Time Extension Request Form and Process - Emergency Relief (ER) Time Extension Request Workshop - California ...

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Time Extension Request Form and Process - Emergency Relief (ER) Time Extension Request Workshop - California ...
Emergency Relief (ER)
      Time Extension Request
      Workshop

Time Extension Request Form and Process

                     Bob Baca, P.E.
             ER & Other Programs Manager
              Office of Federal Programs
              Division of Local Assistance
                       July 2021
Time Extension Request Form and Process - Emergency Relief (ER) Time Extension Request Workshop - California ...
Overview
   ►   ER Time Extensions – A Brief Overview

   ►   Timeline and Deadlines

   ►   2021 Time Extension Request Form

   ►   Resources

                     Outline
Time Extension Request Form and Process - Emergency Relief (ER) Time Extension Request Workshop - California ...
Photos: 2004 FFY CA Wildfires near Miramar (SD County) & Simi Fire (Ventura County)

                     ER Time Extensions – Before 2017
Time Extension Request Form and Process - Emergency Relief (ER) Time Extension Request Workshop - California ...
Photos: CA17-2 Jan-Feb 2017 Storms Disaster; Whitney Portal Road in Inyo County

                     ER Time Extensions – 2017 to 2019
Time Extension Request Form and Process - Emergency Relief (ER) Time Extension Request Workshop - California ...
Photos: CA18-3 Thomas Fire Debris Flow on North Jamison Lane in Coast Village

                     ER Time Extensions – Today (2020)
Time Extension Request Form and Process - Emergency Relief (ER) Time Extension Request Workshop - California ...
SU   M    TU   W    TH        SA

2021 ER Time Ext. Req. Timeline                   JULY    4    5    6    7    8    9    10
                                                          11   12   13   14   15   16   17
                                                          18   19   20   21   22   23   24
 July 2nd – Solicitation for Requests                    25   26   27   28   29   30   31
 July 8th & 12th – ER Time Ext. Req. Workshops   AUG.    1    2    3    4    5    6    7
                                                          8    9    10   11   12   13   14
 July 23rd – Recommended last day for RFAs               15   16   17   18   19   20   21
                                                          22   23   24   25   26   27   28
            (for best chance of E76 this FFY)
                                                          29   30   31
 Aug. 20th – Local Agency Req. Due (DLAE)
 Aug. 27th – DLAE Reviewed Req. Due (HQ)         SEPT.                  1    2    3    4
                                                          5    6    7    8    9    10   11
 Sept. 30th – E76 CON Deadline                           12   13   14   15   16   17   18
 Dec. – est. FHWA Response Letter                        19   20   21   22   23   24   25
                                                          26   27   28   29   30

                           Schedule and Deadlines
Time Extension Request Form and Process - Emergency Relief (ER) Time Extension Request Workshop - California ...
l:rlllWIT Ill T1I:

                                                                                                                                                          L\':lilBIT ll-Il

                                                                                                                                                                                                                 l :XHIBIT ll-Il

                                                                                                                                                                                                                                                               LUIIBIT 11-Il

                                                                                                                                                                                                                                                                                                            [XHIBIT 11-Il
                                                                                                                          milestones reached. All gaps in the timeline roost be

                                                                                                                          """"""
                                                                                                                                                                                  wer each question in this section.)
                                                                                                                                                                                                                                                                                                                                                        I:XHIBIT ll-Il
                                                                                                                                                                                  cy and prohibited advancement to E76 CON. ror EO
 ---:, - - - - - - - - - - - - - - - - - - - -                                                                                ENVIRONMENTAL MILESTONES
                                                                                                                                                                                  s (FFYs) after the FFY of the Disaster begin date

   1'!1                       ~ --------                                                                                                                  Est 1
                                                                                                                                                                                                                                           n the Time Exteosion Justification section

                                                                                                                         nicalRe ort 5
                                                                                                                           ntractor rocurementdate                                                                                                                                                                                             commen t s
                                                                                                                           iniU ated
                                                                                                                                                                                                                                            ching the allotted two-year deadline           1c,~"7,
                                                                                                                                                                                                                                                                                                "~120~,~,)~. ,~,eru
                                                                                                                                                                                                                                                                                                                ce ~at~~~prepared
                                                                                                                                                                                                                                           this application , specify the study / report    the requ ired infOfTTlation has n ot been
                                                                                                                                                                                                                                             delay justification (ex. extra study            is provided, it is not guarantee or
                                                                                                                                                                                                                                                                                             ittalto·

