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HomeMy WebLinkAbout03- SEPA CHECKLISTSEPA Environmental checklist (WAC 197-11-960) July 2016 Page 1 of 23 SEPA ENVIRONMENTAL CHECKLIST Purpose of checklist: 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. 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 SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part D). 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. A. Background [HELP] 1. Name of proposed project, if applicable: Pomona Woods 2. Name of applicant: Ann Burkhart *Exhibit C* SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 2 of 23 3. Address and phone number of applicant and contact person: PO Box 145, Port Hadlock, WA 98339, 206-480-8467 4. Date checklist prepared: 8/19/2021 Project is currently in the Conditional Use Permit application phase (under review by Jefferson County). 5. Agency requesting checklist: Jefferson County DCD 6. Proposed timing or schedule (including phasing, if applicable): The road, well and septic installation will start as soon as the C.U.P. approved. Construction will start in Spring/Summer 2022. 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. No. The retreat center and caretaker house are the only buildings planned at this time. 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. A Geologic Hazard Assessment was completed by Stratum Group in July 2021 (attached). We also received a Custom Soil Resource Report for the area from NRCS data provided by WA State DNR forester Matt Provencher. 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. We are currently in-process with Jefferson County DCD for a Conditional Use Type III Permit and Road Access Permit. In addition, we have prepared our Class IV-General Forest Practice Application Notification for DNR and had it reviewed by Ross Goodwin. As soon as we have the SEPA Final Determination letter we will submit it with a site map to DNR with payment. 10. List any government approvals or permits that will be needed for your proposal, if known. To date I am only aware of Jefferson County approvals and permits identified on the Submittal Checklist Residential / Commercial Building Application. As mentioned above, we are currently in process to get a Conditional Use Type III Permit from Jefferson County DCD. We have submitted all documentation, updated to respond to changes and questions from DCD, and will go before the Hearing Examiner with DCD is ready. 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 specific information on project description.) The proposed project, Pomona Woods, will be a 24 room retreat center with a commercial kitchen on-site to serve guests 3 meals a day. It is currently allowable under RR-20 zoning under Jefferson County Code 18.20.350 classification of Small-scale recreation and tourist uses. (9) Rural Recreational Lodging or Religious Conference Center/Retreat Facilities. Guests will always be there as one group, not for individual room stays (corporate or not-for-profit strategic planning off site, yoga workshop, family or friends gathering, etc). The SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 3 of 23 maximum square footage of the 2 story retreat building will be 12,000 SF and there will be 29 parking spaces for the retreat center. In addition, there will be a small caretaker house on-site with 2 parking spaces. The road will be just over 1,800 ft long and will have conduits to take electricity, cabel and water to the site and septic from the retreat and caretaker cabin to the septic field. The Stormwater Site Plan shows the planned location of the buildings, road and septic field. The size of the 2 parcels combined is 938,282 SF. The construction site for the retreat center and caretaker cabin combined will be 7,000 SF. The driveway will be 46,787 SF. Pomona Woods will incorporate smart building design, to meet or exceed Washington State Energy Code requirements. The plans include a high efficiency heat pump system, a high efficiency building envelope, low air leakage with a heat recovery ventilation system, energy efficient lighting, energy efficient water heating and kitchen appliances, and rooftop solar panels. To minimize use of concrete (and the associated high carbon footprint) and lessen the impact on the soil and fungal mycelium we will use helical screw piles vs. concrete foundation. We are partnering with an environmentally committed contractor to execute our sustainable, small-footprint vision. Our architect is LEED certified and the interior designer is GREENleader certified from the Sustainable Furnishings Council. 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 permit applications related to this checklist. The presumed street address is 3030 Oak Bay Road (not official). Jefferson County Parcel #s 921183008 and 921183002. Section: 18, Township: 29N, Range: 1E (Base Site Plan attached). B. Environmental Elements [HELP] 1. Earth [help] 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)? From the road to the top of the property the slope is 14%, but there are some flat areas at the top. The steepest areas of the site probably aren’t much more than 16 or 17%. From the attached Stratum Group Report, “Slopes throughout the properties are moderate slopes. Slopes along some of the relict valley slides are somewhat steeper. There is a moderately steep low cut slope along portions of the east side of the property associated with Oak Bay Road (Figure 4). No slope failures are evident along the cut slope. The slopes are forested with a mix stand of mature trees including western red cedar, Douglas fir, western hemlock, big leaf maple and red alder. The understory vegetation is SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 4 of 23 predominantly sword fern throughout most of the site. The upper very gentle slopes have thicker brush areas and more red alder.” The site is pictured below in a revised image below from Dan McShane. It now shows the steepest area, 30% slope, and the potential erosion areas due to periodic water flow. 