HomeMy WebLinkAboutMLA16-00035- FPA16-00001 SEPA ChecklistSFP ENVIRONMENTAL CHECKLIST
Purpose of checklist W I lam Fe A ra CQ H Tp
Governmental agencies use this checklist to help determine whether the environmental impacts of your
proposal are significant. This information is also helpful to determine if available avoidance, minimization
or compensatory mitigation measures will address the probable significant impacts or if an environmental
impact statement will be prepared to further analyze the proposal.
Instructions for applicants:
This environmental checklist asks you to describe some basic information about your proposal. Please
answer each question accurately and carefully, to the best of your knowledge. You may need to consult
with an agency specialist or private consultant for some questions. You may use "not applicable" or
"does not apply" only when you can explain why it does not apply and not when the answer is unknown.
You may also attach or incorporate by reference additional studies reports. Complete and accurate
answers to these questions often avoid delays with the SEPA process as well as later in the decision-
making process.
The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of
time or on different parcels of land. Attach any additional information that will help describe your proposal
or its environmental effects. The agency to which you submit this checklist may ask you to explain your
answers or provide additional information reasonably related to determining if there may be significant
adverse impact.
Instructions for Lead Agencies:
Please adjust the format of this template as needed. Additional information may be necessary to
evaluate the existing environment, all interrelated aspects of the proposal and an analysis of adverse
impacts. The checklist is considered the first but not necessarily the only source of information needed to
make an adequate threshold determination. Once a threshold determination is made, the lead agency is
responsible for the completeness and accuracy of the checklist and other supporting documents.
The help links in this checklist are intended to assist users in accessing guidance on the checklist
questions. Links are provided to the speck sections of the guidance applicable to the questions.
However, the links may not work correctly on all devices. If the links do not work on your device, open the
guidance at _ _ea/SeUa/aD0L11Qe!L and navigate to
the appropriate section.
Use of checklist for nonproject proposals
For nonproject proposals (such as ordinances, regulations, plans and programs), complete the applicable
parts of sections A and B plus the Please
completely answer all questions that apply and note that the words "project," "applicant," and "property or
site" should be read as'proposal,"'proponent," and "affected geographic area," respectively. The lead
agency may exclude (for non -projects) questions in Part B - Environmental Elements —that do not
contribute meaningfully to the analysis of the proposal.
21!M
SEPA Envlmnme al CO RIIM(WAC 180-114601 May 2014 JEFFERSON COUNTY M91 of 74
A. Background
1. Name of proposed project, if applicable: William Petro COHP
P%�(>r' �a� 035/FPAIh-C�ODI
2. Name of applicant: William Petro
3. Address and phone number of applicant and contact person:
William Petro 11966 Airport Cuttoff Road, Port Townsend, WA 98368 Ph 360-385-2626
Agent: Mike (Oronin CF, Cronin Forestry, 371 Hidden Trail Road, Port Townsend, WA 98368
Ph. 360-385-5454
4. Date checklist prepared: 04/07/16
5. Agency requesting checklist Jefferson County DCD
6. Proposed timing or schedule (including phasing, if applicable): June — September 2016
7. Do you have any plans for future additions, expansion, or further activity related to or
connected with this proposal? If yes, explain. Yes. Construction of single family home at a later
date.
8. List any environmental information you know about that has been prepared, or will be
prepared, directly related to this proposal. FPA
9. Do you know whether applications are pending for governmental approvals of other
proposals directly affecting the property covered by your proposal? If yes, explain. No
10. List any government approvals or permits that will be needed for your proposal, if known.
Approved FPA
11. Give brief, complete description of your proposal, including the proposed uses and the size
of the project and site. There are several questions later in this checklist that ask you to
describe certain aspects of your proposal. You do not need to repeat those answers on this
page. (Lead agencies may modify this form to include additional speck information on project
description.)
Construction of access road and clearing of future homesite.
12. Location of the proposal. Give sufficient information for a person to understand the precise
location of your proposed project, including a street address, if any, and section, township, and
range, if known. If a proposal would occur over a range of area, provide the range or
boundaries of the site(s). Provide a legal description, site plan, vicinity map, and topographic
map, if reasonably available. While you should submit any plans required by the agency, you
are not required to duplicate maps or detailed plans submitted with any pernit applications
related to this checklist.
The proposal is located on an undeveloped 5.7 acre parcel at 5185 Dabob Road, near
Quilcene, WA. in the SW1/4 NW Y. of Section 5, T27N, R1 W. W.M.
