OPR
Staff Use Only / Date Application Received: / OPR Tracking Number: / Date Application Reviewed: / OPR
Staff Use Only
PART I. ENTITY APPLYING FOR LISTING
Is this form being submitted by the Offset Project Operator (OPO) or by the Authorized Project Designee (APD)?
Notes:
1. The person completing this form should be an OPO/APD employee.
2. If the APD is submitting this form, the OPO should submit the form Designation of Authorized Project Designee simultaneously. / OPO
APD
Name of Person Completing Form: / Organization, if applicable:
Date Form Completed: / Phone Number: / Email Address:
PART II. OFFSET PROJECT INFORMATION
Offset Project Name:
Offset Project Commencement Date: / First Reporting Period Start Date: / First Reporting Period End Date:
Provide an explanation and justification for the commencement date. Specify the action(s) that identify the offset project commencement date.
Location of Project:
Approximate Latitude of Offset Project: / Approximate Longitude of Offset Project:
Urban Forest Offset Project Type: Municipality Project Educational Campus Project Utility Project
PART III. OPO/APD INFORMATION
A. OPO
OPO Name: / OPO’s CITSS ID#:
CA
Mailing Address: / City: / State: / Zip:
Contact Person: / Phone Number: / Email Address:
B. APD (if applicable) No APD/Not Applicable
APD Name: / APD’s CITSS ID#:
CA
Mailing Address: / City: / State: / Zip:
Contact Person: / Phone Number: / Email Address:
Explain the involvement of the APD (if applicable)
C. RESPONSIBLE PARTY
Provide the name and contact information of the person or entity responsible for the planning, implementation, and reporting of project activity.
Entity/Person Name: / Phone Number: / Email Address:
PART IV. GOALS AND pLANNED ACTIVITIES OF OFFSET PROJECT
A. Describe the goals of the offset project:
B. Summarize the plans for implementation of the planned Urban Forest offset project. Include general information on the number of project tree sites and locations, the number of trees planted including replacements, the species, and the tree maintenance and monitoring plans.
C. Will project trees be planted in maintained landscapes and spaced at least 5 m (16 ft) apart so as to be open-growing? / Yes
No
PART V. Offset Project boundaries
A. Describe the project boundary including planned tree sites, an outline of the geographical boundary of the municipality, educational campus or utility service area, and the tree care facilities
Attach a map depicting the offset project boundary. Submit supporting document as attachment labeled “Attachment A.” See Part X of this listing document for more information.
B. List the greenhouse gas sources and greenhouse gas sinks that will be included in the Offset Project Boundary (based on Section 4 of the Compliance Offset Protocol Urban Forest Projects, October 20, 2011).
C. Does the offset project occur on any of the following categories of land? (check all that apply)
Land that is owned by, or subject to, an ownership of possessory interest of a Tribe
Land that is “Indian lands” of a Tribe as defined by 25 U.S.C. §81(a)(1)
Land that is owned by any person, entity, or Tribe, within the external borders of such Indian lands
None of the above
If “none of the above,” skip to Part V. Otherwise, proceed to questions F1 and F2.
Further documentation is required for projects occurring on land listed in the first three categories. Submit supporting documents as attachments labeled “Attachment B.” See Part X of this listing document for more information.
1. Does a limited waiver of sovereign immunity between ARB and the governing body of the Tribe exist? / Yes
No
2. Describe how the land within the Project Area is owned.
PART VI. OFFSET PROJECT ELIGIBILITY
A. Required for ALL Urban Forest Project Types
1. Is any portion of the planned tree planting activity occurring within the Project Area required by local, state, regional, or federal regulation? If “yes,” explain: / Yes
No
2. Describe tree planting requirements outside of the Project Area that are mandated by law and are planned to be undertaken by the entity.
3. What is the expected average annual net project tree sites that will be created over the Project Life?
B. Required for Municipality and Educational Campus Projects ONLY N/A
1. What is the average annual Net Tree Gain (NTG) prior to offset project commencement?
2. State the total number of trees within the proposed Project Area prior to the start of the offset project.
PART VII. INITIAL TREE MAINTENANCE PLAN
Report the following for annual level of service (tree care activities performed during year such as trees planted and removed, trees pruned per year by age class, etc.), expenditure, and anticipated future annual level of service.
