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Federal Emergency Managemer( gency E-Grants <br />Page.5 of 16 <br />Please provide the Scope of Work for the <br />estimate: <br />(maximum 4000 characters) <br />Would you like to add the Hazard Mitigation No <br />Proposal as a cost line Item to the project cost? <br />GIS Coordinates <br />Project Location <br />Latitude <br />Longitude <br />South Harbor Blvd Site 1: Flood <br />33.741666 <br />-117.92222 <br />Channel <br />33.74038 <br />-117.92865 <br />Special Considerations <br />1. Does the damaged facility or item of work have insurance coverage and/or is it an Yes <br />insurable risk (e.g„ buildings, equipment, vehicles, etc)? <br />If you would like to make any comments, please enter them below. <br />(maximum 4000 characters) <br />see attached insurance policy <br />2. Is the damaged facility located within a floodplain or coastal high hazard area and/or does No <br />It have an Impact on a floodplain or wetland? <br />3. Is the damaged facility or Item of work located within or adjacent to a Coastal Barrier No <br />Resource System Unit or an Otherwise Protected Area? <br />4, Will the proposed facility repairs/reconstructlon change the pre -disaster conditions (e.g., No <br />footprint, material, location, capacity, use of function)? <br />5. Does the applicant have a hazard mitigation proposal or would the applicant like technical No <br />assistance for a hazard mitigation proposal? <br />6. Is the damaged facility on the National Register of Historic Places or the state historic No <br />listing? Is itolder than 50 years? Are there more, similar buildings near the site? <br />7. Are there any pristine or undisturbed areas on, or near, the project site? Are there large No <br />tracts of forestland? <br />8. Are there any hazardous materials at or adjacent to the damaged facility and/or item of No <br />work? <br />9. Are there any other environmental or controversial issues associated with the damaged No <br />facility and/or item of work? <br />Attachments <br />For Category C, D, E, F, and G Projects only <br />Is effective mitigation feasible on this project? No <br />If you answered Yes to the above question, the next question is required <br />Will mitigation be performed on any sites in this project? No <br />If you answered Yes to the above question., the next question is required <br />Do you wish to attach a Hazard Mitigation Proposal? No <br />If you answered Yes to the above question, the next two questions are required <br />Please provide the Scope of Work <br />for the estimate: <br />Would you like to add the Hazard Mitigation NO <br />Proposal as a cost line item to the project cost? <br />I <br />47 httos://isource.fema.eov/emmie/viewAnnlica avieatable&naeeName=&vo.i,,. 7/26/201 <br />j <br />