SCOPE OF WORK THE CITY POLICE DEPARTMENT PATROLLED THE STREETS UTILIZING MORE THAN 1,876 REGULAR TIME FORCE ACCOUNT LABOR AND 13,025 MILES OF FORCE ACCOUNT EQUIPMENT. Page 2 of 6 PROJECT WORKSHEET REPORT DECLARATION NO.FEMA-IA-DR1688 PREPARED DATE 05/16/2007 FIPS NO. 013-82425-00 REPORT DATE 06/19/2007 16:27 APPLICANT NAME WATERLOO,CITY OF INF TYPE 0 INF SUBDIVISION • NON-INF FEMA PW# 626 VSN 0 REF# RH-005 0 REC COST ESTIMATE ITEM] CODE; MATERIAL AND/OR DESCRIPTION 1 LUOM_j T QTY j UNIT PRICE 1 [ COST 1 0 0000 WORK COMPLETED 0 0 $.00 $0.00 2 0 9999 AUTOMOBILE, POLICE TO 250 HP MI 13025 $.55 $7.163.75 Eligible Amounts: Total(this version) $7,163.75 Total Oblig To Date $7,163.75 Unobligated+Obligated $7,163.75 Federal Share for Obligated and Unobligated $5,372.81 SPECIAL CONSIDERATIONS 1 Does the damaged facility or item of work have insurance coverage and/or is it an insurable risk 0 Yes • No 0 Unsure (e.g.,buildings,equipment,vehicles,etc.)? 2 Is the damaged facility located within a floodplain or coastal high hazard area and/or does it have 0 Yes • No 0 Unsure an impact on a floodplain or wetland? 3 Is the damaged facility or item of work located within or adjacent to a Coastal Barrier Resource 0 Yes • No 0 Unsure System Unit or an Otherwise Protected Area? 4 Will the proposed facility repairs/reconstruction change the pre-disaster conditions(e.g.,footprint, 0 Yes • No 0 Unsure material,location,capacity,use or function)? 5 Does the applicant have a hazard mitigation proposal or would the applicant like technical 0 Yes • No 0 Unsure assistance for a hazard mitigation proposal? 6 Is the damaged facility on the National Register of Historic Places or the state historic listing?Is it 0 Yes • No 0 Unsure older than 50 years?Are there more,similar buildings near the site? 7 Are there any pristine or undisturbed areas on, or near,the project site?Are there large tracts of 0 Yes • No 0 Unsure forestland? 8 Are there any hazardous materials at or adjacent to the damaged facility and/or item of work? 0 Yes • No 0 Unsure 9 Are there any other environmental or controversial issues associated with the damaged facility 0 Yes • No 0 Unsure and/or item of work? Page 3 of 6 PROJECT WORKSHEET REPORT DECLARATION NO. FEMA-IA-DR1688 PREPARED DATE 05/16/2007 FIPS NO. 013-82425-00 APPLICANT NAME WATERLOO,CITY OF REPORT DATE 06/19/2007 16:27 SUBDIVISION INF TYPE O INF • NON-INF FEMA PW# 626 VSN 0 REF# RH-005 Q REC ENVIRONMENTAL-All Environmental Review is complete. Laws and Executive Orders Review-All Other Laws/EOs complete.