Environmental Checklist with 8-20-13 review comments.pdfOff° ED4f
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Purpose of Checklist:
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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 Applica,rts:
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. dame of proposed project, if applicable:
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2. Name of applicant: Cd ky t^ -W -I Iyi) V t 6a?
3. Address and phone num
applicant and contact person:
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5. Agency requesting, cheeldist: City�Edmonds
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6. Proposed timing or schedule T (including phasing, if ap livable): I I
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7. Do you have any plans for future additions, expansion, or further activity related to or connected with this
proposal? If yes, explain. /1^
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(STAFF COMMENTS
S. List any environmental information you know about that has been prepared, or will be prepared, directly related
to this DFODOSal.
(STAFF COMMENTS
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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.
(STAFF COMMENTS)
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10. List any gover",nmentAapprovals4 or permits that will be needed for your proposal, if known.
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.
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(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.
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1. Earth
a. General description of the site (circle one)(Fa rolling, hilly, steep slopes, mountainous, other:
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(STAFF COMMENTS
What is the si
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A slope on the site ' (approximate percent slope)?.
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(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 a ricultural soils, specify them and note any prime farmland.
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Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe._
(STAFF
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e. Describe the purpose, type and approximate quantities of any filling or grading proposed. Indicate source
of fill. A I I
(STAFF COMMENTS
f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe.
(STAFF COMMENTS)
g. About what percent of the site will be covered with impervious surfaces after project construction (for
example, asphalt or buildings)?
(STAFF
h. Proposed assures to red a or cor►trol erosion, or other impacts to the earth, if any:
a. What types of emissions to the air would result from the proposal (i.e., dust, automobile, odors, and
Industrial wood sinolix) during construction and when the project is completed? If any, generally describe
and give approximatequatitities if known.
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(STAB COMMENTS)
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b. Are there arty off-site sources of emissions oi- odor that may effect your proposal? If so, generally describe.
(STAFF COMMENTS)
C. Proposeo measures to reduce or control emissions or other impacts to the, if any:
(STAFF COMMENTS
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 COMMENTS) 4e °..
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(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 lans.
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(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.
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(4) Will the proposal require surface water withdrawals or diversions? Give general description,
purpose, and approximate quantities if known.
(STAFF COMMENTS)
(5) Does the proposal lie within a 100 -year floodplain? If so, note location on the site plan.
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(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.
(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.
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(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.
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(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.
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(STAFF COMMENTS
(2) Could waste materials enter ground or surface waters? If so, generally describe.
(STAFF COMMENTS
d Proposed measures to reduce or control surface, ground, and runoff water impacts, if any:
(STAFF
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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:
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- shrubs
k— 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:
b. What kind and amount of,�egetation will be removed or altered?
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(STAFF COMMENTS)
C. List threatened or endangered species known to be on or near the site.
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(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:
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a. Check or circle any birds and animals that have been observed on or 0,, ear the site 1-11 ar a known to be on or
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near the site: 4A, A, A"e-f
- birds: hawk, heron, eagle, songbirds, othe�
- mammals: deer, bear, elk, beaver, other:
- fish: bass, salmon, trout, herring, shellfish, other:
(STAFF COMMENTS)
b. List any threatened or en angered species known to be on or near the site.
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(STAFF COMMENTS)
C. Is the site part of a migration route? If so, explain.
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(STAFF COMMENTS) ---------
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d. Proposed meas es to preserve or enhance wildlife, if any:
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(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.
(STAFF COMMENTS)
b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally
describe. , `
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(STAFF COMMENTS)
C. What kinds of energy conservation features are included in the plans of this proposal? List other proposed
measures to reduce or j�ontrol energy impacts, if any -
(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.
(STAFF COMMENTS)
(1) Describe special emergency services that might be required.
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(STAFF COMMENTS)
(2) Proposed measures to reduce or control environmental health hazards, if any:
(STAFF COMMENTS)
b. Noise
(1) What types of noise exist in the area which may affect your project (for example: traffic, equipment,
operation, of/her)?j�
(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.
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(3) Proposed measures to reduce or control noise impacts, if any:
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8. Land and Shoreline Use
a. What is the current use of the site and adjacent properties?
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(STAFF COMMENTS)
b. Has the site been used for agriculture? If so, describe.
(STAFF COMMENTS)
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C. Describe any st -uctures on the site.