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. Per the attached NRCS Soil Report: • Soils at the top (West) side of the property is SnC (Sinclair gravelly sandy loam, 0 to 15 percent slope. • There is a small section in the upper East section that is SnD (Sinclair gravelly sandy loam, 15 to 30 percent slopes) • The middle section is CfD (Cassolary sandy loam, 15 to 30 percent slopes) • Next to Oak Bay Road it is AmD (Alderwood gravelly loam, 15 to 30 percent slopes) d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. From the attached Stratum Group Report: “The property is underlain by well drained dense silty to sandy hard glacial till. No evidence of previous, ongoing, or incipient landsliding is present on the property. The relict valleys on the property have stable slopes and the road cut above Oak Bay Road appears to be stable with no indications of potential sliding on the cut slopes.” In addition, per Jefferson County maps, the “slight” risk of landslide hazard and “intermediate”, not “unstable”, Shoreline Slope Stability are only on the lower three-quarters of the property. The retreat building and the caretaker cabin will be built at the Eastern, mostly flat quarter of the property. SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 5 of 23 e. Describe the purpose, type, total area, and approximate quantities and total affected area of any filling, excavation, and grading proposed. Indicate source of fill. No excavation has been done on site. For the road, pit run and crushed granite will be used. Per Shold quote for the driveway: • Build construction access into job site by installing a 40' long 12" HDPE culvert and spreading 120 tons of 2" to 4" crushed basalt. • Spread, grade, and compact 760 yards of screened pit run over new driveway 16' Wide for 6" base course. • Spread, grade, and compact 420 tons of 3/4" minus crushed granite over new driveway 14' wide for 2" top course. The plan for the buildings is put them on diamond piers so minimal excavation will be done. Total anticipated cut and fill from the Stormwater calculation worksheet is 2,500 cu/yd of each.d f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. Per Stratum Group quote in answer d., no, considering use of best practices identified in the Stormwater Calculation Worksheet that will be used for the project. g. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? Per submitted Stormwater Calculation Worksheet, the total SF of the two parcels is 938,282 sq. ft. • Gravel driveway and parking is 46,787 SF • Building impervious is 6,710 SF Total Impervious is 53,497 Total Percent Impervious is 5.7% h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: Please refer to completed Stormwater Calculation Worksheet. 2. Air [help] 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. Diminimous. There will be some impact of the actual construction (dust) but the builder, G. Little, will be following all best practices to minimize impact, including: • Cover all on ground stockpiles with poly membrane in dry months and straw during the wet months. • Spraying exposed soil and storage areas with water during dry periods. • Cleaning construction entrances and maintaining construction road as weather and construction activities dictate. The owner, Ann Burkhart, will be on-site monitoring as well. In addition, the 21.5 acres are heavily wooded which will shield neighbors from impact of construction. b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 6 of 23 No. The property is surrounded by commercial forest on the West and North sides, one residence on South side and one next to road on the North. Oak Bay Road is the Eastern boundry with residences on the other side of the road near the water. If/when the commercial forest is logged there will be a possible temporary odor emission from heavy equipment. c. Proposed measures to reduce or control emissions or other impacts to air, if any: We are required to maintain a 250ft setback from the commercial forest and that area is heavily wooded. That will shield the Pomona Woods activities from any possible emissions. 3. Water [help] a. Surface Water: [help] 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. • Per Stratum Group report, “Periodic water flow may take place during unusual weather events such as rapid heavy snow melt on frozen ground. However, no significant erosion was observed in any of the valleys on the properties and with the exception of the very lower end of two of the valleys, there was no evidence of water.” • Jefferson County DCD Staff Biologist Donna Frostholm did an onsite review of all the valleys where they meet the road and determined there are no wetlands on-site. • A review of the Jefferson County Public Land Records Mapping Application showed no evidence of critical areas on the parcel, including water bodies, wetlands or watersheds within the Pomona Woods parcels. 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. A review of the Jefferson County Public Land Records Mapping Application showed no evidence of water bodies, wetlands within the Pomona Woods parcels. 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. A review of the Jefferson County Public Land Records Mapping Application showed no evidence of water bodies, wetlands within the Pomona Woods parcels. 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. A review of the Jefferson County Public Land Records Mapping Application showed no evidence of water bodies, wetlands within the Pomona Woods parcels. 5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. No. A review of the Jefferson County Public Land Records Mapping Application showed no FEMA 100yr flood risk within the Pomona Woods parcels. SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 7 of 23 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 waste materials will be discharged and a review of the Jefferson County Public Land Records Mapping Application showed no evidence of water bodies, wetlands within the Pomona Woods parcels. b. Ground Water: [help] 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. No. We are working with Jefferson County PUD to do a waterline extension from the Quimper Water System. 