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HomeMy WebLinkAbout20151509 CDBG-DR Infrastructure Application Colorado Division of Homeland Security and Emergency Management PART B - APPLICATION: PROJECT MILESTONES / TIMELINES / TASKS Timeline/Tasks Insert the proposed work schedule as tasks to accomplish the overall goal of the proposed activity(i.e., appraisals, title search, closing, etc.), and provide a description of the task's purpose. This timeline will be used as a measurement tool for progress in the project's implementation and is included in the required Quarterly Reports. Also, FEMA uses the timeline for determining the approved period of performance. It will be the basis used to justify delays or extensions, if necessary, and should be estimated carefully. The first and last entries are state requirements and have already been entered. Task I: Grant Process and Environmental Review Timeframe: 3 Months Task?: Emergency Repairs-The initial emergency repairs were made directly I Completed 9 Y P 9 Y P Y Timeframe: Task 3: Permanent Repairs- Becuase the emergency repairs werequick re aiiCompleted P 9 Y P P Timeframe: Task 4: Additional Permanent Repairs-All the necessary repairs were not com 6 Months Timeframe: Task 5: Timeframe: Task 6: Timeframe: Task 7: Timeframe: Task 8: Timeframe: Task 9: Timeframe: Final Inspection Report and Project Closeout Task 10: The Final Inspection Report is a review of the activity's paper documentation, showing the project was implemented as required. Once the review is completed, the 3 Months report and findings will be provided to the grantee for review and concurrence. The Timeframe: State submits the concurrence to FEMA as part of a closeout package to formally Total Project Timeframe: 12 Months Attach any continuations or additional items as an Attachment to the electronic application and e-mail submittal. Page I5 of 20 CDBG-DR Infrastructure Application Colorado Division of Homeland Security and Emergency Management 2. Start Date&Pre-Award Costs: The start date for any project begins upon GRANT AGREEMENT approval by the State Controller. If a dilTerent start date or timeframe is needed,provide an explanation below. Also indicate if any pre- award activities or costs have been incurred or authorized. The proposed project is for local FEMA match dollars and the majority of the work is completed; however, another round of construction will be performed this summer. The repairs for this site began as soon as the flood waters receded and the county crews were able to access the site. The initial phase of repairs were emergency in nature and began in September of 2013 and concluded during November of that same year. Permanent repairs for this site commenced the following year at the beginning of construction season and concluded in October of 2014 because of weather constraints. The final repairs will be completed in October of 2015. Additionally, cost have been incurred through the preparation of this NOI application. Attach any continuations or additional items as an Attachment to the electronic application and e-mail submittal. Page 16 of 20 CMG-DR Infrastructure Application Colorado Division of Homeland Security and Emergency Management Please note that Part B is required for the final Application submittal. Part B sections may optionally be completed and submitted with the NOI. Please update any Part A section information when submitting you full Application. PART B —APPLICATION: ENVIRONMENTAL REVIEW I. Environmental Review Background Information& Environmental Review Worksheet: In accordance with 24 CFR Part 58.22 (see below), all federally funded projects must accomplish an environmental review prior to beginning any work on a project.These HUD regulations are in place for two purposes: I. To ensure federal funds are used to place people of low and moderate income in environmentally safe conditions; and 2. To ensure federal funds are NOT used to negatively impact environmental conditions that exist near a project site. Please note the following limitations on CDBG-DR grant activities pending environmental clearance per 24 CFR Part 58.22. (a) Neither a recipient nor any participant in the development process, including public or private nonprofit or for-profit entities,or any of their contractors, may commit HUD assistance under a program listed in Sec. 58.1(6) on an activity or project until HUD or the state has approved the recipient's RROF and the related certification from the responsible entity. In addition, until the RROF and the related certification have been approved, neither a recipient nor any participant in the development process may commit non-MUD funds on or undertake an activity or project under a program listed in Sec. 58.1(6) if the activity or project would have an adverse environmental impact or limit the choice of reasonable alternatives. (b) N/A for DOLA/CDPS projects. (c) If a recipient is considering an application from a prospective sub-recipient or beneficiary and is aware that the prospective sub-recipient or beneficiary is about to take an action within the jurisdiction of the recipient that is prohibited by paragraph (a) of this section, then the recipient will take appropriate action to ensure that the objectives and procedures of NEPA are achieved. (d) An option agreement on a proposed site or property is allowable prior to the completion of the environmental review ifthe option agreement is subject to a determination by the recipient on the desirability of the property for the project as a result of the completion of the environmental review in accordance with this part and the cost of the option is a nominal portion of the purchase price. There is no constraint on the purchase of an option by third parties that have not been selected for HUD funding, have no responsibility for the environmental review and have no say in the approval or disapproval of the project. (e) Self-Help Homeownership Opportunity Program (SHOP). In accordance with section I I(d)(2)(A) of the Housing Opportunity Program Extension Act of 1996(42 U.S.C. 12805 note),an organization, consortium, or affiliate receiving assistance under the SHOP program may advance non-grant funds to acquire land prior to completion of an environmental review and approval of a Request for Release of Funds (RROF) and certification, notwithstanding paragraph (a)of this section. Any advances to acquire land prior to approval of the RROF and certification arc made at the risk of the organization, consortium, or affiliate and reimbursement for such advances may depend on the result of the environmental review. This authorization is limited to the SHOP program only and all other forms of HUD assistance are subject to the limitations in paragraph(a)of this section. (I) Relocation. Funds may be committed for relocation assistance before the approval of the RROF and related certification for the project provided that the relocation assistance is required by 24 CFR part 42. Attach any continuations or additional items as an Attachment to the electronic application and e-mail submittal. Page 17 of 20 CDRG-DR Infrastructure Application Colorado Division of Homeland Security and Emergency Management Environmental Review Worksheet Check ALL of the activities listed below that will be included as part of the project, REGARDLESS OF THE FUNDING SOURCE: ❑ Information and financial services ❑ Administrative and management activities 0 Environmental and other studies,resource identification,and the development of plans and strategies 0 Most engineering and design costs associated with eligible projects • Inspections and testing of properties for hazards or defects .o • Project planning Q ❑ Purchase of insurance Sp > ro ❑ Purchase of tools 7 27 s ❑ Technical assistance and training k� .E ❑ Interim assistance to arrest the effects of an imminent threat or physical deterioration in which the assistance .' does not alter environmental conditions. Public services that will not have a physical impact or result in any physical changes(e.g., employment, child care, health,education,counseling,welfare) _- ❑ Assistance for temporary or permanent improvements that do not alter environmental conditions and are limited to protection,repair,or restoration activities necessary only to control or arrest the effects from disasters or imminent threats to public safety including those resulting from physical deterioration (Must also complete the Regulatory Checklist at the end of Exhibit/V-A) • ? Q Operating costs(e.g., maintenance,security,operation, utilities, furnishings,equipment,supplies, staff training and recruitment,other incidental costs) U z ❑ Relocation costs ❑� Acquisition,repair, improvement,reconstruction,or rehabilitation when the facilities and improvements arc in U place and will be retained in the same use without change in size or capacity of more than 20 percent ❑ Special projects directed to the removal of material and architectural barriers that restrict the mobility of and U] S accessibility to elderly and handicapped persons U ❑ Acquisition (including leasing)or disposition of,or equity loans on,an existing structure m ❑ Acquisition(including leasing)of vacant land provided the structure or land acquired, financed,or disposed of will be retained for the same use ❑ Acquisition,repair, improvement,reconstruction,or rehabilitation when the facilities and improvements arc in place,but will change in size or capacity of more than 20 percent ❑ Acquisition,repair, improvement,reconstruction, or rehabilitation when the facilities and improvements arc in *T ,., place,but will involve a change in land use, such as from non-residential to residential, commercial to industrial,or from one industrial use to another " tz1 Demolition ✓❑ New construction This checklist must be included with the CDRG application. Please direct questions to the appropriate contact person below: DOLA/DI.C DHSEM i amra Norton,Environmental Compliance Officer Steven 13oand.State Disaster Recovery Manager Department of Public Safety Department of Local Affairs Division of Homeland Security and Emergency Management 1313 Sherman Street,Room 521, 9195 It Mineral Ave,Suite 200 Denver,CO 80203 Centennial,CO 80112 303-866-6398 720.852,6713tamra.nortordedstatc.co.us steven.boandfcpstate.co.us UPS/DOLA USE ONLY: Required level of environmental review: O Exempt O CENST O CESTO EA Reviewed by: Date of Review: Attach any continuations or additional items as an Attachment to the electronic application and e-mail submittal. Page IS of 20 CDBG-DR Infrastructure Application Colorado Division of Homeland Security and Emergency Management 2. Supplemental Environmental Review Information Enter any additional comments related to environmental concerns for the proposed project if desired. Please list and attach any documents or studies that have been prepared that support the Environmental Review Worksheet responses. All environmental issues are addressed on the attached Project Worksheet as supporting documentation. The significant EHP issues were in regards to the Endangered Species Act (ESA) and EHP Standard Conditions. All items were addressed and any additional supporting backup documentation can be provided upon request. Please see below for environmental permits that were obtained. Floodplain Permit 404 Nationwide Permit Migratory Birds Permit (if needed) Threatened and Endangered Species Permit O Attach any continuations or additional items as an Attachment to the electronic application and e.mail submittal. Page 19 of 20 CDRG-DR Infrastructure Application Colorado Division of Homeland Security and Emergency Management PART B - APPLICATION: DETAILED PROJECT BUDGET I. Detailed Project Budget: Please enter or attach a detailed and comprehensive final proposed budget for the project. Please note that CDBG-DR funds may be limited to the amount submitted with the NOI pending the availability of additional funding This Proposed Project is for the Local FEMA Match for costs for WELCO16 (661). These costs were incurred as a result of FEMA-DR 4145. During the incident period of September 11, 2013 to September 30, 2013, Weld County, Colorado received heavy rainfall and debris in the creeks, streams and rivers which caused severe flooding to and along roadways and surface streets, and also severely damaged local infrastructure. This Application request addresses the emergency work / damages that were a direct result of the severe flooding. A Scope of Work and detailed project budget is included within the PW and addresses the work that was completed. It is important to note that a version request has been made for this Project Worksheet and the attached Project Worksheet may not reflect FINAL costs. Attach any continuations or additional items as an Attachment to the electronic application and e-mail submittal. Page 20 of 20 E E 3 G E°u Q o E 9 ° E9 mF > v o E i -_ 3 3 3 - - - 3 .