EPA Region 4 Technical Assistance Request Form

EPA Region 4 Technical Assistance Request Form
Free technical assistance to help redevelop brownfields is available to communities in EPA Region 4 - Kentucky, Tennessee, North Carolina, South Carolina, Georgia, Florida, Alabama, Mississippi.

Fill out the form below and a member of the ICMA TAB team will respond within five working days.
Contact Information
Name*

First NameLast Name
Email*
example@example.com
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number

Area CodePhone Number
Organization name*
Organization Type*

Local governmentNon profit organizationCommunity memberRegional governmentState government
Reason for requesting technical assistance*
Do you currently administer an EPA Brownfield grant?*

YesNo
If yes, what kind?

Assessment (Community Wide, Coalition, etc.)CleanupRevolving Loan FundMultipurposeJob Training
If you are requesting technical assistance in the form of environmental services solicitation review or other document review, please upload your document(s) by clicking "Browse Files" here.

Browse Files

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Please verify that you are human :)*
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Contact Information