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. The septic system is under design by Shold. A single septic system is proposed to treat and discharge domestic sewage from the retreat building and the caretaker house. The total footprint of the septic system is expected to be 5,000 square feet or less, and located primarily in the North-eastern portion of the subject property. c. Water runoff (including stormwater): 1) Describe the source of runoff (including storm 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. Per the revised Stormwater Calculation Worksheet and Site Plan we will be utilizing a dispersion method. The site is big enough and has mature forest to absorb the runoff. In addition, we will be installing rain gardens for both buildings, as described in question d. below. 2) Could waste materials enter ground or surface waters? If so, generally describe. No. We will not be generating waste materials onsite (other than what is properly managed through the septic system). A review of the Jefferson County Public Land Records Mapping Application showed no evidence of critical areas on the parcel, including water bodies, wetlands or watersheds within the Pomona Woods parcels. 3) Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site? If so, describe. No. All the building run-off will be captured throught the rain gardens and, as back up, the full dispersion method described in the Stormwater Calculation Worksheet. There will be no alteration of natural drainage patterns. d. Proposed measures to reduce or control surface, ground, and runoff water, and drainage pattern impacts, if any: SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 8 of 23 To meet MR#9 Operation & Maintenance, and ensure that the approved stormwater management facilities are appropriately mainted for the life of the project, we will be signing and implementing the Stormwater Management Facility Maintenance Agreement prepared by the Public Works Department of Jefferson County. Although not required, we will be installing a rain gardens to control runoff from the roof. The rain garden will be designed per best practices outlined in the Rain Garden Handbook for Western Washington produced by Washington State Department of Ecology and Washington State University Extension. https://apps.ecology.wa.gov/publications/publications/1310027.pdf The full roof surfaces of the retreat building at 6,000 SF, and caretaker building at 710 SF, will each drain into a rain garden. Their locations are marked in the revised Stormwater Site Plan. The retreat building rain garden footprint, including the 1’ overflow area on all sides, will be 684 SF. The caretaker building rain garden footprint, including the 1’ overflow area on all sides, will be 105 SF. Building Roof SF Sizing Factor SF Top Surface Overflow Containment Retreat 6,000 9% 540 684 Cabin 710 9% 63.9 105 The Pomona Woods owner has experience with installation and maintenance of rain gardens as seen at: http://www.seattlechannel.org/CityStream/segments?videoid=x54377 4. Plants [help] 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? Where the retreat building, parking lot and caretaker cabin will be built the current vegetation is predominately nettles, berries, salal, sword fern, alder and some big leaf maple. A few cedars, hemlock and douglas firs may also have to be removed but every effort will be made to preserve trees of significant size/age that are in good health. • Clearing for constructions of structures equals 7,000 SF • Clearing for lawn and other compacted surface equals 5,155 SF Total equals 12,155 SF SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 9 of 23 For the road, cedar, douglas firs, hemlock, and sword fern will be the predominant species removed. • Clearing for the driveway and parking equals 46,787 SF Total percent of site cleared equals 6%. Septic SF of 27,622 was not included because Shold plan indicates that major clearing will not be necessary. c. List threatened and endangered species known to be on or near the site. None. A review of U.S. Fish and Wildlife Endangered species database IPaC Planning and Consultation the following Endangered Species are listed https://ecos.fws.gov/ipac/location/EEJMUE4GYJDYVDPZ3ATBBIUVZE/resources • Golden Paintbrush THERE ARE NO CRITICAL HABITATS AT THIS LOCATION. d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any: We will be leaving native vegetation in all areas except in the land disturbance areas indicated in the revised Stormwater Calculation Worksheet. Where landscaping is done close to the retreat center building we will focus on native plants, with the exception of a small grassy field for gathering and games with adjacent vegetable garden. The combined area of lawn and vegetable garden will be 4,000 SF. As indicated on the revised site plan (dated 11/19/2021) a Screen A Landscaping of at least 50’ will be maintained around the permiter of the property. e. List all noxious weeds and invasive species known to be on or near the site. Holly, laurel 5. Animals [help] 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. Observed onsite: ravens, robins, pileated woodpeckers and deer. Possible species in Port Hadlock/Irondale per iNaturalist https://www.inaturalist.org (excluding marine mammals, waterfowl and shorebirds). Fish species were also not included because there are no water bodies on site. Land Mammals Birds Continued Mule Deer Bald Eagle Douglas’ Squirrel Robin Coyote Dark Eyed Junco Common Racoon American Crow Eastern Gray Squirrel White Crowned Sparrow Virginia Opossum Spotted Towhee Townsend’s Chipmunk Song Sparrow Eastern Cottontail Barn Swallow Black Rat Anna’s Hummingbird Coast Mole Northern Flicker American Shrewmole Red-breasted Nuthatch Long-tailed Weasel House Finch Deer Mouse Chesnut Backed Chickadee SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 10 of 23 Townsend’s Vole Rufous Hummingbird Mountain Lion Red Winged Blackbird Bobcat Yellow-rumped Warbler Northwestern Deer Mouse European Starling Americn Beaver Downy Woodpecker Masked Shrew Cedar Waxwing Townsend’s Mole Steller’s Jay North American Porcupine House Sparrow Meadow Vole American Goldfinch Brown Rat Pileated Woodpecker American Black Bear Black-capped Chickadee Bushy-tailed Woodrat Golden-crowned Sparrow Vagrant Shrew Rock Pigeon Flying Squirrels Bushtit American Water Shrew Common Raven Trowbridge’s Shrew Violet-green Swallow Ambhibians Varied Thrush Northern Pacific Tree Frog Purple Martin Northern Red-legged Frod Ruby-crowned Kinglet Rough-skinned Newt Barred Owl Ensatina Pine Siskin Northern Salamander Red-tailed Hawk