HomeMy WebLinkAboutZON2022-00037_03 SEPA CHECKLISTS EPA 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 helpfulto 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.
I nstru cti o n s fo r ap pl ica nts :
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 mav use "not applicahle" or
"does not applv" onlv when vou can explain whv it does not applv 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 pafis of vour 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.
lnstructions 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 proposars.'
For nonproject proposals (such as ordinances, regulations, plans and programs), complete the applicable
parts of sections A and B plus the supplrrurNrel sHrrt roR ruoNpRo.lrcr Rcttoxs (pad 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 "affecled 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 [neupl
1. Name of proposed project, if applicable:
2. Name of appticant: JU !>-vt'v.t- L C"-- I * c'lr:
3. Address and phone number of appticant and contact person: /L' 3l lA) aJ'^1.+T ,S'!
3ao - 3i 7 - gtE Po r't"Tv"nse^ii' tl A 7836e
SEPA Environmental checklist (WAC r97-1 1-960)July 2016 Page 1 of 12
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4. Date checklist prepared:
5. Agency requesting checklist:
6. Proposed timing or schedule (including phasing, if applicable): A3/, ?
7 . Do you have any plans for future additions, expansion, or further activitv related to orconnecred with thisproposat? lr yes, "*prri"
'?n .:i;;J "?;;J '=ff).I.{r*. d;"ut a ^)\r"f,\Aiv1 *tl- c\.u,n, y\c\-8. List any enviroAmental intormatioiyo;-l<nJ about that has been prepared, orwill be
prepared, directly related to this proposal.
9. Do you know wtrether applications are pending for govemmental approvals of otherproposals directly affecting the property covered by your proposal? lf yes, explain. lV.: vr<_ Ln -^; ,rt
10. List any govemment approvals or permits that will be needed for your proposal, if known.fTA I rl ?em*T , Ca*vdt ?avy,,w-tt't\t
1 1. Give brief, comilete descriftii"n of voul ploposal, inclut/ng the proposed uses and the size..of the project and site. There are several questions later in thii checklist that asf Vou io - -'-n
describe certain aspects of your proposal. you do not need to repeat those answers on thispage. (Lead agencies may modify this form to include additional specific information on projectdescription.)
12. Location of the proposal. Give sufficient information for a person to understand the preciselocation-of your proposed project, including a street address, if any, and section, township, andrange, if known. lf a proposal would occur over a range of area, provide the range orboundaries of the site(s). provlde a legal description, site plan, vicinity ,rp, .njtopographicmap, if reasonably available. While you should submit any plans required by the agency, youare not required to duplicate maps or detailed plans submitteO witn any permit appticationsrelated to this checklist. OO I O te I W G
B. Environmental Elements lnrr_pl
W i'ttle-r,t
vra_raJive-'Dw-\,.-.\-J
1. Eafth lhetpl
a. General description of the site:
(circle one)rolling
t"P
b. What is the steepest
""?
, hitry, 3 tE€snpountainous, otrer flibi Slrye, -lo lt z- f(Ovl h ,o- afa^3 l"\*{it o., S(-rtt^r, ^ Sffi ;;J;: {,slope on the site (approximate percent stope)?'
"Z1+-WL;g* t:
c. What general types of soils are found on the site (for example, clay, sand. gravel, peat,muck)? lf you know the classification of agricultural soils, specify them anjnote anyagricultural land of longterm commercial significance and whether the proposal results inremoving any of these soils.
SEPA Environmentat checktist (WAC 197_1 1-960)July 2016 Page 2 of 12
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d. Are there surface indications or history of unstab{e soils in the immediate vicinity? lf so, , , \ I
describe. Ncrtt^"-^ bo,iq- =**r+ =\-ge-. $o9\\1 Lt!€.t\-v',:rfc*ate^r\ '>^)'
{l^*:. ro\af,ue-[1 =i=b\.-- B-J.otr= >hr;4s-S l*t*J].-f-oc e-
e. Describe the purpose, type, total area, and approximate quantities and total affe,cted alqa of - , ,
anyfilling,excavation,andgradingproposed. lndicate.oriooinll.-VF-;+. t\t 1;X+9' ,\ .