-645 •82E V > C a o O i 2 2 f 992 o 0 A ;e ' � Mo # R ' 450, AM' a � M < eM �e aae o Poo 5rtmg 0 3 3 a 0 ^ m mmm m E ti r r m m m r m « ( r m .. r .. r rv ^ ^ N .. ti N 0 0 0 2 3 0 o a ^ o 8 o 0 o N o o a a o ^ ^ a a '^° .. .. ., .. m .. ^ m .. ti .. .. u .arvry who 3 3 0 I ^ �, 8 8 8 o o 8 2 d'' a a a a a a a a a a a a a a a a a a a a a a Q Q Q a i'> > > > w > > > > > > 8 > > > > > > > > w F f > > > > > f f F > > > > > > > w ez 4 •...... t at IS a ► a I I 01 01 m r t ' r4 • B LL LLWLLI ( III :. n ip• '- - t: • . , z ^ 'raj` ' // • '11 ~.r it . - - S' ' , ..t. 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Address 2 City CENTENNIAL State CO Zip 80112 Email Deanna.Butterbaugh@state.co.us Is the application preparer the Point of Contact? No Point of Contact Information Prefix First Name Roy Middle Initial Last Name Rudisill Title Director- OEM Agency/Organization Director- OEM Address 1 PO BOX 758 Address 2 City Greeley State CO ZIP 80632 Phone 970-304-6540 https://connectI.dhs.gov/emmie/.Danalnfo=isource.fema.net.SSL+dispatch Destination.do?... 5/6/2014 Federal Emergency Management Agency F-Grants Page 2 of 36 Fax Email rrudisill@weldgov.com Alternate Point of Contact Information Prefix First Name Middle Initial Last Name Title Agency/Organization Address 1 Address 2 City State ZIP Phone Fax Email Project Description Disaster Number: 4145 Pre-Application Number: PA-08-CO-4145-RPA-0088 Applicant ID: 123-99123-00 Applicant Name: WELD(COUNTY) Subdivision: Project Number WELCO16 Standard Project Number/Title: 399- Road System Damage Please Indicate the Project Type: Neither Alternate nor Improved Application Title: WELCO16-Various Bridges- Part 1 Category: C.ROADS & BRIDGES Percentage Work Completed? 67.0% As of Date: 11-13-2013 Comments Attachments User Date Document Description Hard Copy File File Name Action Type Reference KATHLEEN 02-25- Map Location map WELCO16_Location Map.pdf View RUVARAC 2014 (130.78 kb) 04-03- Location Map[from WELCO16[20] MARK SPAHR 2014 Map WELCO20] _Location_Map_1.pdf(108.69 View kb) 04-03- Location Map 2 WELCOI6[20] MARK SPAHR 2014 Map [from WELCO20] _Location_Map_2.pdf(110.76 View kb) https://connectl.dhs.uoviemmie/.DanaIn tb=isource.fema.net.SSLAispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency F-Grants Page 3 of 36 Damage Facilities (Part 1 of 2) Facility Site Number Facility Name Address County City State ZIP Previously Action Damaged? 1 BR 13-54A over Big Thompson River Weld CO No 2 BR 23-8A over Big Dry Creek Weld CO No 3 BR 8-21A over Big Dry Creek Weld CO No 4 BR 23-6C over Big Dry Creek Weld CO No 5 BR 21-6A over Big Dry Creek Weld CO No 6 BR 4-15A over Big Dry Creek Weld CO No 7 BR 15-2A over Big Dry Creek Weld CO No Comments Attachments Hard Copy User Date Document Type Description File File Name Action Reference KATHLEEN 2- 205- Map Photos WELCO16_CR13 over Big Thompson View RUVARAC 2014 River Photos.pdf(502.13 kb) KATHLEEN 02 Applicant RUVARAC 25- Photos Photos Applicant Photos.pdf(1.20 Mb) View 2014 KATHLEEN 02 RUVARAC 25- Narrative WELCO16_DDD_SOW.pdf(83.45 kb) View 2014 KATHLEEN 25- Building Bridge Inspection Report.pdf(2.89 Mb) View RUVARAC 2014 Survey/Document Photos MARK 03- Photos Locations 2-7 WELCO16 [20]_Photos_Locations 2- Vie w ew SPAHR 2014 [from 7.pdf(947.54 kb) WELCO20] Bridge MARK 04- Bridge Inspection Location_2_BR_23- SPAHR 2014 Survey/Document Report- 8A_Inspection_Report.pdf(1.94 Mb) view Location 2 Bridge 04- Location 3 BR 8- MARK Bridge Inspection — SPAHR 2014 Survey/Document Report- 21A_Bridgepe ibon_Report.pdf View 2Location 3 —(1.60 ) Bridge 04- Location_ _ 4 BR 23- MARK 03 Bridge Inspection 6C_Bridge_Inspection_Report.pdf(1.62 View SPAHR 2014 Survey/Document Report- Mb) Location 4 Bridge 04- Location_ _ 5BR 4- MARK 03 Bridge Inspection 15 A Bridge_Inspection_Report.pdf View SPAHR 2014 Survey/Document Report- — — (1.24 Mb) Location 5 04- Bridge Location_6_BR_21- View MARK 03- Bridge Inspection 6A_Bridge_Inspection_Report.pdf(1.10 https://connectl.dhs.gov/emmie/.Dana[nfo=isource.fema.net.SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency F-Grants Page 4 of 36 SPAHR 2014 Survey/Document Report- Mb) Location 6 Bridge 04- Location 7 BR 15- _ _ MARK 03 Bridge Inspection 2A Bridge_Inspection_Report.pdf(1.26 View SPAHR 2014 Survey/Document Report- — Mb) Location 7 Facility Name: BR 13-54A over Big Thompson River Address 1: Address 2: County: Weld City: State: CO ZIP: Was this site previously damaged? No Percentage Work Completed? 50.00 PA-08-CO-4145-PW-00661(0): Location 1 Bridge 13-54A over Big Thompson River, in Section 19, T5N, R68W. Location: Lat: N40.38280 Long: -W104.94500 PA-08-CO-4145-PW-00661(0): During the incident period of September 11, 2013 to September 30, 2013, Weld County, Colorado received heavy rainfall and debris in the creeks, streams and rivers which caused damage to numerous roads and bridges in Weld County. This project worksheet addresses damages to CR 13 north roadway approaches and Bridge 13-54A over Big Thompson River, in Section 19, T5N, R68W. On November 13, 2013, Kathleen Ruvarac, FEMA TAC Bridge Specialist, David Ray, FEMA Hazard Mitigation Specialist, Gary Moore, FEMA Environmental, Historical, Preservation Specialist, and Donald Dunker, Weld County Public Works Engineer, performed a site investigation at this location to document damages. The road and bridge was open and repairs completed at the time of inspection. Lat: N40.38280 Long: -W104.94500 Flooding of the Big Thompson River resulted in damages on CR 13 include washout of asphalt, roadway base and embankment material on the north roadway approach. The double span concrete bridge, 125 ft in length x 67 ft in width, traverses the Big Thompson River and consists of a two (2) inch asphalt deck on a 7.5 inch concrete deck supported by twelve (12)—58 ft— 4 inch long 5.5 ft wide x 18 inch deep prestressed concrete box girders in each span, one (1) concrete pier with four(4)—3 ft diameter concrete columns and a 4 ft x 4 ft x 10 inch thick concrete cap and two (2) 2 ft 8 inch thick concrete abutments. The bridge is flanked on both sides with a galvanized w-beam on steel posts. Embankment Material lost in north roadway approach travel lanes measuring 76 ft L x 40 ft W x 4.7 ft D = 529.2 CY. https://connect I.dhs.gov/emmie/.Danalnlo=isource.fema.net.SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency F-Grants Page 5 of 36 One asphalt patch on roadway measured 76 ft L x 40 ft W= 3,040 SF x 0.575 ft D = 1,748 CF x 146 LB/CF x 1 ton/2000 LB = 127.6 tons asphalt Asphalt material behind the southeast section of guardrail and steel posts was raveled due to the flood water overtopping the roadway and shoulder, exposing the previously embedded portion of the posts. The quantity of material to be placed on the shoulder is 92 ft L x 2 ft W x 0.33 ft D= 2.2 CY =4.0 tons asphalt. Ditch cleaning each side of the road to reshape ditches at the site is estimated to be 484 ft in length on the northeast shoulder and 501 ft in length on the northwest shoulder adjacent to the travel lanes, and 50 ft in length on the southeast shoulder totaling 1,035 LF. Turf Reinforcement Mat installed on the NE shoulder(downstream)was damaged during the flood and subsequent filling operations at the site, estimated to be 110 ft L x 16 ft W= 195.6 SY. Turf Reinforcement Mat installed on the SE shoulder(downstream)was damaged during the flood and subsequent filling operations at the site, estimated to be 92 ft L x 20 ft W=204.4 SY, totaling 400 SY. Rip Rap was washed away at the northeast wingwall of the north abutment is estimated to be 35 ft L x 3 ft W towards the channel x 1.5 ft D = 5.8 CY. Rip rap was washed away at the southwest wingwall of the south abutment and is estimated to be 35 ft in length x 3 ft W towards the channel x 3 ft D = 11.7 CY, totaling 17.5 CY. Damage Description and Dimensions: Barbed wire fence with treated wooden posts was damaged on both the east(100 ft) and west side (100 ft) of the bridge, total 200 ft in length. A small amount of debris material was observed at the bridge site and is estimated to be 10 CY, approximately one truck load of material. Recent bridge inspection report was provided by the applicant dated May 22, 2012. The bridge was built in 2009 and had a sufficiency rating of 90.7 in 2012. 2012 inspection notes of elements include: bridge deck pavement crack sealing, vertical hairline cracks on concrete curbs, light water stains on prestressed girders, small spall on column 2D pier. One inch wide cracks in asphalt at approach ends. The deck condition is noted as good condition (7) on a scale of 0 to 9. The superstructure and substructure were noted as very good condition (8). The channel banks were observed to be protected or well vegetated (8). Maintenance items included bridge deck repair sealing cracks in asphalt surface. The Applicant has provided pictures of the road and bridge facilities documenting damages. These photos are attached to this project worksheet. PA-08-CO-4145-PW-00661(0): WORK COMPLETED Location 1: 1 —Fill void in roadway travel lanes, embankment and north approach— 529.2 CY x 1.82 (Conversion Factor CY ABC Class 6 Material to Tons= 963.1 tons x $33.70/ton (CDOT Item Number 304-06000 Aggregate Base Course Class 6 x 2 due to economies of scale as compared with number of CDOT annual projects) = $32,456.47 Scope of Work: 2— Install asphalt on north roadway approach and southeast shoulder behind guardrail = 131.6 tons x$81.70/ton (CDOT Item Number 403-33741 Hot Bituminous Pavement(Grading S) (75) (PG 64-22) = $10,751.72 3—Ditch re-shaping on the NE, NW and SE shoulders = 1,035 LF x $3.40/LF (FEMA Cost Code 3070 Ditch Cleaning and shaping) = $3,519.00 4- Install Turf Reinforcement Mat on NE and SE shoulders =400 SY X 10.00/SY (CDOT Item Number 216-00301) = $4,000.00 5— Install Rip Rap north and south abutments, 17.5 CY x$83.17/CY (Rip Rap 18 inch CDOT Item Number 506-00218) = $1,455.48 https://connect I.dhs.gov/emm ie/.Danalnfo=isource.lema.net.SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency E-Grants Page 6 of 36 6—Install 200 LF of barbed wire fence with treated wooden posts x 5.50/LF (CDOT Item Number 607-01055) = $1,100.00 7—Remove debris at site 10.0 CY x$5.00/CY estimate = $50.00 Total = $53,332.67 cost estimate prepared by project specialist using 2013 CDOT Average Unit Prices Hazard Mitigation Proposal Is effective mitigation feasible on this site? I No If you answered Yes to the above question, the next question is required Will mitigation be performed on this site? I No If you answered Yes to the above question. the next question is required Do you wish to attach a Hazard Mitigation No Proposal? If you answered Yes to the above question, the next two questions are required Please provide the Scope of Work for the estimate: (maximum 4000 characters) Would you like to add the Hazard Mitigation No Proposal as a cost line item to the project cost? GIS Coordinates Project Location Latitude Longitude BR 13-54A over Big Thompson River 40.3828 -104.945 Facility Name: BR 23-8A over Big Dry Creek Address 1: Address 2: County: Weld City: State: CO ZIP: Was this site previously damaged? No Percentage Work Completed? 50.00 % PA-08-CO-4145-PW-00661(0): Location 2 —Bridge 23-8A over Big Dry Creek Lat: N40.04414 Location: Long: -W104.84853 PA-08-CO-4145-PW-00661(0): Location 2—Bridge 23-8A over Big Dry Creek Lat: N40.04414 Long: -W104.84853 Flooding of the Big Dry Creek resulted in damages on CR 23 include washout of rip rap material on the channel side of the wingwalls and abutments at Bridge WEL023.0-008.0A. Rip Rap was washed away at the abutments is estimated to be 32+20 ft= 52 ft L x 5ftW towards the channel x3ft D x2 abutments = 57.8 CY The 39.25 ft long x 32.0 ft wide steel structure traverses the Big Dry Creek in https://connectl.dhs.gov/emmie/.Danalnfo=isource.fema.net,SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency E-Grants Page 7 of 36 Weld County, CO. The bridge is a single (1) span bridge consisting of a 10 inch asphalt overlay on corrugated steel deck, Seven (7)—W27x94 steel girders, seven (7) HP [H-Piles] 10x57 steel piles with HP 10x57 steel cap with 3 inch x 18 inch vertical steel sheet pile backwall at the abutments and (1) HP 10x57 Pile w/3 inch x 18 inch vertical steel sheet piling wing walls. The deck is flanked on both sides with a galvanized W rail beam bolted to steel posts. Recent bridge inspection report was provided by the applicant dated May 21, 2012. The bridge was built in 1982 and had a sufficiency rating of 79.9 in Damage Description and Dimensions: 2012. 