Long-toed Salamander Blcak-headed Grosbeak Western Red-backed Salamander Brown-headed Cowbird Birds Eurasian Collared-Dove Warbling Vireo House Wren Black-throated Gray Warbler Red-breasted Sapsucker Townsend’s Warbler Cooper’s Hawk Evening Grosbeak Red Crossbill Mountain Bluebird Savannah Sparrow Hutton’s Vireo Golden-crwoned Kinglet American Dipper Pacific Wren Canada Jay Hairy Woodpecker White-Winged Crossbill Bewisck’s Wren Townsend’s Solitaire Wilson’s Warbler Lincoln’s Sparrow Orange-crowned Warbler White-throated Sparrow Band-tailed Pigeon Lazuli Bunting Fox Sparrow Say’s Phoebe Turkey Vulture Evening Bats Purple Finch Old World Buntings Brown Creeper Ring-necked Pheasant Western Tanager California Quail Tree Swallow Cliff Swallow Sharp-Shinned Hawk Northern Rough Winged Swallow Northern Harrier Olive-sided Flycatcher Pacific-slope Flycatcher Brewer’s Blackbird Mourning Dove California Scrub-Jay Peregrine Falcon Merlin Marsh Wren Hermit Thrush Swainson’s Thrush Cackling Goose Willow Flycatcher Chipping Sparrow Yellow Warbler Western Meadowlark Common Yellowthroat SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 11 of 23 b. List any threatened and endangered species known to be on or near the site. None. A review of the Jefferson County Public Land Records Mapping Application showed no evidence of Riparian Cover (PNPTC, 2009), Channel Migration Zones or Marbled Murrelet and Spotted Owl Habitat (USFWS). A review of U.S. Fish and Wildlife Endangered species database IPaC Planning and Consultation the following Endangered Species and Migratory Birds are listed https://ecos.fws.gov/ipac/location/EEJMUE4GYJDYVDPZ3ATBBIUVZE/resources • Streaked Horned Lark (Threatened) • Yellow-billed Cuckoo (Threatened) THERE ARE NO CRITICAL HABITATS AT THIS LOCATION. c. Is the site part of a migration route? If so, explain. No. A review of the Jefferson County Public Land Records Mapping Application showed no evidence of Riparian Cover (PNPTC, 2009), Channel Migration Zones or Marbled Murrelet and Spotted Owl Habitat (USFWS). A review of the Jefferson County Public Land Records Mapping Application showed no evidence of water bodies, wetlands within the Pomona Woods parcels. A review of U.S. Fish and Wildlife Endangered species database IPaC Planning and Consultation the following Endangered Species and Migratory Birds are listed https://ecos.fws.gov/ipac/location/EEJMUE4GYJDYVDPZ3ATBBIUVZE/resources • Streaked Horned Lark (Threatened) • Yellow-billed Cuckoo (Threatened) d. Proposed measures to preserve or enhance wildlife, if any: Preservation of the forest, creation of a rain garden as described in question 3.d. The rain garden will be planted with native species. e. List any invasive animal species known to be on or near the site. Per the site https://invasivespecies.wa.gov/find-a-priority-species/?_sft_priority-specie-type=invasive-animals. The possible species (non-aquatic) could include Bullfrog, but they have not been heard or seen on the property. 6. Energy and Natural Resources [help] 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. Pomona Woods will incorporate smart building design, to meet or exceed Washington State Energy Code requirements. For the retreat building the plans include a high efficiency heat pump system for heating the building, a high efficiency building envelope, low air leakage with a heat recovery ventilation system, energy efficient lighting, energy efficient water heating and kitchen appliances, and rooftop solar panels. b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally describe. No. The building will be 2 stories high, shorter than the surrounding forest that will be maintained as a screen along the outer edge of the property. SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 12 of 23 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: Smart building design, to meet or exceed Washington State Energy Code requirements. The plans include high efficiency heat pump heating, a high efficiency building envelope, low air leakage with a heat recovery ventilation system, energy efficient lighting, energy efficient water heating and kitchen appliances, and potential rooftop solar panels. 7. Environmental Health [help] 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. None. The retreat center will be for lodging and education/meetings in a group format. Non-toxic cleaning supplies will be used for housekeeping. There will be an outdoor firepit on site with sand buckets and a water spigot close by for thoroughly extinguishing fires. It will only be used if winds are below 15mph and there are no county burn bans. There will be no overhanging vegetation near the fire pit. 1) Describe any known or possible contamination at the site from present or past uses. There are no structures on the parcels and the only evidence of use is from selective logging. 2) Describe existing hazardous chemicals/conditions 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. There are no pipeline or other chemicals/conditions that might affect the project development and design. The site has been walked and the parcel history reviewed on the Jefferson County Parcel Search. 3) Describe any toxic or hazardous chemicals that might be stored, used, or produced during the project's development or construction, or at any time during the operating life of the project. Per Trent McKnight at G. Little Construction, the project builder, “we do not store or produce toxic or hazardous chemicals. Some paints, cabinet finish products, floor finishes have properties that could be defined as hazardous. With the philosophy of this project we will be looking to find alternatives to all of those products.” Regardless of the types of paints and finishes used, we will be ensuring that they are stored on-site in a way that prevents leaks and spills and that partially used product and packaging is properly disposed of off-site. 4) Describe special emergency services that might be required. Pomona Woods will potentially utilize regular emergency services (fire, medical emergency, police). We will also reach out to county/Tri-Area emergency services to explore how we can be of service in the local disaster response plan since we will have rooms and a certain amount of food stored on site, as well as a generator. 