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23601 EDMONDS WAY.PDF11111111111111 11026 23601 EDMONDS WAY 0 TAX ACCOUNT/PARCEL NUMBER: BUILDING PERMIT (NEW STRUCTURE): COVENANTS (RECORDED) FOR: op5. cc.)st CRITICAL AREAS:— . I DETERMINATION: Ej Conditional Waiver 0 Study Required Owaiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE $: LID SHORT PLAT FILE: LOT: !q BLOCK: 19 SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: WATER METER TAP CARD DATED: LATEMKI)STsTomis\Street File CheckliSLdoc #P20 05-97 Critical Areas Checklist CA File No: . Site Information (soils/ topography/ hydrology/ vegetation) 1. Site Address/ Location: 23601 Edmonds Way, Edmonds WA 2. Property Tax Account Number: 00463300300401 3. Approximate Site Size (acres or square feet): 024 Acres 4. Is this site currently developed? X yes; — no. If yes; how is site developed? .1 7 Describe the general site topography. Check all that apply. X Flat: less than 5-feet elevation change over entire site. Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal distance of 66-feet). Hilly: slopes present on site of more than 15% and less than 30% (a vertical rise of 10-feet over a horizontal distance of 33 to 66-feet). Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal distance of less than 33-feet). Other (please describe): Site contains areas of year-round standing 'Water: No ; Approx. Depth: Site contains areas of seasonal standing water: No ; Approx. Depth: - What season(s) of the year? 8. Site is in the floodway: No floodplain of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? No Flows are year-round? Flows are seasonal? — (What time of year? 10. Site is primarily: forested meadow ;shrubs mixed urban landscaped (lawn, shrubs etc) Asphalt Paved 11. Obvious wetland is present on site: None For City Staff Use Only 1. Plan Check Number, if applicable? Pt�!,-- 0 1 L4 2. Site is Zoned? t�� r_j 3. SCS mapped soil type(s)? J��k 14. Critical Areas inventory or C.A. map indicates Critical Area on site? 5. Site within designated earth subsidence landslide hazard area? DETERMINATION .STUDY REQUIRED Reviewed Critical Areas Checklist - 23601 Edmonds Way/5.10.2005 M WAIVER ma�j 31 05 08:31a Stephen Spencer 0 # 1 1,2 0 City of Edmonds i PLI1111ino Division r. Phone: J-25.771.02120 42S,771.0221 11W Ct'llicA Area.� ChvAlist contaillvd oil this forn 1 1 is hQ filled out by aily pQrsoii prepaririiga' D-- - Pcrmit Applicatloi) (Ior tile.. City ol 111s"llo:1- subillitull ol'tile. The Purpose ol Octerlilific wl P (253 369-15228 P.2 o5, aq Date Received:_51),-7 0-5 City Reccipt #: Critical Areas File 4-: Critical Areas Checklist Fee: --jim..00 Date Mailed to ADDlicant: v ownor, or his/her laijilmrized Itj( die. chocklist, sion ai)d (1,11c ',,, Illkl st,I)III-1 -1 "'o" CILV will revle�� 111V (:11ecklisf, IWIke :I dete.1.111111:16(111 ol, 11. i.11- and make , Ic lleec.,;S:Iry to ckullplo;lc I d,:\Ck)PII1eIIL li�atiol". niav De, Stin T-lease Submit a vicillily Mow-, with tile sil-'Iml Copy liceded , o Qolllpl be casily oftlil.� form tomsim cily st�lj'j'lll 1111ding and Itx:;itiw, dic 71ou Id awillablo: iroill le sitc or data avall.ibic at spccific piece (-)I' propuly described on 1111,; 1,61-111. 111 k If\: Hall (Ci a arcas maps, or soil addillon, the appli(:,vit . shall survc s). mclude otlicr puilif)CM itil'orination (e.g. sitc plill, 111;,j). c(c.) or SLLIdIQ.', ill C011.)MICtI011 \\Jth (11IS to compicutig flicir pro;liminary as.-ic.s.siuclij ()I ti, i 'I he 1.111dersiguiv.d applicant, an(l liis/lier/its heirs. and assigils, irl conside.ratloii on (ho; processlii-, ol'the to releasc, itldcniiiil�, deleii(I and hold tile City of Fdmoiids liarnfless from any and all dmnagcs, Mcludillh, N.'IS011 . 11)lv �Illorlley s I'Qcs. arisiiig froin any action or in1'raction base(l ill wliole or ptirt upoii I'lilse, Or- 11,1compIcte 'Hil'Ornlation lumished by the applicatit, his/her/i it%, agents of' elliployces. B\, inY sigilature, I Qcrtify tll�it the Wl'oritiation and exhihils horOvith -subillitted are Irtie and corroct to ilik- best of' mv kiiowledge fit(] diat I ani authorized to tile this appitical loll oil tile beliall'ofille owileras lisico.1 below, SHINA HHZI-'(w A11111.1c.V-4 1'/A(;1-'1N."r OA 11: Property Owur's Nuthorization By my sionaltirc, I ccrtif' -it I I I -I tile abovo; and uN Applicyt/Agent to apply* lor the subjcct 1, e ;q)plic:itioi1 ,and oraw mv I)Cl'llllssl()Il Tr —id 7t; soi�* I All-Ionds to enter di� subj?ct propul). 