2012 inspection notes of elements include: bridge deck and approach railing inadequate, pavement crack sealing, install signage, debris in channel. The deck condition is noted as fair (5) on a scale of 0 to 9. The superstructure is noted as satisfactory (6) and substructure is noted as fair(5). The channel banks were observed to be slumping (6). Maintenance items included sealing cracks in deck overlay, railing replacement, install object markers at all corners and remove debris from channel. PA-08-CO-4145-PW-00661(0): WORK TO BE COMPLETED Location 2 Scope of Work: 1 -Replace Rip Rap 57.8 CY x $83.17/CY (Rip Rap 18 inch CDOT Item Number 506-00218) = $4,807.23 Hazard Mitigation Proposal Is effective mitigation feasible on this site? No If you answered Yes to the above question, the next question is required Will mitigation be performed on this site? I No If you answered Yes to the above question, the next question is required Do you wish to attach a Hazard Mitigation No Proposal? If you answered Yes to the above question, the next two questions are required Please provide the Scope of Work for the estimate: (maximum 4000 characters) Would you like to add the Hazard Mitigation No Proposal as a cost line item to the project cost? GIS Coordinates Project Location Latitude Longitude Bridge 23-8A over Big Dry Creek 40.04414 -104.84853 Facility Name: BR 8-21A over Big Dry Creek Address 1: Address 2: County: Weld City: State: CO ZIP: https://connect).dhs.gov/emmie/,Danalnfo=isource.fema.net.SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency E-Grants Page 8 of 36 Was this site previously damaged? No Percentage Work Completed? 50.00 % PA-08-CO-4145-PW-00661(0): Location 3—Bridge 8-21A over Big Dry Creek Lat: N40.04356 Location: Long: -W104.84942 PA-08-CO-4145-PW-00661(0): Flooding of the Big Dry Creek resulted in damages on CR 8 include washout of rip rap material on the channel side of the wingwalls and abutments at Bridge WEL008.0-021.0A. Rip Rap was washed away at the abutments is estimated to be 32.5+16 ft= 48.5 ft Lx 5 ft W towards the channel x 3 ft D x2 abutments = 53.9 CY The 39.0 ft long x 32.5 ft wide steel structure traverses the Big Dry Creek in Weld County, CO. The bridge is a single (1) span bridge consisting of a 1 inch gravel over 4 inch asphalt overlay on corrugated steel deck, Ten (10)— W24x76 steel girders, HP 10x57 steel piles with HP 10x57 steel cap with 3 inch x 18 inch vertical steel sheet pile backwall at the abutments and (1) HP 10x57 Pile w/3 inch x 18 inch vertical steel sheet piling wing walls. The deck is flanked on both sides with a galvanized W rail beam bolted to steel posts. Damage Description and Dimensions: Recent bridge inspection report was provided by the applicant dated May 21, 2012. The bridge was built in 1983 and had a sufficiency rating of 97 in 2012. 2012 inspection notes of elements include: bridge deck and approach railing inadequate. lapped bridge rail connection, damaged concrete in abutment, dirt and gravel berms along both sides of deck, light rust on girders. The deck condition is noted as satisfactory(6)on a scale of 0 to 9. The superstructure and substructure were noted as satisfactory(6). The channel banks were observed to be in need of minor repairs(7). Maintenance items included railing replacement, install 4 bolts in lapped w beam rail connection, consider encasing abutments in concrete, install object markers at all corners and remove gravel berms from deck. PA-08-CO-4145-PW-00661(0): Location 3 1 -Replace Rip Rap 53.9 CY x$83.17/CY(Rip Rap 18 inch COOT Item Scope of Work: Number 506-00218)=$4,482.86 Hazard Mitigation Proposal Is effective mitigation feasible on this site? INo If you answered Yes to the above question, the next question is required Will mitigation be performed on this site? I No If you answered Yes to the above question, the next question is required Do you wish to attach a Hazard Mitigation No Proposal? If you answered Yes to the above question. the next two questions are required Please provide the Scope of Work for the estimate: https://connect l.dhs.gov/emm ie/.Danaln tu=isource.tema.net.SSL+dispatch Destination.do?... 5/6/2014 Federal Emergency Management Agency F-Grants Page 9 of 36 (maximum 4000 characters) Would you like to add the Hazard Mitigation No Proposal as a cost line item to the project cost? GIS Coordinates Project Location Latitude Longitude Bridge 8-21A over Big Dry Creek 40.04356 -104.84942 Facility Name: BR 23-6C over Big Dry Creek Address 1: Address 2: County: Weld City: State: CO ZIP: Was this site previously damaged? No Percentage Work Completed? 50.00 PA-08-CO-4145-PW-00661(0): Location 4—Bridge 23-6C over Big Dry Creek Lat: N40.04103 Location: Long: -W104.84859 PA-08-CO-4145-PW-00661(0): Flooding of the Big Dry Creek resulted in damages on CR 23include washout of rip rap material on the channel side of the wingwalls at Bridge WEL023.0-6C. Rip Rap was washed away in front of the wingwalls is estimated to be 40 ft Lx 6 ft W towards the channel x 3 ft D x 2 abutments= 53.3 CY use 55CY The 39.25 ft long x 32.0 ft wide steel structure traverses the Big Dry Creek in Weld County, CO. The bridge is a single (1) span bridge consisting of an 8 inch asphalt overlay on corrugated steel deck, Seven (7)—W27x102 steel girders, six (6)with 10 inch x 10.25 inch H piles abutments with horizontal 10 inch steel h cap with vertical 3.25 ft x 18 inch steel sheet pile backwall and 1 ft- 10 inch steel H pile and horiztonal whaler with vertical steel sheet pile wing walls. The deck is flanked on both sides with a galvanized W rail beam bolted to steel posts. Damage Description and Dimensions: Recent bridge inspection report was provided by the applicant dated May 21, 2012. The bridge was built in 1995 and had a sufficiency rating of 91.2, Structurally Deficient, in 2012. 2012 inspection notes of elements include: bridge deck and approach railing inadequate, pavement crack sealing, light rust on bottom of girders, w-beam steel posts, and steel sheet pile abutments. The deck condition is noted as poor(4) on a scale of 0 to 9. The superstructure is noted as satisfactory (6) and substructure is noted as good (7). The channel banks were observed to be in need of minor repairs (7). Maintenance items included sealing crack in deck overlay and railing replacement. PA-08-CO-4145-PW-00661(0): WORK TO BE COMPLETED: Location 4 https://connectl .dhs.gov/emmie/,Danalnfo=isource.fema.net,SSI+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency [-Grants Page 10 of 36 1 -Replace Rip Rap 55CY x$83.17/CY (Rip Rap 18 inch CDOT Item Number 506-00218)= $4,574.35 Scope of Work: Hazard Mitigation Proposal • Is effective mitigation feasible on this site? I No If you answered Yes to the above question, the next question is required Will mitigation be performed on this site? I No If you answered Yes to the above question,the next question is required Do you wish to attach a Hazard Mitigation No Proposal? If you answered Yes to the above question, the next two questions are required Please provide the Scope of Work for the estimate: (maximum 4000 characters) Would you like to add the Hazard Mitigation No Proposal as a cost line item to the project cost? GIS Coordinates Project Location Latitude Longitude Bridge 23-6C over Big Dry Creek 40.04103 -104.8485 Facility Name: BR 21-6A over Big Dry Creek Address 1: Address 2: County: Weld City: State: CO ZIP: Was this site previously damaged? No Percentage Work Completed? 50.00 % PA-08-CO-4145-PW-00661(0): Location 5—Bridge 21-6A over Big Dry Creek Lat: N40.03720 Location: Long: -W104.86711 PA-08-CO-4145-PW-00661(0): Flooding of the Big Dry Creek resulted in damages on CR 21 include washout of rip rap material on the channel side of the abutments and wingwalls at Bridge WEL021.0-006.0A. Loss of embankment material on the North east shoulder exposed 20 LF of 24 inch CMP estimated to be 20 ft Lx10ftWx4ftD = 29.6CY. Rip Rap was washed away in front of the abutments and wingwalls is estimated to be 32 ft+20 ft= 52 ft Lx 5 ft W towards the channel x 3 ft D x 2 abutments= 57.8 CY The 49.7 ft long x 32.1 ft wide concret/steel structure traverses the Big Dry Creek in Weld County, CO. The bridge is a single (1) span bridge consisting of a 4 inch asphalt overlay on top of cast in place concrete topping slab on 2 inch tope flange of double tee girders, four(4) 30 inch deep double tee girders, six(6) ten inch H piles with concrete walls between with precast https://connectl.dhs.gov/emm ie/,Danalnfo=isource.fema.net.SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency E-Grants Page 11 of 36 concrete cap abutment and concrete wingwalls. The deck is flanked on both sides with a galvanized W rail beam bolted to steel posts. Recent bridge inspection report was provided by the applicant dated May 21, 2012. The bridge was built in 1970 and had a sufficiency rating of 97.0 in 2012. 2012 inspection notes of elements include: bridge deck and approach railing Damage Description and Dimensions: inadequate, pavement crack sealing, light rust on bottom of girders.The deck condition is noted as satisfactory(6) on a scale of 0 to 9. The superstructure and the substructure are noted as satisfactory(6). The channel banks were observed to be protected or well vegetated. Maintenance items included sealing crack in deck overlay, railing replacement. fill holes in shoulders at southwest and northwest corners of deck, install object markers at all corners. PA-08-CO-4145-PW-00661(0): WORK TO BE COMPLETED: Location 5 1 —Fill embankment material lost on northeast shoulder—29.6 CY x 1.82 (Conversion Factor CY ABC Class 6 Material to Tons= 53.9 tons x $33.70/ton (CDOT Item Number 304-06000 Aggregate Base Course Class 6 Scope of Work: x 2 due to economies of scale as compared with number of CDOT annual projects)=$1,816.43 2—Replace Rip Rap 57.8/CY x $83.17/CY (Rip Rap 18 inch CDOT Item Number 506-00218) = $4,807.23 WORK TO BE COMPLETED TOTAL= $6,623.66 Hazard Mitigation Proposal Is effective mitigation feasible on this site? INo If you answered Yes to the above question, the next question is required Will mitigation be performed on this site? I No If you answered Yes to the above question, the next question is required Do you wish to attach a Hazard Mitigation No Proposal? If you answered Yes to the above question, the next two questions are required Please provide the Scope of Work for the estimate: rnaximum 4000 characters) Would you like to add the Hazard Mitigation No Proposal as a cost line item to the project cost? GIS Coordinates Project Location Latitude Longitude Bridge 21-6A over Big Dry Creek 40.0372 -104.86711 Facility Name: BR 4-15A over Big Dry Creek Address 1: Address 2: https://connect l.dhs.gov/emmie/.Danalnl.=isource.fema.net,SSL+dispatchDestination.do'?... 5/6/2014 Federal Emergency Management Agency F-Grants Page I2 of 36 County: Weld City: State: CO ZIP: Was this site previously damaged? No Percentage Work Completed? 50.00 PA-08-CO-4145-PW-00661(0): Location 6— Bridge 4-15A over Big Dry Creek Lat: N40.01472 Location: Long: -W104.91122 PA-08-CO-4145-PW-00661(0): Flooding of the Big Dry Creek resulted in damages on CR 4 include washout of surface gravel on bridge deck at Bridge WEL004.0-015.OA. 1. Loss of surface gravel is estimated to be 30 ft L x 32 ft W x 0.33 ft D = 11.7 CY. 2. Rip rap and soil/seed cover washed away at each wingwalls/embankment estimated to be [10LF x 5FT wide x 3FT deep/27] x 4 =22.2CY use 23CY [rip rap]. Soil washed away estimated to be[10FT x 5FT wide x 4/12FT deep/27] x 4 = 2.47CY use 3CY The 33.75 ft long x 32.0 ft wide steel structure traverses the Big Dry Creek in Weld County, CO. The bridge is a single (1) span bridge consisting of a 1 inch gravel on 4 inch asphalt overlay on corrugated steel deck, twelve (12)— W21x62 steel girders, 10 inch x 8 inch H-cap on six(6) 10 inch piles with sheet pile backwall abutments and 10 inch H pile with waler and sheet pile Damage Description and Dimensions: backwall wing walls. The deck is flanked on both sides with a galvanized W rail beam bolted to steel posts. Recent bridge inspection report was provided by the applicant dated May 21, 2012. The bridge was built in 2003 and had a sufficiency rating of 97 in 2012. 2012 inspection notes of elements include: bridge deck and approach railing inadequate, pavement crack sealing, light rust on bottom of girders, heavy rust at water level of steel sheet pile abutments. The deck condition is noted as satisfactory (6) on a scale of 0 to 9. The superstructure is noted as good (7) and substructure is noted satisfactory (7). The channel banks were observed to be slumping (6). Maintenance items included railing replacement, remove gravel berms along both sides of the deck, and line southeast bank with wire enclosed rock for 100 ft upstream of bridge. PA-08-CO-4145-PW-00661(0): WORK TO BE COMPLETED: Location 6 1 —Replace surface gravel lost on deck—11.7 CY x 1.82 (Conversion Factor CY ABC Class 6 Material to Tons= 21.3 tons x$33.70/ton (CDOT Item Number 304-06000 Aggregate Base Course Class 6 x 2 due to economies of scale as compared with number of CDOT annual projects) = $717.81 2a. Install rip rap at wingwalls: 23CY x $83.17/CY [Rip rap 18 inch CDOT Item Number 506-00218] = $1,912.91 https://connect).dhs.gov/emmie/.Dana[nfo=isource.fema.net.SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency E-Grants Page 13 of 36 2b. Install topsoil over rip rap. 3CY x$10.11/CY = $30.33 CDOT 207-00205 2c. Install seeding. [10LF x 5FT] x 4 = 200SF/43560=0.009AC use 0.005AC x$545.81/AC =$2.73 CDOT 212-00006[use$10.00] Scope of Work. 2d. Install soil retention blanket. 