Environmental Facility Certification Survey - Sports Field Manager - Version 3.0 Report Card - Part I Fill in the requested information. This portion of the assessment captures information specific to your facility. Please be as detailed as necessary to provide a solid overview of your facility and any environmental challenges you manage. SFMA will provide your answers back to you in a PDF within two weeks with instructions on engaging your attester.SFMA does allow a synthetic surface to be assessed but only within a Complex that is primarily natural grass fields. A synthetic complex does not qualify for assessment.NOTE: Be sure to use the PREV button at the bottom if you need to go back to a previous page, not the back arrow, as it will erase your answers and you will need to start over. Question Title * 1. General Facility & Resource Information Sports Field Manager Name: Complex/Facility Name: Email Address: Phone Number: Question Title * 2. What type of facility are you applying for? Yes No Are you applying for a Complex? (Sports fields that are contained by fencing or a perimeter boundary, with the fields contained within that space). A synthetic complex is not qualified to be assessed. Are you applying for a Complex? (Sports fields that are contained by fencing or a perimeter boundary, with the fields contained within that space). A synthetic complex is not qualified to be assessed. Yes Are you applying for a Complex? (Sports fields that are contained by fencing or a perimeter boundary, with the fields contained within that space). A synthetic complex is not qualified to be assessed. No Or, are you applying for a single field certification? If you are applying for a single field certification, it must be a natural grass field. Or, are you applying for a single field certification? If you are applying for a single field certification, it must be a natural grass field. Yes Or, are you applying for a single field certification? If you are applying for a single field certification, it must be a natural grass field. No Question Title * 3. Where is the facility/field located? Street address: City: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming Zip: Question Title * 4. Is this (select one): Urban Suburban Rural Question Title * 5. What is the original construction date of the facility/field? (Year) Question Title * 6. Provide a brief history and description of the site. Include information about any major renovations or major changes over the years. Question Title * 7. Complex and/or field acreage information: What is the total acreage of your complex and/or field? What is the acreage of actively managed fields/turfgrass areas? How many acres are sports fields? How many acres are passively managed, i.e. native areas, low traffic? Question Title * 8. Do you manage any synthetic fields? Yes No If YES, how many synthetic fields (fill in the blank) Question Title * 9. Do you manage any trails? Yes No If YES, how many miles of trails? Question Title * 10. How many HOURS per YEAR are your fields in use for its primary activities? HOURS per YEAR Question Title * 11. What are those primary activities? Question Title * 12. What other activities/events are the fields used for? (e.g. graduation, concerts) Question Title * 13. How many HOURS per YEAR are the fields used for these activities? HOURS per YEAR: Question Title * 14. Describe any environmental factors, such as streams, ponds, rivers, wildlife habitats, endangered species, that you need to be attentive to in managing your fields. Question Title * 15. Do you have any state or local mandates on fertilizer, pesticides, nutrients, noise, lighting, etc.? Yes No If yes, please describe Question Title * 16. Are there any local environmental groups that affect your work on your fields? Yes No If yes, please describe Question Title * 17. List your application rates for ATHLETIC FIELDS PER YEAR: (include unit of measurement) Nitrogen: Phosphorus: Potassium: Question Title * 18. List your application rates for OTHER areas within the perimeter PER YEAR: (include unit of measurement) Nitrogen: Phosphorus: Potassium: Question Title * 19. If you have restrictions on the application of any of the above, please note:(If you have no restrictions, please enter none) Question Title * 20. List your pesticides’ names and application rates PER YEAR: (include unit of measurement) Insecticides: Herbicides: Fungicides: Question Title * 21. Tell us about your management resources. Would you consider your facility to be: Yes No Managed with a limited staff? Managed with a limited staff? Yes Managed with a limited staff? No Supported by upper management? Supported by upper management? Yes Supported by upper management? No Confined by limited space or topography? Confined by limited space or topography? Yes Confined by limited space or topography? No Low budget? Low budget? Yes Low budget? No Question Title * 22. Please provide your attester’s information: Name: Organization: City: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming Email Address: Phone Number: Next