River-Friendly Business Certification Program Application CONTACT INFORMATION Date: _______________ Business Name: _______________________________________________________ Mailing Address: ______________________________________________________________________________ ______________________________________________________________________________ Street Address: ______________________________________________________________________________ If different from above Facility Staff Maintenance Manager Environmental Director River-Friendly Contact Name Phone Number CAMPUS DESCRIPTION Please provide a sketch or site plan of your facility. A. Total Property Area: __________ B. The building was originally built in what year? __________ C. Number of year-round maintenance staff: __________ D. Indicate the size (in acres) of the following: Type of Area Existing building area Other impervious cover (sidewalks, parking lots) Mowed Lawn Area Wetland Area Forested Area Meadow Area Waterbodies Detention Basins Total River-Friendly Application – 1 Acres Email Address E. Please indicate the locations and sizes on your property of the following: No-mow Areas (acres): ________________________________________________________________________ No-spray Areas (acres): ________________________________________________________________________ Stream Buffers (linear feet & width): _____________________________________________________________ F. What is the yearly maintenance cost for your grounds, excluding capital expenditures? __________________________________________________________________________________________ G. How many hours are spent on grounds maintenance per year, excluding capital projects? ________________ H. When adding plants, do you use native plant species? Yes No Sometimes WATER QUALITY MANAGEMENT I. Please identify where runoff from different areas flows. For instance, does runoff flow directly into streams or ponds? If so, which ones? If not, where does the runoff flow? Please illustrate on your site plan. ___________________________________________________________________________________________ ___________________________________________________________________________________________ J. How would you classify the water quality of the streams and ponds on or near your business now? Poor Please circle: K. Fair Good Excellent Has your facility experienced any water quality problems (e.g., algal blooms, muddy water, etc.)? Yes No If yes, specify: _________________________________________________________ If yes, were you able to identify any of the potential sources or causes (e.g. poor water flow, geese)? Explain. ___________________________________________________________________________________________ ___________________________________________________________________________________________ River-Friendly Application – 2 L. Which of the following does your business implement? : Integrated Pest Management (If yes, please attach a copy of your plan, including a map of the area and tolerated threshold levels, methods of monitoring and identification, and plan for pest control) Yes No N/A Yearly soil samples Use of pesticides with low toxicity Use of pesticides with low solubility Use of slow-release fertilizers Use of organic turf application products Composting of leaves and grass clippings on site Water quality monitoring program (If so, please attach a summary) M. Please attach a descriptive summary of your fertilizer usage for the past 2 years, including rates, timing, and total amount applied per year. N. Please attach a descriptive summary of your pesticide usage for the past 2 years, including rates, timing, and total amount applied per year. WATER CONSERVATION TECHNIQUES O. Check the following that are applicable to your business: Yes No Does your course have a conservation strategy? (If yes, please attach) Do you collect rainwater for irrigation and watering? Do you use reclaimed wastewater for irrigation? Do you mulch trees, shrubs, and flowerbeds on site? Do you use leaves, grass, and tree clippings as natural mulch or fertilizer? P. What is your average indoor water usage (indicate units per day or per month)? : Summer usage: _______________________ Winter usage: ________________________ Q. What is your average outdoor water usage (indicate units per day or per month)? Summer usage: _______________________ River-Friendly Application – 3 Winter usage: ________________________ WILDLIFE AND HABITAT ENHANCEMENT R. What successes and problems have you had in maintaining, protecting, or enhancing wetlands, naturalized areas, no-mow areas, no-spray areas, etc. on site? ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ S. What species of wildlife do you see or have evidence of at your site on a regular basis? ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ T. Does your business do anything to encourage or protect these species (e.g. bird/bat houses)? ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ U. Please describe any habitat restorations that have been done at your facility. ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ V. Describe if and how your facility controls wildlife (such as deer, Canada geese, etc.). ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ River-Friendly Application – 4 EDUCATION AND OUTREACH W. Have employees, clients or other members of the local community ever encouraged your business to implement environmentally friendly practices? Please include any specific examples. ___________________________________________________________________________________________ ___________________________________________________________________________________________ X. Have employees, clients or members of the local community ever complained about practices of your business? Explain. ___________________________________________________________________________________________ ___________________________________________________________________________________________ Y. Describe and explain any educational and outreach programs or facilities your business has implemented. ___________________________________________________________________________________________ ___________________________________________________________________________________________ OTHER COMMENTS Z. Is there anything else that you have previously done to make your business river-friendly? ___________________________________________________________________________________________ ___________________________________________________________________________________________ AA. What special features of your facility should we know about? ___________________________________________________________________________________________ ___________________________________________________________________________________________ BB. Are there other items specific to your site that we should know about? ___________________________________________________________________________________________ ___________________________________________________________________________________________ River-Friendly Application – 5 YOUR GOAL(S) CC. Are there any specific projects that you hope to implement at your facility through your participation in the River-Friendly Business Certification Program? ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ____________________________________________________________________ ___________________ ____________________________________________________________________ ___________________ Business River-Friendly Contact SBMWA River-Friendly Coordinator Date Date Please complete this application form in its entirety and send, with supporting documents, to the Stony Brook-Millstone Watershed Association River-Friendly Coordinator: Email: bmusolino@thewatershed.org Fax: 609-737-3735 ext.37 Mail: Stony Brook-Millstone Watershed Association Attn: River-Friendly Business Program 31 Titus Mill Road Pennington, NJ 08534 Visit www.thewatershed.org for more information River-Friendly Application – 6