Document the most recent (Initial Year) and Anticipated future levels of service (Annual averaged over 10 years) and expenditures for all criteria in the Tree Maintenance Plan.
A. Tree Planting - New Sites / Initial Year / Anticipated Annual Level
1. Project trees only (do not include non-project trees)
Number / #
Expenditures / $
2. Non-project trees only
Number / # / #
Expenditures / $ / $
3. Describe how project tree planting sites will be identified and prioritized.
B. Tree Planting - Replacement / Initial Year / Anticipated Annual Level
1. Project trees only (do not include non-project trees)
Number / #
Expenditures / $
2. Non-project trees only
Number / # / #
Expenditures / $ / $
3. Estimate the tree mortality rate for newly planted project trees and explain how estimates were derived / %
4. Estimate the tree mortality rate for established project trees and explain how estimates were derived. / %
5. Describe how project trees that need replacing will be identified, the timing of replacement, and the species and size of replacement trees.
C. Tree Planting - Relocation / Initial Year / Anticipated Annual Level
1. Project trees only (do not include non-project trees)
Number / #
Expenditures / $
D. Young Tree Care / Initial Year / Anticipated Annual Level
1. Project trees only (do not include non-project trees)
Number / #
Expenditures / $
2. Non-project trees only
Number / # / #
Expenditures / $ / $
3. Inspection and pruning cycle (total number of project trees / number of project trees treated each year).
E. Mature Tree Care / Initial Year / Anticipated Annual Level
1. Project trees only (do not include non-project trees)
Number / #
Expenditures / $
2. Non-project trees only
Number / #
Expenditures / $ / $
3. Inspection and pruning cycle (total number of project trees / number of project trees treated each year).
F. Tree Removal / Initial Year / Anticipated Annual Level
1. Project trees only (do not include non-project trees)
Number / #
Expenditures / $
2. Non-project trees only
Number / # / #
Expenditures / $ / $
3. Removal cycle (total number of project trees to remove / number of project trees to be removed per year)
G. Administration/Other / Initial Year / Anticipated Annual Level
1. Average $/tree site expenditures (Project trees only) / $
2. Average $/tree site expenditures (Non-project trees only) / $ / $
3. Average $/tree site expenditures (Project trees only) / $
4. Average $/tree site expenditures (Non-project trees only) / $ / $
H. Personnel Involved in Project
Identify the department and personnel that will implement and manage the project. Provide a description of their roles and responsibilities. Identify the funds required for salary, operations, training, and overhead over the duration of the project. Other related activities may be included (public relations, accounting, fundraising, outreach).
1. / Name: / Title: / Affiliation: / Funds Required:
$
Role and Responsibilities:
2. / Name: / Title: / Affiliation: / Funds Required:
$
Role and Responsibilities:
3. / Name: / Title: / Affiliation: / Funds Required:
$
Role and Responsibilities:
4. / Name: / Title: / Affiliation: / Funds Required:
$
Role and Responsibilities:
5. / Name: / Title: / Affiliation: / Funds Required:
$
Role and Responsibilities:
6. / Name: / Title: / Affiliation: / Funds Required:
$
Role and Responsibilities:
PART VIII. PROJECT TREE MONITORING PLAN
A. Which approach will be used for quantifying carbon stock / Census
Sampling
B. Provide a detailed description of the procedures that will be used to census (or sample, if applicable), measure, and report information on the project trees, including survey method, sample sizes, and method for choosing samples.
C. Provide a detailed description of the methods that will be used to measure and record tree dimensions.
D. Provide a detailed description of the methods that will be used and information collected on tree survival and health.
E. Provide a detailed description of the statistical methods that will be used to extrapolate sample data to the total project tree population, if applicable.
F. Provide a detailed description of procedure for estimating sample error, if applicable.
PART IX. ADDITIONAL QUESTIONS
Have any project trees within the physical boundary of the offset project been listed or registered with an offset project registry or program in the past?
If “yes,” identify the registry or program and provide details on the issued credits below. / Yes
No
Have greenhouse gas emission reductions or removal enhancements associated with the planting and maintenance of project trees within the physical boundary of the offset project been credited or claimed for the purpose of greenhouse gas mitigation or reduction goals, whether in a voluntary or regulatory context?