200SF/9= 22.2SY x$2.15/SY=$47.73 COOT 216-00042 WORK TO BE COMPLETED TOTAL = $2,718.78 Hazard Mitigation Proposal Is effective mitigation feasible on this site? INo If you answered Yes to the above question, the next question is required Will mitigation be performed on this site? I No If you answered Yes to the above question, the next question is required Do you wish to attach a Hazard Mitigation No Proposal? If you answered Yes to the above question, the next two questions are required Please provide the Scope of Work for the estimate: (maximum 4000 characters) Would you like to add the Hazard Mitigation No Proposal as a cost line item to the project cost? GIS Coordinates Project Location Latitude Longitude Bridge 4-15A over Big Dry Creek 40.01472 -104.91122 Facility Name: BR 15-2A over Big Dry Creek Address 1: Address 2: County: Weld City: State' CO ZIP: Was this site previously damaged? No Percentage Work Completed? 50.00 PA-08-CO-4145-PW-00661(0): Location 7—Bridge 15-2A over Big Dry Creek Lat: N40.00872 Location: Long: -W104.92390 PA-08-CO-4145-PW-00661(0): Flooding of the Big Dry Creek resulted in damages on CR 15 include vegetative debris accumulating at Bridge WEL015.0-002.0A. 1.Vegetative debris is estimated to be 32 + 10 + 10 = 52ftLx35ftWx4ft https://connectl.dhs.govlemm ie/.Danalntb=isource.lema.net.SSIL-FdispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency E-Grants Page 14 of 36 D = 269.6 CY. 2. Rip rap washed away at the following wingwalls [Total 45CY]: 2a. Northwest: 20LF x 10FT x 3FT deep/27= 22.2CY use 23CY 2b. Northeast: 20LF x 5FT x 3FT deep/27= 11.1 CY use 11 CY 2c. Southeast: 20LF x 5FT x 3FT deep/27 = 11.1 CY use 11 CY 3. Soil/seed cover on Item 2 [rip rap]washed away [20LF x 10FT] +[2oLF x 5FT] + [2oLF x 5FT] = 400SF x 4/12FT deep/27=4.9CY use 5CY The 36.53 ft long x 32.0 ft wide steel structure traverses the Big Dry Creek in Weld County, CO. The bridge is a single (1) span bridge consisting of a 3 inch gravel on 4 inch asphalt overlay on corrugated steel deck, Eight(8)— W27x102 steel girders, 12 inch H piles on six(6)with 12 inch H piles with sheet pile backwall abutments and 2tow (2) 12 inch H pile with waler and sheet pile backwall wing walls. The deck is flanked on both sides with a Damage Description and Dimensions: galvanized W rail beam bolted to steel posts. Recent bridge inspection report was provided by the applicant dated May 21, 2012. The bridge was built in 2003 and had a sufficiency rating of 97 in 2012. 2012 inspection notes of elements include: bridge deck and approach railing inadequate, pavement crack sealing, light rust on bottom of girders, w-beam steel posts, and steel sheet pile abutments. The deck condition is noted as good (7) on a scale of 0 to 9. The superstructure and substructure are noted as good (7). The channel banks were observed to be in need of minor repairs (7). Maintenance items included sealing crack in deck overlay, railing replacement, install object markers on all corners, place wire enclosed gabions along southwest bank to repair slumping and erosion. Photos of the bridge facilities are included in the bridge inspection report attached to this project worksheet. PA-08-CO-4145-PW-00661(0): Location 7 WORK COMPLETED 1 —Debris removal at site—269.6 CY x$5.00/CY estimated cost= $1,348.00. The applicant indicated that the debris would be disposed of at its landfill in Kennesburg, Colorado. Tree limbs, etc. would be disposed of at A-1 Organics Rattler Ridge, 12002 CR 59, Kennesburg, CO. Solid Waste would be disposed of at Waste Management- Buffalo Ridge Landfill, 11655 CR 59, Keenesburg, CO. WORK COMPLETED TOTAL= $1,348.00 WORK TO BE COMPLETED: 2. Install rip rap at NW, NE, and SE wingwalls: 45CY x$83.17/CY [Rip rap 18 inch CDOT Item Number 506-00218] = $3,742.65 3a. Install topsoil over rip rap. 5CY x $10.11/CY = $50.55 CDOT 207-00205 3b. Install seeding. 400SF/43560 = 0.009AC use 0.01AC x$545.81/AC = $5.45 CDOT 212-00006 [use$10.001 https://connectl.dhs.gov/emmie/.Danalnfo=isource.fema.net,SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency F-Grants Page I S of 36 3c. Install soil retention blanket. 400SF/9=44.45Y x$2.15/SY = $95.46 CDOT 216-00042 WORK TO BE COMPLETED TOTAL = $3,898.66 PROJECT NOTES: 1. During repair or reconstruction, applicant may incur additional costs related to clearing and grubbing, dewatering, placement of topsoil, erosion and sedimentation control, sanitary facilities mobilization and flagging/traffic control. Such costs are generally addressed in the "in-place" unit costs of repair or reconstruction items, and not specifically addressed in the Scope of Work. However, if a project requires an extraordinary use of any such items, to where a specific reference in the PW should be considered, applicant is advised to contract Colorado Department of Emergency Management requesting a revision to the PW's Scope of Work. 2. Applicant has completed a substantial percentage of the work but will not have cost data available within the fourteen day Pocket Guide rule. Per Field Operations Pocket Guide, Section 7, Cost Estimates, Page 26, "If the applicant has not produced cost data within two weeks of the site inspection, the Project Specialist will prepare the PW on the basis of an estimate for the work accomplished". Applicant and FEMA personnel jointly conducted all inspections and agreed to use CDOT costs for in-place costs to derive estimates on this project worksheet. Applicant understands that all actual support documentation, invoices, FA records, contract and proof of payment will be required for final reconciliation and or closeout process. Attached is the CDOT average in-place cost for materials. 3. The Applicant will notify FEMA and the State of their intent to perform Scope of Work: permanent work related to this site before any work commences in the field. Failure to do so may jeopardize the sub-grant for permanent work related to the work in this sub-grant. 4. Pursuant to 44 CFR 13.42, Grantees and Subgrantees are required to retain records, including source documentation, to support expenditures/costs incurred against the grant award, for 3 years from the date of submission to FEMA of the final Financial Status Report. 5. The applicant must obtain all required federal, state, and local permits prior to the commencement of work. 6. The subgrantee is requesting direct administrative costs that are directly chargeable to this specific project. Associated eligible work is related to administration of the PA project only and in accordance with 44 CFR 13.22. These costs are treated consistently and uniformly as direct costs in all federal awards and other subgrantee activities and are not included in any approved indirect costs. 7. Payment for small projects is made at the time of project approval, based on validated documentation included in the PW, including documents, site visit observations and/or photos. At the time that this PW was written, no documentation was available regarding DAC. Since DAC can only be validated through documentation provided by the applicant, no allowance was included. 8. Project was reviewed for 406 Hazard Mitigation and a proposal is attached to this project worksheet. Applicant may offer other opportunities for 406 HM following a review by their engineering consultants. https://connectl.dhs.gov/emmie/.Danalnfo=isource.fema.net.SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency E-Grants Page 16 of 36 9. The applicant is aware that all projects are subject to an insurance review as stated in 44 C.F.R. Sections 206.252 and 206.253. If applicable, an insurance determination will be made either as anticipated proceeds or actual proceeds in accordance with the applicant's insurance policy that may affect the total amount of the project. 10. The applicant is required to adhere to State and Federal Government Procurement rules and regulations and maintain adequate records to support the basis for all purchasing of goods and materials and contracting services for projects approved under the Public Assistance program, as stated in 44 CFR 13.36. The applicant has advised they have followed their normal procurement procedures. 11. At the Applicant's request, WELCO16 and WELCO20 have been combined into this PW with Reference No. WELCO16. Locations 2-7 were formerly Sites 1-6 in WELCO20. WELCO20 was rewritten for$0. Hazard Mitigation Proposal Is effective mitigation feasible on this site? I No If you answered Yes to the above question. the next question is required Will mitigation be performed on this site? I No If you answered Yes to the above question, the next question is required Do you wish to attach a Hazard Mitigation No Proposal? If you answered Yes to the above question, the next two questions are required Please provide the Scope of Work for the estimate: (maximum 4000 characters) Would you like to add the Hazard Mitigation No Proposal as a cost line item to the project cost? GIS Coordinates Project Location Latitude Longitude Bridge 15-2A over Big Dry Creek 40.00872 -104.9239 Special Considerations 1. Does the damaged facility or item of work have insurance coverage and/or is it an insurable risk No (e.g., buildings, equipment, vehicles, etc)? 2. Is the damaged facility located within a floodplain or coastal high hazard area and/or does it Yes have an impact on a floodplain or wetland? If you would like to make any comments, please enter them below. (maximum 4000 characters) Zone B-Areas between limits of the 100 year flood and and 500 year flood; etc. Flood Map Panel 0802660615C dated September 28, 1982 3. Is the damaged facility or item of work located within or adjacent to a Coastal Barrier Resource No System Unit or an Otherwise Protected Area? 4. Will the proposed facility repairs/reconstruction change the pre-disaster conditions (e.g., No footprint, material, location, capacity, use of function)? 5. Does the applicant have a hazard mitigation proposal or would the applicant like technical Yes assistance for a hazard mitigation proposal? 6. Is the damaged facility on the National Register of Historic Places or the state historic listing? Is No it older than 50 years?Are there more, similar buildings near the site? https://connectl.dhs.gov/emmie/,Danalnfo=isource.fema.net.SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency'[-Grants Page 17 of 36 7, Are there any pristine or undisturbed areas on. or near,the project site?Are there large tracts of No forestland? 8. Are there any hazardous materials at or adjacent to the damaged facility and/or item of work? No 9. Are there any other environmental or controversial issues associated with the damaged facility Yes and/or item of work? If you would like to make any comments, please enter them below. (maximum 4000 characters) EHP to conduct review Attachments User Date Document Type Description Hard Copy File File Name Action Reference KATHLEEN 02-25- Floodplain Firmette.pdf(279.87 View RUVARAC 2014 kb) KATHLEEN 02-25- Environmental/Historic EHP email approval of View RUVARAC 2014 Document TRM.pdf(94,76 kb) 04-03- Floodmap[from Firmette_1.pdf(230.79 MARK SPAHR 2014 Floodplain WELCO20] kb) View MARK SPAHR 04-03- Floodplain Floodmap[from Firmette_2.pdf(187.55 View 2014 WELCO20] kb) MARK SPAHR 04-03- Floodplain Floodmap[from Firmette_3.pdf(187.69 View 2014 WELCO20] kb) For Category C, D, E, F, and G Projects only Is effective mitigation feasible on this project? Yes If you answered Yes to the above question, the next question is required Will mitigation be performed on any sites in this No project? If you answered Yes to the above question. the next question is required Do you wish to attach a Hazard Mitigation No Proposal? If you answered Yes to the above question, the next two questions are required Please provide the Scope of Work for the estimate: Would you like to add the Hazard Mitigation No Proposal as a cost line item to the project cost? Comments Attachments Hard Copy User Date Document Type Description File File Name Action Reference 04- EHP approval MARK 03 Environmental/Historic [from EHP_email_approval_of_TRM.pdf View SPAHR 2014 Document WELCO20] (94.76 kb) Cost Estimate Is this Project Worksheet for https://connect1.dhs.