                                                                                                                                                                                   well as PR under EO procedures work and/of EO                                                                                                        ion3I page(s). as needed
                                                                                                                                                                                                                                           responsive
                                                                                                                                                                                  er begin date to submit to the District. cite how long
                                                                                                                                                                                   delay.
                                                                                                                                                                                                                                                                                                    Date: - - - - - -
                                                                                                                                                                                                                                           responsive
                                                                                                                                                                                                                                           this applic;;;rtion, specify the document
                                                                                                                          trasheet, if needed.
                                                                                                                                                                                                                                            r(s), Wh ich the reviewers should di rect
                                                                                                                                                                                                                                                                                                                                                       Corrment s
                                                                                                                         BiO Suive s Required 4
                                                                                                                          c om letiOn Date
                                                                                                                          CompletiOn Date
                                                                                                                          trasheelifneeded
                                                                                                                                                                                                                                           this applicalion , specify the document
                                                                                                                                                                                                                                           Geotechnlcal reconvnendatlon

                                                                                                                                                                                   nd a stucry took longer than anticipated, or reqllred
                                                                                                                                                                                                                                                                                            cal ER Projects) for ER pro1ect                            Comments
                                                                                                                         demnat1on 5 Dates                                                                                                                                                  mplete . Based o n th e in fo nnation

                                                     ,_.,
                                                                                                                                                                                  pro;ect triggered lhe nee
Time Extension Request Form and Process - Emergency Relief (ER) Time Extension Request Workshop - California ...
Page 1 Overview                                                 ~ I I E1R Pf"~l

                                       ~ :::::::::::                         I'>"    j., : : : : : : : : : : :

                    _......,, - - - - - - - - - - - - - - - - - - - - - - - - -
                           f!i!                              . ili!ili - - - - .... -~                --------

                                                                       ,_.,
                     ~•••~"i'e-.                    ..,__.~,          ;•c,...__1              1""""iJA9' •n:1....-"'ni~

                  iA·l !i#4h'iii· ,1{di/ii-\·i Ml• ii
                                  Est T01111 Amounl     Federal Amounl m       Ctnent AC         Federal Amounl    Federal Amounl
                      Phase       for PhnseofWorit           O\led   DAF     Amount Non..fe        Obh nled           lnv01ced
                   EO - PE
                   EO-RW
                   EO - CON
                   PR - PE
                   PR - RW
                   PR -CON

                                                                                                                                    Credit: AP Photo/David Swanson

              2021 Time Extension Request Form
Time Extension Request Form and Process - Emergency Relief (ER) Time Extension Request Workshop - California ...
Page 1

   L ocal Assistauc,e Program Gui.delliues                                                          EXHIBIT 11-TE
                                                                                                                    fflCI1IIl
                                 Request for Time Extensii on of E76 CONI Deadlin,e
    DLA.E Received o,at e ::
                                               (L1o call ER P'r,oj e1c ts)1

                                                                              rnsaster Event INo. :: CA.- - - -

      Fed Project Nio . :: EO                              OAF No{s).: _ _ _ _ _ __
                         PR - - - - - - - -

     Route/Roadway :
                        ----------------------------------
            PM (Beg):           PM (Endt:       Loca ll Agency:
                        -----             -----                 -----------

                                  2021 Time Extension Request Form
Time Extension Request Form and Process - Emergency Relief (ER) Time Extension Request Workshop - California ...
1- --1 -~·::::;;-...:.:~--
                                                                                                                                 ...,.
                                                                                                                                 . ._. . ======   --===== ======
Page 1

                                                                                                                                 IICI1II1
       INITIAL SCRIEEN ING

       lf 011e of the fon:owiing reasons co11bibute
.....
                                                                                                                                               1---1      -~~...:!~--
                                                                                                                                                . ._. . ====== --=====   ====

       Page 1

-+                                 ------                                                                                                      fflCI1IIl
        Selecii.the below reason (s , be,yo:nd 1Jl'1,e ,c ontrol of Die loca,I agency, EO CON a111d/or IPiR CON could not.be a1Jtllorized by tll,e .___ _ _ _ _ _....,
        ,deadlt11e and a time exiten                          :i                            r,eq1Jired as part ofsubm il:tal package] llf multiple reasons for
        ,detay, indicat,e the P , rima main/le.adi111 cause, of de)ar . alilld the S secondary ca1Js,es of delay. (Tillis wi1I he1lp expedite 1he rev1iew.)
         □ L_f Exti.e1r1sive nv1ronmen                 11a ua on ,or         e ay ''I e r esource ge11cy
                                                                              1   •

         □ L_f Cornpl,ex Right ofi Way Acquisition
         □ L_f Liligation
         □ L_f Erte1r1sive GeotecllnicaBSt1Jdy
 . _._..1
        r;:-;-;-:;:-" other (must. be beyond local age111,cy control;: also, show locaBagency was pmaciive in effm1s to advanoe project)
             NIA SUBMITTED complete R:equ;est for Aulhmizalio111 (RFA) CON to DLAE1 - Avraitirng E76. 2
                   11 Tille complete Request for Al!llUmritzation (RFA) package for CON              ust include all req1Jired documentation arnd be received by
                          DLAE on, or prio:r to, the Sept 30lli dead □ ne to qualify.
                   2 f no o1her jl!lstificatiorn boxes above are selected you may skip to Required Attachments seotion of llis form ,on page 3.