-PCHINNI Laws/EOs Status Coastal Barriers Resources Act(CBRA) Gen Revw/NA Clean Water Act(CWA) Gen Revw/NA Coastal Zone Management Act(CZMA) Gen Revw/NA Endangered Species Act(ESA) Gen Revw/NA Fish and Wildlife Coordination Act(FWCA) Gen Revw/NA National Historic Preservation Act(NHPA) Gen Revw/NA Clean Air Act(CAA) Gen Revw/NA E.O. 11988: Floodplains Gen Revw/NA E.O. 11990:Wetlands Gen Revw/NA E.O. 12898:Environmental Justice for Low Income and Minority Populations Gen Revw/NA NEPA Level of Review-06/19/2007 16:27:40-This project is statutorily excluded from the requirements of the National Environmental Policy Act and no other environmental review or documentation is required.-PCHINNI Page 4 of 6 PROJECT WORKSHEET REPORT DECLARATION NO. FEMA-IA-DR1688 PREPARED DATE 05/16/2007 FIPS NO. 013-82425-00 REPORT DATE 06/19/2007 16:27 APPLICANT NAME WATERLOO, CITY OF INF TYPE 0 INF SUBDIVISION • NON-INF FEMA PW# 626 VSN 0 REF# RH-005 0 REC Standard Conditions 1. Any change to the approved scope of work will require re-evaluation for compliance with NEPA and other Laws and Executive Orders. 2. This review does not address all federal,state and local requirements.Acceptance of federal funding requires recipient to comply with all federal,state and local laws. Failure to obtain all appropriate federal,state and local environmental permits and clearances may jeopardize federal funding. 3. If ground disturbing activities occur during construction, applicant will monitor ground disturbance and if any potential archeological resources are discovered,will immediately cease construction in that area and notify the State and FEMA. GENERAL COMMENTS EMERGENCY PROTECTIVE MEASURES THIS PROJECT IS AN EMERGENCY ACTION OF SEARCH AND RESCUE,EMERGENCY CARE, ISSUES OF LIVE SAFETY,CONSTRUCTION OF TEMPORARY MEASURES TO REDUCE IMMEDIATE THREATS TO LIFE, PROPERTY AND PUBLIC HEALTH OR SAFETY. EMERGENCY ACTIONS ARE STATUTORILY EXCLUDED FROM FURTHER REVIEW UNDER THE NATIONAL ENVIRONMENTAL POLICY ACT. THE APPLICANT HAS IDENTIFIED NO ENVIRONMENTAL ISSUES WITH THIS PROJECT. PAUL CHINN 05/25/2007 RECORD MAINTENANCE COMPLETE RECORDS AND COST DOCUMENTS FOR ALL APPROVED WORK MUST BE MAINTAINED FOR AT LEAST 3 YEARS FROM THE DATE THE LAST PROJECT WAS COMPLETED OR FROM RECEIPT OF FINAL PAYMENT,WHICHEVER IS LATER. ALL APPROVED PWS WITHIN A PROJECT APPLICATION ARE SUBJECT TO RANDOM AUDITS. QUARTERLY REVIEWS ARE CONDUCTED ON ALL APPROVED PW'S WHICH EQUAL OR EXCEED$59,700 AND HAVE NOT RECEIVED FINAL PAYMENT. ANY JURISDICTION RECEIVING$500,000 OR MORE IN TOTAL FEDERAL FINANCIAL ASSISTANCE IN A FISCAL YEAR MUST SUBMIT A COPY OF ITS SINGLE AUDIT(AS REQUIRED BY THE SINGLE AUDIT ACT OF 1984)TO THE STATE.-PAUL CHINN 05/25/2007 Page 5 of 6 PROJECT WORKSHEET REPORT DECLARATION NO.FEMA-IA-DR1688 PREPARED DATE 05/16/2007 FIPS NO. 013-82425-00 APPLICANT NAME WATERLOO,CITY OF REPORT DATE 06/19/2007 16:27 SUBDIVISION INF TYPE Q INF • FEMA PW# 626 VSN 0 REF# RH-005 NON-INF REC PW REQUIRED REVIEWS REVIEW ASSIGNED DATE DATE REVIEW STATUS RECOMMENDATION REVIEWER REVIEWER SUBMITTED REVIEWED Initial Complete Eligible STATE pchinnl 05/25/2007 05/28/2007 Complete Eligible phall 05/28/2007 