6EPA E.W,.nmenle10eck1i9(WAG 107-11460) May 2014 Page 2&14
B. ENVIRONMENTAL ELEMENTS
1. Earth
a. General description of the site:
(circle one): Flat, rolling, hilly, steep slopes, mountainous, other
b. What is the steepest slope on the site (approximate percent slope)? +-15%
c. What general types of soils are found on the site (for example, clay, sand, gravel, peat,
muck)? If you know the classification of agricultural soils, specify them and note any
agricultural land of long-term commercial significance and whether the proposal results in
removing any of these soils.
Alderwood gravelly, sandy loam
d. Are there surface indications or history of unstable soils in the immediate vicinity? If so,
describe. No
e. Describe the purpose, type, total area, and approximate quantifies and total affected area of
any filling, excavation, and grading proposed. Indicate source of fill. Approximatiy .9 acres to
be logged and cleared for future homesite. Approximately 70 cubic yards of crushed rock
from a commercial source to be used for road surface.
f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe.
Erorion will be minimal on this well -drained site.
g. About what percent of the site will be covered with impervious surfaces after project
construction (for example, asphalt or buildings)? 2%
h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any:
BMPs to followed in all phases.
2. Air
a. What types of emissions to the air would result from the proposal during construction,
operation, and maintenance when the project is completed? If any, generally describe and
give approximate quantities if known.
Heavy construction/logging equipment will emit normal exhaust fumes for a period of 3-7 days
during construction. If slash and or stump piles are burned on site it will be under the
requirements of the appropriate bum permit Smoke from this potential slash burning will be
limited to a few days duration outside of air quality hazard days.
b. Are there any off-site sources of emissions or odor that may affect your proposal? If so,
generally describe. No
c. Proposed measures to reduce or control emissions or other impacts to air, if any:
See a. above
MPA Environmental C re Iiet (WAC 1ff-11A 1 Mer M14 Page 3 of 14
3. Water j
a. Surface Water:
1) Is there any surface water body on or in the immediate vicinity of the site (including
year-round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe
type and provide names. If appropriate, state what stream or river it flows into.
No
2) Will the project require any work over, in, or adjacent to (within 200 feet) the
described
waters? If yes, please describe and attach available plans.
No
3) Estimate the amount of fill and dredge material that would be placed in or removed
from surface water or wetlands and indicate the area of the site that would be affected.
Indicate the source of fill material.
None
4) Will the proposal require surface water withdrawals or diversions? Give general
description, purpose, and approximate quantities if known.
No
5) Does the proposal lie within a 100 -year floodplain? If so, note location on the site plan.
No
6) Does the proposal involve any discharges of waste materials to surface waters? If so,
describe the type of waste and anticipated volume of discharge.
No
b. Ground Water:
1) Will groundwater be withdrawn from a well for drinking water or other purposes? If so,
give a general description of the well, proposed uses and approximate quantities
withdrawn from the well. Will water be discharged to groundwater? Give general
description, purpose, and approximate quantities if known.
Not under this permit
9EPA Environmental O.klld(WAC 197-11-980) May 2014 Page 4 o 14
2) Describe waste material that will be discharged into the ground from septic tanks or
other sources, if any (for example: Domestic sewage; industrial, containing the
following chemicals... ; agricultural; etc.). Describe the general size of the system, the
number of such systems, the number of houses to be served (if applicable), or the
number of animals or humans the system(s) are expected to serve.
None under this permit
c. Water runoff (including stormwater):
1) Describe the source of runoff (including stone water) and method of collection
and disposal, if any (include quantities, if known). Where will this water flow?
Will this water flow into other waters? If so, describe.
No flowing streamson site. Runoff will disperse onto undisturbed forest floor.
2) Could waste materials enter ground or surface waters? If so, generally describe.
Only in the unlikely event of a fuel spill from heavy equipment.
3) Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site? If
so, describe.
No
d. Proposed measures to reduce or control surface, ground, and runoff water, and drainage
pattern impacts, if any:
Following BMPs in all phases
4. Plants
a. Check the types of vegetation found on the site:
—x—deciduous tree: alder, maple, aspen, other
—x–evergreen tree: fir, cedar, pine, other
x_shrubs
_grass
_pasture
_crop or grain
Orchards, vineyards or other permanent crops.
wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other
_water plants: water lily, eelgrass, milfoil, other
_other types of vegetation
b. What kind and amount of vegetation will be removed or altered?
Approximately 15 MBF of Douglas fir, western red cedar, western hemlock, red alder
and big -leaf maple will be harvested and removed. Native shrub species will be Geared
from the .9 acre clearing site
SERA EnvSmmenhl caeokllsl JWAL 197-114801 May2014 Page 5 of 14
c. List threatened and endangered species known to be on or near the site.