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(STAFF COMMENTS)
d. Will any structures be demolished? If so, what?
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(STAFF COMMENTS
C. What is the current zoning classification of the site?
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(STAFF COMMENTS)
f. What Is the current comprehensive plan designation of the site?
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(STAFF COMMENTS
g. If applicable, what Is the current shoreline master plan designation of the site?
(STAFF COMMENTS)
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It. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify.
(STAFF COMMENTS
I. Approximately how malty people would reside or work in the completed project?
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(STAFF COMMENTS)
J. Approximately how many people would the completed project displace?
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(STAFF COMMENTS)
k. Proposed measures to avoid or reduce displacement impacts, if any:
(STAFF COMMENTS
1. Proposed measures to ensure the proposal Is compatible with existing and projected land uses and plans, if
any:
(STAFF COMMENTS)
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9. Housing
a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-income
housing. 43
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(STAFF COMMENTS)
b. Approximately how many units, if any would be eliminated? Indicate whether high, middle, or low-income
housing.
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(STAFF COMMENTS)
C. Proposed measures to reduce or control housing impacts, if any:
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(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?
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(STAFF COMMENTS IV v
Revised on 8119111 P71- SEPA Checklist Page 16 of 24
b. What views in the immediate vicinity would be altered or obstructed?
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(STAFF COMMENTS)
C. Proposed measures to reduce or control aesthetic impacts, if any:
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(STAFF COMMENTS)
11. Light and Glare
a. What type of light or glare willthe proposal pr( /
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What time of day would it m
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b. Could light or glare from the finished project be a safety hazard or interfere with views?
(STAFF COMMENTS)
C. What existing off-site sources of light or glare may affect your proposal?
(STAFF COMMENTS)
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d. Proposed measures to reduce or control light and glare impacts, if any:
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(STAFF COMMENTS)
12. Recreation
a. What designated and informal recreational opportunities are in the immediate vicinity?
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(STAFF COMMENTS)
b. Would the proposed project displace any existing recreation uses? If so, describe.
(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:
(STAFF COMMENTS)
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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) Ile-
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b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance
known to be on or next to the site,
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(STAFF COMMENTS
C. Proposed easures to reduce or control impacts, if any:
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(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 4p1I us, if any.
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(STAFF COMMENTS
Revised on 8119111 P71- SEPA Checklist Page 19 of 24
b. Is site currently served by public transit? If no, what is the approximate distance to the nearest transit
stop?
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(STAFF COMMENTS)
C. How many parking spaces would the completed project have? How many would the project eliminate?
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(STAFF COMMENTS) All arv"S;,Ve_ Q11A1.r—\K1.-1r%Q COM �Je.- C,2'�Ajn
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).
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(STAFF COMMENTS)
e. Will the project use (or occur in the Immediate vicinity of) water, rail, or ail, transportation? If so,
generally describe.
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(STAFF COMMENTS)a1JL_jZ L
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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.
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(STAFF COMMENTS)
g. Proposed measures to reduce or control transportation impacts, if any:
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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.
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(STAFF
b. Proposed measures to reduce or control direct impacts on public services, if any:
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(STAFF COMMENTS)
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16. Utilities
a. Circlties cn-rently available at the site: eTtu al
lectric* Y, as, Cwatei; C-e�use se Cele��n
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Ritary sewer,eptic system, other:
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(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.
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(STAFF COMMENTS
C. SIGNATURE
I declare under penalty of peduaws that the above answers are true and correct to the best of my knowledge. I understand
that the lead alley is rely� qpo make its decision.
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Date Submitted
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D. SUPPLEMENTAL SHEET FOR NONPROJE CT ACTIONS
(do not use this sheet for project actions)
Because these questions are very general, it may be helpful to read them in conjunction with the list of the elements of the
environment,
When answering these questions, be aware of the extent the proposal, or the types of activities likely to result fi-oni 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,
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?
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Proposal measures to avoid or reduce such increases are:
2. How would the proposal be likely to affect plants, animals, fish, or marine life?
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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?
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Proposed measures to protect or conserve energy and natural resources are:
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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, lloodplains, or prime farmlands?
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Proposed measures to protect such resources or to avoid or reduce impacts are:
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?
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Proposed+ measures to reduce or respond to such demand(s) are:
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7. Identify, if possible, whether the proposal may conflict with local, state, or federal laws or requirements for the
protection of the environment.
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