R"t& d"=V*.h^,. i^J =r^rti L*,,\\,* \ o,rt.n-\-pe- -aYa- \"c-\eA "ri *"+11
f. Could erosiqn occur as a result of clearing, cpnstructied, oi uieZ lf {o, generally describe. 'rf.Vozjr .\-J -'Vt-tct t
V"\ t\Y.lg, fla-* -tt \'rr,1 nitrA a\ofzo wilv. vrnYr rc' s{e.
g. About what percent of the site will bC covered with irhpervious surfaces after project
construclion (for example, asphalt or buildings)? Z lOa,
h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any:
r d .,
'1'tt *,u*T$tt'i ?a s 5''-L' as tPLle+' '17s*Pa-|t='
2. Airthetpl Cd,I VI.T-S t Cwr+a;n'dnirns- (;+1L-sa,, c,,'*11 g^ ^ *7fe'r
a. What types of emissions to the air would result from the proposal during construction,tJ ( e'' "ru'*^"
operation, and maintenance when the project is complqted? lf any, generally describe and
give approximate quantities if known. N'o r'te- ,l n v t J^ I{-* o dt c-€- -
b. Are there any off-site sour@s of emissions or odor that may affect your proposal? lf so,
generally describe.^/l ,+
c. Proposed measures to reduce or control emissions or other impacts to air, if any:
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I ,f
3. Water fhelpl
a. Surface Water: Ihelp]
1) ls there any surface water body on or in the immediate vicinity of the site (including
year-round and seasonal streams, saltwater, lakes, ponds, wetlands)? lf yes, describe
type and provide names. lf appropriate, state what stream or river it flows into. ttf a
x ned turw br^L ,/>]<n/;^t alz-n q A[*-rLu'-n hon) urw 1 n*
Ava,'r "f T;^ de H.a.
2) Willthe project require any work over, in, or adjacent to (wtthin 200 feet) the described
waters? lf yes, please describe and attach available plans. * 4 e-e ^tou i? ay\s -) ev:
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 affecled.
lndicate the source of fill material.ll ,+
4) Will the proposal require surface water withdrawals or diversions? Give general
description, purpose, and approximate quantities if known.,4*
SEPA Enyironmental checklist (WAC 197-l 1-960)July 2016 Page 3 of 12
5) Does the proposal lie within a 100-year floodplain? lf so, note location on the site plan. N I k
6) Does the proposal involve any discharges of waste materials to surface waters? lf so, N I ,fdescribe the type of waste and anticipated volume of discharge.
b. Ground Water lhelpl
1) Will groundwater be withdrawn from a well for drinking water or other purposes?
give a general description of the well, proposed uses and approximate quantities
withdrawn from the well. Willwater be discharged to groundwater? Givegeneral
description, purpose, and approximate quantities if known.tles . 5'^i/r iJ-,^,'tr- - tu-':;;L-,",; 7:-p,,=.-J .
hrwsehil) vs;- ;nFli-,eoiti Le- in
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lf so,
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2) Describe waste material that will be discharged into the ground ftom septic tanks or
other sources, if any (for example: Domestic sewage; industrial, containing the
following chemicals. . . ; agricultural;etc.). Describe the generalsize of the system, thenumber of such systems, the number of houses to be served (if applicable), or thenumber of animals or humans
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). \y'fhere will this water flow?
\Mll this water flow into other waters? lf so, describe.
2) Could waste materials enter ground or surface waters? lf so, generally describe.
3) Does the proposal alter or othenrise affect drainage patterns in the vicinity of the site? lf
so, describe.
d. Proposed measures to reduce or control surface, ground, and runoff water, and drainage
pattem impacts, if any:
4. Plants [hetpl
a. Check the types of vegetation found on the site:
-T)ornz slic- ;the system(s) qre expected to serve._ , ,**. Jfnj{ "- -A.^;lJ YaslcLe<.t<-<- f.P,
4
SEPA Environmental checklist (WAC 197-11-960)July 2016 Page 4 of 12
reen
shrubs =
or grain
Orchards, vineyards or other permanent crops.
wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other
water plants: water lily, eelgrass, milfoil, other
\Zlother types of vegetation
-1-4," n 5
5. Animals lhelpl
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:, eagle,l*n sc>+
b. What kind and amount of veoetation will be remoyed or altered?Mi^l^ui * -+^. Anvpv{>^t <, b",-; l)6, all-e .