1",w the t le Pki I I la rid t -,s( i -oftl . City oH. p -poses of­n-�pcctiot and posi'- cii ut I 0SI to til I , ap I i oil S1GNA.T(;'l%1-, (q, :1z DA*! I 0 w III c r1A p p I i c a n t: Laurelhurst Oil (.'o. - Toln Marier Name "' Avenue N.V '71140 - 26' Sti-cel Addi,Q.,�s seaitle 'WA 98115 01tv statc Zip 'I elephorle: (206)52.1-4,50(1 1:niail address (optional): r' cst.net .1marieraiusm Applicant Repr,esentativ'e: Stephen -Spencer- FMS, 1.111C. Name 652 8(h Avenue Strce( Address 11"OX NVA 9833.1 City t t C /1' 1) Tclepholle (2753) 921-7059 s.Npencer�*ti�eiii.s(7r4)tli)llc.coni :",, 'M.,\ CITY OF EDMONDS 121 5TH AVENUE NORTH - EDMONDS, WA 98020 1 (425) 771-0220 FAX (425) 771-0221 Website: wwwdedrnondsma.us DEVELOPMENT SERVICES DEPARTMENT Planning - Building - Engineering February 28, 2005 Marier & Marier, LLC 7040-26 Avenue NE Seattle, WA 98155 RE: Sight Distance Obstruction at 236th Street SW and Edmonds Way GARY HAAKENSON MAYOR Our records indicate that you are the owner of the subject property at 23601 Edmonds Way. We have received a complaint that a portion of your pine shrub located at the northwest comer of your property is making it difficult for drivers to enter onto 236h Street SW from northbound Edmonds Way due to poor sight distance. City of Edmonds staff has investigated the matter and deten-nined the shrub in question does, in fact, create a sight distance hazard per Edmonds Community Development Code (ECDC), Street Obstructions, Chapter 9.25 (copy enclosed). In order to reduce the hazard and enhance public safety, the City of Edmonds is requesting that you trim the plant to a height of three feet. This should significantly enhance sight distance safety at this intersection. Please complete the trimming by March 17, 2005. Your cooperation in bringing your vegetation into compliance is appreciated. Please feel free to call me with any questions at 425-771-0220, Ext. 1328. Sincerely, 4t DARRELL C. SMITH, P.E. Traffic Engineer DCS/cmc Enclosure c: Mike Thies, Code Enforcement Officer David K. Gebert, City Engineer Jim Kammerer, Street Division Manager SAENGR\Daffc11\Traffic Concerns%SR104 and 236 sw sight sisfwclappbwated August 11, 1890 .qictor ri+iy - Poizinz%n Tn"nn 0 ED CITY OF EDMONDS 121 5TH AVENUE NORTH, EDMONDS, WA 98020 (425) 771-0220 RCW 197-11-970 Determination of Nonsignificance (DNS) MITIGATED DETERMINATION OF NONSIGNIFICANCE Description of proposal: Decommissioning and removal of a 12,000-gallon underground diesel fuel storage tank located at-2S601 Edmo-nds-Way." Proponent: Laurelhurst Oil Company, 7040 26'h Ave NE, Seattle, WA 98115; aftn: Tom Marier Location of proposal, including street address if any: Lead agency: CITY OF EDMONDS The lead agency has determined that the requirements for environmental analysis and protection have been adequately addressed in the development regulations and comprehensive plan adopted under chapter 36.70A RCW, and in other applicable local, state, or federal laws or rules, as provided by RCW 43.21C.240 and WAC 197-11-158 and/or mitigating measures have been applied that ensure no significant adverse impacts will be created. An environmental impact statement is not required under RCW 43.21.030(2)(c). This decision was made after review of a completed environmental checklist and other information on file with the lead agency. This information is available to the public on request. There is no comment period for this DNS. xx This DNS is issued under 197-11-340(2); the lead agency will not act on this proposal for 14 days from the date below. Comments must be submitted by August 24 2005. Responsible Official: Robert Chave Position/Title: Manager - Planning Division Phone: 425-771-0220 Address: City of Edmonds, 121 5th Avenue North, Edmonds, WA 98020 Date: August 10, 2005 Signature: if xx You may appeal this determination to Robert Chave, Planning Manager, at 121 5th Avenue North, Edmonds, WA 98020, by filing a wriften appeal citing the specific reasons for the appeal with the required appeal fee, adjacent property owners list and notarized affidavit form no later than —August 24, 2005. You should be prepared to make specific factual objections. Contact Rob Chave to read or ask about the procedures for SEPA appeals. xx Posted on August 10, 2005, at the Edmonds Public Library, Edmonds Community Services Building, and the Edmonds Post Office. xx Distribute to "Checked" Agencies on the reverse side of this form, along with a copy of the Checklist. Page I of 2 LAURELFIURST OIL TANK PEMOVAL SEPA DETERMINATION DOC 8/10/05.SEPA Mailed to the following along with the Environmental Checklist: XX Environmental Review Section XX Department of Ecology P.O. Box 47703 Olympia; WA 98504-7703 XX COMCAST Outside Plant Engineer, North Region 410 Valley Ave NW #12 Puyallup, WA 98371-3317 XX Department of Fish & Wildlife 16018 Mill Creek Boulevard Mill Creek, WA 98012 XX Washington State Dept. of Transportation Attn: Ramin Pazooki SnoKing Developer Services, MS 221 15700 Dayton Ave. N. PO Box 330310 Seattle, WA 98133-9710 XX Washington State Department of Health Division of Drinking Water P.O. Box 47822 Olympia, WA 98504-7822 XX XX Town of Woodway Attn.: Clerk -Treasurer 23920 113th Place West Woodway, WA 98020' Community Transit Attn.: Brent Russell 7100 Hardeson Road Everett, WA 98203 Olympjc View Water & Sewer District 23725 Edmonds Way, Edmonds, WA 98020 XX Anne Sharar Department of Natural Resource P.O. Box 47001 Olympia, WA 