                   3 Indicate if justification is til e primary ca1.1se of dela11 [P] o:r secondary cause fm d~ay [S] example: 0 L.EJ Litigation)

                                                2021 Time Extension Request Form
.....
                                                                        . .- . . ======

   Page 1

.......   PERMIT PROB LEM   s   I

                                    2021 Time Extension Request Form
.....
                                                                                                                         1-- -1     -~~...:!~--
                                                                                                                          . ._. . ====== --=====   ====

   Page 1

.......   PROJECT FUN[)[NG INFORMATION

             Phase
                         Est. Total Amount
                         for Phase of Work
                                               Federal Amount in
                                                Approved DAF
                                                                     Current AC
                                                                   Amount ~on-Fed)
                                                                                     Fede.-al Amount
                                                                                        Obligated
                                                                                                       Fede.-al Amount
                                                                                                          Invoiced
                                                                                                                         fflCI1IIl
           EO - PE
           EO - RW
           EO - CON
           PR - PE
           PR - RW
           PR - CON
          EO~Emergency Opening; PR: 1Perma11ent Resto:raoon

                                          2021 Time Extension Request Form
Local Assisrauu- PJ'O&l'a m Guideliuu                                                                  LUIIBIT II-IT

Page 2 Overview   ld+Pi#5Ei3ii# i 1 i■ +.:11mii ■ iil iiiii
                  Enter bek7N the projected schedule leading lo EO andl'or PR CON including milestones reached   All   gaps in the timeline roost be
                  explained and justified, otherwise the project will rd qualify for a E76 CON true extension

                       EOsWorklnformation
                       EOPEWorkBeoins
                       EOPEWorkEnds
                       EO NEPA Document Approved
                       EO RW Work 81!flins
                       EORWWorkEnds
                       EORWCertified
                       EO CON Work B""ins

                       FirSt OAF Jnfomiation
                       1"' LocalAgencySigned&Dall?d
                          OAF Submittal to DLAE

                          roved OAF District Si nature
                       Approved OAF FHWA s - nature

                       E0 5 AuttlOfiZationlnformation
                       E76 EO PE Submitted to DLAE
                       E76EOPEAl)proved
                       E76 EO RW Submttll?d to DLAE
                       E76 EO RW Approvl?d
                       E76 EO CON Pkg. sent lo DLAE
                       E76 EO CON Annroved

                                                                                  Court Hearin
                                                                                  Court Notice to File
                                                                                  Resolution Dale

                                                                                  Foot not es:

                     I                                   I I
                       PR CON 5                                                   1 use E lor Estimated, A for Actual , or NIA.

                       E76 PR CON su~itted to DLAE                                2 t!grealerthan3monlhsexplaininttleNarrative
                       E76 PR CON Est                         E                   3 11notpartofPESOf'i!linalsubmittal
                                                                                  4 ti contribull?d to delay of PR CON authorization.
                                                                                  5 Only complete sub-section ii project inchJdes this type of
                                                                                     wo
Page 2                                                                                                                              ~~~
                                                                                                                                          ~

 PROJECT SCHEll)ULE ANO MILESTONES
                                                                                                                                          ~
En ter below the pm'j,ected schedule leading to EO and/or PR OO r including milestones reached_ All ,gaps in the timeline must be         ~:::F=J
explatrted and justified, otherwise Ute projecit will not qualify for a E76 CON time ext,e mion ..                                  ...   ~Fl
                                                                                                                                    ~ ~ 0 =3
                                                                                                                                    ~     E
                                                                                                                                          ::-~           ====i
 •111■MiJ&111,1.1-11
            i iELJIVERY MILESTOINF§i
                                           iinn,1-mw
                                      Es,. •
                                                                                                                                    ~     ::·::::.-~
                                                                                                                                          '"!._ _ , __ ._,.. .