06/06/2007 Final Complete Eligible dteska 06/06/2007 06/06/2007 Page 6 of 6 PROJECT WORKSHEET REPORT DECLARATION NO.FEMA-IA-DR1688 PREPARED DATE 05/16/2007 FIPS NO. 013-82425-00 REPORT DATE 06/19/2007 16:27 APPLICANT NAME WATERLOO,CITY OF INF TYPE 0 INF SUBDIVISION • NON-INF FEMA PW# 637 VSN 0 REF# MLD018 0 REC CATEGORY C.Roads&Bridges COUNTY BLACK HAWK FUNDING OPTION COST SHARE 0.75 STD PROJECT NO. 399 PROJECT TITLE ROADS AND BRIDGES PROJECTED CMPLTN DT09/14/2008 ACTUAL CMPLTN DT WORK COMPLETE AS OF 05/16/2007 0 % ELIGIBILITY Yes AMOUNT ELIG$13,413.11 FEDERAL SHARE $10,059.83 PRIORITY Normal BEGIN DESIGN DT BEGIN CONSTR DT FPW REVIEWER DATA REVIEWER NAME DATE END DESIGN DT END CONSTR DT INITIAL REVIEW CHINN,PAUL 05/28/2007 PREPARER DEAN,MARK FINAL REVIEW TESKA,DAVID 06/06/2007 ROLE PAC DATA SOURCE Paper STATE DEAN,MARK MT PROP 0 Yes• No VALIDATED • Yes 0 No DATE OBLGTD 06/06/2007 PACKAGE DATE 06/06/2007 PNP QUESTIONS 0 Yes• No STATE RVWD 0 Yes• No PACKAGE ID 57 ATTACH • Yes 0 No Does the Scope of Work change the pre-disaster conditions at the site? 0 Yes • No 0 Unsure Special Considerations issues included? 0 Yes • No 0 Unsure Is there insurance coverage on this facility? 0 Yes • No 0 Unsure Hazard Mitigation proposal included? 0 Yes • No 0 Unsure Page 1 of 6 PROJECT WORKSHEET REPORT DECLARATION NO. FEMA-IA-DR1688 PREPARED DATE 05/16/2007 FIPS NO. 013-82425-00 REPORT DATE 06/19/2007 16:27 APPLICANT NAME WATERLOO,CITY OF INF TYPE Q INF SUBDIVISION NON-INF FEMA PW# 637 VSN 0 REF# MLD018 O REC SITE NUMBER 1 of 1 FACILITY NAME TRAFFIC SIGNAL CONTROL BOX Latitude 42.52374 ADDRESS Longitude -92.35783 CITY WATERLOO STATE IA ZIP Was this site previously damaged? O Yes 0 No • Unsure SITE NUMBER 1 -LOCATION CITY WIDE SITE NUMBER 1 -DAMAGE DIMENSIONS AND DESCRIPTION ON 2-23-07 DURING THE SEVERE WINTER STORM, LIGHTNING STRUCK AND DAMAGED A TRAFFIC SIGNAL BOX AT THE INTERSECTION OF BROADWAY AND BURTON.THE CABINET AND CONTROLLER INSIDE WERE BOTH HEAVILY DAMAGED AND IS NEED OF REPLACEMENT. SITE NUMBER 1 -SCOPE OF WORK DURING THE SEVERE WINTER STORM FROM 2-23-07 TO 3-2-07, LIGHTNING STRUCK AND DAMAGED,BEYOND REPAIR,A TRAFFIC SIGNAL CONTROL CABINET AND CONTROLLER MOUNTED INSIDE.THE CITY HAS DONE SOME WORK ON THIS SITE TO GET THE LIGHTS WORKING. WORK TO BE COMPLETED; THE CITY HAS RECEIVED AN ESTIMATE FROM BROWN TRAFFIC PRODUCTS, INC. IN THE AMOUNT OF$9,925.00 FOR REPLACEMENT OF THE CABINET AND CONTROLLER.OTHER IN STOCK PARTS TO REPLACE ITEMS DAMAGE BRING THE TOTAL TO$10,668.82 TO REPLACE THE DAMAGED EQUIPMENT. Page 2 of 6 PROJECT WORKSHEET REPORT DECLARATION NO.FEMA-IA-DR1688 PREPARED DATE 05/16/2007 FIPS NO. 013-82425-00 REPORT DATE 06/19/2007 16:27 APPLICANT NAME WATERLOO,CITY OF INF TYPE 0 INF SUBDIVISION • NON-INF FEMA PW# 637 VSN 0 REF# MLD018 O REC COST ESTIMATE ITEM NSWCODE1 MATERIAL AND/OR DESCRIPTION ( UOM L QTY 1 L UNIT