ADB-11-63 Environmental Checklist.pdfPurpose of Checklist:
The State Environmental Policy Act (SEPA), chapter 43.21C 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.
Instructions for 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
may be significant adverse impact.
Use of checklist for nonproject 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," respectively.
1. Name of proposed project, if applicable: Edmonds Medical Office Building
2. Name of applicant: First Western Development Service
3. Address and phone number of applicant and contact person:
8129 Lake Ballinger Way #104
Edmonds, WA 98026
Contacts: Scott Shanks or Dale Pinney 425- 329-0848
4. Date checklist prepared: June 8, 2011
5. Agency requesting checklist: City of Edmonds
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6. Proposed timing or schedule (including phasing, if applicable): Entitlement and Permit work is anticipated for
summer and early fall 2011; Construction start in early 2012 completing in late 2012. The project will be constructed
a
91
9.
in one
(STAFF
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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)
List any environmental information you know about that has been prepared, or will be prepared, directly related
to this proposal.
A Phase I environmental report was performed on the site, no issues noted. A geotechnical report for building foundation
recommendations will be performed in June 2011. A trip generation report is provided with this application.
(STAFF COMMENTS) ,r war k- %DNi 'r). e- WA-e,,,i Cvcxuam, I,, c� . d" -e q16111Y 11 an-Ve d
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Vo"Yo'u"�—n�',6'74" WA-ethe"r pp icationds are peent�i'neg�'flo'tr"�g4odve'edrn4\m%%eSnt'�aI approvals of other proposals irecty affecting
the property covered by your proposal? If yes, explain.
No
(STAFF COMMENTS)
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I
10. List any government approvals or permits that will be needed for your proposal, if known.
The project will require: Design Review, Building Permit, City of Edmonds R/W permit, State NPDES permit for
construction storm water, State Certificate for a Surgery Center, and a Sign Permit.
(STAFFCOMMENTS)
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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.
The proposal includes construction of a three store medical office building. The first and second floors contain 54,440
SF of structured parking and the third floor contains 27,220 SF of Medical office. There is a lobby and entry area on
each parking level with the main entry lobby on the office floor. The medial office use will include clinical space,
surgery suites, X-ray and MRI facilities and administrative offices. The project will gain access directly from 72nd Ave.
West. All the required utilities are also in 72nd. The project provides 123 parking stalls in the garage.
(STAFF COMMENTS) Mc'�4 64r.'C' fIkV'I..r_AOlAde o. -Asm a-
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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.
The site address is 21401 72nd Ave W. The site is located on 72nd, directly north of the McDonalds driveway. The
site is currently fenced in with an access gate at the curb cut on 72nd. Vicinity map is attached.
(STAFF COMMENTS)
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1. Earth
a. General description of the site (circle one): Flat, rolling, hilly, steep slopes, mountainous, other:
Flat, old parking lot
b.
C.
d.
(STAFF COMMENTS)
What is the steepest slope on the site (approximate percent slope)?
1%
(STAFF COMMENTS)
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.
As part of the site evaluation both test pits and borings were installed. From these, it was determined that the
northern and southern halves of the site had different profiles. The southern portion has 6-16 feet of medium dense
glacial till over medium dense native silty sand material. The northern half has 3-4 ft of medium dense till like fill
over 10-16 ft. of peat and organic material, which overlays a medium dense native silty sand material.
Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe.
No
(STAFF COMMENTS)
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e. Describe the purpose, type and approximate quantities of any filling or grading proposed. Indicate source
of fill.
The on site concrete paving will be removed and replaced with a layer of gravel. Finish floor will be at a very
f.
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similar elevation as the existing grade. The only excavation that will be taken offsite will be foundation excavation.
9
Could erosion occur as a result of clearing, construction, or use? If so, generally describe.
A small amount of surface erosion could occur if there were a large rain event during the time when the foundation
work is occurring.
(STAFF COMMENTS)
About what percent of the site will be covered with impervious surfaces after project construction (for
example, asphalt or buildings)?
Approx. 97%
(STAFF COMMENTS)
h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any:
Best management practices will be employed during wet weather foundation work to insure that any bare soil
is covered. Any apparent drainage courses will be strawed or treated with rip rap. Catch basin protection will be
installed at the start of construction.
(STAFF COMMENTS) yg. _ "�� �� ✓a nd�a° C.AM 1" r tor. Z— �r.'e..
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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.
There is a possibility that the project may temporarily create some dust and engine exhaust during construction.
