GRANT APPLICATION: Oil Spill Response Equipment

Please fill out the following information. If you have further questions, please contact David Byers, Response Section Manager at 360-407-6974. You can also download a printed copy at: www.ecy.wa.gov/biblio/ecy070220.html.

	* Required fields
*Agency or Tribe Name:
*Contact Name:
*Phone 1:
Phone 2:
Fax:
*Mailing Address:
Mailing Address 2:
*City:
*State:	(2 letter code, ex. WA)
*Postal Code:
Email Address:

	Equipment Request:
	Trailer with General Purpose Boom Trailer with River Boom Boom Vane(s) Other (Specify):

	Where will the equipment be located? Identify where the equipment will be stored and what resources or assets will be protected.


	*How will the equipment be deployed?* Explain who will deploy the equipment and what support equipment (such as boats) will be used.