  Disaster Damage Oiscov,ery                                      Geot,echn ical R!epmt 5
  Dama: •e Incident Date                                        Geote dh contractor ornourement date
  Damage Dis oovery Date                                        IJate Stl!.ldy initiated
                                                                Geote dhnical ReiD0rt date comDJetedl
  EO5 Work Information
  EO PE Work Beains                                              PES Information
  EO PE Work Ends                                                1si: PES PR Submitted to, Distriot 2
  EO NEPA Doc1.1men1 Approved                                    1si: PES Signed by D LAE
  EO RW Work Booins                                              1si: PES HQ DEA ENV CoO'rd_Conrnr
  EO RWWork Ends
  EO RW Certified                                                List additional ENV studies required 3
  EO COIN Work 13,eains

  First DAF lnforma~ion
  1si: Local Ag,ency Signed & Dated                             Attach exlira sheet, iii' needed .
      DAF Submittal to DLAE            A
 Approv,ed OAF Local Sign at1.Jre                                List any Bio Surveys Req1..1ired 4
 A!oorov,ed OAF District Signature
 A!pprov,ed OAF FHWA Signature        2021 Time Extension Request Form
                                                                Survey 2 Com pleHon Date
                                                                Attach ex1ra sheet, if needed..
__ .,_ __.,_,.,,,._
                                                                                                                                  """""""'

               DELIVERY MILESTONES                                        ENVIRONMENTAL MILESTONIES
Page 2                         Est 1       (MM/DDJYYYY)               Milestone or Activity   Est 1

 EO 5 ALl~hmi~~ion Information     I

 E76 IEO PE Subm itted to DLAE                            Rl/V Acquisition 5
 E76 IEO PE Approved
 E76 IEO RW SubmiHed to DLAE                                                                                                      ~               E
                                                                                                                                                  ::-~           ====i
 E76 IEO RW Approved                                                                                                              ~               ::·::::.-~
                                                                                                                                                  '"!._ _ , __ ._,.. .

 E76 IEO CON Pky. sent to [I LAE                          RW Condemnation 5 Dates
 E76 IEO CON Approved                                     Condemnation Proc,eedim11s BeCJin
                                                          Condemna~ion Proceedings En d
 PR PE 5                                                  Firnal dlate for corndemnatiolill
 PR PE Work Bea ins
 PR PE Work.Endls                                         Utility Relocation 5
 E76 IPR PE Submitted to DLAE                             1..i: utility Owner INloHfiedfCont.aot,ed
 E76 IPR PE Acmmv,ed                                      Date Ulfiri Relocated

 PRRW 5                                                   Litigation 5 Dates
 E76 IPR RW S1L.1bmitted to DLAE                          Cou rt Hearing
 E76 IPR RW A!tmrov,ed                                    Court Notfoe to Fille
 PR RW Work Ends                                          Resolufio11 Date
 PR RW Certified

 PR CON 5                                                 1 l!ls,e E for Estimated, A fm Acrual, m NIA.
 E76 IPR CON Submitlied to DLAE                           2 If gr,eater tlllan 3 mo1i11U11s explain ilill 1he Narramre.
 E76 IPR CON Est.                      E                  3 If not part of PES original s11.1 brniltal..

                                       2021 Time Extension Request
                                                           if
                                                                   Form
                                                          4 If corntr1
                                                                     ibufed to delay of PR CON auilho:rizatio:n.
                                                          5 Onliy complete sub-seo~ion            proJect includes this type of
                                                              work.
Page 3 Overview
                  Local Assisrauu- PJ'O&l'a m Guideliues                                                                     LUIIBIT II-IT

                    i f·"!'t-hii3!9'·'!t-h-ll
                    ~         tional pages to this submittal , as needed   to   adequately answer eactl question in this section.)

                    1    Explal n how each delay was beyond the control of the local agency and JYohibited advancement to E76 CON. for EO
                         and/or PR, beyond the deadline, l'mich is two Federal Fiscal Years (FFYs) aner the FFY ol lhe Disaster begin date.

                    2    II the first Preliminary Environmenta l Study (fE.s.) for PR work (as well as PR under EO procedures work and/or EO
                         work, ii applicable) took looger Ulan three months from the Disaster beg in date to submit to lhe District, cite hoW long
                         it tOOK to SWrri t the PES to the District. Explain the reason for the delay.

                    3.   If the delay was caused by fldensive fnVimrvnental Evaluation and a study took longer Ulan anticipated , or reqllired
                         additional work. identify the study and explain what aspect of the project triggered the need for the additional work.
                                  Provide the estimated or actual oo~etion date for the study
                                  Do this !or each study Iha! cmllibuted to the delay; add additional pages if necessary
                              •   As part of this submittal request. provide a ropy o f eactl completed study you mention

                                                                                                                                                     Credit: AP Photo/David Swanson

              2021 Time Extension Request Form
NIARRATIVE EXP LAINATION

    (!Add add itio 11a I pag es to this submittal, as needed , to ad:eq u ately answer ,e ach q u1est i:on in this sedio 11.}

l   1[   Explain hm¥ each de lay was _beyon~ th~ contro l of the l~ cal agencyand prohibited advan cement _to E76                   co.
                                                                                                                                      I~ , t:or EO
         and/or PR., h eyond the de adlm1 e, whi1ch 1s two Fe dernl F 1sca.l Years (FFYs) aft:eir t he FIFY of t ile D 1iSaste ir be gm d a.t e.