)vtai n 11 4i -, C'''\ >''r- 4 [*r^ lwZ- #az- g '
c. List threatefdd and endangered species known to be on or near the site./Vrrvr-e-, KneuoYz
d. Proposed landscaping, use of native plants, or other measures to pregprve,or e4fapce
vegetation on the sile, if any: Vp "tt U-m pleh ry7 . o* b wi I 4 t n q .
il o.-- ?roposL a tl.
-i'ui-'iu 'v*)o*iJ--; b e '/-1*ua\V h'tZl.*. L;A zredi - \)
e. List all noxious weeds and invasive species known to be on or near the site.
/Y o-v'*- kh",.1/1-
mammals:
fish. bass,
, elk,other:
trout, hening, shellfish,
b. List any th.reatened and endangered sppcies knov14 to be on or near the site.
/-lrv o St e- ru E ,1 le -s + l-y l./
c. rs the site part of a m,nr$,::,ry", ,?i[-o'12, ,J = -t b, v o\ n " .t e S
d Proposeo,T3]"":I}"::H ";uit**g9 n "A!;--h (^-t.,ve v3'** a\^
/<-z-z-- l-t,_;{ po++ , b\q.
e. List any invasive bnimal species known to be on or near the site. .7 (Uy.*_ )afr rt: ff
SEPA Environmental checklist (WAC 197-11-960)July 2016 Page 5 of 12
6. Energy and Natural Resources [hetpl
a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet
the completed project's energy needs? Describe whether it will be used for heating, . tmanufacturing, etC. E li-1-,L_, 1)-,_R, I l, bo- p 1,,* Jlf 1 N-'1,^ J hava--
= J raT > rn-{- *-,A"ffxfi J "r*\ ffiilB,r; _Utt rHy"?,*fr[ v_**b. Would your project affect the potential use of solar energy by'adjacent prdperties? \ \ , , rl - f-
tf so, generauy describe N--., t ,.6ld,U:J;L-
,./\{ a w ^,J ) \* o- 1, *b} so\-. r\ ,\ , ,\\ \nur a and\r^v\ S.\-.;
c. What kinds of energy conservation features are included in the plans of this proposal? J .^ --' i ,^r .List.other proposed measures to reduce or control energy impacts, if any: J* '
rXl a- ',! -*"t -+D Ae-rrq, 2 Vu'r\"[' ,-^-v- \y"; N\,e- a 9 e*evq1
a-CH a ie^rt > s- C=<,',V\e \ ,v.j.d \\ Lr. ge axce-\\ c^_* l[$:-{-
,7. Environmentat Heatth rheipr t r^^"lta ;, ;t;= ; o;*..;;;i; h e_---_r, ^e ra. Are there any environmental health halards, inctudng exposure to toiii chemicals, risk ^_\._ )'of fire and explosion, spill, or hazardous waste, that could occur as a result of this proposal? ffi1-- -
lf so' describe' Nc, n o \z- *-o.c, nrr
1) Describe any known or possible contamination at the site from present or past uses.
hd.,-r-.*- Krg6ru n
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. Nfo.a"r_ EVf,."t Z Vf
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 \\( c'---\je-- E-wa-..: v-r
4) Describe special emergency services that might be required i \fo.r".z_ F".r"=g6 ^
5) Proposed measures to reduce or control
A[. s Wll-)Srr-<-€-
b. Nolse Vt^rn^-t
environmental health hazards, if any:5 -o , t\ be- -\aY€nr-th,r-n^*{-t'^'-F
? ro@le =^^A "e,. .-\\ -$(*r"'v a
1) What types of noise exist in the area which may affect your project (for example: VK- <'
traffic, equipment, operation, other)? X[.,-u,,r- k_.*V.6l,r.1 n
^J
SEPA Environmental checklist (WAC 197-11-960)July 2016 Page 6 of 12
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8. Land and Shoreline Use lhelpl
a. What is the current use of the site and adjacent properties? Will the proposal gffect currgnt i )
land uses on nearby or adjacent properties? lf so, describe. L[t..r\aV e-loe egl V-a.\A) t au-d
Crr.rre^V\\ - ff^oqose-J ,c-ov\varc-iey-.. ,1,r- ;i" qi. -{6-*,1. L1 fe=,i|r*LL -- )," oIn,l"$ru,"6\.Yfi"r;*axrgg#,kn?"fi,il)e5',[",?t#3tv1 *'$b. Has the project sil
How much agricultural or forest land of longterm commercial significanc" *iu oJ-"oi-rl-ttJJio '\ Vvt-*<"*
other uses as a result of the proposal, lf any? lf resource lands have not been designated,
how many acres in farmland or forest land tax status will be converted to nonfarm or
nonforest use?V.,
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? lf so, how: irl L?