98504-7001 XX Alderwood Water District 3626 156th Street Southwest Lynnwood, WA 98037 XX XX State Department of Labor and Industries Attn: Stefan Dobratz P.O. Box 44610 XX Olympia, WA 98504 XX Puget Sound Water Quality Authority P.O. Box 40900 Olympia, WA 98504-0900 XX Snohomish County Planning & Development Services 3000 Rockefeller Everett, WA 98201 XX Snohomish County Public Works Attn.: Environmental Coordinator 2930 Wetmore, #101 Everett, WA 98201 XX Snohomish County Fire District No. 1 Headquarters Station No. 1 Attn.: Director of Fire Services 12310 Meridian Avenue South Everett, WA 98208-5764 XX City of Shoreline Attn.: Project Manager 17544 Midvale Avenue North Shoreline, WA 98133-4921 XX Snohomish County Health District Attn: Bruce Straughn 3020 Rocker Ave Everett, WA 98201-3900 Puget Sound Energy Attn: Elaine Babby PO Box 90868, M/S XRD-1W Bellevue, WA 98009 Dean Saksena, Senior Manager Snohomish Co. PLID PO Box 1107 Everett, WA 98206-1107 XX Kojo Fordjour Department of Transportation Environmental Manager 2911 2 nd Ave. Seattle, WA 98121-1081 XX Environmental Management Services, LLC Attn: Stgphen Spencer 652 — 8 Avenue Fox Island, WA 98333 XX Laurelhurst Oil Company Attn: Tom varier 7040 — 26t Ave. NE Seattle, WA 98115 XX MITIGATING MEASURES INCORPORATED INTO THE PROPOSAL: 1. THIS PROJECT WILL BE COMPLETED ACCORDING TO THE (REVISED) LIST CLOSURE WORK PLAN, DATED JUNE 15,2005. Attachments Page 2 of 2 LAURELHURST OIL TANK REMOVAL SEPA DETERMNATIONDOC 8/10/05.SEPA 1p'. 18913 July 18, 2005 0 a CITY,OF EDMONDS 121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221 Website: www.d.edmondsma.us DEVELOPMENT SERVICES DEPARTMENT Planning - Building - Engineering Marier & Mafier, LLC 7040-26 1h Avenue NE Seattle, WA 98155 RE: Sil!ht Distance Obstruction at 236th Street SW andEdmonds Way GARY HAAKENSON MAYOR Our records indicate that you are the owner of the subject property at 23601 Edmonds Way. Thank you for your prompt action on a previous concern the city had with certain vegetation on your property. However, the city has received additional concerns that an another portion of your landscaping fronting SR 104 is making it difficult for drivers to enter into the northbound lanes of the street from westbound 236 th Street SW due to poor sight distance. City of Edmonds staff has investigated the matter and determined the landscaping in question does, in fact, create a sight distance hazard per Edmonds Community Development Code (ECDC), Street Obstructions, Chapter 9.25 (copy enclosed). In order to reduce the hazard and enhance public safety, the City of Edmonds is requesting that you either reduce the height of existing landscaping along Edmonds Way to less than two feet, or replant with low -growth ground cover. This should significantly enhance sight distance safety at this intersection. Please complete the trimming by August 1, 2005. Your cooperation in bringing your vegetation into compliance is . appreciated. Please feel free to call me with any questions at 425-771-0220, Ext. 1328. Sincerely, DARRELL C. Traffic Engineer DCS/cmc Enclosure c: Mike Thies, Code Enforcement Officer Jim Kammerer, Street Division Manager S:\ENGR\ED\Lettm\Vcgetation-SightDist�Edmnds Way - 23t0foco rpo rated August 11, 1890 0 Sister City - Hekinan, Japan J.) Environmenfal Management ServiceS, LLC May 2, 2005 Revised: June 15, 2005 Laurelhurst Oil Company UST Closure Work Plan 23601 Edmonds Way Edmonds, Washington Environmental Management Services, LLC (EMS) will be managing the closure and removal of one (1) 12,000 gallon diesel underground storage tank (UST) located at 23601 Edmonds Way, Edmonds, Washington. This work plan detailed the closure activities and project responsibilities during the UST decommissioning project. The tasks included in this work plan are presented below. Task 1 — Pre -Construction Activities Pre -construction activities will include the following tasks: • Preparation of site specific Health and Safety Plan; • Application for UST Decommissioning permit through Edmonds / King County Fire Department; • Notification of proposed UST closure activities to the Department Of Ecology (Ecology); Submittle of UST Closure Bid to select contractors. The decommissioning contractor will be responsible for physically preparing the site for upcoming work and deliver needed personnel, machinery, and supplies to the worksite will be the responsibility of the selected contractor. Work activities in this task include: • Oversee the mobilize excavation equipment and supplies to the site; • Install temporary security fencing where necessary (location for fence shown on site map attached); • Install silt fencing, straw bails and other storm water management best management practices (BMP's) around the work area perimeter (BMP Placement shown on site map attached); • Install signage (e.g. "Keep Out", "No Trespassing", "Emergency Phone Numbers", etc.) Task 2 — Surface Demolition Activities The