`gov'emmie/.Danalnfo=isource.tema.net.SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency E-Grants Page 18 of 36 (Preferred) Repair Material Unit Unit of Subgrant Cost Sequence Code and/or Quantity Measure Unit Price Budget Class Type Estimate Action Description ***Version 0 *** Work Completed Site 1 Location 1 - BR 13-54A 1 9999 over Big 1 LS $ CONSTRUCTION Work $ 53,332.67 Thompson 53,332.67 Completed River Site 7 Location 2 9999 7-BR 15-2A 1 LS $ CONSTRUCTION Work $ 1,348.00 over Big Dry 1,348.00 Completed Creek Work To Be Completed Site 2 Location Work To 23-82 3 9999 2- BR r Big Dry 1 LS 4 807.23 CONSTRUCTION Be $4,807.23 oCreek Completed Site 3 Location Work To 4 9999 over BR Big Dry 1 LS 4,482.86 CONSTRUCTION Be $4.482.86 Creek Completed Site 4 Location Work To 5 9999 4-BR 23-6C 1 LS $ CONSTRUCTION Be $4,574.35 over Big Dry 4,574,35 Completed Creek Site 5 Location Work To 5-6 9999 ov BR Dry 1 LS 6,623.66 CONSTRUCTION Be $6,623.66 Creek Completed Site 6 Location Work To 7 9999 6- BR 4-15A 1 LS $ CONSTRUCTION Be $2,718.78 over Big Dry 2,718.78 Completed Creek Site 7 Location Work To 8 9999 7-BR 15-2A 1 LS $ CONSTRUCTION Be $ 3,898.66 over Big Dry 3,898.66 Completed Creek Direct Subgrantee Admin Cost Direct Direct 9 9901 Administrative 1 LS $ INDIRECT Subgrantee $ 1,000.00 Costs 1,000.00 CHARGES (Subgrantee) Admin Cost Total Cost: $ 82,786.21 Insurance Adjustments(Deductibles, Proceeds and Settlements)-5900/5901 Subgrant Se uence Code Material and/or Descri tion Unit Unit of Unit Budget Type Cost Action 4 p Quantity Measure Price Clas yp Estimate s Total Cost: $0.00 l I l https://connect/.dhs.gov/emm ie/,Danaln fo=-isource.tenia.net,SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency E-Grants Page 19 of 36 Total Cost Estimate: 82 786.21 (Preferred Estimate Type+Insurance Adjustments) Comments Attachments Document Hard Copy User Date Type Description File File Name Action Reference KATHLEEN 02 CDOT Weld County-2013 COOT Average Unit RUVARAC 25 Miscellaneous Average Unit Prices.pdf(37.37 kb) View 2014 Price Sheet MARK 04- Additional CDOT unit Weld_County_ SPAHR 03 Information prices[from _2013_CDOT_Average_Unit_Prices.pdf View 2014 WELCO20] (37.37 kb) Existing Insurance Information Insurance Type Policy No. Bldg/Property Content Insurance Deductible Years Amount Amount Amount Amount Required Comments On file at JFO Attachments Comments and Attachments Name of Section Comment Attachment WELCO16 Location Map.pdf Project Description WELCO16[201 Location Map 1.pdf WELCO16 [201 Location Map 2.pdf WELCO16 CR13 over Big Thompson River Photos.pdf Applicant Photos.pdf WELCO16 DDD SOW.pdf Bridge Inspection Report.pdf WELCO16 [20] Photos Locations 2-7.pdf Damage Facilities Location 2 BR 23-8A Inspection Report.pdf Location 3 BR 8-21A Bridge Inspection Report.pdf Location 4 BR 23-6C Bridge Inspection Report.pdf Location 5 BR 4-15 A Bridge Inspection Report.pdf Location 6 BR 21-6A Bridge Inspection Report.pdf Location 7 BR15-2A Bridge Inspection Report.pdf Firmette.pdf EHP email approval of TRM.pdf Special Considerations Firmette 1.pdf Firmette 2.pdf Firmette 3.pdf Mitigation EHP email approval of TRM.pdf Cost Estimate Weld County-2013 CDOT Average Unit Prices.pdf Weld County - 2013 CDOT Average Unit Prices.pdf Insurance Information On file at JFO Bundle Reference#(Amendment#) Date Awarded https://connect 1.dhs.gov/emmie/.DanaInfo=isource.fema.net.SSL+dispatch Destination.do'?... 5/6/2014 Federal Emergency Management Agency F-Grants Page 20 of 36 IPA-08-CO-4145-State-0051(50) 105-01-2014 Subgrant Application - FEMA Form 90-91 Note: The Effective Cost Share for this application is 75% FEDERAL EMERGENCY MANAGEMENT AGENCY PROJECT WORKSHEET DISASTER PROJECT NO. PA ID NO. DATE CATEGORY WELCOI6 123-99123- 12-05-2013 C FEMA 4145 I- IDR I-CO 00 APPLICANT. WELD(COUNTY) WORK COMPLETE AS OF. 11-13-2013 67% Site 1 of 7 DAMAGED FACILITY. COUNTY. Weld BR 13-54A over Big Thompson River LOCATION. LATITUDE. LONGITUDE. 40.3828 -104.945 PA-08-CO-4145-PW-00661(0). Location 1 Bridge 13-54A over Big Thompson River. in Section 19.T5N, R68W. Lat N40.38280 Long. -W104.94500 DAMAGE DESCRIPTION AND DIMENSIONS. PA-08-CO-4145-PW-00661(0). During the incident period of September 11. 2013 to September 30. 2013.Weld County.Colorado received heavy rainfall and debris in the creeks,streams and rivers which caused damage to numerous roads and bridges in Weld County. This project worksheet addresses damages to CR 13 north roadway approaches and Bridge 13-54A over Big Thompson River. in Section 19,T5N. R68W. On November 13. 2013 Kathleen Ruvarac. FEMA TAC Bridge Specialist. David Ray.FEMA Hazard Mitigation Specialist,Gary Moore,FEMA Environmental. Historical,Preservation Specialist,and Donald Dunker. Weld County Public Works Engineer. performed a site investigation at this location to document damages. The road and bridge was open and repairs completed at the time of inspection. Lat N40.38280 Long. -W104.94500 Flooding of the Big Thompson River resulted in damages on CR 13 include washout of asphalt,roadway base and embankment material on the north roadway approach.The double span concrete bridge. 125 ft in length x 67 ft in width.traverses the Big Thompson River and consists of a two(2)inch asphalt deck on a 7.5 inch concrete deck supported by twelve(12)—58 ft—4 inch long 5.5 ft wide x 18 inch deep prestressed concrete box girders in each span. one(1)concrete pier with four(4)—3 ft diameter concrete columns and a 4 ft x 4 ft x 10 inch thick concrete cap and two(2)2 ft 8 inch thick concrete abutments. The bridge is flanked on both sides with a galvanized w-beam on steel posts. Embankment Material lost in north roadway approach travel lanes measuring 76 ft L x 40 ft W x 4.7 ft D=529.2 CY. One asphalt patch on roadway measured 76 ft L x 40 ft W=3.040 SF x 0.575 ft D= 1,748 CF x 146 LB/CF x 1 ton/2000 LB= 127.6 tons asphalt Asphalt material behind the southeast section of guardrail and steel posts was raveled due to the flood water overtopping the roadway and shoulder exposing the previously embedded portion of the posts.The quantity of material to be placed on the shoulder is 92 ft L x 2 ft W x 0.33 ft D=2.2 CY=4.0 tons asphalt. Ditch cleaning each side of the road to reshape ditches at the site is estimated to be 484 ft in length on the northeast shoulder and 501 ft in length on the northwest shoulder adjacent to the travel lanes,and 50 ft in length an the southeast shoulder totaling 1,035 LF. Turf Reinforcement Mat installed on the NE shoulder(downstream)was damaged during the flood and subsequent filling operations at the site, estimated to be 110 ft L x 16 ft W= 195.6 SY.Turf Reinforcement Mat installed on the SE shoulder(downstream)was damaged during the flood and subsequent filling operations at the site. estimated to be 92 ft L x 20 ft W=204.4 SY.totaling 400 SY. Rip Rap was washed away at the northeast wingwall of the north abutment is estimated to be 35 ft L x 3 ft W towards the channel x 1.5 ft D=5.8 CY. Rip rap was washed away at the southwest wingwall of the south abutment and is estimated to be 35 ft in length x 3 ft W towards the channel x 3 ft D= 11.7 CY.totaling 17.5 CY. Barbed wire fence with treated wooden posts was damaged on both the east(100 ft)and west side(100 ft)of the bridge.total 200 ft in length. A small amount of debris material was observed at the bridge site and is estimated to be 10 CY. approximately one truck load of material. Recent bridge inspection report was provided by the applicant dated May 22. 2012.The bridge was built in 2009 and had a sufficiency rating of 90.7 in 2012. 2012 inspection notes of elements include bridge deck pavement crack sealing vertical hairline cracks on concrete curbs light water stains on https://connectl.dhs.gov/emmie/,Danalntb=isource.fema.net,SSL+dispatchDestination.do7... 5/6/2014 Federal Emergency Management Agency El-Grants Page 21 01 36 prestressed girders, small spall on column 2D pier.One inch wide cracks in asphalt at approach ends. The deck condition is noted as good condition(7)on a scale of 0 to 9. The superstructure and substructure were noted as very good condition(8).The channel banks were observed to be protected or well vegetated(8). Maintenance items included bridge deck repair sealing cracks in asphalt surface. The Applicant has provided pictures of the road and bridge facilities documenting damages. These photos are attached to this project worksheet. SCOPE OF WORK. PA-08-CO-4145-P W-00661(0) WORK COMPLETED Location 1 1 —Fill void in roadway travel lanes.embankment and north approach—529.2 CY x 1.82(Conversion Factor CY ABC Class 6 Material to Tons= 963.1tons x$33.70/ton(CDOT Item Number 304-06000 Aggregate Base Course Class 6 x 2 due to economies of scale as compared with number of CDOT annual projects)_$32.456.47 2—Install asphalt on north roadway approach and southeast shoulder behind guardrail= 131.6 tons x$81.70/ton(CDOT Item Number 403-33741 Hot Bituminous Pavement(Grading S)(75)(PG 64-22)=$10,751.72 3—Ditch re-shaping on the NE.NW and SE shoulders=1,035 LF x$3.40/LF(FEMA Cost Code 3070 Ditch Cleaning and shaping)=$3,519.00 4-Install Turf Reinforcement Mat on NE and SE shoulders=400 SY X 10.00/SY(CDOT Item Number 216-00301)=$4.000.00 5—Install Rip Rap north and south abutments, 17.5 CY x$83.17/CY(Rip Rap 18 inch CDOT Item Number 506-00218)=$1,455 48 6—Install 200 LF of barbed wire fence with treated wooden posts x 5.50/LF(CDOT Item Number 607-01055)=$1.100.00 7—Remove debris at site 10.0 CY x$5.00/CY estimate=$50.00 Total=$53.332.67 cost estimate prepared by project specialist using 2013 CDOT Average Unit Prices Site 2 of 7 DAMAGED FACILITY. COUNTY. Weld BR 23-8A over Big Dry Creek LOCATION. LATITUDE. LONGITUDE. 40.04414 -104.84853 PA-08-CO-4145-P W-00661(0). Location 2 —Bridge 23-8A over Big Dry Creek Lat:N40.04414 Long. -W104.84853 DAMAGE DESCRIPTION AND DIMENSIONS. PA-08-CO-4145-PW-00661(0). Location 2—Bridge 23-8A over Big Dry Creek Lat N40.04414 Long: -W104.84853 Flooding of the Big Dry Creek resulted in damages on CR 23 include washout of rip rap material on the channel side of the wingwalls and abutments at Bridge WEL023.0-008.0A. Rip Rap was washed away at the abutments is estimated to be 32+20 ft=52 ft L x 5 ft W towards the channel x 3 ft D x 2 abutments=57.8 CY The 39.25 ft long x 32.0 ft wide steel structure traverses the Big Dry Creek in Weld County. CO. The bridge is a single(1)span bridge consisting of a 10 inch asphalt overlay on corrugated steel deck,Seven(7)—W27x94 steel girders,seven(7)HP[H-Piles] 10x57 steel piles with HP 10x57 steel cap with 3 inch x 18 inch vertical steel sheet pile backwall at the abutments and(1)HP 10x57 Pile w/3 inch x 18 inch vertical steel sheet piling wing walls.The deck is flanked on both sides with a galvanized W rail beam bolted to steel posts. Recent bridge inspection report was provided by the applicant dated May 21 2012 The bridge was built in 1982 and had a sufficiency rating of 79.9 in 2012. 2012 inspection notes of elements include,bridge deck and approach railing inadequate pavement crack sealing, install signage. debris in channel. The deck condition is noted as fair(5)on a scale of 0 to 9. The superstructure is noted as satisfactory(6)and substructure is noted as fair(5). The channel banks were observed to be slumping(6). Maintenance items included sealing cracks in deck overlay railing replacement. install object markers at all corners and remove debris from channel. SCOPE OF WORK. PA-08-CO-4145-P W-00661(0). WORK TO BE COMPLETED Location 2 https://connectl .dhs.gov/emmieLDanalnfo=isource.fema.net,SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency F-Grants Page 22 of 36 1 -Replace Rip Rap 57.8 CY x$83.17/CY(Rip Rap 18 inch CDOT Item Number 506-00218)=$4,807 23 Site 3 of 7 DAMAGED FACILITY. COUNTY. Weld BR 8-21A over Big Dry Creek LOCATION. LATITUDE. LONGITUDE. 40.04356 -104.84942 P A-08-CO-4145-PW-00661(0)'. Location 3—Bridge 8-21A over Big Dry Creek Lat: N40.04356 Long. -W104.84942 DAMAGE DESCRIPTION AND DIMENSIONS. P A-08-CO-4145-P W-00661(0). Flooding of the Big Dry Creek resulted in damages on CR 8 include washout of rip rap material on the channel side of the wingwalls and abutments at Bridge WEL008.0-021.0A. Rip Rap was washed away at the abutments is estimated to be 32.5+16 ft=48.5 ft L x 5 ft W towards the channel x 3 ft D x 2 abutments=53.9 CY The 39.0 ft long x 32.5 ft wide steel structure traverses the Big Dry Creek in Weld County, CO. The bridge is a single(1)span bridge consisting of a 1 inch gravel over 4 inch asphalt overlay on corrugated steel deck.Ten(10)—W24x76 steel girders. HP 10x57 steel piles with HP 10x57 steel cap with 3 inch a 18 inch vertical steel sheet pile backwall at the abutments and(1)HP 10x57 Pile w/3 inch x 18 inch vertical steel sheet piling wing walls.The deck is flanked on both sides with a galvanized W rail beam bolted to steel posts. Recent bridge inspection report was provided by the applicant dated May 21.2012.The bridge was built in 1983 and had a sufficiency rating of 97 in 2012. 