PRICE -1 COST 1 0 0000 WORK TO BE COMPLETED 0 0 S.00 $0 00 2 0 9007 FORCE ACCOUNT LABOR LS 1 $1,918.77 $1,918.77 3 0 9008 FORCE ACCOUNT EQUIPMENT LS 1 $1,072.40 $1,072.40 4 0 9009 MATERIAL LS 1 $10,421 94 $10,421.94 Eligible Amounts: Total(this version) $13,413.11 Total Oblig To Date $13,413.11 Unobligated+Obligated $13,413.11 Federal Share for Obligated and Unobligated $10,059.83 SPECIAL CONSIDERATIONS 1 Does the damaged facility or item of work have insurance coverage and/or is it an insurable risk 0 Yes • No 0 Unsure (e.g., buildings,equipment,vehicles,etc.)? 2 Is the damaged facility located within a floodplain or coastal high hazard area and/or does it have 0 Yes • No 0 Unsure an impact on a floodplain or wetland? COMMENTS: 05/23/2007 20:21:27 A CREEK IN THE CITY RUNS THROUGH THE STRUCTURE 3 Is the damaged facility or item of work located within or adjacent to a Coastal Barrier Resource 0 Yes • No 0 Unsure System Unit or an Otherwise Protected Area? 4 Will the proposed facility repairs/reconstruction change the pre-disaster conditions(e.g.,footprint, 0 Yes • No 0 Unsure material, location,capacity,use or function)? 5 Does the applicant have a hazard mitigation proposal or would the applicant like technical 0 Yes • No 0 Unsure assistance for a hazard mitigation proposal? 6 Is the damaged facility on the National Register of Historic Places or the state historic listing?Is it 0 Yes • No 0 Unsure older than 50 years?Are there more,similar buildings near the site? 7 Are there any pristine or undisturbed areas on,or near,the project site?Are there large tracts of 0 Yes • No 0 Unsure forestland? 8 Are there any hazardous materials at or adjacent to the damaged facility and/or item of work? 0 Yes • No 0 Unsure 9 Are there any other environmental or controversial issues associated with the damaged facility 0 Yes • No 0 Unsure and/or item of work? Page 3 of 6 PROJECT WORKSHEET REPORT DECLARATION NO. FEMA-IA-DR1688 PREPARED DATE 05/16/2007 FIPS NO. 013-82425-00 REPORT DATE 06/19/2007 16:27 APPLICANT NAME WATERLOO,CITY OF SUBDIVISION INF TYPE INF • NON-INF FEMA PW# 637 VSN 0 REF# MLD018 0 REC ENVIRONMENTAL-All Environmental Review is complete. Laws and Executive Orders Review-All Other Laws/EOs complete.-PCHINNI Laws/EOs Status Coastal Barriers Resources Act(CBRA) Gen Revw/NA Clean Water Act(CWA) Gen Revw/NA Coastal Zone Management Act(CZMA) Gen Revw/NA Endangered Species Act(ESA) Gen Revw/NA Fish and Wildlife Coordination Act(FWCA) Gen Revw/NA National Historic Preservation Act(NHPA) Gen Revw/NA Clean Air Act(CAA) Gen Revw/NA E.O. 11988: Floodplains Gen Revw/NA E.O. 11990:Wetlands Gen Revw/NA E.O. 12898: Environmental Justice for Low Income and Minority Populations Gen Revw/NA NEPA Level of Review-06/19/2007 16:27:43-This project is statutorily excluded from the requirements of the National Environmental Policy Act and no other environmental review or documentation is required.