         If ~he fi rst Pr,elliminary Eff'ilviimrn menta l Study (PES) foir PR work (as v1ell as PR under EO pro oeduires work and/or IEO
         work, if appli cable ) to ok I on gier than tllriee months from t he Dis a.ste ir be gin d a.t e to submit ro thie Dishict, dte how lo 11g
         i t too k to submit t he PE S to the, Distri:ct Exp! a.iin the reaso n fo ir t he delay.

         lfr ~he defary w as caused by Extensive Environmental Evalluatio11., and a study 'took lo1n geir t hall'il a.ntidpat:ed, or requ i'red
         addilliona II work, ide,ntify the study and ,e xplai n what a.s peel of th,e project triggered lli e need for the additi ona I wo rk.

     ---
             •    Pmvide th,e esti mat ed o ir act11Jal compl,etiion date for t he studry .
             ,.   Do this for e acll study that contributed to lli e delay; add ad ditio n al pages if ll'il ecessary.
             ,.   As part of this submittal riequ est, provi'de a copy of eadh completed study yo u mention.

                                            Time Extension Request Form
Page 4 Overview
                  Local Assisrauu- PJ'O&l'a m Guideliues                                                                     LUIIBIT II-IT

                  pg. :;..;a ,..,..,. i i# ,ti
                  Attach the required documents indicated below, eoinciding with the selection(s) in the n me Extension Justification section
                  on page 1.

                  Extensive Envi ronmenta l Eva.lua1ion
                       □     Provide a ~ or each ENV st~ and/or report Illa! delayed project reaching the allotted two-year deadline
                       □     Qfl the ~    hmenl: Reference P11~ • which you Ml find on the last page of this application, specify the study / report
                             name(s) and reference the page and paragraph number(s) supporting the delay justification (ex. extra study
                             requirement spedfled), v.tlich the reViewers should direct llleir attention
                       □     copy of latest approved DAF subrr"ittal package.

                  Comp l ex Right of Way Ac qu is it i o n
                    D COpy of Notice lo contact property owner.
                    □ copy of property owner response or indicate if property owner was non-responsive
                    □ copy of attefll)ts to follow-up on notice 'Mill property owner
                    □ copy or p            owner response or indicate if property owner was non-responsive.
                    □ Ofl the "Anachment: Reference Pa~ · which you wil find on the last page of this application. specify the document
                         name(s). type (s), request or responsiveness , and rererence page number(s), wtl lch the reVie"wers should direct
                         lhei" attentiOfl
                    □ copy of latest approved DAF subrr"ittal package.

                  O t h er
                  -□
                   - Copy Of latest approved DAF subrr"ittal package.
                   D Airy other documentation supporting the d aim made to justify a time extension and
                       □     ...list these documents and the reference page number(s ), which the reviewers Should direct their attention, using
                             the "Anachmem : Reference P11ge." which you will find on the last page of this application:

                  D SUBMITT ED c omplete RF A for E76 C O N 10 DLAE

                       ~~~l ~~~~·a~~~~ ~~gNe ~~~~t~ 1 ~=i"~~ ~d~efl1lle~ :~:ve~ ;t ~ ! ~~ a~2~~ve

                                                                                                                                                       Credit: AP Photo/David Swanson

              2021 Time Extension Request Form
Page 4
  REQUIRED   ATTACHMEITTS
  Attach tlhe required documents indicated Delow, coinaiding1wirth the selectiion(s), in tlhe Time Extension Justification seotion
  on page ·11.

  Extens ive Envi r,o nmen·ta l Eva lua:f on
     D Pmviide a oo y of each ENV stud andlor report hat d'. elayed project reachling the allotted! two-year deadline.
     D On th.e "Attachment: Reference Page ~which you wi[I find on the last page of this application, specify the study I report
        name(s} andl reference tile page and paragraph numbeir(s) supporting the delay JusUfication (ex. extra study
        requirement speoified ), W'hidh the reviewers sh.ou l'd direct their attenfion.
     D Copy of latest a,pproved OAF suDmiltlall pacikag:e.

  Co m1p lex Rig ht of Way Acg um    siUon
     D Copy of Notice to contact property owner.
     D Copy of property owner response or indicate irf property owner was non.Jresponsive .
     D Copy of attempts to follow-up, on notice with property owner.
     D Copy of ~ro~(filV owner re§Ponse or indicate irf property owner was non-,responsive .
     D On th.e "Attachment : Reference Pa e ~ which you \Yi[I find on the last pag,e of this application, specify the d'ooument
          name(s), type(s},, request or responsirve.ness, and refere111oe page number(s), whiidh the reviewers shnu ldl direct
          their attention.
     D Copy of latest approved OAF suDmiUall pacikag,e.