decommissioning contractor will be responsible for the following items: Concrete and asphalt covering the underground storage tank and the pump island area will be removed and disposed of off site at a local disposal or recycling facility by the contractor. Dust Environmental Management Services, LLC 6528 1h Avenue Fox Island, Washington 98333 Phone: (253) 921-7059 Fax: (253) 369-6228 ems@emsgroupllc.com UST Closure and Site Assessment Work Plan & Cost Proposal April 4, 2005 Laurelhurst Oil Company UST Closure 23601 Edmonds Way Edmonds, Washington control will be provided as necessa[y using water. No water will be discha[ged from the site during demolition activities. Straw bails or silt fence will be placed on the down gradient side of the excavation area. Any water accumulating on the northern end of the site will be pumped, transported off site and disposed at a local disposal facilily. Trucks enterina the r)roi)ertv site will enter from the south bound lanes of Edmonds Way. The trucks will leave the site from the north entrance/ exit on to 236,h Street to the east through the intersection and south along Edmonds way to 1-5. Flagging use exiting the site to 236th is not anticiDated as the total truck traffic will be limited to four loads of imi)ort and one load of exDort. PCS transport off site is not anticipated Task 3 — UST Closure Activities EMS will be responsible for permitting through the City of Edmonds or King County. This process will be required for the UST closure activity. The permitting process can take several weeks. A 30 day notice will be required by the Department of Ecology. This notice is to be submitted by the LIST decommissioning company or the project environmental consultant. It is not uncommon for Ecology to wave the 30 day notice if the closure schedule can be expedited. The decommissioning contractor will be responsible for the following items: Upon receipt of the proper permitting, decommissioning activities will be started. Each dispenser and piping backflow' devises will be dismantled to allow all gasoline to be drained back into the USTs prior to any excavation activity. Each dispenser pump will be drained and removed from the pump islands. The UST will be pumped of all existing contents and triple rinsed to remove any residual contents. UST contents will be disposed at a local recycling facility. All associated product piping will be exposed by excavation and inspected by the UST Site Assessor prior to removal. The UST be excavated exposing the top of the UST and associated piping. All piping will be removed only after it is inspected by the UST Site Assessor. Piping location will be plugged with the appropriate sized plugs. A vent will be erected on each UST to allow for venting of the UST during the inertion process. Following the UST inertion and cleaning process, each UST will be excavated and removed under the supervision of a State of Washington certified UST Site Assessor and an IFCI certified UST decommissioner per Ecology decommissioning requirements set out in WAC 173-360. Each fiberglass UST will be disposed of through a local demolition debris d.isposal company. The UST excavation area will be backfilled with pit run material following the UST closure and site assessment activities. Backfill will be compacted to meet 95% proctor or as specified by the project engineer. The excavation area will be capped with 5/8" recycled or better gravel backfill. Environmental Management Services, LLC 6528 th Avenue Fox Island, Washington 98333 Phone: (253) 921-7059 Fax: (253) 369-6228 ems@emsgroupllc.com 0 - *. 0 UST Closure and Site Assessment Work Plan & Cost Proposal April 4, 2005 Laurelhurst Oil Company UST Closure 23601 Edmonds Way Edmonds, Washington Task 4 — Sampling, Closer Report Preparation and Submittal UST Site Assessment activities will be completed as outlined in the Washington Administrative Code (WAC) 173-360 and new Ecology sampling method 5035 by a licensed UST Site Assessor provided by EMS. Soil samples will be collected from below the UST, from each excavation. sidewall, from the excavated soil stockpile, from below the LIST system piping at 100 foot intervals and from below each UST dispenser. Up to 12 samples are anticipated. If groundwater is encountered during excavation activities, representative samples (2) will be collected from the excavation. Each sample will be analyzed for diesel range petroleum hydrocarbons by method NWTPH-Dx. Sample analyses will be complete by an Ecology accredited laboratory. Following LIST closure and sampling activities, a UST Site Assessment and Closure Report will be completed detailing the closure activities, site conditions and sample analytical results. Site assessment and report preparation time can vary depending on conditions encountered during the decommissioning process. Total time on site is anticipated not to exceed 8 hours. In the event unanticipated services are required, additional