2012 inspection notes of elements include, bridge deck and approach railing inadequate lapped bridge rail connection,damaged concrete in abutment,dirt and gravel berms along both sides of deck,light rust on girders.The deck condition is noted as satisfactory(6)on a scale of 0 to 9. The superstructure and substructure were noted as satisfactory(6).The channel banks were observed to be in need of minor repairs(7). Maintenance items included railing replacement. install 4 bolts in lapped w beam rail connection,consider encasing abutments in concrete,install object markers at all corners and remove gravel berms from deck. SCOPE OF WORK. PA-08-CO-4145-PW-00661(0)'. Location 3 1 -Replace Rip Rap 53.9 CY x$83.17/CY(Rip Rap 18 inch CDOT Item Number 506-00218)=$4,482.86 Site 4 of 7 DAMAGED FACILITY. COUNTY. Weld BR 23-6C over Big Dry Creek LOCATION. LATITUDE. LONGITUDE. 40.04103 -104.8485 PA-08-CO-4145-P W-00661(0) Location 4—Bridge 23-6C over Big Dry Creek Lat. N40.04103 Long. -W104.84859 DAMAGE DESCRIPTION AND DIMENSIONS. PA-08-CO-4145-PW-00661(0). Flooding of the Big Dry Creek resulted in damages on CR 23include washout of rip rap material on the channel side of the wingwalls at Bndge WEL023.0-6C. Rip Rap was washed away in front of the wingwalls is estimated to be 40 ft L x 6 ft W towards the channel x 3 ft D x 2 abutments=53.3 CY use https://connectI.dhs.gov/emmie/.Danalnfo=isource.fema.net.SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency E-Grants Page 23 of 36 SSCY The 39.25 ft long x 32.0 ft wide steel structure traverses the Big Dry Creek in Weld County. CO. The bridge is a single(1)span bridge consisting of an 8 inch asphalt overlay on corrugated steel deck.Seven(7)—W27x102 steel girders,six(6)with 10 inch x 10.25 inch H piles abutments with horizontal 10 inch steel h cap with vertical 3.25 ft x 18 inch steel sheet pile backwall and 1 ft—10 inch steel H pile and horiztonal whaler with vertical steel sheet pile wing walls.The deck is flanked on both sides with a galvanized W rail beam bolted to steel posts. Recent bridge inspection report was provided by the applicant dated May 21 2012. The bridge was built in 1995 and had a sufficiency rating of 91.2. Structurally Deficient,in 2012. 2012 inspection notes of elements include bridge deck and approach railing inadequate,pavement crack sealing,light rust on bottom of girders, w-beam steel posts and steel sheet pile abutments. The deck condition is noted as poor(4)on a scale of 0 to 9. The superstructure is noted as satisfactory(6)and substructure is noted as good(7).The channel banks were observed to be in need of minor repairs(7). Maintenance items included sealing crack in deck overlay and railing replacement. SCOPE OF WORK. PA-08-CO-4145-PW-00661(0) WORK TO BE COMPLETED. Location 4 1 -Replace Rip Rap 55CY x$83.17/CY(Rip Rap 18 inch CDOT Item Number 506-00218)=$4.574.35 Site 5 of 7 DAMAGED FACILITY. COUNTY. Weld BR 21-6A over Big Dry Creek LOCATION. LATITUDE. LONGITUDE. 40.0372 -104.86711 PA-08-CO-4145-P W-00661(0). Location 5—Bridge 21-6A over Big Dry Creek Lat: N40.03720 Long: -W104.86711 DAMAGE DESCRIPTION AND DIMENSIONS. PA-08-CO-4145-PW-00661(0)'. Flooding of the Big Dry Creek resulted in damages on CR 21 include washout of rip rap material on the channel side of the abutments and wingwalls at Bridge WEL021.0-006.0A. Loss of embankment material on the North east shoulder exposed 20 LF of 24 inch CMP estimated to be 20 ft L x 10 ft W x 4 ft D.29.6 CY. Rip Rap was washed away in front of the abutments and wingwalls is estimated to be 32 ft+20 ft=52 ft Lx 5 ft W towards the channel x 3 ft D x 2 abutments=57.8 CY The 49.7 ft long x 32.1 ft wide concret/steel structure traverses the Big Dry Creek in Weld County.CO. The bridge is a single(1)span bridge consisting of a 4 inch asphalt overlay on top of cast in place concrete topping slab on 2 inch tope flange of double tee girders.four(4)30 inch deep double tee girders. six(6)ten inch H piles with concrete walls between with precast concrete cap abutment and concrete wingwalls.The deck is flanked on both sides with a galvanized W rail beam bolted to steel posts. Recent bridge inspection report was provided by the applicant dated May 21. 2012.The bridge was built in 1970 and had a sufficiency rating of 97.0 in 2012. 2012 inspection notes of elements include:bridge deck and approach railing inadequate,pavement crack sealing. light rust on bottom of girders. The deck condition is noted as satisfactory(6)on a scale of 0 to 9. The superstructure and the substructure are noted as satisfactory(6).The channel banks were observed to be protected or well vegetated. Maintenance items included sealing crack in deck overlay railing replacement. fill holes in shoulders at southwest and northwest corners of deck, install object markers at all corners. SCOPE OF WORK. PA-08-CO-4145-P W-00661(0). WORK TO BE COMPLETED Location 5 1 —Fill embankment material lost on northeast shoulder—29.6 CY x 1.82(Conversion Factor CY ABC Class 6 Material to Tons=53.9 tons x $33 70/ton(CDOT Item Number 304-06000 Aggregate Base Course Class 6 x 2 due to economies of scale as compared with number of CDOT https://connectl.dhs.gov/emmie/,Danalnfo=isource.fema.net.SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency F-Grants Page 24 of 36 annual projects)=$1-816.43 2—Replace Rip Rap 57.8/CY x$83.17/CY(Rip Rap 18 inch CDOT Item Number 506-00218)=$4,807.23 WORK TO BE COMPLETED TOTAL=$6 623.66 Site 6 of 7 DAMAGED FACILITY. COUNTY. Weld BR 4-15A over Big Dry Creek LOCATION. LATITUDE. LONGITUDE. 40.01472 -104.91122 PA-08-CO-4145-PW-00661(0). Location 6—Bridge 4-15A over Big Dry Creek Let N40.01472 Long. -W104.91122 DAMAGE DESCRIPTION AND DIMENSIONS. PA-08-CO-4145-PW-0066110)'. Flooding of the Big Dry Creek resulted in damages on CR 4 include washout of surface gravel on bridge deck at Bridge WEL004.0-015.0A. 1. Loss of surface gravel is estimated to be 30 ft L x 32 ft W x 0.33 ft D=11.7 CY. 2.Rip rap and soil/seed cover washed away at each wingwalls/embankment estimated to be[10LF x 5FT wide x 3FT deep/27]x 4=22.2CY use 23CY[rip rap]. Soil washed away estimated to be[10FT x 5FT wide x 4/12FT deep/27]x 4=2.47CY use 3CY The 33.75 ft long x 32.0 ft wide steel structure traverses the Big Dry Creek in Weld County.CO. The bridge is a single(1)span bridge consisting of a 1 inch gravel on 4 inch asphalt overlay on corrugated steel deck.twelve(12)—W21 x62 steel girders, 10 inch x 8 inch H-cap on six(6) 10 inch piles with sheet pile backwall abutments and 10 inch H pile with water and sheet pile backwall wing walls.The deck is flanked on both sides with a galvanized W rail beam bolted to steel posts. Recent bridge inspection report was provided by the applicant dated May 21.2012. The bridge was built in 2003 and had a sufficiency rating of 97 in 2012. 2012 inspection notes of elements include bridge deck and approach railing inadequate,pavement crack sealing,light rust on bottom of girders. heavy rust at water level of steel sheet pile abutments.The deck condition is noted as satisfactory(6)on a scale of 0 to 9. The superstructure is noted as good(7)and substructure is noted satisfactory(7). The channel banks were observed to be slumping(6). Maintenance items included railing replacement. remove gravel berms along both sides of the deck,and line southeast bank with wire enclosed rock for 100 ft upstream of bridge. SCOPE OF WORK. PA-08-CO-4145-PW-00661(0). WORK TO BE COMPLETED. Location 6 1—Replace surface gravel lost on deck—11.7 CY x 1.82(Conversion Factor CY ABC Class 6 Material to Tons=21.3 tons x$33 70/ton(CDOT Item Number 304-06000 Aggregate Base Course Class 6 x 2 due to economies of scale as compared with number of CDOT annual projects)= $717.81 2a. Install rip rap at wingwalls. 23CY x$83.17/CY[Rip rap 18 inch CDOT Item Number 506-00218]=$1 912.91 2b.Install topsoil over rip rap. 3CY x$10.11/CY=$30.33 CDOT 207-00205 2c Install seeding. [10LF x SET]x 4=2005F/43560=0.009AC use 0.005AC x$545.81/AC=$2.73 CDOT 212-00006[use$10.00] 2d. Install soil retention blanket. 200SF/9=22.2SY x$2.15/SY=$47.73 CDOT 216-00042 WORK TO BE COMPLETED TOTAL=$2 718.78 Site 7 of 7 DAMAGED FACILITY. COUNTY Weld https://connectl.dhs.gov/emmie/,Dana[nfo=isource.fema.net,SSl,+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency F-Grants Page 25 of 36 BR 15-2A over Big Dry Creek LOCATION LATITUDE. LONGITUDE. 40.00872 -104.9239 PA-08-CO-4145-P W-00661(0) Location 7—Bridge 15-2A over Big Dry Creek Lat N40.00872 Long. -W104.92390 DAMAGE DESCRIPTION AND DIMENSIONS. PA-08-CO-4145-P W-00661(0). Flooding of the Big Dry Creek resulted in damages on CR 15 include vegetative debris accumulating at Bridge WEL015.0-002.0A. 1.Vegetative debris is estimated to be 32+ 10+ 10=52 ft L x 35 ft W x 4 ft D=269.6 CY. 2. Rip rap washed away at the following wingwalls[Total 45CY]. 2a Northwest. 20LF x 10FT x 3FT deep/27=22.2CY use 23CY 2b. Northeast.20LF x 5FT x 3FT deep/27= 11.1 CV use 11CY 2c.Southeast:20LF x 5FT x 3FT deep/27= 11.1 CY use 11CY 3. Soil/seed cover on Item 2[rip rap]washed away[20LF x 10FT]+[20LF x 5FT[+[20LF x 5FT]=400SF x 4/12FT deep/27=4.9CY use 5CY The 36.53 ft long x 32.0 ft wide steel structure traverses the Big Dry Creek in Weld County. CO. The bridge is a single(1)span bridge consisting of a 3 inch gravel on 4 inch asphalt overlay on corrugated steel deck, Eight(8)—W27x102 steel girders. 12 inch H piles on six(6)with 12 inch H piles with sheet pile backwall abutments and 2tow(2) 12 inch H pile with waler and sheet pile backwall wing walls.The deck is flanked on both sides with a galvanized W rail beam bolted to steel posts. Recent bridge inspection report was provided by the applicant dated May 21. 2012. The bridge was built in 2003 and had a sufficiency rating of 97 in 2012. 2012 inspection notes of elements include bridge deck and approach railing inadequate,pavement crack sealing,light rust on bottom of girders, w-beam steel posts.and steel sheet pile abutments.The deck condition is noted as good(7)on a scale of 0 to 9. The superstructure and substructure are noted as good(7).The channel banks were observed to be in need of minor repairs(7). Maintenance items included sealing crack in deck overlay railing replacement,install object markers on all corners,place wire enclosed gabions along southwest bank to repair slumping and erosion. Photos of the bridge facilities are included in the bridge inspection report attached to this project worksheet. SCOPE OF WORK. PA-08-CO-4145-P W-00661(0) Location 7 WORK COMPLETED 1—Debris removal at site—269.6 CV x$5.00/CY estimated cost=$1.348.00.The applicant indicated that the debris would be disposed of at its landfill in Kennesburg.Colorado.Tree limbs,etc.would be disposed of at A-1 Organics Rattler Ridge, 12002 CR 59. Kennesburg. CO. Solid Waste would be disposed of at Waste Management-Buffalo Ridge Landfill. 11655 CR 59. Keenesburg,CO. WORK COMPLETED TOTAL=$1,348.00 WORK TO BE COMPLETED: 2.Install rip rap at NW.NE.and SE wingwalls.45CV x$83.17/CY[Rip rap 18 inch CDOT Item Number 506-00218]=$3.742.65 3a.Install topsoil over rip rap. 5CY x$10.11/CY=$50.55 CDOT 207-00205 3b Install seeding. 400SF/43560=0.009AC use 0.01AC x$545.81/AC=$5.45 CDOT 212-00006[use$10.00] 3c. Install soil retention blanket. 400SF/9=44.4SV x$2.15/SY=$95.46 CDOT 216-00042 WORK TO BE COMPLETED TOTAL=$3.898.66 PROJECT NOTES. 1. During repair or reconstruction, applicant may incur additional costs related to clearing and grubbing.dewatenng,placement of topsoil. https://connectl.dlis.gov/emm ie/DanaInfo=isource.fema.net.SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency E-Grants Page 26 of 36 erosion and sedimentation control sanitary facilities mobilization and flagging/traffic control. Such costs are generally addressed in the"in-place" unit costs of repair or reconstruction items,and not specifically addressed in the Scope of Work. However. if a project requires an extraordinary use of any such items to where a specific reference in the PW should be considered.applicant is advised to contract Colorado Department of Emergency Management requesting a revision to the PWs Scope of Work. 2. Applicant has completed a substantial percentage of the work but will not have cost data available within the fourteen day Pocket Guide rule. Per Field Operations Pocket Guide, Section 7. Cost Estimates. Page 26. If the applicant has not produced cost data within two weeks of the site inspection,the Project Specialist will prepare the PW on the basis of an estimate for the work accomplished".Applicant and FEMA personnel jointly conducted all inspections and agreed to use CDOT costs for in-place costs to derive estimates on this project worksheet.Applicant understands that all actual support documentation. invoices. FA records contract and proof of payment will be required for final reconciliation and or closeout process.Attached is the CDOT average in-place cost for materials. 3. The Applicant will notify FEMA and the State of their intent to perform permanent work related to this site before any work commences in the field. Failure to do so may jeopardize the sub-grant for permanent work related to the work in this sub-grant. 