                                    2021 Time Extension Request Form
=-------------
Page 4                                                                                                                                    'T::"l':£:===-:-=,..,..~-
                                                                                                                                           0   e.,:-r....:.:.:z.••..•_.. -·

  !Extens ive Geotechn ica l St:u dy
      □   Copy of Geotedlu1ical Re 11.(s),
      □   On th e '"Attachment: Reference Page m which you will find on the last page of this applica ·on, speoify th e d'oou nent
          name(s ), andl page numbers th,at support justifi.cafion ciitedl; also cirte m e Geotech riii cal recomme111dati:or1 .
      □   Copy of latest a,pprnved OAF submirttall paclkag,e.

  Other
      □   Copy of latest ~pproved OAF submirttall package.
      □   Any other dooumeritation supporting the dai m madie to justi1fy a time extension and . ...
      □   ...liist these documents and the reference page number(s), wlh ichi m e reviiewers slhould diiirect their atten tiion, usingr
          the "Attachment: Reference Pa ,~ which you will find on the last page ofthis application

  □   SUI IBMITTIED com1p lete, RFA for E7 6, CON ·to DILAIE
                                                 1

      IN ote: to qua l' , the ER E76 CON submittal paclkag:e must be complete, received b the DLA , an.di ave
       o :LAE/O iIstrict date sta mp on page 0111e of tlhiis req uest with a date on , or before September 30th 2021 .
                                                           1

                                    2021 Time Extension Request Form
Page 5 Overview
                  Local Assisrauu- PJ'O&l'a m Guideliues                                                                 LUIIBIT II-IT

                   Local Agency Certifi cat ion:

                   TIiis Request for Time Extension ER prOjE!ct nunt>er{s ) = = ~ = = = ~ ~ = ~ ~.has been prepared
                   in accordance with the LAPM Chapter 11 ER 23 CFR 668.105 (h) & FHWA ER Manual (2013). I certify Illa! Ille
                   informallon provided In lllls document Is accurate and correct. I understand that if Ille required lnlormalion has not been
                   provided the request may be rejected. I understand lhat even if all the informati on is proVided. it is nol guarantee of
                   approval or my request. You may direct any questions regarding this request submittal to
                  - - - -(~N,~me~) ~ - - - " - 7 (-PtiOOe=~No=
                                                             .) -

                         Signature: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date : _ _ _ _ __

                              Name:
                                Title: - - - - - - - - - - - - - - - -

                           At~~{i----------------
                      Phone No.: _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

                   c;iitr;ans District Loc;a1Auist;mc, Enaiottr Accept;a nc, ;md Btcomm,od;atlon·

                   I have reviewed th is Request for Time Extension of E76 CON Deadline (local ER Projects) for ER project
                   number(s) _ _ _ _ _ _ __ _ _ _~ and agree it is complete. Based oo the information
                   submitted a nd my personal knowledge of the project, I.. .

                   ... th is project receive a one-year time extension to authorize the Permanen t Repair Con struction phase of
                   work .

                         Signature: _ _ __ _ __ _

                                N~~: - - - - - - - - - - - - - - - -
                          Agency: _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
                           E-mail: _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
                        Phone No.: _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

                  Di stribu ti on:
                   (l )Oiginal -DlAE
                   (2) Copy- Division d local Assistance, t-0 ER Pro!,am Manager /C-ooroin
Page 5
    E-iteh ti uh1¥i
    Local Ag:ency c,e:rt:ifiicat:ion::

      This Request for nme Extension ER. prnjeot number(s) - - - - - - - - - - - - - - -~ has been prepared!
       in accordance with the IL APM Chapter 111 ER 23 CFR 6'6 8.105, (11), & f HWA ER Manual (20 113). I certify that tile
                                                              1

       infol"mation proviided in 11his document is accurate and ,c onect I understand that if the requ ired information has not been
       provided the request may be rejected . I understand 11hat even irf al the i1nformation i1s pro\liided, it i s not guarantee of
       approva of my req,uest. You may d'i1rect any questions reg:arding1fllis request submirttall to :
                                                  at
....iiiiiiiiii.- - ------n:~~- - - -                 ------
                         (Name),                        (Phone INo.)

          Signature:
                           - - - - - ~ - - - - - - -d-'W-et'-signa~- - - - - - 0.ate:
                                                              - -urej)
              1Name:
                       ------------------------
                TitIe:
            Agency:
          E-mail:
       Phone No. :

                                            2021 Time Extension Request Form
==-.::::.~--·. . --..=!..._...:..   ....

Page 5
                                                                                                                                                             ~
                                                                                                                  -------,;;;;;;; ~~

 car ,rans. Di s.tiri ct Local Ass istance Enginee r Accep,t:ain,c,e andl Reoommendlatioin:                        B

 I have reviewed th is Request for T ime Extension of E76 CON Dead line (Local ER Projects) for ER project
 numlb eri(s) - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ and agiree it is complete. Based on the information
 submitted and my persona knowledg e of tlhe project, I. . .

