HomeMy WebLinkAboutSEPA_Checklist_finalMidoriSEPA Environmental checklist (WAC 197-11-960) January 2023 Page 1 of 17
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.
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A. Background Find help answering background questions
1. Name of proposed project, if applicable: 294152 Hwy 101 rezone to AG
2. Name of applicant: Marko Colby, Midori Farm LLC
3. Address and phone number of applicant and contact person:
10 Old State Hwy, Quilcene, WA 98376 360.531.4579
4. Date checklist prepared:
2-28-23
5. Agency requesting checklist:
Jefferson County Dept of Community Development
6. Proposed timing or schedule (including phasing, if applicable):
7. Do you have any plans for future additions, expansion, or further activity related to or
connected with this proposal? If yes, explain.
No
8. List any environmental information you know about that has been prepared, or will be
prepared, directly related to this proposal.
NA
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.
NA
10. List any government approvals or permits that will be needed for your proposal, if known.
NA
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11. Give a 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 proposal is to change two parcels of property totaling 14.7 acres currently zoned for
Rural residential 1 in 5 to AG zoning.
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.
Parcel# 702133028 Address: 294152 Hwy 101 Quilcene WA 98376 Section 13
Township 27 N Range 2W
Parcel # 702133029 Address: 200 W Columbia St. Quilcene WA 98376 Section 13
Township 27 N Range 2W
Site map attached
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B. Environmental Elements
1. Earth Find help answering earth questions
a. General description of the site: 14.7 acres flat farmland with no buildings.
Circle or highlight one: Flat, rolling, hilly, steep slopes, mountainous, other: FLat
b. What is the steepest slope on the site (approximate percent slope)? 1%
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. Quilcene alder complex. Sandy to sandy gravel 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 quantities and total affected area of any
filling, excavation, and grading proposed. Indicate source of fill.
None
f. Could erosion occur because of clearing, construction, or use? If so, generally describe.
NA
g. About what percent of the site will be covered with impervious surfaces after project
construction (for example, asphalt or buildings)?
None
h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any.
NA
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2. Air Find help answering air questions
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.
None
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.
NA
3. Water Find help answering water questions
a. Surface Water: Find help answering surface water questions
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.
There is a seasonal drainage ditch on the SW corner of parcel # 702133028. It flows into Quilcene
Bay.
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 a general description,
purpose, and approximate quantities if known. No
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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: Find help answering ground water questions
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 a general description, purpose, and
approximate quantities if known.
There is currently a well on each parcel that are used for low use agricultural purposes.
No more than 3000 gallons per day.
2. Describe waste material that will be discharged into the ground from septic tanks or other sources,
if any (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.
NA
c. Water Runoff (including stormwater):
a) 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.
NA
b) Could waste materials enter ground or surface waters? If so, generally describe.
NA
c) Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site? If so,
describe. NO
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d) Proposed measures to reduce or control surface, ground, and runoff water, and drainage
pattern impacts, if any.
No changes to existing agricultural practices are planned.
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4. Plants Find help answering plants questions
a. Check the types of vegetation found on the site:
☐ deciduous tree: alder, maple, aspen, other
☐ evergreen tree: fir, cedar, pine, other
☐ 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? None
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. Continue to enhance perimeter with Native species plantings
e. List all noxious weeds and invasive species known to be on or near the site.
Canada thistle, Teasel and Himalayan blackberry
5. Animals Find help answering animal questions
a. List any birds and other animals that have been observed on or near the site or are known to be
on or near the site.
Songbirds, hawks, eagles. Deer.
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.
c. Is the site part of a migration route? If so, explain. NO
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d. Proposed measures to preserve or enhance wildlife, if any. No changes
e. List any invasive animal species known to be on or near the site. NA
6. Energy and Natural Resources Find help answering energy and natural resource questions
1. 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. Electricity for basic farm needs. Already exists.
2. Would your project affect the potential use of solar energy by adjacent properties? If so, generally
describe. No
3. 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 Find help with answering environmental health questions
a. Are there any environmental health hazards, including exposure to toxic chemicals, risk of fire and
explosion, spill, or hazardous waste, that could occur because of this proposal? If so, describe.
No.
1. Describe any known or possible contamination at the site from present or past uses.
None known.
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.
None
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.
None.
4. Describe special emergency services that might be required.
None.
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5. Proposed measures to reduce or control environmental health hazards, if any. None.
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b. Noise
1. What types of noise exist in the area which may affect your project (for example:
traffic, equipment, operation, other)? Proximity to Hwy 101
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)? Indicate what hours
noise would come from the site)? No change to existing noise levels.
3. Proposed measures to reduce or control noise impacts, if any. No changes
8. Land and Shoreline Use Find help answering land and shoreline use questions
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.
Current use of site is organic agriculture. No change of use is planned. Adjacent properties are AG
zoned farm land on the West, Rural residential properties to the N and S and Hwy 101 to the East.
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 because 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 project site has always been entirely in working farmland and there is no change to the proposed
use.
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? The proposal is to continue its use as working organic farmland.
c. Describe any structures on the site. There are two shipping container for storage and a
1200 sq ft hoop house for growing crops.
d. Will any structures be demolished? If so, what? No.
e. What is the current zoning classification of the site? Rural Residential 1 in 5.
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f. What is the current comprehensive plan designation of the site?
g. If applicable, what is the current shoreline master program designation of the site?
h. Has any part of the site been classified as a critical area by the city or county? If so,
specify.
i. Approximately how many people would reside or work in the completed project?
The existing farm has a seasonal staff of 5. No current plans for residences.
j. Approximately how many people would the completed project displace? None
k. 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. The plan is to continue existing land use.
m. Proposed measures to reduce or control impacts to agricultural and forest lands of long-term
commercial significance, if any. NA
9. Housing Find help answering housing questions
a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-
income housing. None
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
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10. Aesthetics Find help answering aesthetics questions
a. What is the tallest height of any proposed structure(s), not including antennas; what is
the principal exterior building material(s) proposed? No proposed structures at this time
b. What views in the immediate vicinity would be altered or obstructed?
None
c. Proposed measures to reduce or control aesthetic impacts, if any.
No to change to existing aesthetics.
11. Light and Glare Find help answering light and glare questions
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.
NA
12. Recreation Find help answering recreation questions
a. What designated and informal recreational opportunities are in the immediate vicinity?
Quilcene Bay, Olympic National Forest.
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.
NA
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13. Historic and Cultural Preservation Find help answering historic and cultural preservation
questions
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.
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 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.
There are no potential impacts.
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.
NA
14. Transportation Find help with answering transportation questions
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.
Hwy 101 is the main access to the farm. There is a mostly un-uses access on W. Columbia
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.
c. 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.
d. Will the project or proposal use (or occur in the immediate vicinity of) water, rail, or air
transportation? If so, generally describe. No
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e. 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?
This proposal creates no changes to existing traffic or vehicle use.
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f. 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
g. Proposed measures to reduce or control transportation impacts, if any. NA
15. Public Services Find help answering public service questions
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.
NA
16. Utilities Find help answering utilities questions
a. Circle utilities currently available at the site: electricity, natural gas, water, refuse service,
telephone, sanitary sewer, septic system, other:
Currently there is power and an existing septic system.
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.
No additional utilities required.
C. Signature Find help about who should sign
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.
X
Type name of signee: Marko Colby
Position and agency/organization: Co-owner Midori Farm LLC, representative for this project.
Date submitted: 2/28/2023
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