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�.N Department of Ecology <br /> SOLID WASTE AND FINANCIAL FOR ECOLOGY USE ONLY <br /> ASSISTANCE PROGRAM Application No. <br /> WASHINGTON 9r1IT ECY 070-104 Site Mana <br /> OTTANINTNI Of <br /> ECOLOGY Facility Site ID <br /> Application for Remedial Action Grant <br /> °GENERAL INFORMATION t ' <br /> 1. APPLICANT <br /> Name City of Everett Address 3200 Cedar Street <br /> (Street or PO Box No.) <br /> Dept/Div Public Works Department Everett Washington 98201 <br /> (Town/City, State and ZIP+4) <br /> Tax ID Number 91-6001248 <br /> Applicant Type (Check appropriate box or boxes) <br /> ❑ State ✓ City ❑ Other(Specify) <br /> ❑ County ❑ Special Purpose District ❑ Health Department/District <br /> 2. PROJECT TITLE Everett Landfill &Tire Fire Site Remedial Construction; Site#2696 <br /> 3. COST OF PROJECT 4. PROJECT PERIOD <br /> Total $ 4,849,879.00 From July 1,2008 <br /> Eligible $ 3,775,332.00 To June 30, 2012 <br /> Total Grant or Loan Requested $3,775,332.00 <br /> 5. TYPE OF GRANT <br /> ❑ Independent. Remedial Action ❑ Derelict Vessel ❑ Safe Drinking Water Action ❑Site Hazard Assessment <br /> ❑ Meth Lab ✓ Oversight Remedial Action ❑ Areawide Groundwater Contamination <br /> ❑ Site Study and Remediation ❑ Standard Loan ❑ Extraordinary Financial Hardship Loan <br /> 5A. Oversight Remedial Action Grant. Will the remedial action grant activities include: <br /> ✓ New substantial economic development ❑ Habitat restoration ❑ Public recreation <br /> ❑ Acquisition of vacant, orphaned, or abandoned property ❑ Use of outside contracts to conduct necessary studies <br /> ❑ Purchase of remedial action cost-cap insurance note: redevelopment project includes all above. <br /> 6. INVESTMENT IN ENVIRONMENT(Which of the following environmental benefits will result from the project proposal?) <br /> ✓ Regulatory compliance with MTCA ❑ Restore or Protect Designated Beneficial Uses <br /> ❑ Eliminate a Public Health Emergency <br /> ✓ Other: site cleanup for re-development *Note: See Appendix 5 of RAG Guidelines for assistance. <br /> 7. PROJECT LOCATION <br /> Snohomish City of Everett <br /> County Municipality <br /> Street Address 2900 36`' Street, Everett WA 98201 LAT/LONG 47°7'00"; 122°11'30" <br /> Legislative District(s) 38th Legislative District <br /> 8. IS THIS PROJECT COVERED BY AN AGREEMENT? <br /> ✓ Consent Decree, Ecology/EPA ❑ Agreed Order, Ecology ❑ Administrative Order, EPA <br /> ✓ Prospective Purchaser Agreement ❑ Enforcement Order, Ecology/EPA Other <br /> Please Note: Provide the Official Document Number and include a signed copy of the document with your application. <br /> Official Document No. <br /> T/l <br /> ECY 070-104 <br />