4. Pursuant to 44 CFR 13.42.Grantees and Subgrantees are required to retain records including source documentation.to support expenditures/costs incurred against the grant award.for 3 years from the date of submission to FEMA of the final Financial Status Report 5. The applicant must obtain all required federal state. and local permits prior to the commencement of work. 6. The subgrantee is requesting direct administrative costs that are directly chargeable to this specific project. Associated eligible work is related to administration of the PA project only and in accordance with 44 CFR 13.22. These costs are treated consistently and uniformly as direct costs in all federal awards and other subgrantee activities and are not included in any approved indirect costs. 7. Payment for small projects is made at the time of project approval based on validated documentation included in the PW,including documents site visit observations and/or photos. At the time that this PW was written no documentation was available regarding DAC. Since DAC can only be validated through documentation provided by the applicant,no allowance was included. 8. Project was reviewed for 406 Hazard Mitigation and a proposal is attached to this project worksheet.Applicant may offer other opportunities for 406 HM following a review by their engineering consultants. 9. The applicant is aware that all projects are subject to an insurance review as stated in 44 C.F.R. Sections 206.252 and 206.253.If applicable. an insurance determination will be made either as anticipated proceeds or actual proceeds in accordance with the applicant's insurance policy that may affect the total amount of the project. 10. The applicant is required to adhere to State and Federal Government Procurement rules and regulations and maintain adequate records to support the basis for all purchasing of goods and materials and contracting services for projects approved under the Public Assistance program, as stated in 44 CFR 13.36.The applicant has advised they have followed their normal procurement procedures. 11.At the Applicant's request,WELC016 and WELCO20 have been combined into this PW with Reference No. WELCOI6, Locations 2-7 were formerly Sites 1-6 in WELCO20. WELCO20 was rewritten for$0. Does the Scope of Work change the pre-disaster conditions at the site? Yes No Special Considerations included? Yes No Hazard Mitigation proposal included? Yes No Is there insurance coverage on this facility? Yes No PROJECT COST ITEM CODE NARRATIVE QUANTITY/UNIT UNIT PRICE COST ***Version 0 *** Work Completed 1 9999 Site 1 Location 1 - BR 13-54A over 1/LS $53,332.67 $ 53,332.67 Big Thompson River 2 9999 Site 7 Location 7- BR 15-2A over 1/LS $ 1,348.00 $ 1,348.00 Big Dry Creek Work To Be Completed 3 9999 Site 2 Location 2 - BR 23-82 over 1/LS $4,807.23 $4,807.23 Big Dry Creek 4 9999 Site 3 Location 3- BR 8-21A over 1/LS $4,482.86 $4.482.86 Big Dry Creek 5 9999 Site 4 Location 4- BR 23-6C over 1/LS $4,574.35 $4,574.35 Big Dry Creek 6 9999 Site 5 Location 5- BR 21-6A over 1/LS $ 6,623.66 $ 6,623.66 Big Dry Creek https://connectI.dhs.gov/emmie/.Danalnfo=isource.Yema.net.SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency E-Grants Page 27 of 36 7 9999 Site 6 Location 6- BR 4-15A over 1/LS $2,718.78 $2,718.78 Big Dry Creek 8 9999 Site 7 Location 7- BR 15-2A over 1/LS $ 3,898.66 $ 3,898.66 Big Dry Creek Direct Subgrantee Admin Cost 9 9901 Direct Administrative Costs 1/LS (Subgrantee) $ 1,000.00 $ 1,000.00 TOTAL COST $ 82,786.21 PREPARED BY KATHLEEN RUVARAC TITLE TAC BRIDGE SPECIALIST SIGNATURE APPLICANT REP. Roy Rudisill TITLE Director-OEM SIGNATURE WELD(COUNTY) : PA-08-CO-4145-PW-00661 Conditions Information Review Name Condition Type Condition Name Description Monitored Status This review does not address all federal, state and local requirements. Acceptance of federal funding requires recipient to Final Review Other(EHP) Standard comply with all federal, state and No Approved Condition#2 local laws. Failure to obtain all appropriate federal, state and local environmental permits and clearances may jeopardize federal funding. Any change to the approved scope Final Review Other(EHP) Standard of work will require re-evaluation for No Approved Condition#1 compliance with NEPA and other Laws and Executive Orders. Applicant is responsible for Executive Order coordinating with the local Final Review Other(EHP) 11988- floodplain manager. All required No Approved Floodplains permits should be maintained as part of the permanent record. Debris must be appropriately separated and disposed of in an approved disposal site or landfill. Asphalt must be recycled as a blended base material or appropriately separated and disposed of in an approved State Hazardous disposal site or landfill in Materials and accordance with the CDPHE Final Review Other(EHP) Solid Waste authorized waste management No Approved Laws regulations. For any"Asbestos Containing Material", lead-based paint and/or other hazardous materials found during remediation or repair activities. the Applicant must comply with all Federal, State, and local abatement and disposal requirements. Applicants are responsible for ensuring contracted removal of hazardous debris also https://connectI .dhs.gov/emmie/.Danalnfo=isource.fema.net,SSI,+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency E-Grants Page 28 of 36 follows these guidelines. If ground disturbing activities occur during construction, applicant will monitor ground disturbance and if Final Review Other (EHP) Standard any potential archeological No Approved Condition#3 resources are discovered, will immediately cease construction in that area and notify the State and FEMA. Emergency Consultation - Recommended Conservation Measures PRE-CONSTRUCTION DESIGN: 1. Design the project to avoid and minimize the permanent and temporary impacts to riparian and adjacent upland habitats. a. Before construction, identify and prioritize riparian and adjacent upland habitats within the project area. Design the project so that it avoids these habitats whenever possible. b. Minimize the amount of concrete, riprap, bridge footings, and other"hard," impermeable engineering features within the stream channel and riparian or adjacent upland habitats. c. Use bioengineering techniques to stabilize stream banks. d. Minimize the number and footprint of access routes, staging areas, and work areas. e. Locate access routes, staging areas, and work areas within previously disturbed or Endangered modified non-habitat areas. f. Final Review Other(EHP) Species Act Maintain habitat connectivity under No Approved (ESA) bridges or through culverts by installing ledges or dry culverts adjacent to the culverts with water flow. g.Avoid fragmenting linear riparian corridors. 2. Install limits of work fencing (e.g., orange barrier netting or silt fencing), signage, or other visible markers to delineate access routes and the project area from habitats. Use this fencing to enforce no-entry zones. 3. Hold a preconstruction briefing for onsite personnel to explain the limits of work and other conservation measures. 4. Follow regional stormwater guidelines and design best management practices (BMPs) to control contamination, erosion, and sedimentation, such as silt fences, silt basins, gravel bags, and other controls needed to stabilize soils in denuded or graded areas, during and after construction. 5. Locate utilities along existing road corridors, and if possible,within the roadway or road shoulder. a. Bury https://conneetl.dhs.gov/emm ie/DanaInfo=isourcetema.net.SSI+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency F-Grants Page 29 of 36 overhead utilities whenever possible. b. Directionally bore utilities and pipes underneath habitats. 6. Develop and implement a habitat restoration plan that addresses site preparation, planting techniques, control of non-native weeds, native seed mixtures, and post-construction monitoring. PROJECT IMPLEMENTATION: 7. Contact the Service immediately by telephone at (303) 236-4773 if a Preble's is found alive, dead. injured, or hibernating within the project area. Please also contact the Service if any other listed species are found within the project area. 8. To the maximum extent practicable, limit disturbing (e.g., crushing. trampling) or removing (e.g.. cutting, clearing) all vegetation, such as willows, trees, shrubs, and grasses within riparian and adjacent upland habitats. a. Restrict the temporary or permanent removal of vegetation to the footprint of the project area. b. Minimize the use of heavy machinery and use smaller equipment when possible. c. Soil compaction: Temporarily line access routes with geotextiles or other materials, especially in wet, unstable soils to protect roots and the seed bank. 9. Use the attached table to track the acres or square feet of riparian and upland habitats temporarily or permanently affected by the response activities. a. Temporary Impacts: Native vegetation and habitats will reestablish following rehabilitation (e.g., access route that is rehabilitated with native, weed-free seeds and plants). b. Permanent Impacts: Riparian or upland habitats will not return as a result of project activities (e.g.. road surface. concrete footings) The applicant should implement appropriate FWS conservation measures identified in the Emergency Consultation between Endangered FEMA and USFWS, dated September 24, 2013, to the extent Final Review Other (EHP) Species Act possible; including a post- No Approved (ESA) construction estimate of the amount of habitat affected by the emergency response, an evaluation of how conservation recommendations were implemented, and the results of https://connect l .dhs.gov/emmie/.Danalnfb=isource.fema.net.SSL+dispatchDestination.do'?... 5/6/2014 Federal Emergency Management Agency E-Grants Page 30 of 36 implementation in minimizing adverse effects. The applicant is responsible for verifying and compliance with all permit requirements, including permit conditions, pre-construction notification requirements and regional conditions as provided by the US Army Corps of Engineers (USAGE). The applicant is Clean Water Act responsible for implementing, Final Review Other(EHP) (CWA) monitoring, and maintaining all Best No Approved Management Practices (BMP's) and Pre-Construction Notification (PCN) conditions of applicable Nation Wide Permits (NWP). This is to include any requirements per the Colorado Department of Public Health and Environment 401 Water Quality Certification for Clean Water Act permits. 10. Track the volumes of any water from onsite sources stored or used for dust abatement, soil compaction, concrete mixing, or other activities. 11. Locate. store, stage, operate, and refuel equipment outside of riparian or adjacent upland habitats. a. Operate equipment from previously disturbed or modified roadbeds or road shoulders above the riparian habitats. b. Limit the number of entrance and exit points leading into the project area. c. Stockpile topsoil and debris outside the riparian corridor and protect from stream flows or runoff. 12. During the Preble's active season (May 1 through November 1), work only Endangered during daylight hours to avoid Final Review Other(EHP) Species Act disrupting Preble's nocturnal No Approved (ESA) activities. 13. Promptly remove waste to minimize site disturbance and avoid attracting predators. 14. Cover exposed holes or piles of loose dirt with boards, tarps, or other materials to prevent entrapment. 15. Use best management practices (BMPs)to limit construction-related disturbance, such as soil compaction, erosion, and sedimentation, and to prevent the spread of invasive weeds; a. Soil compaction: Establish one access route for workers, vehicles, and machinery, preferably along a previously disturbed surface or route. b. Soil compaction: Temporarily line access routes with geotextiles or other materials, https://connect .dhs.gov/emmie/.Danalnfo=isource.fema.net.SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency [-Grants Page 31 of 36 especially in wet, unstable soils. c. Weed control: Wash and inspect vehicles and equipment before entering or leaving the project area so that they are free of noxious weed seeds and plant parts. d. Weed control: Use only weed free certified materials, including gravel, sand, top soil, seed, and mulch. 16. Complete construction before beginning restoration or enhancement activities. POST- CONSTRUCTION: 17. Upon project completion, revegetate all disturbed areas with native shrubs, trees, and grasses. a. Rip compacted access routes prior to replanting with native vegetation. b. Fill and reseed with weed free material and native seed mixtures. c. Consult the Service before finalizing a seed and plant list. 18. Bury riprap, then plant with native riparian vegetation. 19. Rehabilitate adjacent habitats impacted by floodwaters to restore connectivity and prevent future impacts from erosion or sedimentation. 