5) Proposed measures to reduce or control environmental health hazards, if any: SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 13 of 23 As a retreat center focused on connection to nature we will be actively monitoring forest health through daily walks throughout the forest, at least annual arborist/forester visits, and by keeping all systems such as the rain garden in good working order. Invasive plants like English Ivy, Himalayan blackberry and Holly will be promptly removed so they do not spread on-site or to the neighbors. The road will be reviewed annually to make sure drainages are working properly and there is no danger of erosion. To meet MR#9 Operation & Maintenance, and ensure that the approved stormwater management facilities are appropriately mainted for the life of the project, we will be signing and implementing the Stormwater Management Facility Maintenance Agreement prepared by the Public Works Department of Jefferson County. b. Noise 1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? None that I’m currently aware of. The Oak Bay Road traffic can barely be heard at the top (West) side of the property so it will not disturb even the outdoor activities near the retreat. While guests walk the trails on the property they will hear the traffic but it is just a light whoosh and not disruptive. The traffic on Oak Bay Road is light. If the commercial forest land is harvested that will be a temporary disruption. 2) What types and levels of noise would be created by or associated with the project on a short-term or a long-term basis (for example: traffic, construction, operation, other)? Indi- cate what hours noise would come from the site. Traffic: Most guests are likely to arrive via private car or rented van/bus via roads and WA State Ferry Service. Based on Pomona Woods proprietary business financial projections, where the number of guests per year is calculated, we estimate that the average number of guests on site at peak will be as shown in the table below. Average guests on site per night is 24, times 71% average occupancy in a year, times 365 days. Because the facility is only rented to groups most will carpool to the location and will be encouraged to do so. Guests will arrive in the between 8:00am-7:00pm on their arrival day and leave between 8:00am-11:00am on their departure day. Deliveries will be scheduled for business hours – 8:00am-5:00pm so as to not disturb neighbors or guests. Construction: There will be typical construction noise while the retreat center and caretaker cabin is being built. Guests/yr@ peak, yr 7 (24*.71*365)6,219.60 RT = yearly guest estimate*2 12,439.20 Divide by Av. Carpool 2-3 (used 2.5)4,975.68 Trips per day (divide by 365)13.63 6 commuting staff *2 for RT 12.00 Deliveries 2x Week *2 for RT 0.57 Total trips / day 25.63 SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 14 of 23 Operations: During the day (9:00am-8:00pm) the guests may do some gathering outside for team building activities. It will never be more than 35 people and amplification won’t be allowed on site. 3) Proposed measures to reduce or control noise impacts, if any: Traffic: • Guests will be strongly encouraged to carpool or make use of shuttles • 15mph signs will be posted on the driveway to minimize noise and protect the road Short Term Construction: • Per noise ordinance 02-0209-15 construction related activities will be limited to 7:00AM to 10:00PM. G. Little is typically on site from 7:00AM to 3:30PM and will minimize the noise before 8:00AM. • Minimize noise during the first hour of the acceptable noise ordinance period by focusing on lower noise construction activities such as staging, team meetings, plan reviews and material mobilization. • MInimize weekend work and evening work. • Owner will be living on-site to monitor noise and other impacts. Long Term Business Operations: • Quiet hours at the retreat center will be 10:00PM - 8:00AM. • There will be no amplification allowed on-site. • Most of the meetings will be held indoors. • Guest contracts, website language and guest orientations will emphasize the need to respect neighbors. 8. Land and Shoreline Use [help] 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. Site has not been used. Pomona Woods activities would not affect current land uses adjacent or nearby. Pomona Woods is designed to spark a lasting connection with nature, one's self, and each other – all while adding value to the local community. We will host small group retreats for the purpose of education, enrichment and connection. To ensure and manage minimal impact on the site and for neighbors, and create a uniquely intimate experience for guests, we will limit occupancy to a maximum of 35 guests. We will not be hosting individual bookings at our retreat. Per Jefferson County Unifed Development Code requirement in 18.30.140(1), outdoor safety lights will be located lower than 20 feet and will be aimed low to encourage star gazing by guests. They will be energy-efficient and shielded or recessed so that direct glare and reflections are contained within the boundaries of the parcel. They will also be directed downward and away from adjoining properties. Roll shades will be installed on the windows so they can come down at night to control glare. The at least 50 feet of forest screening that will be maintained around the property will provide additional shielding. Quiet hours from 10:00PM - 8:00AM will be strictly maintained. No amplification will be allowed outside any time of day. The property line to the South will be professionally surveyed and will be clearly marked every 50 feet with no trespassing signs to make sure SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 15 of 23 guests do not wander off the property onto neighbor’s land. The dirt walking trails will not go within the 50 feet screening area identified in the site plan. 