time and expense beyond this scope will be accrued only after prior client approval based on the attached rate sheet. The following field screening techniques will be used on each sample collected: • Olfactory Observations • Visual Observations • Photoionization Detector (PID) — As necessary • Sheen Test Task 5 — Petroleum Contaminated Soil Management Petroleum Contaminated Soil (PCS) exceeding the Model Toxic Control Act (MTCA) method A cleanup limits (MTCA WAC 173-340), will be staged onsite for later disposal. A PCS staging area will be completed using hay bails or other appropriate storm water management BMP's. All PCS will be Dlaced on and covered with 6 millimeter Nastic. It is not exi)ected that PCS will be encountered during this voiect. Task 6 — Test Pit Sampling Follow Ing the closure of the UST system, EMS will complete up to five test pit excavations to a depth of 10 to 12 feet bgs using the onsite contractor's excavation equipment. Soil samples will be collected from each test pit at 4 to 5 feet bgs and 10 to 12 feet bgs. Each sample will be analyzed for total petroleum hydrocarbons by method HCID (Hydrocarbon Identification Scan). EMS will complete a separate report detailing the sample collection process and analytical results along with recommendations. Environmental Management Services, LLC 6528 th Avenue Fox Island, Washington 98333 Phone: (253) 921-7059 Fax: (253) 369-6228 ems@emsgroupllc.com 4 236th Street SW 7. Concrete Curb 'F r 13ails'l Silt, Truck Exit for wa er Runoff'Contro 7 'S'. .12,00011, a lon Dies6i Fuel US fflo Be Removed) -5 Trucks to I 7 Concrie'te Fueling Pad oved� J'J Rem 'na n c 1:iiainte' e a Purrip island uanoby-.' Pump Isl' nd W/ 4 Dispensers 4' (T6�V (T e �T o Be Removed) k6t&-For Dust 6ontro I' se�d As r4e6ess (D ary) 4 Temporary.PCS Storage Area !^Curb Concr tecu�� PCs to, be placed onto,6 mil pf�stic Asphalt Parking Lot,,, t il, AS ic. and covered with,.6 m ip T % 2. 0- C L Lu Note Total time anticipated is 4� three consecutive working days A total of 16 tons of concrete will be 0 transported off site A total of 48 to rted cubic yards will be transpo the site to backfill the excavation (4 cubic yards per 1000 gallons) S' 20' Q'I Approximate Scale In Feeti Project No./Name: Laurehurst Fuels Figure / Sheet No. Site Map UST Closure Bid Request Edmonds UST Project Date: May 07, 2005 23601 Edmonds Way 2 of 3 &'�X �JEMS Edmonds Washington Drawn / Created By: S.Spencer Environmental Services I I Checked By: S.Spencer Environmental Management Services, LLC Providing Practicle Environmental Compliance Solutions OV EDA, CITY OF EDMONDS j2eSt)31 ENVIRONMENTAL CHECKLIST RECEIVE:D AUG 2 2005 PERMIT COUNTER Purpose of Checklist: The State Environmental Policy Act (SEPA), chapter 43.21 C RCW, requires all governmental agencies to consider the environmental impacts of a proposal before making decisions. An environmental impact statement (EIS) must be prepared for all proposals with probable significant adverse impacts on the quality of the environment. The purpose of this checklist is to provide information to help you and the agency identify impacts from your proposal (and to reduce or avoid impacts from the proposal, if it can be done) and to help the agency decide whether an EIS is required. Instructionsfor Applicants: This environmental checklist asks you to describe some basic information about your proposal. Governmental agencies use this checklist to determine whether the environmental impacts of your proposal are significant, requiring preparation of an EIS. Answer the questions briefly, with the most precise information known, or give the best description. you can, You must answer each question accurately and carefully, to the best of your knowledge.* In most cases, you should be able to answer the questions from your own observations or project plans without the need to hire experts. If you really do not know the answer, or if a question does not apply to your proposal, write "do not know" or does not apply". Complete answers to the questions now may avoid unnecessary delays later. Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations. Answer these questions if you can. If you have problems, the governmental agencies can assist you. 