    D Recommend
    D   Do Not Recommend (For the reason(s) provided in the below text box..)

 .. .thiis project reoeiive a one-year fme ex.tension to authoinize the Perman ent Repa ·r Gonstmction phase of
 work .

      Signature: - - - - --                                                                   Date :
                                           nature or scanned 'Wet' signaturei)
        Name:
                 -----------------------
          Titie:
                 -----------------------
       Agency:
                 -----------------------
        E-ma iI:
                 -----------------------
     Phone No.:
                                        2021 Time Extension Request Form
Distribution
Distribution
1) Original -– DLAE
   Copy-
2) Copy – DLA HQ via ER.Time.Extensions@dot.ca.gov

                      Submittal Distribution
Page 6 Overview
                   Local Assisrauu- PJ'O&l'am Guideliues                                                                LUIIBIT II-IT

                  ~h:lh·J:liiHiltft:I

                                                                                      ••
                  Ex tens ive En vironment.11 Ev.1lu.1tion
                   ENV studV or Reoort Name             FNe Name           Paae#                                Cormlef1tlsl
                   &ample ENVSludvName                NEPA-St.                3         f     Reasoosludvts1Mured

                  Note. Add IONS, use MachmeR Reference Page (last page of this apphcatlon), or use additional page(s), as needed.

                  Complex Right of Way Acquisit ion
                     Parcel / Easement No.      ===   _ _ _ _ _ __

                       Document File Name

                   Document File Name

                  Extensive Geotechnical Stud y
                   Geotectmical Study Name                 File Name            Page#       JI #                  Comment(s)

                  Note: Add IONS lo above table, as needed.
                                                                                            I I
                  Other s upponin g Docum•nts
                       Document Name                       File Name                                                Cormlef1IS

                  Note. Add IONS, use MachmeR Reference P39e (last~ of this apphcabon), or use adcitiooal p;)!:Je(s), as needed.

                                                                                                                                        Credit: AP Photo/David Swanson

              2021 Time Extension Request Form
Page 6                                                                                                        I_,_ li :if 1"'·t1 -
                                                                                                              ~nri_z
                                                                                                              =:._;- -· ",
                                                                                                              ■IJ_[fl JJJ
                   REFERENCE PAGE

                                                                                                                                     I
   Ext ensive Envi1ronmnent:a l Evaluati on
    ENV study or Report. Name            File Name           Page#   1)#                         Comment(s)
    Ex.ample: ENV Study Name          NEPA-Study.pd{           3      1    Reason study is required.

----
   Note: Add rows or use addit arl!s.l page(s), as needed.

                                          2021 Time Extension Request Form
Page 6

                                                                                                                                        ■IJ_[fl JJJ
  Comj!:!•lex Rig1lilt of Way_ Acg uisition
    P arce l / Easement Nlo . =
                                                                                                                                                      I
                                                                         Responsive?       PaQe
       Document File Name                      Document Type              {Y, IN, NIA)     # (s)                  Comment(s)
                                          Notice
                                          Prooeritv O1.vner Res:oonse
                                          Notice Follow-,up
                                          Properily Owner Response

     Pa1icel / Ease m e nt No. =
                                                                         Responsive?       Page
   Document File Name                          Document Type              (Y , IN, NIA)    # (s)                  Co mrment( s)
                                          Notice
                                          Prooeritv Owner Res:oonse
                                          Notice Follo1,11-1up
                                          Properly: O·.vner Res:ponse

  Note: Add   fOINS   to above taible andfor add additional ~IParcellEasemenr tabl,es here, or attadh additional page(s),, as needed.

                                            2021 Time Extension Request Form
Page 6

                                                                                              ■IJ_[fl JJJ
     Ext ensive Geot:ecllm ica l Study
      Geotechn ical stud Name                      File Name                #-   Comments                   I

       ote: Add rows to above till e, as needed.

     Other Sup1p orting Documents
             Document Name                         File Name      Paae #   ff#   Comment€s)

._....N.ote: Add rows or LESe aclditional page(s), as n;eecled.