No permanent emissions will be generated by the completed project, other than some auto exhaust.
(STAFF COMMENT
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b. Are there any off-site sources of emissions or odor that may effect your proposal? If so, generally describe.
No
(STAFF COMMENTS)
C. Proposed measures to reduce or control emissions or other impacts to the, if any:
Site watering or Best Management Practices will be followed to control construction dust.
(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.
No
(STAFF COMMENTS)
(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 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
(STAFF COMMENTS)
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(4) Will the proposal require surface water withdrawals or diversions? Give general description,
purpose, and approximate quantities if known.
No
(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 COMMENTS)
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.
No
(STAFF COMMENTS)
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(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.
10
(STAFF
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.
The building area covers virtually the entire site, the only run off will be from the building roof. This water
will be collected in an underground detention vault and off site flows will be metered per code. The water
will flow into the existing city storm water system. No treatment is planned as the roof water is considered
clean. During construction surface water from rain events could run off the site.
(2) Could waste materials enter ground or surface waters? If so, generally describe.
Any waste material entering ground water would be from some construction action.
(STAFF COMMENTS)
d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any:
Best Management Practices will be utilized with regard to construction activities, fueling and surface erosion.
(STAFF COMMENTS) n, . .. ` „ex -A-, r .
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4. Plants
a. Check or circle 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
wet soil plants: cattail, buttercup, bulrush, skunk cabbage, other:
water plants: water lily, eelgrass, milfoil, other:
X other types of vegetation: None, concrete and gravel lot.
(STAFF COMMENTS) " g./, c- 9I.& A,
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b. What kind and amount of vegetation will be removed or altered?
None
(STAFF COMMENTS)
threatened or endangered species known to�b on or ne rYgY
C. List th the
teat Y.°�
site.
None
(STAFF COMMENTS)
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d. Proposed landscaping, use of native plants, or other materials to preserve or enhance vegetation on the site,
if any:
Code required landscaping will be installed on all perimeters of the project.
(STAFF COMMENTS) I I . - a. �er%S,�Ar-wc,
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: none
mammals: deer, bear, elle, beaver, other: none
fish: bass, salmon, trout, herring, shellfish, other: none
b. List any threatened or endangered species known to be on or near the site.
None
(STAFF COMMENTS)
C. Is the site part of a migration route? If so, explain.
No
(STAFF COMMENTS)5-In ke... ` t �r ��� �". 'C
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d. Proposed measures to preserve or enhance wildlife, if any:
None
(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.
The building will use both natural gas and electric for heating/cooling. The project will use normal roof mounted
HVAC equipment.
(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:
It is anticipated that a horizontal window shade element may be used to reduce thermal gain and lower cooling
costs.
(STAFF COMMENTS)
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7. Environmental Health
a. Are there any environmental health hazards, including exposure to toxic chemicals, risk of fire and
explosion, spill, or hazardous waste, that could occur as a result of this proposal? If so describe.
No
(STAFF COMMENTS)
(1) Describe special emergency services that might be required.
The building will contain a surgical center and there may be a need for ambulance service to the building.
(STAFF
(2) Proposed measures to reduce or control environmental health hazards, if any:
None
(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)
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(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.
Short term noise would be related to construction. No long term noise would be generated by the project.
Traffic noise in the area is already extremely high, the addtional traffic to this building would not create a
noticeably difference.
(STAFF COMMENTS)
(3) Proposed measures to reduce or control noise impacts, if any:
None
(STAFF COMMENTS)
S. Land and Shoreline Use
a. What is the current use of the site and adjacent properties?
The site is currently vacant. To the north, is a building supply warehouse; east, is a gas station and fast food
restaurant; south, is a commercial building; west, across the street is a retirement home.
(STAFF COMMENTS)
b. Has the site been used for agriculture? If so, describe.
No
(STAFF COMMENTS)
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C. Describe any structures on the site.
None
(STAFF COMMENTS)
d. Will any structures be demolished? If so, what?
No
(STAFF COMMENTS)
C. What is the current zoning classification of the site?
CG2
(STAFF COMMENTS)
f. What is the current comprehensive plan designation of the site?
CG2
g. If applicable, what is the current shoreline master plan designation of the site?
N/A
(STAFF COMMENTS)
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h. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify.
No, see Critical Area Report # -W11 ®0 qq
(STAFF COMMENTS) tA c,, dex-
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i. Approximately how many people would reside or work in the completed project?