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 maybe significant adverse impact. NOTE: Projects generating new traffic will be required to submit a Traffic Study prepared by a licensed Professional Civil Engineer. Specific requirements for the Traffic Study may vary depending upon the project, and will be provided by the City Engineer upon request. Please contact the Engineering Division at 425-771-3202 for specific study requirements. City review of the Traffic Study may require assessment of the "Development Project Peer Review" fee of $45 plus the cost of the review. Use of checklistfor nouproject proposals: Complete this checklist for nonproject proposals, even though questions may be, answered "does not apply." IN ADDITION, complete the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part D). For nonproject actions, the references in the checklist to the words "project," "applicant," and "property or site" should be read as "proposer," and "affected geographic area," respective,ly. A. BACKGROUND Name of proposed project, if applicable: Laurelhurst Oil Co.. UST Closure Project 2. Name of applicant: Laurelhurst Oil Co. 3. Address and phone number of applicant and contact person: 7040 — 2e Avenue NE Seattle, WA 98115 Page I of24 sepa chmkfist - 23601 edmonds way:5.10.2005 0 0 4. Date checklist prepared: May 9, 2005 5. Agency requesting checklist: City ofEdmonds 6. Proposed timing or schedule (including phasing, if applicable): UST Closure Scheduled for Mid June 2005 (STAFF COMMENTS) 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. No (STAFF COMMENTS 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. UST Closure and Site Assessment to be completed Mid June 2005 (STAFF COMMENTS) 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. None Pending (STAFF COMMENTS) Page 2 of 24 s�pa chmkfisl - 23601 edmonds way.5. 10.2005 10. List any government approvals or permits that will be needed for your proposal, if known. UST Closure Permit — Edmonds Fire Department Ecology 30Day UST Closure Notification Edmonds Cr itical Areas Checklist (STAFF COMMENTS) 11. Give brief, complete description of your proposal, including the proposed uses and 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. Undergorund Storage Tank (UST) Closure by Removal. One 12,000 izallon UST will be nroDerlv decommissioned by a licensed UST closure contractor. The UST will be excavated, transported off site and disposed per WAC 173-340. A UST Site Assessment will be completed during the UST closure by a licensed UST Site Assessor (WAC 173-340). A UST Site Assessment Report will be _generated detailing the site conditions during and following the UST closure. (STAFF COMMENTS) 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 range or boundaries of the site(s). Provide 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. SE Comer of Edmonds WAy and 236h Street SW, Edmonds Washin�ton (STAFF COMMENTS) Page 3 of 24 sepa chmkfist - 23-601 edmonds way:5.10.2005 TO BE COMPLETED BY APPLICANT B. ENVIRONMENTAL ELEMENTS 1. Earth a. General description of the site (circle one): Flat, rolling, hilly, steep slopes, mountainous, other: Flat, jzraded into storm water conveyance system (STAFF COMMENTS b. What is the steepest slope on the site (approximate percent slope)? <1% (STAFF COMMENTS) C. What general types of soils are found on the site (for example, clay, sand, gravel, peat, and muck)? If you know the classification of agricultural soils, specify them and note any prime farmland. Medium to cource sand with gravel — Assumed. (STAFF COMMENTS) d. Are there surface indications or history of unstable soils in the immediate viciniq? If so, describe._ No (STAFF COMMENTS) Page 4 of 24 sepa chmklist - 236,01 edmonds way*.5.10.2005 e. Describe the purpose, type and approximate quantities of any filling or grading proposed. Indicate source of fill. Back fill will be placed into the UST excavation follwong UST removeal. Approximately 45 yards of 13Te 17 engioneered fill material will be placed ihto the excavation and completed to 95% (STAFF COMMENT S f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. No (STAFF COMMENTS) g. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? 90% (STAFF COMMENTS) h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: (STAFF 2. AIR a. What types of emissions to the air would result from the proposal (i.e., dust, automobile, odors, and industrial wood smoke) during construction and when the project is completed? If any, generally describe and give approximate quantities if known. Excavator exhaust during the three dqys of site work. (STAFF COMM b. Are there any off -site sources of emissions or odor that may effect your proposal? If so, generally describe. Page 5 of24 sepachecklist- 23601 edmonds�ay:5.10.2005 (STAFF COMMENTS) C. Proposed measures to reduce or control emissions or other impacts to th6; if any: None (STAFF COMMENTS) 3. WATER a. Surface: (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, and wetlands)? If yes, describe type and provide names. If appropriate, state what stream or river it flows into. (STAFF COMM (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 (STAFF COMMENTS) (3) Estimate the amount of rill 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. (STAFF COMMENTS) (4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known.. Page 6 of 24 wpa checkh�t - 23601 edmonds ­y:5.10_2005 0 0 (STAFF COMMENTS) (5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. No (STAFF COMMENTS) (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 (STAFF COMM b. Ground: (1) Will ground water be withdrawn, or will water be discharged to ground