None
d. Proposed landscaping, use of native plants, or other measures to preserve or enhance
vegetation on the site, if any:
Parts ofthe site will be planted with native and ornamental trees and shrubs after clearing.
d. List all noxious weeds and invasive species known to be on or near the site.
e. Robertum Geranium, Herb Robert, scotchbroom are on or near the site.
5. Animals
a. List any birds and other animals which have been observed on or near the site or are known
to be on or near the site.
Examples include:
birds: hawk heron eagle songbirds, other:
mammals: deer, bear, elk, beaver, other.
fish: bass, salmon, trout, herring, shellfish, other
b. List any threatened and endangered species known to be on or near the site.
None known
c. Is the site part of a migration route? If so, explain.
No
d. Proposed measures to preserve or enhance wildlife, if any: Maintainence of most of the
parcel forest cover.
f List any invasive animal species known to be on or near the site.
None known
6. Energy and Natural Resources
a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet
the completed project's energy needs? Describe whether it will be used for heating,
manufacturing, etc.
None in the completed COHP
SEPA EnvllonmeMal checklist(WAC IV -114W) May 2014
b. Would your project affect the potential use of solar energy by adjacent properties?
If so, generally describe. No
c. What kinds of energy conservation features are included in the plans of this proposal?
List other proposed measures to reduce or control energy impacts, if any: None
7. Environmental Health
a. Are there any environmental health hazards, including exposure to toxic chemicals, risk
of fire and explosion, spill, or hazardous waste, that could occur as a result of this
proposal?
If so, describe.
Some slight risk of health hazard will result from operation of heavy equipment.
1) Describe any known or possible contamination at the site from present or past uses.
None known
2) Describe existing hazardous chemicalsfconditions that might affect project development
and design. This includes underground hazardous liquid and gas transmission pipelines
located within the project area and in the vicinity.
None known
3) Describe any toxic or hazardous chemicals that might be stored, used, or produced
during the projects development or construction, or at any time during the operating
life of the project.
Fuel for heavy equipment to be on site for short construction period.
4) Describe special emergency services that might be required.
Emergemy medical reponse only in the unlikely event of an accident on site.
5) Proposed measures to reduce or control environmental health hazards, if any:
None
b. Noise
1) What types of noise exist in the area which may affect your project (for example:
traffic, equipment, operation, other)?
None
2) What types and levels of noise would be created by or associated with the project on a
short-term or a long -teen basis (for example: traffic, construction, operation, other)?
Indicate what hours noise would come from the site.
Short term constructon equipment operation.
SEPA EAWmamea0al cneckW(WAC 167-114WI May 2014 Page 70f 14
3) Proposed measures to reduce or control noise impacts, if any:
None
8. Land and Shoreline Use
a. What is the current use of the site and adjacent properties? Will the proposal affect
current land uses on nearby or adjacent properties? If so, describe.
No effects on adjacent land use anticipated. Currently the site is vacant land.
b. Has the project site been used as working farmlands or working forest lands? If so,
describe. How much agricultural or forest land of long-term commercial significance will
be converted to other uses as a result of the proposal, if any? If resource lands have not
been designated, how many acres in farmland or forest land tax status will be converted
to nonfarm or nonforest use?
The site has been used in the past for commercial timber production and most of the
parcel will remain forested with entire parcel being rural residential property.
1) Will the proposal affect or be affected by surrounding working farm or forest land normal
business operations, such as oversize equipment access, the application of pesticides,
tilling, and harvesting? If so, how:
No effects on adjacent land use anticipated.
c. Describe any structures on the site.
None
d. Will any structures be demolished? If so, what?
No
e. What is the current zoning classification of the site?
Rural residential 1:5
f. What is the current comprehensive plan designation of the site?
R,uraJ I:Lo
f. If applicable, what is the current shoreline master program designation of the site?
NA
g. Has any part of the site been classified as a critical area by the city or county? If so,
specify.
No
SEPA Environmental cOmtlW iMC ler-1149601 May 2014 Page 8 of 14
h. Approximately how many people would reside or work in the completed project?
Single family after construction of residence.
i. Approximately how many people would the completed project displace?
None
j. Proposed measures to avoid or reduce displacement impacts, if any:
NA
L. Proposed measures to ensure the proposal is compatible with existing and projected land
uses and plans, if any: None
m. Proposed measures to ensure the proposal is compatible with nearby agricultural and forest
lands of long -tern commercial significance, if any: None
9. Housing
a. Approximately how many units would be provided, if any? Indicate whether high, mid-
dle, or low-income housing.