-PCHINNI Page 4 of 6 PROJECT WORKSHEET REPORT DECLARATION NO. FEMA-IA-DR1688 PREPARED DATE 05/16/2007 FIPS NO. 013-82425-00 REPORT DATE 06/19/2007 16:27 APPLICANT NAME WATERLOO,CITY OF SUBDIVISION INF TYPE O INF NON-INF FEMA PW# 637 VSN 0 REF# MLD018 Q REC Standard Conditions 1. Any change to the approved scope of work will require re-evaluation for compliance with NEPA and other Laws and Executive Orders. 2. This review does not address all federal,state and local requirements.Acceptance of federal funding requires recipient to comply with all federal,state and local laws. Failure to obtain all appropriate federal,state and local environmental permits and clearances may jeopardize federal funding. 3. If ground disturbing activities occur during construction, applicant will monitor ground disturbance and if any potential archeological resources are discovered,will immediately cease construction in that area and notify the State and FEMA. Page 5 of 6 PROJECT WORKSHEET REPORT DECLARATION NO.FEMA-IA-DR1688 PREPARED DATE 05/16/2007 FIPS NO. 013-82425-00 REPORT DATE 06/19/2007 16:27 APPLICANT NAME WATERLOO,CITY OF INF TYPE Q INF SUBDIVISION • NON-INF FEMA PW# 637 VSN 0 REF# MLD018 Q REC GENERAL COMMENTS ROAD REPAIR THIS PROJECT IS FOR ROAD RESTORATION TO PREDISASTER CONDITION, INCLUDING NUMBER AND WIDTH OF LANES,SHOULDERS, MEDIANS, DRAINAGE APPURTENANCES, DITCHES, ETC. MINOR DEVIATIONS MAY BE MADE FOR CHANGES IN MATERIALS, CONSTRUCTION TECHNIQUES OR CURRENT CONSTRUCTION CODES PROVIDED ENVIRONMENTAL IMPACTS ARE NEGLIGIBLE. REPAIR/REPLACEMENT TO PREDISASTER CONDITION IS STATUTORILY EXCLUDED FROM FURTHER REVIEW UNDER THE NATIONAL ENVIRONMENTAL POLICY ACT. THE APPLICANT HAS IDENTIFIED NO ENVIRONMENTAL ISSUES WITH THIS PROJECT.-PAUL CHINN 05/25/2007 RECORD MAINTENANCE COMPLETE RECORDS AND COST DOCUMENTS FOR ALL APPROVED WORK MUST BE MAINTAINED FOR AT LEAST 3 YEARS FROM THE DATE THE LAST PROJECT WAS COMPLETED OR FROM RECEIPT OF FINAL PAYMENT,WHICHEVER IS LATER. ALL APPROVED PWS WITHIN A PROJECT APPLICATION ARE SUBJECT TO RANDOM AUDITS. QUARTERLY REVIEWS ARE CONDUCTED ON ALL APPROVED PW'S WHICH EQUAL OR EXCEED$59,700 AND HAVE NOT RECEIVED FINAL PAYMENT. ANY JURISDICTION RECEIVING$500,000 OR MORE IN TOTAL FEDERAL FINANCIAL ASSISTANCE IN A FISCAL YEAR MUST SUBMIT A COPY OF ITS SINGLE AUDIT(AS REQUIRED BY THE SINGLE AUDIT ACT OF 1984)TO THE STATE.-PAUL CHINN 05/25/2007 06/06/07-THIS PROJECT WAS 0%COMPLETE AT THE TIME OF INSPECTION THEREFORE QUARTERLY PROGRESS REPORTS ARE REQUIRED.-DAVID TESKA PW REQUIRED REVIEWS REVIEW ASSIGNED DATE DATE REVIEW STATUS RECOMMENDATION REVIEWER REVIEWER SUBMITTED REVIEWED Initial Complete Eligible pchinnl 05/25/2007 05/28/2007 STATE Complete Eligible phall 05/28/2007 06/06/2007 Final Complete Eligible dteska 06/06/2007 06/06/2007 Page 6 of 6