water? Give general description, purpose, and approximate quantities if known. (STAFF COMMENTS Page 7 of 24 sepa checklist - 23601 edmonds way:5.10.2005 (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. (STAFF COMMENTS) C. Water Runoff (including storm water): (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. None — Proiect to take 3 days (STAFF COMMENTS) (2) Could waste materials enter ground or surface waters? If so, generally describe. No (STAFF COMMENTS) d. Proposed measures to reduce.or control surface, ground, and runoff water impacts, if any: None (STAFF COMMENTS) 4. Plants a. -Check or circle types of vegetation found on the site: Page 8 of 24 sepa checklist - 23601 edmonds way:5.10.2005 deciduous tree: alder, maple, aspen, other: evergreen tree: fir, cedar, pine, other: x shrubs grass pasture crop or grain wet soil plants: cattail, buttercup, bulrush, skunk cabbage, other: water plants: water lily, eelgrass, milfoil, other: other types of vegetation: (STAFF COMMENTS) b. What kind and amount of vegetation will be removed or altered? None (STAFF COMMENTS) C. List threatened or endangered species known to be on or near the site. None (STAFF COMMENTS) d. Proposed landscaping, use of native plants, or other materials to preserve or enhance vegetation on the site, if any: Page 9 of 24 sepa chmkfist - 23601 edmonds wa)r.5.10.2005 (STAFF COMMENTS) 5. Animals a. Check or circle any birds and animals that have been observed on or near the site or are known to be on or near the site: birds: hawk, heron, eagle, songbirds, other: mammals: deer, bear, elk, beaver, other: fish: bass, salmon, trout, herring, shellfish, other: (STAFF COMMENTS) b. List any threatened or endangered species known to be on or near the site. (STAFF COMMENTS) C. Is the site part of a migration route? If so, explain. No (STAFF COMMENTS d. Proposed measures to preserve or enhance wildlife, if any: None Page 10 of 24 sepa checklist - 23601 edmonds way:5. 10.2005 0 (STAFF COMMENTS) 6. Energy and Natural Resources a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet the completed project's energy needs? Describe whether it will be used for heating, manufacturing, etc. None (STAFF COMMENTS) b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally describe. No (STAFF COMMENTS) C. What kinds of energy conservation features are included in the plans of this proposal? List other proposed measures to reduce or control energy impacts, if any: None (STAFF COMMENTS) 7. Environmental Health Page I I of 24 wpa checklisi - 23601 edmonds way:5.10.2005 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. UST closure and associated hazards to be managed by properly licensed UST porofessionals (STAFF COMMENTS) (1) Describe special emergency services that might be required. Fire (STAFF COMMENTS) (2) Proposed measures to reduce or control environmental health hazards, if any: Site Specific Health & Safty Plan Properly licensed and traned employees (STAFF COMMENTS) b. Noise (1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? None (STAFF COMMENTS) Page 12 of 24 sepa checklist - 23601 edmonds �ay:5.10.2005 0 (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 hour's noise would come from the site. Excavator - 24 hours total Soil Compaction — 4 hours total (STAFF COMMENTS) (3) Proposed measures to reduce or control noise impacts, if any: Lfit work hours (STAFF COMMENTS) 8. Land and Shoreline Use a. What is the current use of the site and adjacent properties? Site Use: Fuel Station Adiacent Prope!1y: Multi Family Residential (STAFF COMMENTS) b. Has the site been used for agriculture? If so, describe. No (STAFF COMMENTS) Page 13 of24 sepa cbecklist - 23601 edmonds �ay:5.10.2005 0 C. Describe any structures on the site. 8 x 8 Storage Shed 40 x 40 Fuel Dispenser Canopy 4 x 40 Fuel Dispenser Pump Island (STAFF COMMENTS) d Will any structures be demolished? If so, what? 3 — 12,000 gallon UST, 40 x 40 Fuel DiMenser Canopy & 4 x 40 Fuel Dispenser Pump Island (STAFF COMMENTS) e. What is the current zoning classification of the site? Commercial (STAFF COMMEN E What is the current comprehensive plan designation of the site? (STAFF COMMENTS) g. If applicable, what is the current shoreline master plan designation of the site? NA (STAFF COMMENTS) Page 14 of 24 sepa checklisi - 23601 edmonds way-.5.10.2005 r- L'I h. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify. (STAFF COMMENTS) i. Approximately how many people would reside or work in the completed project? None (STAFF COMMENTS) j. Approximately how many people would the completed project displace? None (STAFF COMMENTS) k. Proposed measures to avoid or reduce displacement impacts, if any: NA (STAFF COMMENTS) 1. Proposed measures to ensure the proposal is compatible with existing and pr jected land uses and plans, if 01 any: None (STAFF COMMENTS) Page 15 of 24 sepa ch�kfist - 23601 edmonds way.5.10.2005 0 0 9. Housing a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-income housing. (STAFF COMMENTS) b. Approximately how many units, if any would be eliminated? Indicate whether high, middle, or low-income housing. NA (STAFF COMMENTS) Proposed measures to reduce or control housing impacts, if any: NA (STAFF COMMENTS) 10. Aesthetics a. . What is the tallest height of any proposed structure(s), not incl uding antennas; what is the principle exterior building material(s) proposed? NA (STAFF COMMENTS) Page 16 pf 24 sepa checklist - 23601 edmonds way:5.10.2005 0 b. What views in the immediate vicinity would be altered or obstructed? None (STAFF COMMENTS) C. Proposed measures to reduce or control aesthetic impacts, if any: None (STAFF COMMENTS) 11. Light and Glare a. What type of light or glare will the proposal produce? What time of day would it mainly occur? NA (STAFF COMMENTS) b. Could light or glare from the finished project be a safety hazard or interfere with views? NA (STAFF COMMENTS) C. What existing off -site sources of light or glare may affect your proposal? None (STAFF COMMENTS) Page 17 of 24 sep chtckfisl - 23601 edmonds way:5.10.2005 0 d. Proposed measures to reduce or control light and glare impacts, if any: (STAFF COMMENTS) 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? Unknown (STAFF COMMENTS) b. Would the proposed project displace any existing recreation uses? If so, describe. No (STAFF C. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: (STAFF COMMEN Page 18 of 24 sepa checklist - 23601 edmonds way:5.10.2005 13. Historic and Cultural Preservation a. Are there any places or objects listed on, or proposed for, national, state, or local preservation registers known to be on or next to the site? If so, generally describe. (STAFF COMMENTS) b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. None (STAFF COMMENTS) C. Proposed measures to reduce or control impacts, if any: (STAFF COM 14. Transportation a. Identify public streets and highways serving the site, and describe proposed access to the existing street system. Show on site plans, if any. (STAFF COM Page 19 of 24 sepa chmkfist - 23601 edmonds way:5.10-2005 0 0 b. Is site currently served by public transit? If no, what is the approximate distance to the nearest transit stop? (STAFF COMMENTS) C. How many parking spaces would the completed project have? How many would the project eliminate? (STAFF COMMENTS) d. Will the proposal require any new roads, streets, or improvements to existing roads or streets, not including driveways? If so, generally describe (indicate whether public or private). (STAFF COMMENTS) e. Will the project use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe. No (STAFF COMMENTS) Page 20 of 24 �pa chmkfist - 23601 edmonds —y:5.10.2005 f. How many vehicular trips per day would be generated by the completed project? If known, indicate when peak volumes would occur. (STAFF COMMENTS) g. Proposed measures to reduce or control transportation impacts, if any: None (STAFF COMM 15. Public Services . a. Would the project result in an increased need for public services .(for example: fire protection, police protection, health care, schools, other)? If so, generally describe. (STAFF COMMENTS) b. Proposed measures to reduce or control direct impacts on public services, if any: None (STAFF COMMENTS) Page 21 of 24 sepa chmkiist - 23601 edmonds —y:5. 10.2005 16. Utilities a. Circle utilities currently available at the site<� natural ga<i�i� refuse servic C—sa—nit—ary—sew`e-�> septic system, other: ------------- (STAFF COMMENTS) 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. None .(STAFF COMMENTS) C. SIGNATURE my knowledge. I understand that the lead agency is relying on them to 01 Date Submitted Page 22 of 24 sepa checklist - 23601 edmonds way:5. 10.2005 0 0 D. SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (do not use this sheelfor 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; production, storage, or release of toxic or hazardous substances; or production of noise? No Possibili1y Proposal measures to avoid or reduce such increases are: 2. How would the proposal be likely to affect plants, animals, fish, or marine life? No Possibilfty Proposed measures to protect or conserve plants, animals, fish, or marine life are: None I How would the proposal be likely to deplete energy or natural resources? No Possibil Proposed measures to protect or conserve energy and natural resources are: None Page 23 of 24 sepa checklist - 23601 edmonds way:5.10.2005 0 0 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? No Possibility Proposed measures to protect such resources or to avoid or reduce impacts are: None 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? No Possibility 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. None 7. Identify, if possible, whether the proposal may conflict with local, state, or federal laws or requirements for the protection of the environment. Page 24 of 24 sepa ch�kfisl - 23601 edmonds —y:5.10.2005