One single family home to be constructed under future permit.
b. Approximately how many units, if any, would be eliminated? Indicate whether high,
middle, or low-income housing.
None
c. Proposed measures to reduce or control housing impacts, if any:
NA
10. Aesthetics
a. What is the tallest height of any proposed structure(s), not including antennas; what is
the principal exterior building matedal(s) proposed?
Unknown at this time
b. What views in the immediate vicinity would be altered or obstructed?
Slightly more light will enter the site as a result of logging and clearing.
MPA EnvironmvAalchecklbt)WAL 18741-960) May 2014 Page 9 o 14
g. Proposed measures to reduce or control aesthetic impacts, if any:
None
11. Light and Glare
a. What type of light or glare will the proposal produce? What time of day would it mainly
occur?
None
b. Could light or glare from the finished project be a safety hazard or interfere with views?
No
c. What existing off-site sources of light or glare may affect your proposal?
None
d. Proposed measures to reduce or control light and glare impacts, if any:
None
12. Recreation
a. What designated and informal recreational opportunities are in the immediate vicinity?
Public and rivate forest lands adjacent host berry picking, hunting and hiking.
b. Would the proposed project displace any existing recreational uses? If so, describe.
No
c. Proposed measures to reduce or control impacts on recreation, including recreation
opportunities to be provided by the project or applicant, if any:
None
13. Historic and cultural preservation
a. Are there any buildings, structures, or sites, located on or near the site that are over 45
years old listed in or eligible for listing in national, state, or local preservation registers
located on or near the site? If so, specifically describe.
No
b. Are there any landmarks, features, or other evidence of Indian or historic use or
occupation? This may include human burials or old cemeteries. Are there any material
SEPA Emimnme al Cn MM 1WAC 197-114Wl Mar2014
evidence, artifacts, or areas of cultural importance on or near the site? Please list any
professional studies conducted at the site to identify such resources.
No
c. Describe the methods used to assess the potential impacts to cultural and historic
resources on or near the project site. Examples include consultation with tribes and the
department of archeology and historic preservation, archaeological surveys, historic
maps, GIS data, etc.
None
d. Proposed measures to avoid, minimize, or compensate for loss, changes to, and
disturbance to resources. Please include plans for the above and any permits that may
be required.
None
14. Transportation
a. Identify public streets and highways serving the site or affected geographic area and
describe proposed access to the existing street system. Show on site plans, if any.
See site plan map
b. Is the site or affected geographic area currently served by public transit? If so, generally
describe. If not, what is the approximate distance to the nearest transit stop?
No, distance to bus stop is unknown
c. How many additional parking spaces would the completed projector non -project
proposal have? How many would the project or proposal eliminate?
None
d. Will the proposal require any new or improvements to existing roads, streets, pedestrian,
bicycle or state transportation facilities, not including driveways? If so, generally describe
(indicate whether public or private).
No
Will the project or proposal use (or occur in the immediate vicinity of) water, rail, or air
transportation? If so, generally describe.
No
SEPA Envllonme,Hal chekUV(NAL IW -014160) 101ay2014 Page 11
f. How many vehicular trips per day would be generated by the completed project or
proposal? If known, indicate when peak volumes would occur and what percentage of
the volume would be trucks (such as commercial and nonpassenger vehicles). What
data or transportation models were used to make these estimates?
3-5 loads of logs will be removed and 2-4 equipment transport truck/trailer trips will be
needed to move eqiuipment in and out.
g. Will the proposal interfere with, affect or be affected by the movement of agricultural and
forest products on roads or streets in the area? If so, generally describe.
No
h. Proposed measures to reduce or control transportation impacts, if any:
None
15. Public Services
a. Would the project result in an increased need for public services (for example: fire
protection, police protection, public transit, health care, schools, other)? If so, generally
describe.
No
b. Proposed measures to reduce or control direct impacts on public services, if any.
None
16. utilities
a. Circle utilities currently available at the site:
electricity, natural gas, water, refuse service, telephone, sanitary sewer, septic system.,
other
b. Describe the utilities that are proposed for the project, the utility providing the service,
and the general construction activities on the site or in the immediate vicinity which might
be needed. Electricy and telephone to be extended into the parcel under separate future
permits.
C. Signature
The above answers are true and complete to the best of my knowledge. I understand that the
lead agency is relying on them to make
its decision.
Signature: ��eZ-2(/�e>•,...__
Name of signee Michael R. Cronin CF,
Position and Agency/Organization: Owner and Certified Fortester, Cronin Forestry
Date Submitted: 04/07/16
SEPA iMrvir.O.eMalchecklbl(WAC 197-11460) May 2014 Page 12 M 14