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? There is evidence of a harvest around the early 1900s (spring board notches in cedar stumps) and then 1-2 other selective harvests, per the WA State DNR forester who came on site to provide advice on keeping the forest healthy. The land is not designated as a commercial forest. There is no evidence of regular, sustained use of any kind on the 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. If the commercial forest on the W and N sides are harvested it will be noticed, but we have to maintain a 250 ft setback anyway for all buildings. c. Describe any structures on the site. None. A review of Jefferson County Assesor and Treasurer records for the 2 parcels confirms no improvement/buildings. d. Will any structures be demolished? If so, what? Per question c. there are no structures to demolish. e. What is the current zoning classification of the site? Parcel # 921183002 is RR5 and Parcel # 921183008 is RR20 f. What is the current comprehensive plan designation of the site? Rural Residential (In the Tri-Area Planning Area) g. If applicable, what is the current shoreline master program designation of the site? A review of the Jefferson County Public Land Records Mapping Application showed no evidence of critical areas on the parcel, including water bodies, wetlands or watersheds within the Pomona Woods parcels. h. Has any part of the site been classified as a critical area by the city or county? If so, specify. A review of the Jefferson County Public Land Records Mapping Application showed no evidence of critical areas within the Pomona Woods parcels. Exception: Per Jefferson County maps, the “slight” risk of landslide hazard and “intermediate”, not “unstable”, Shoreline Slope Stability are only on the lower three-quarters of the property. The retreat building and the caretaker cabin will be built at the Eastern, mostly flat quarter of the property. The lower third of the property is in the Coastal SIPZ “<100ppm chloride and ¼ mile from shoreline” but we will be connecting to the Quimper Water System. i. Approximately how many people would reside or work in the completed project? SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 16 of 23 1 person will live on site in the caretaker cabin and up to 7 people will work on site. Guests on site will be limited to 35 so maximum total people on site at any time is 43. j. Approximately how many people would the completed project displace? None. No one has been living on-site and there are no structures on-site, so no one will be displaced. k. Proposed measures to avoid or reduce displacement impacts, if any: No one has been living on-site and there are no structures on-site, so no one will be displaced. L. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: There are no existing land use plans. m. Proposed measures to reduce or control impacts to agricultural and forest lands of long-term commercial significance, if any: We are required to maintain a 250 ft setback to the adjacent forest lands so will have no impact on them. There are no agricultural lands close by. 9. Housing [help] a. Approximately how many units would be provided, if any? Indicate whether high, mid- dle, or low-income housing. No housing for sale or rental. This is a retreat center for short-term guests. There will be 24 single rooms and capacity will be capped at 35 people. b. Approximately how many units, if any, would be eliminated? Indicate whether high, middle, or low-income housing. None. No one has been living on-site and there are no structures on-site, so no one will be displaced. c. Proposed measures to reduce or control housing impacts, if any: No one has been living on-site and there are no structures on-site, so no one will be displaced. 10. Aesthetics [help] a. What is the tallest height of any proposed structure(s), not including antennas; what is the principal exterior building material(s) proposed? 27 ft. (2 stories). Either Hardie board or cedar plank (dark brown) will be used on the exterior. Approx. 4,500 sq ft of windows. b. What views in the immediate vicinity would be altered or obstructed? None. There is a mature forest throughout the 2 parcels which are higher than the 2 story retreat building. A natural forest screening of 50Ft. will be maintained around the edge of the property. In addition, the only close neighbor (on the S Side) is downhill from the project site. See picture below. SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 17 of 23 b. Proposed measures to reduce or control aesthetic impacts, if any: Natural forest screening of 50Ft. will be maintained around the edge of the property. Sign: We have not designed the actual sign yet but it will be as per 18.30.150 (h) a “Directional sign” meant to designate the location of Pomona Woods and will be submitted for permit when designed. We will design something similar to the picture below, but not to exceed 4 ft high and 8 ft wide (32 square feet). The sign will be located on the North side of the entrance road to the property, at least 10 feet back from Oak Bay Road (past the brush trimming line for Oak Bay Road) and parallel to the road. The illumination will be shielded and directed so the light intensity/brightness shall not adversely affect surrounding properties or create a hazard or nuisance to the traveling public. The sign location is noted on the site plan. 11. Light and Glare [help] a. What type of light or glare will the proposal produce? What time of day would it mainly occur? We will have safety lights outside to mark paths and the large glass windows will emit light at night. b. Could light or glare from the finished project be a safety hazard or interfere with views? No. Per Jefferson County Unifed Development Code requirement in 18.30.140(1), outdoor safety lights will be located lower than 20 feet and will be aimed low to encourage star gazing by guests. They will be energy-efficient and shielded or recessed so that direct glare and reflections are contained within the boundaries of the parcel. They will also be Neighbor Retreat Building SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 18 of 23 directed downward and away from adjoining properties. Roll shades will be installed on the windows so they can come be lowered at night to control glare. The at least 50 feet of forest screening that will be maintained around the property will provide additional shielding so they will not be a safety hazard or interfere with views. In addition, the only close neighbor (on the S Side) is downhill from the project site. c. What existing off-site sources of light or glare may affect your proposal? None I am aware of. Surounding