There will be 30 full time and 10 part time employees.
(STAFF COMMENTS)
Approximately how many people would the completed project displace?
None
(STAFF COMMENTS) c 1`10 t!eI&IrAe_, C4;1%
k. Proposed measures to avoid or reduce displacement impacts, if any:
None
(STAFF COMMENTS)
1. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if
any:
The project will be designed and permitted based on current city codes and ordinances.
(STAT FCOMMENTS) -JA,,, Cot -
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9. Housing
a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-income
housing.
None
(STAFF COMMENTS)
b. Approximately how many units, if any would be eliminated? Indicate whether high, middle, or low-income
housing.
None
(STAFF COMMENTS)
C. Proposed measures to reduce or control housing impacts, if any:
None
(STAFF COMMENTS)
10. Aesthetics
a. What is the tallest height of any proposed structure(s), not including antennas; what is the principle
exterior building material(s) proposed?
The height of the building will be about 43 feet. The exterior will combine precast concrete, steel and engineered
panelling products for the bulk of the facade. It is also anticipated that green screen elements will be used to soften
the two garage levels.
(STAFF COMMENTS)
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b. What views in the immediate vicinity would be altered or obstructed?
None
(STAFF COMMENTS) Im
C. Proposed measures to reduce or control aesthetic impacts, if any:
None
(STAFF COMMENTS) $,0 "YA, cL,,Jt, se eJ \=,°v a:A)i ,MaX.
11. Light and Glare
a. What type of light or glare will the proposal produce? What time of day would it mainly occur?
The project may create some indirect light from the garage and office levels in the evenings or at night.
(STAFF COMMENTS)
b. Could light or glare from the finished project be a safety hazard or interfere with views?
No
(STAFF COMMENTS)
C. What existing off-site sources of light or glare may affect your proposal?
None
(STAFF COMMENTS)
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d. Proposed measures to reduce or control light and glare impacts, if any:
We will evaluate potential glare from the parking garage fixtures; if required cutoff lenses or shades could be
employed. Any exterior lighting will be low level and pointed away from off site areas.
(STAFF COMMENTS)
12. Recreation
a. What designated and informal recreational opportunities are in the immediate vicinity?
None
(STAFF COMMENTS)
b. Would the proposed project displace any existing recreation uses? If so, describe.
No
(STAFF COMMENTS)
C. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be
provided by the project or applicant, if any:
None
(STAFF COMMENTS)
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13. Historic and Cultural Preservation
a. Are there any places or objects listed on, or proposed foe, national, state, or local preservation registers
known to be on or next to the site? If so, generally describe.
No
(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:
None
(STAFF COMMENTS)
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.
The entry to the project will be directly from 72nd Street West into the parking garage. This is the one and only
access.
(STAFF COMMENTS)xr% l
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b. Is site currently served by public transit? If no, what is the approximate distance to the nearest transit
stop?
Yes, there is a bus stop on the side walk in front of the project and a park and ride across the street.
(STAFF COMMENTS)
C. How many parking spaces would the completed project have? How many would the project eliminate?
The project would provide 116 off street parking stalls. None are eliminated.
(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).
No
(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)
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f. How many vehicular trips per day would be generated by the completed project? If known, indicate when
peak volumes would occur.
The project will generate 816 daily trips. The peak hour volumes would occur in the PM. The PM peak
volume is 59 trips.
(STAFF COMMENTS) 'AX A- Af-� ih� 4a iQ� MCI
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g. Proposed measures to reduce or control transportation impacts, if any:
The project proposes signage modifications at the 216th / 72nd intersection. See the attached traffic report for
details.
(STAFF COMMENTS)
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.
As stated previously, there may be a periodic need for ambulance access. There would not be a need for any
additional public services beyond what exists in the area.
(STAFF COMMENTS)
b. Proposed measures to reduce or control direct impacts on public services, if any:
None
(STAFF COMMENTS
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16. Utilities
a. Circle utilities. currently available at the site: electrici natural as ate efus service tele ho
sanitary sewe 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.
The project will require electrical power (Snohomish County PUD) Water and Sanitary Sewer (City of Edmonds)
natural gas (PSE) Telecom (Frontier) and cable (Comcast). All of these utilities are in the area.
(STAFF COMMENTS)
I declare under penalty of perjury laws that the above answers are true and correct to the best of my knowledge. I understand
that the 01a ?ncys rel g on them to make its decision.
Signature of Proponent
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Date Submitted
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