c. Describe any structures on the site. Mo #-
d. Will any structures be demolished? lf so, what?I'rl/r
e. What is the current zoning classification of the slte? V-5 L 1"" \ r. eVe-
%f. What is the cunent comprehensive plan designation of the site?
:;:AA- .sct1 O,-^b &grl^fi + (
? s. ffaPPricao,"tE:ffi:prlgram.designation of the site?
l+;a,,.u"n >/rrent shoreline master
.t\Cr.^r.t1
h. Has any part of the site been classified as a critical area by the city or ""r"Wi! il_"Wn T"#"_^d *++ - ) f ra lri *& *e-+ ba-(L *l' . rv"zz*'a\te<evrP-
$tu^=-l-,.- Pla-,'t = [5b'i. Approximately how many people would reside or work in thd completed project? t o, 15e*)o&V ,A= "+ riSw* nd^r - 7
j. Approximately how many people would the completed project displace? q
k. Proposed measures to avoid or
7v, \o+e- c\ ro\;h(o
feduce displacement impacts, if any:
11 Vcrl t*"-i\ J;Jaog uvtr-wf b*i\Ar13 srea
) -/ d\^ tl^.!->€- A"U kxes
SEPA Environmental checklist (WAC 197-l l-960)Jut,2ol6 . l \ . t ea5]d12x er6t[- r**'on l J.i.-f,"rtanLL +" i ht r -t' r -\;J,*,iai ,S, v',rJ;,\or-\ M\'outf^ts,e1r
c. Proposed measures to reduce or control lrousing impagts, if any:
l'v\ rn i r,r nl +"1 F ,f ,.-Fs
10. Aesthefics lhelpl
a. What is the tallest height of any proposed structure(s), not including antennas; what is
the principal exterior building material(q) propose{?2 tfl pl C*fr"/o +-T
L.
m
9.
a.
b
b
b.
11
a.
b
d. Proposed measures to reduce or control light and
Mo
c. What existing off-site sources of light or glpre may affect your proposal?N.w*- K+*on
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if
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SEPA Environmental checklist (wAC 197-1 1-960)
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(,
middle, or low-income housing.
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12, Recreation fhelpl
a. \ffhat designated and informal recreational opportunities are in the immediate vicinity?
Wtu)c +L be>.h
b. Would the proposed project displace any existing recreational uses? lf so, describe.
ll o v^-c- Q-tb\) c-_
I
c. Proposed measures to reduce or control impacts on recreation, including recreation
opportunities to be provided by the project or applicant, if any: Ir{ qr^__ lAvlJ_}i N
[\ZLA-51>>!- 1
13. Historic and cultural preseruation thelpl J
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 ? lf so,
specifically describe. (e.yle.-
b. Are there any landmarks, features, or other evidence of lndian 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. \{,n .*.- [*ravU V^r
c. Describe the methods used to assess the potential impacts to cuttural and historic resources
on or near the project site. Examples include consuttation with tribes and the department of
archeorogv a"':':x;: :"'"s'"";T1"ffi: =["P*iilil'j; :],t"t!1 rn, r = \ "^J .'J--- -. J J
d. Proposed measures to avoid, minimize, or @mpensate for loss, changes to, and disturbance
to resources. Please include plans for the above and any permits that may be required.
