Form Bcap-1 - Biomass Conversion Facility Overview

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Form Approved – OMB No. 0560-0082

(See Page 6 for Privacy Act and Paperwork Reduction Act Statements.)

BCAP 1 -

U.S. DEPARTMENT OF AGRICULTURE

Attachment 1

(05-26-15)

Commodity Credit Corporation

Biomass Conversion Facility Overview

Purpose: This application is used to determine an applicant’s qualified Biomass Conversion Facility Status and provide Biomass Conversion Facility

overview information for the BCAP project proposal.

1. Name of Biomass Conversion Facility

National Office Use Only

2A. Facility ID Number

2B. Date ID Assigned

(MM-DD-YYYY)

3A. Street Address

3B. City

3C. State

3D. Zip Code

3E. Mailing Address (Include Zip Code)

4. County of Primary Location

5. State and County Code

6. Telephone Number

7. Email Address

(Include Area Code)

PART A - Business Overview

8A. Counties of Operation:

State and County Code

8B. Company Structure (Check all that apply):

Individual

Association of agricultural producers

Indian tribe

National laboratory

Unit of State or local government

Institution of higher education

Partnership

Rural electric cooperative

Corporation

Public power entity

Farm Cooperative

Consortium of any of the above entities

Farmer cooperative organization

Other:

8C. North American Industry Classification System (NAICS) Code:

9. Biomass Conversion Production Status:

A. Production

B. Date (MM-DD-YYYY)

Since

Expected

10. Brief Overview of Facility Business Operations and Biomass Utilization

The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers, employees, and applicants for emplo yment on the basis of race, color, national origin, age, disability, sex, gender

identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual’s income is derived from any public assistance

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