If “yes,” identify the registry or program and provide details on the issued credits below. / Yes
No
Registry/Program: / Reporting Period(s): / Vintage(s): / Number of Credits Issued:
PART X. Attachments
A. Map of the physical boundary of the offset project, including planned tree sites, an outline of the geographical boundary of the municipality, educational campus, or utility service area, and tree care facilities (location where vehicles and equipment are housed). N/A
B. If the project is located on one of the categories of Tribal land listed in Part IV(F), provide documentation demonstrating that the land within the Project Area is owned by a tribe or private entity. Provide proof of the existence of a limited waiver of sovereign immunity between ARB and the governing body of the Tribe entered into pursuant to section 95975(l) of the Cap-and-Trade Regulation. N/A
C. Provide the species, size, and location of trees to be planted in new tree sites in Years 1-5. This information may be presented in the form of a map. N/A
D. Provide the species, size, and location of trees to be planted in existing and relocated tree sites in Years 1-5. This information may be presented in the form of a map. N/A
E. Projects requiring additional space in Part VII.F shall provide the information on additional sheets of paper as necessary and include as an attachment to this document. N/A
PART XI. ATTESTATIONS AND OPO SIGNATURE
_____
Initial / I certify under penalty of perjury under the laws of the State of California the GHG reductions and/or GHG removal enhancements for
Project Name: / from / Crediting Period
Start Date: / to / Crediting Period
End Date:
will be measured in accordance with the Compliance Offset Protocol Urban Forest Projects, October 20, 2011, and all information required to be submitted to ARB is true, accurate, and complete.
_____
Initial / I understand I am voluntarily participating in the California Greenhouse Gas Cap-and-Trade Program under title 17, article 5, and by doing so, I am now subject to all regulatory requirements and enforcement mechanisms of this program and subject myself to the jurisdiction of California as the exclusive venue to resolve any and all disputes arising from the enforcement of provisions in this article.
_____
Initial / I understand that the offset project activity and implementation of the offset project must be in accordance with all applicable local, regional, and national environmental and health and safety laws and regulations that apply to the offset project location. I understand that offset projects are not eligible to receive ARB or registry offset credits for GHG reductions and GHG removal enhancements that are not in compliance with the requirements of the Cap-and-Trade Program.
In signing this form, I certify under penalty of perjury of the laws of California that the information contained in this form is true, accurate, and complete. I further certify that I am an Account Representative of the Offset Project Operator (OPO).
Signature: / Printed Name:
Title: / DatE:
Background for Application of Listing an Urban Forest Offset Project
Section 95975 of the Cap-and-Trade Regulation describes the requirements and process for an Offset Project Operator (OPO) or Authorized Project Designee (APD) to list an offset project with an approved Offset Project Registry. This form is designed to help an OPO or APD fulfill the requirements of Section 95975 of the Cap-and-Trade Regulation and of Appendix C of the Compliance Offset Protocol Urban Forest Projects, October 20, 2011, for listing an offset project. The information in the completed form should be submitted to the approved Offset Project Registry with which the OPO or APD would like their offset project listed.
Where to Submit Information Contained in This Form
Please complete the information on the form using your computer. Then either add an electronic signature to the form or print, sign, and scan the form. The completed and signed information and all supporting documentation should be submitted to the appropriate Offset Project Registry.
Copies of this form can be downloaded from the ARB website at:
http://www.arb.ca.gov/cc/capandtrade/offsets/forms/forms.htm
Detailed Instructions for Application for Listing an Urban Forest Offset Project
This form is protected with restricted editing to facilitate completing the form. If the applicant wishes to unprotect the form, the password is “form”.
Part I. Entity Applying for Listing:
· Indicate whether the Offset Project Operator (OPO) or Authorized Project Designee (APD) is submitting the information for project listing. Section 95975(a) of the Cap-and-Trade Regulation requires that the OPO and, if applicable, the APD must register with ARB for the Cap-and-Trade Program prior to listing a project. It also requires that neither the OPO nor APD be subject to any Holding Account restrictions imposed as part of an enforcement action. To register with ARB, please visit the website for Compliance Instrument Tracking System Services (CITSS): https://www.wci-citss.org/