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Landfill Methane Outreach Program

Endorser Agreement


OMB Control No. 2060-0446
Approval expires 03/31/16

between the U.S. Environmental Protection Agency's (EPA's) Landfill Methane Outreach Program (LMOP) and

Organization Name *:

LMOP Endorsers support LMOP in principle and encourage their members to promote LMOP's goal of increasing the development of landfill gas as an energy resource, thereby reducing emissions of methane, a potent greenhouse gas.

LMOP Endorsers and EPA agree that, while this agreement is in effect, either party may publicize the fact that this endorsement has been made. Upon your acceptance as an LMOP Endorser, your organization and contact information will be considered publicly available information.

LMOP Endorsers and EPA also agree to cooperate on at least one public recognition event or outreach activity (e.g., newsletter or journal article, conference presentation) per year to promote the goals of LMOP and the Endorser.

Both EPA and your organization recognize that this agreement is voluntary, and may be terminated at any time by either party without notice or penalty. EPA will only release information obtained from the Endorser without prior authorization from that organization if required to do so under the Freedom of Information Act, the Agency's regulations at 40 CFR part 2, subpart B, or other applicable law.

 

The undersigned officials execute this Endorser Agreement on behalf of their parties.
 

Authorized
Representative *:

Date *: / /
(mm/dd/yyyy)


Paul M. Gunning:
Director, Climate Change Division, U.S. EPA

EPA Signature:

EPA Signature

Date: 

Date

Please identify your organization's designated Landfill Methane Outreach Program (LMOP) Coordinator:

Name *:

 

Title:

 

Address *:

Suite/Floor #:

City *:

 

State *:

Zip *:

Phone *:

    Ext.: 

Fax:

Email Address *:

 

 

   

Organization
website:

 

May we provide a link to your website?

Yes No


Please provide a brief description (150 words or less) of your organization and any involvement in LFG energy projects (if applicable) as you would like it to appear on the LMOP website:

Fields indicated with an asterisk (*) denote a required field.

The public reporting and recordkeeping burden for this collection of information is estimated to average 1.5 hours per response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques, to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

EPA Form No. 5900-158

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