20. Consider monitoring the revegetated areas for success. The Service can help establish success criteria during the consultation process. If ground disturbing activities occur during construction, applicant will monitor ground disturbance and if EHP Review Other(EHP) Standard any potential archeological No Recommended Condition#3 resources are discovered, will immediately cease construction in that area and notify the State and FEMA. This review does not address all federal, state and local requirements. Acceptance of federal funding requires recipient to EHP Review Other(EHP) Standard comply with all federal, state and No Recommended Condition #2 local laws. Failure to obtain all appropriate federal, state and local environmental permits and clearances may jeopardize federal funding. Any change to the approved scope EHP Review Other(EHP) Standard of work will require re-evaluation for No Recommended Condition #1 compliance with NEPA and other Laws and Executive Orders. Applicant is responsible for Executive Order coordinating with the local EHP Review Other(EHP) 11988- floodplain manager. All required No Recommended Floodplains permits should be maintained as part of the permanent record. https://connectI.dhs.gov/emmie/.Danajnfo=isource.fema.net.SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency 8-Grants Page 32 of 36 Debris must be appropriately separated and disposed of in an approved disposal site or landfill. Asphalt must be recycled as a blended base material or appropriately separated and disposed of in an approved disposal site or landfill in State Hazardous accordance with the CDPHE Materials and authorized waste management EHP Review Other(EHP) Solid Waste regulations. For any"Asbestos No Recommended Laws Containing Material", lead-based paint and/or other hazardous materials found during remediation or repair activities, the Applicant must comply with all Federal, State, and local abatement and disposal requirements. Applicants are responsible for ensuring contracted removal of hazardous debris also follows these guidelines. 10. Track the volumes of any water from onsite sources stored or used for dust abatement. soil compaction, concrete mixing, or other activities. 11. Locate, store, stage, operate, and refuel equipment outside of riparian or adjacent upland habitats. a. Operate equipment from previously disturbed or modified roadbeds or road shoulders above the riparian habitats. b. Limit the number of entrance and exit points leading into the project area. c. Stockpile topsoil and debris outside the riparian corridor and protect from stream flows or runoff. 12. During the Preble's active season (May 1 Endangered through November 1), work only during daylight hours to avoid EHP Review Other(EHP) Species Act disrupting Preble's nocturnal No Recommended (ESA) activities. 13. Promptly remove waste to minimize site disturbance and avoid attracting predators. 14. Cover exposed holes or piles of loose dirt with boards, tarps, or other materials to prevent entrapment. 15. Use best management practices (BMPs)to limit construction-related disturbance, such as soil compaction, erosion, and sedimentation, and to prevent the spread of invasive weeds; a. Soil compaction: Establish one access route for workers, vehicles. and machinery, preferably along a previously disturbed surface or route. b. Soil compaction: Temporarily line access routes with geotextiles or other materials, https://connectI.dhs.gov/emmie/.Dana[nfo=isource.fema.net.SSL-fdispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency F-Grants Page 33 of 36 especially in wet, unstable soils. c. Weed control: Wash and inspect vehicles and equipment before entering or leaving the project area so that they are free of noxious weed seeds and plant parts. d. Weed control: Use only weed free certified materials, including gravel, sand, top soil, seed, and mulch. 16. Complete construction before beginning restoration or enhancement activities. POST- CONSTRUCTION: 17. Upon project completion, revegetate all disturbed areas with native shrubs, trees, and grasses. a. Rip compacted access routes prior to replanting with native vegetation. b. Fill and reseed with weed free material and native seed mixtures. c. Consult the Service before finalizing a seed and plant list. 18. Bury riprap,then plant with native riparian vegetation. 19. Rehabilitate adjacent habitats impacted by floodwaters to restore connectivity and prevent future impacts from erosion or sedimentation. 20. Consider monitoring the revegetated areas for success. The Service can help establish success criteria during the consultation process. Emergency Consultation - Recommended Conservation Measures PRE-CONSTRUCTION DESIGN: 1. Design the project to avoid and minimize the permanent and temporary impacts to riparian and adjacent upland habitats. a. Before construction, identify and prioritize riparian and adjacent upland habitats within the project area. Design the project so that it avoids these habitats whenever possible. b. Minimize the amount of concrete, riprap, bridge footings, EHP Review and other"hard," impermeable engineering features within the stream channel and riparian or adjacent upland habitats. c. Use bioengineering techniques to stabilize stream banks. d. Minimize the number and footprint of access routes, staging areas, and work areas. e. Locate access routes. staging areas, and work areas within previously disturbed or modified non-habitat areas. f. Maintain habitat connectivity under bridges or through culverts by installing ledges or dry culverts https:/,/connectl.dhs.gov/emmie/,Danalnfo=isource.fema.net,SSL+dispatchDestination.do?... 5/6/2014 Federal Emergency Management Agency F:Grants Page 34 of 36 adjacent to the culverts with water flow. g. Avoid fragmenting linear riparian corridors. 2. Install limits of work fencing (e.g., orange barrier netting or silt fencing), signage, or other visible markers to delineate access routes and the project area from habitats. Use this fencing to enforce no-entry zones. 3. Hold a preconstruction briefing for onsite personnel to explain the limits of work and other conservation measures. 4. Follow regional stormwater guidelines and design best management practices (BMPs) to control contamination, erosion, and sedimentation, such as silt fences, silt basins, gravel bags, and other controls needed to stabilize soils in denuded or graded areas, during and after construction. 5. Locate utilities along existing road corridors, and if possible, within the roadway or road shoulder. a. Bury overhead utilities whenever possible. b. Directionally bore utilities and pipes underneath habitats. 6. Develop and implement a habitat restoration plan that addresses site preparation, planting Endangered techniques, control of non-native Other(EHP) Species Act weeds, native seed mixtures, and No Recommended (ESA) post-construction monitoring. PROJECT IMPLEMENTATION: 7. Contact the Service immediately by telephone at (303) 236-4773 if a Preble's is found alive, dead, injured, or hibernating within the project area. Please also contact the Service if any other listed species are found within the project area. 8. To the maximum extent practicable. limit disturbing (e.g., crushing, trampling) or removing (e.g., cutting, clearing) all vegetation, such as willows, trees, shrubs, and grasses within riparian and adjacent upland habitats. a. Restrict the temporary or permanent removal of vegetation to the footprint of the project area. b. Minimize the use of heavy machinery and use smaller equipment when possible. c. Soil compaction: Temporarily line access routes with geotextiles or other materials, especially in wet, unstable soils to protect roots and the seed bank. 9. Use the attached table to track the acres or square feet of riparian and upland habitats temporarily or permanently affected by the response activities. a. https://connectl.dhs.gov/emm ie/Danaln lb—isourcelema.net.SSL.+dispatch Destination.do?... 5/6/2014 Federal Emergency Management Agency E-Grants Page 35 or 36 Temporary Impacts: Native vegetation and habitats will reestablish following rehabilitation (e.g., access route that is rehabilitated with native, weed-free seeds and plants). b. Permanent Impacts: Riparian or upland habitats will not return as a result of project activities (e.g., road surface, concrete footings) The applicant is responsible for verifying and compliance with all permit requirements, including permit conditions, pre-construction notification requirements and regional conditions as provided by the US Army Corps of Engineers (USACE). The applicant is Clean Water Act responsible for implementing, EHP Review Other(EHP) Clean monitoring, and maintaining all Best No Recommended Management Practices (BMP's) and Pre-Construction Notification (PCN) conditions of applicable Nation Wide Permits (NWP). This is to include any requirements per the Colorado Department of Public Health and Environment 401 Water Quality Certification for Clean Water Act permits. The applicant should implement appropriate FWS conservation measures identified in the Emergency Consultation between FEMA and USFWS, dated September 24, 2013. to the extent Endangered possible; including a post- EHP Review Other(EHP) Species Act construction estimate of the amount No Recommended (ESA) of habitat affected by the emergency response, an evaluation of how conservation recommendations were implemented, and the results of implementation in minimizing adverse effects. Internal Comments No. Queue User Date/Time Reviewer Comments 5 Award SYSTEM 05-01-2014 ACCEPTED Review 09:57 PM GMT Final Reviewer finds eligible the application and approves the funding of this CAT-C project worksheet based on the applicant having performed all required procurement 4 Final PALACIO 04-18-2014 procedures, perform all required special considerations Review JOSE 11:48 PM GMT recommendations such as permits to address EHP considerations and securing all actual cost documentation for the financial reconciliation of this project. Task Force Leader- J. Palacio 04/18/2014 Category: C, 95% complete, Weld County, Weld County. Applicant used contract services and/or force account https://connect I.dhs.gov/emm ie/,Danaln fo=isource.tema.net,SSL+dispatch Destination.do?... 5/6/2014 Federal Emergency Management Agency E-Grants Page 36 of 36 resources to re-open and repair to pre-disaster condition a bridge(BR 13-54A)over the Big Thompson River.Applicant will:fill a void in roadway travel lanes,embankment,and north approach using aggregate Course class 6;install asphalt on roadway approach and shoulder;re-shape the ditch on shoulders;install turf reinforcement mat on shoulders;install rip rap on abutments;install barbed wire fence with treated wooden posts;and remove debris.Mitigation—none. - msmith73-03/03/2014 20:56:58 GMT Project activities have the potential to impact Waters of the United States or wetlands. Project involves dredge,fill, excavation and/or modification.-msmith73-03/03/2014 21:13:19 GMT Project site work is not in a mapped wetland.-msmith73- 03/03/2014 21:22:07 GMT The entire community will benefit from the completion of this project.-msmith73-03/03/2014 18:59:31 GMT EHP PATTERSON 03-04-2014 Action is addressed under the attached Emergency 3 Review MOLLY 11:18 PM GMT Consultation between FEMA and USFWS,dated September 24.2013.The consultation includes conservation measures intended to minimize impacts to the federally listed Preble's Meadow Jumping Mouse,Ute's Lady's Tress and Colorado Butterfly Bush,and Designated Critical Habitat protected under the ESA.-msmith73-03/03/2014 20:50:00 GMT Work involves removal,staging,transporting,and/or disposal of debris.(Includes culverts)-msmith73-03/03/2014 18:52:19 GMT Project is located in Zone B,FIRM panel 082660615C,dated 9/28/1982. Per 44 CFR Part 9.5(g)Step 1:Project repairs are determined to have no effect on floodplain or wetlands provided that the repairs remain in the existing footprint and do not impact previously undisturbed areas.No further floodplains review is required.-msmith73-03/03/2014 21:08:58 GMT The scope of work has been reviewed and meets the criteria of the 2013 signed Programmatic Agreement,Item I,Section A, Item III,Section A,E,F,G,H,I,and N,agreed to by FEMA and the SHPO.-msmith73-03/03/2014 18:42:42 GMT Mitigation 03-03-2014 This repair/restoration project has been reviewed for mitigation 2 Review DROST BRIAN 04:04 PM GMT opportunities and there is no opportunity because work has been completed-Brian W.Drost,406 Specialist Applicant's property insurance through the CAPP risk pool 1 Insurance GILLIAM 03-03-2014 affords no coverage for bridges,roadways or embankments. Review ROBERT 02:18 PM GMT Insurance proceeds are not anticipated,and there is no insurance purchase requirement. https://connectI.dhs.gov/emmie/.DanaIntu=isource.fema.net,SSL+djspatchDestinatjon.do?... 5/6/2014 Hello