land is either commercial forest or residential. The residence to the South is at least 97ft. from the property line. At the Eastern end of the property next to Oak Bay Road the residence to the North is 138ft from the property line. That residence is far down hill from the retreat building. The distances were measured using tools on the Jefferson County Public Land Records Mapping Application. d. Proposed measures to reduce or control light and glare impacts, if any: Per Jefferson County Unifed Development Code requirement in 18.30.140(1), outdoor safety lights will be located lower than 20 feet and will be aimed low to encourage star gazing by guests. They will be energy-efficient and shielded or recessed so that direct glare and reflections are contained within the boundaries of the parcel. They will also be directed downward and away from adjoining properties. Roll shades will be installed on the windows so they can come down at night to control glare. The at least 50 feet of forest screening that will be maintained around the property will provide additional shielding so they will not be a safety hazard or interfere with views. 12. Recreation [help] a. What designated and informal recreational opportunities are in the immediate vicinity? Biking local rural roads, hiking foothills and mountains of the Olympics and the Salish Sea shoreline, water sports in Sound and lakes, farm visits, art, culture and history of Port Townsend. b. Would the proposed project displace any existing recreational uses? If so, describe. No. It would benefit from and contribute to them because guests will learn about them and use them as is intended. We will focus on supporting local businesses such as recreational opportunities. Part of our vision is to connect guests with the local community through farm visits and dinner lectures from craftspeople, environmentalists, storytellers, artists and local tribal members. c. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: Since any impact will be positive, there is no need to reduce or control impacts. With maximum 35 guests at a time, any increase in demand will be slight. 13. Historic and cultural preservation [help] 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 ? If so, specifically describe. None are on site. The closest historical sites are Fort Townsend and Fort Flagler. SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 19 of 23 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 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. There is no evidence on the property site. The Chimacum Tribe used to occupy the Port Hadlock area. After their decline, the area became inhabited by the S’Klallam Tribe. Port Hadlock was an important tribal center known as the Capital of Puget Sound Clans. https://test.co.jefferson.wa.us/WebLinkExternal/0/edoc/1719247/Chapter3-PortHadlockEnvironmentalReportSEPA,September2008.pdf According to a Historylink.org article, “Chimacum, just south of Port Hadlock and three miles east of Discovery Bay, is a community that was once the site of an Indian village. It was named for the Chem-a-kum, a now-extinct Indian tribe that once inhabited the valley.” https://www.historylink.org/file/7472 Chimacum is about 5 miles from the property. According to the Jamestown S’Klallum Tribe website, Tamanowas Rock Sanctuary is an area of cultural importance. It is located near Anderson Lake State Park, just over 6 miles from the property. https://jamestowntribe.org/wp-content/uploads/2019/02/Tamawas-Rock-Sanctuary.pdf 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. Research over the Internet was conducted with a focus on the websites listed above in questions b. 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. If potentially significant archaeological sites are discovered during excavation, construction will be halted and a qualified archaeologist will be retained to determine an appropriate course of action. 14. Transportation [help] 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. The project site is served by county road Oak Bay Road, which, per conversation with John Fleming of Jefferson County, has a daily traffic count of 2,000-3,000 cars. The access is shown on the attached site plan next to milepost 3. Oak Bay Road in front of the property is a long straight stretch. According to JeffCo data, https://www.jeffersoncountypublichealth.org/DocumentCenter/View/12232/2021-Local- Traffic-Safety-Plan-Appendices: 7 accidents occurred • 1 was alcohol related • 2 involved hitting a deer • 1 was mechanical • 2 were driver error • 1 involved a group of cyclists From 2015-2019 no serious injury or fatal crashes occurred on Oak Bay Road. SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 20 of 23 Per the Department of Public Works Memorandum dated September 30, 2021 regarding Stormwater Site Plan Review and Comments: “Public Works Department Recommendation: Based on the minor increase in traffic, and low accident rate history along Oak Bay Road in the vicinity of the proposed project, the Department recommends finding that the proposal is not likely to result in significant adverse impacts related to transportation.” 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? Oak Bay Road is served by the #7 Jefferson County Transit Bus that goes from Port Townsend to Poulsbo (transit center). c. How many additional parking spaces would the completed project or non-project proposal have? How many would the project or proposal eliminate? 31 parking places will be created as a part of the project (See PW Base Site Plan for dimensions). None exist currently. 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. Per the Department of Public Works Memorandum dated September 30, 2021 regarding Stormwater Site Plan Review and Comments, “Public Works Department Recommendation: Public Works Department Recommendation: Based on the minor increase in traffic, and low accident rate history along Oak Bay Road in the vicinity of the proposed project, the Department recommends finding that the proposal is not likely to result in significant adverse impacts related to transportation. e. Will the project or proposal use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe. Most guests are likely to arrive via private car or rented van/bus via roads and WA State Ferry Service. 