013-applicant certification clause-3.9.2012.doc

Updated October 14, 2010

EDA Environmental Narrative Requirements

Appendix A: Applicant Certification Clause

The applicant represents and certifies that it has used due diligence to determine that the description of the project site described herein is accurate with respect to the presence or absence of contamination from toxic and hazardous substances. The term “site” includes the entire scope of the project, including future phases of the project and all areas where construction will occur.

1. Is the site currently, or has it in the past 50 years, been used for any of the following operations or activities:

a. Generation of hazardous substances or waste?

______ Yes ______ No

b. Treatment, storage (temporary or permanent), or disposal of solid or hazardous substances or waste?

c. Storage of petroleum products?

d. Used/waste oil storage or reclamation units?

e. Research or testing laboratory?

f. Ordinance research, testing, production, use, or storage?

g. Chemical manufacturing or storage?

h. Weapons or ammunition training, use, or testing?

i. Iron works/foundry?

j. Railroad yard?

k. Industrial or manufacturing operation?

If any of the above operations ever occurred at the site, and if appropriate cleanup or other mitigation actions were performed in accordance with the local, State, and federal laws, please attach documentation of these actions.

2. Do wells draw from an underlying aquifer to provide the local domestic water supply?

______ Yes ______ No

3. Has a federal, State, or local regulatory authority ever conducted an environmental assessment, environmental impact statement, or a preliminary assessment/site inspection, or similar environmental surveyor inspection report at the site? If yes, please list here and attach copies of these reports or results.

1) _______________________________________________________________________________

2) _______________________________________________________________________________

3) _______________________________________________________________________________

4) _______________________________________________________________________________

5) _______________________________________________________________________________

4. Have any environmental or OSHA citations or notices of violation been issued to a facility at the site? If yes, please attach copies.

5. Have any unauthorized releases of hazardous substances occurred at any facility at the site which resulted in notification of the EPA’s National Response Center?

6. Is any material containing asbestos or lead paint located at the site? If yes, please attach information concerning State and federal regulatory compliance.

7. Is there any equipment (electrical transformers, etc.) containing polychlorinated biphenyls (PCB) on the site? If yes, please attach a description of the equipment.

8. Are there underground or above ground storage tanks on the site? If yes, please attach a detailed description, including the number of underground storage tanks on the site, whether the tanks have been inspected (or removed) and the results of such inspections.

9. Has the site been tested for radon? If yes, please attach results.

10. Have there been, or are there now any environmental investigations by federal, State or local government agencies that could affect the site in question? If yes, please attach available information.

______ Yes ______ No The applicant acknowledges that this certification regarding hazardous substances and/or waste is a material representation of fact upon which EDA relies when making and executing an award. EDA reserves the right to terminate any award made in conjunction with the representations contained herein if, at any time during the useful life of the project, EDA becomes aware of the presence of hazardous materials or waste at the site, or that hazardous materials or waste have been inappropriately handled thereon.

Further, if it is determined at any time that the presence of hazardous materials or waste, or handling thereof, has been misrepresented, EDA may pursue other available legal remedies against the applicant.

Applicant’s Name

Name and Title of Applicant’s Authorized Representative Signature of Applicant’s Authorized Representative

Date