No*f-- \4r.,orS1a We-U-<3v] ,l/! W-d d-5cl'..ti oru4S ye- l/"r,LL€' -frf f-^St+€-
A-tqfl"-rtfi e4 I '>"Jr,/L;-x-\ ,"i [t tDa ,*{fie* .1 lhelpl
a. ldentify public streets and highways serving the site or affected geographic area and
describe proposed access to the qxisting street system. Show on site plang, if any.
?".posei a<-cc-ar.z *r"r W"i]tr\u p.o il"1 LJ . t"-++I I r\viuy'c,o\1 Nrr,Mr ku-r:, LLI 4 ZZ3*
b. ls the site or affected gee$raphic area currently served by public trE-nsit? lf so, generally
-+
orooosal' ;t L v\4-\)
not,
(,
what is the approximate distance to the nearest transit stop?
,^rLL +" +\"=\Y = l8-&.z
c. How many additional parking spaces would the completed project or non-project
have? How many would the project or proposal eliminate? yr,i rvl A,u\r fi^
c re.o\e} No* a[i*'o\ "i -"'\'
describe. lf
i
SEPA Environmental checklist (WAC 197-1 1-960)July 2016 Page 9 ol 12
d. Willthe proposal require any new or improvements to existing roads, streets, pedestrian,
bicycle or state transportation facilities, not including driveways? lf so, generally describe
(indicate whether public or private). t{'r,
e. Willthe project or proposal use (or occur in the immediate vicinity of) water, rail, or air
transportation? lf so, generatly describe AVr/_ [ff-r*|ru-n".*] on ) er , I tt"x__
J>"-c-e-\ i= ervr --l-vrr- s$'a-i-t:. *+ &=--. A.--f* L>,
f. How many vehicular trips per day would be generated by the completed project or proposal?
lf 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
modets were used to make these estimates? - \ o i c *p;+ t;,^;..r.+. 5 -lD*
K*.1 --F ,,., v'us €- ^-o\ A *^ t \ I r'
\t L*\ o(-cu?r,^i wav (-= -\"=,^ \"o** .
g. Wiltthe proposal interfere with, affectoi be affected by the movement of agricultural and
forest products on roads or streets in the area? lf so, generally describe.
|f, V\.a-- L**,., 1-1
h. Proposed measures to reduce or controltransportation impacts, if any:
trl ^".r-\ru-"C-.e-S " t3 tu-a-+- i s
[-ryy^ ^: 11
a. Would the project result in an increased need for public services (for example: fire protection,
b (9-- -
1
a. Circle utilities currently available at the site:
electricity, naturalgas, water, refuse service, telephone, sanitary sewer, septic system,other_ \$O n .(_
b. Describe the utilities that are proposed for the project, the utility providing the seryice,
and the generalconstruction activities on the site or in the immediate vicinity which might
be needed.
lrrna,.S-!"\+=-.o-*-
15. Public Services lhetpl
zl
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l>ri\\
\VI
\oi;'V\<-l=l*u
t 1,.uJat\
c(/\ L)+R,
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SEPA Environmental checklist (lAlAC t97-it-960)July 2016
tli C-
Page 10 of 12
public transit, health
2- fe>'t&"xf+
4r, rr-l r \\ ,rr."\1
Proposed measures to reddce
>\
Ue-
or control
Nor.r- Kroo*rn- WL.a-.sS T N-A
C, Signature IHELPI
The above answers are true and complete to the best of my knowledge. I understand that the
lead agency is relying on to make its decision
Signature,
Name of signee
Position and
Date Submitted:
D, Supplemental sheef for nonproject actions lHerpl
(lT lS NOT NECESSARY to use this sheet for project actions)
Because these questions are very general, it may be helpfulto 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
generalterms.
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:
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 affecl environmentally sensitive areas or
areas designated (or eligible or under study) for govemmental protection; such as parks,
SEPA Environmental checklist (WAC 197-l{-960)July 2016 Page 11 of 12
wilderness, wild and scenic rivers, threatened or endangered species habitat, historic or
cultural sites, wetlands, floodplains, or prime farmlands?
Proposed rneasures 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. ldentifu, if possible, whether the proposal may conflict with local, state, or federal laws or
requirements for the protection of the environment.
sEPA Environmentat checklist {wAc 197-11-960)July 2016 Page 12 of 12