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? Based on Pomona Woods proprietary business financial projections, where the number of guests per year is calculated, we estimate that the average number of guests on site at peak will be as shown in the table below. Average guests on site per night is 24, times 71% average occupancy in a year, times 365 days. Because the facility is only rented to groups most will carpool to the location and will be encouraged to do so. Guests/yr@ peak, yr 7 (24*.71*365)6,219.60 RT = yearly guest estimate*2 12,439.20 Divide by Av. Carpool 2-3 (used 2.5)4,975.68 Trips per day (divide by 365)13.63 6 commuting staff *2 for RT 12.00 Deliveries 2x Week *2 for RT 0.57 Total trips / day 25.63 SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 21 of 23 During peak season – May to September – occupancy may reach 90% with a maximum of 35 guests on site at a time. The guests would stay 2-3 nights at a time. The facility will be rented out as a whole, not for individual room rental. 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. Oak Bay Road is predominately residential. 35 guests and 7 staff coming and going would have minimal overall impact on the 2-3,000/day cars that move on the road (traffic data from https://www.jeffersoncountypublichealth.org/DocumentCenter/View/12232/2021-Local-Traffic-Safety-Plan-Appendices Per the Department of Public Works Memorandum dated September 30, 2021 regarding Stormwater Site Plan Review and Comments, Public Works Department Recommendation: Based on the minor increase in traffic, and low accident rate history along Oak Bay Road in the vicinity of the proposed project, the Department recommends finding that the proposal is not likely to result in significant adverse impacts related to transportation. h. Proposed measures to reduce or control transportation impacts, if any: Guests will be encouraged to car pool or hire group transport. The entrance to the property is on a straight road with a low accident rate history. The bushes at the entrance to the property will be kept trimmed to ensure visibility. 15. Public Services [help] 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. There would be a diminimous impact on public services for maximum capacity of 35 guests and 7 staff. We will become a PUD customer for water and electricity. We will also require Fire Department and Police Protection. Some guests may make use of public transit available on Oak Bay Road. The owner will make use of local health care. No school service will be required. b. Proposed measures to reduce or control direct impacts on public services, if any. While we won’t be able to reduce the fact we may need the services described above, we will be extending the Quimper Water System at owner expense and will work with local emergency services disaster planning to see how we can be a part of that plan by potentially providing emergency shelter. 16. Utilities [help] a. Circle utilities currently available at the site: electricity, natural gas, water, refuse service, telephone, sanitary sewer, septic system, other ___________ There are no utilities currently available at the site. Power is at the road. 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. SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 22 of 23 On site septic will be built by Shold. Electricity will be brought in via the new driveway and will be provided by Jefferson PUD. We will also extend the Quimper Water System from Eagle Ridge Road to the end of the property so we can bring water up the road to have water service from Jefferson PUD. As soon as the Type III Conditional Use Permit is approved Shold will build the road and trench for the utilities. The retreat building and caretaker residence described in the site plan will be constructed starting in 2022. C. Signature [HELP] 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: ___________________________________________________ Name of signee __Ann M. Burkhart___________________________________ Position and Agency/Organization __Owner____________________________ Date Submitted: _November 17, 2021____________ D. Supplemental sheet for nonproject actions [HELP] (IT IS NOT NECESSARY to use this sheet for project actions) Because these questions are very general, it may be helpful to read them in conjunction with the list of the elements of the environment. When answering these questions, be aware of the extent the proposal, or the types of activities likely to result from the proposal, would affect the item at a greater intensity or at a faster rate than if the proposal were not implemented. Respond briefly and in general terms. 1. How would the proposal be likely to increase discharge to water; emissions to air; pro- duction, storage, or release of toxic or hazardous substances; or production of noise? Proposed measures to avoid or reduce such increases are: 2. How would the proposal be likely to affect plants, animals, fish, or marine life? Proposed measures to protect or conserve plants, animals, fish, or marine life are: SEPA Environmental checklist (WAC 197-11-960) July 2016 Page 23 of 23 3. How would the proposal be likely to deplete energy or natural resources? Proposed measures to protect or conserve energy and natural resources are: 4. How would the proposal be likely to use or affect environmentally sensitive areas or areas designated (or eligible or under study) for governmental protection; such as parks, wilderness, wild and scenic rivers, threatened or endangered species habitat, historic or cultural sites, wetlands, floodplains, or prime farmlands? Proposed measures to protect such resources or to avoid or reduce impacts are: 5. How would the proposal be likely to affect land and shoreline use, including whether it would allow or encourage land or shoreline uses incompatible with existing plans? Proposed measures to avoid or reduce shoreline and land use impacts are: 6. How would the proposal be likely to increase demands on transportation or public services and utilities? Proposed measures to reduce or respond to such demand(s) are: 7. Identify, if possible, whether the proposal may conflict with local, state, or federal laws or requirements for the protection of the environment.