                                              2021 Time Extension Request Form
Time Extension Questions
     ?•                                                               ?•

              -.+                !! -+la/trans·
                                              3

                                              s4
                                                                                       FHWA
                          1011
                            9

Local Agency                                            Division of Local Assistance

                     District Local Assistance Office

  https://dot.ca.gov/programs/local-assistance/other-important-issues/local-assistance-contacts

                                 Next Steps & Local Agency Contacts
Emergency Relief (ER) Program Web Site
      ~    v                                                           About Caltrans   Contact Us   AfJA Certification   Req uestAfJA Compliant Documents               -I) Settings   S Translate

                     ·{b/tran5·
                                                                        Travel           Wo rk w ith Caltrans             Programs                Caltrans Near Me                      Search

      Home                      Local Assist ance     fe>cl e>r11 1and Stat e Prgg@m~    Emergency Relief Progra m

      Emergency Relief Program                                                                                                                Emergency Re lief Program
                                                                                                                                                     Websites
      The Federal Highway Adm inistrat ion's {FHWA) Emergency Relief (ER} Program was authorized by Congress to
      repair or reconstruct fede ra l-aid routes t hat have suffered serious damage as a direct result of a declared                  , Disasters

      event (see Title 23, Un ited States Code, Section 125). The progra m is available to State. . . . . . • J\pplication Process
                  • departments w •ith roads suffenng
      transportation                                  • senous
                                                             •                            •
                                                                 damage from natu ral d1saste               , ER Time Exten sions ( E76  CONJ
                                                                                                                                     ........
      fa ilures f rom external causes. ER funding is intended t o supplement resources from States, loca lities and                   •   Frm~
      other Federal agencies to help in the re pair of facilities damaged by eligible events.                                         • l 117 pgr:t1111 t [)e>:;;
                                                                                                                                      , Manua.ls, Memos, etc.
      Important: Loca l agencies reporting disaster damage info rma t io n must report their damages to both                          • Proced ures
      CalOES and Caltra ns. Ca lOES and Caltrans sepa rately administ er differe nt disaster relief funding programs,                 • Report & Status (under const ruction)

https://dot.ca.gov/programs/local-assistance/fed-and-state-programs/emergency-relief-program

                                                Resources
Emergency Relief (ER) Program Web Site
    ~     V                                                           About Caltrans    Contact Us   ADA Certification      Request ADA Compliant Documents                O Settings   @)Translate

                   ·lbJtrans·                                            r.P.,

                                                                        Travel            Work w ith Caltra ns              Progra ms               Caltrans Near Me                    Sea rch

    Home                       Local Assistance       Federal.and.. St ate.Programs                                           ER Time Ext ensions (E76 CON)

    ER Tim e Exte nsions (E76 CON )                                                                                                             Emergency Re lief Program
                                                                                                                                                       Websites
    The dead li ne for ER projects to autho rize construction (a.k.a. E76 CO N) for t he Eme rgency Open ing {EO) and
                                                                                                                                        , Disasters
    Permanent Repair (PR) segments of work is two Federal Fisca l Yea rs (FFYs) after t he FFY the disaster event
    began. This m eans local agencies, with an ER proj ect resulting from an 2018 FFY disaster, t hat are unable to                     , App licationProcess

    authorize construction (for either EO or PR) by the end of t his FFY, must subm it an ER Tim e Extension                            , ER Tim eExten sio ns(E76 CON)
                                                                                                                                        , Forms
    Request for t heir proj ect and receive FHWA app roval of t he request to avoid losing fed eral funds. Likewise,
                                                                                                                                        , Important Deadlines
    ER proj ects with a cu rrently approved FHWA Time Extension , that are unable to au tho rize construction {fo r
    eit her EO or PR) by t he end of t his FFY, m ust submit anot her ER Tim e Extension Request fo r t heir proj ect and               • fy111r1 LJ c1(s,fy1E:rr1g5., E:tc:,
    receive FHWA approval of t he req uest to avoid losing federal fu nds. This is because ER E76 CON Tim e                             , Proced.ures

                                         Resources
ER Time Extensions (E76 CON)

Links
   .. ER Tl ME EXTENSIION R.EQU EST FORM (Word) - Com1ing Soon
   .. J.9.?..+.. ..F..f.Y. ~9.0~,.t.~J!:9..~. .-: . .~.R.T~.rn.~..~xt.~.u~I9..U..R~g_
                                                                                    y_~-~~-- R~q©_b!.~.~-- '·~~~-~u. . . . . . . . .
   . A~-~H.JY..~-~-.R.~_qy_~§J..~~-?.t.?.. f ~9.-~- - P..~~Y.:!.9.:~~-Y~9.-~~

ER Contact                                                                                                                             ►

                                      Links
Tim1e Extens ion Requests Rece ived (2021 FFY So li citation )
!. .AST UPDATED ON
                                             t            t             t
                                                                                                                    Time Ext.
IDisaster ICa ltrans I             I         I            I    Loca l   I                I             I            I Request
  Event    District      DAF No.       FPN       County       Agency        Road/Route       Beg. PM       End PM     Status

                                         Time Extension Request Status Sheet
CT Contact Info   https://dot.ca.gov/programs/local-assistance/other-important-issues/local-assistance-contacts
CT ER Website     https://dot.ca.gov/programs/local-assistance/fed-and-state-programs/emergency-relief-program

                                 Questions and Answers
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