1-2025 04 22 KY Non-State DOT Direct Recipient NEPA Checklist.pdf

National Environmental Policy Act (NEPA) Checklist for Local Public Agencies

Kentucky Division

This document is intended to assist local public agencies (LPA) that are administering any direct Federal-aid grant program in determining requirements and documentation requirements under the National Environmental Policy Act (NEPA). FHWA’s NEPA regulations are codified in 23 CFR Part 771. Primary contact for LPAs is the Planning, Environment, and System Performance Team Leader (System Performance Team Leader) assisted by the Environmental Protection Specialist and acts as the Division LPA Program Coordinator. Throughout the development of your project, coordination with the Division Office is imperative as there are certain responsibilities for coordination that remain with FHWA and cannot be delegated to the LPA or it’s consultant (if applicable), such as coordination with the USFWS under Section 7 of the Endangered Species Act or coordination with the SHPO/THPO under Section 106 of the National Historic Preservation Act. FHWA retains responsibility for coordination with all resource and regulatory agencies and tribal governments. It is the expectation of FHWA that the applicant or grantee will be responsible for completing all required technical studies to support the NEPA process and will provide those documents to FHWA for coordination with the appropriate State or Federal agency.

FHWA has the final decision on level of NEPA documentation.

FHWA-KY Categorical Exclusion (CE) Form for Local Public Agencies Date:

Section I) Project Information* Project Sponsor (Applicant): Federal Project #:

Name of Project: State Project #:

Is the project on an approved STIP/TIP? Yes No STIP Reference #:

Funding or Grant Source(s):

Estimated Cost:

Purpose and Need:

Project Description:

Alternatives Analysis:

Logical Termini & Independent Utility:

Is there a previously approved FHWA / State DOT Categorical Exclusion for the project?

Yes Environmental process is complete. Identify State DOT Project and forward CE to FHWA.

No Continue

Is there a previously approved FHWA / State DOT Planning & Environmental Linkage (PEL) study for the project?

Yes Consult PEL documentation and incorporate results.

No Continue

Scope of the Proposed Action Will the proposed project: No Yes Comments Be a facility on a new alignment?

Have any ground disturbing activities?

Be constructed within the existing operational right of way?

Add through traffic lanes to an existing facility?

Provide a substantial change in access control to the roadway?

Result in a permanent alteration of local traffic pattern?

Right-of-Way (R/W) Will the proposed project: No Yes Comments Involve right-of-way acquisition or easements?

How many acres fee simple?

Involve any residential or commercial relocations?

Section II) Environmental Resources Evaluations* Involvement with Resources:

Yes No Studies, Coordination and Comments Air Quality Impacts

Mobile Source Air Toxics (MSAT) NAAQS/Particulate Matter 2.5 (PM 2.5)

Noise Hazardous Materials Cultural Resources (Section 106)

- Archaeological Resources

- Architectural Historic Resources

Native American Consultation Wetlands Streams and Rivers Section 401 Water Quality Certification Section 404 Waterway Permits USCG Section 9 Bridge Permit Stormwater Permits Floodplain Impacts Threatened/Endangered Species Farmlands Section 4(f) Property Section 6(f) Property Economic Impacts Social Impacts Local Land Use & Transportation Plan Community or Title VI Impacts Public Involvement Plan Public Controversy Reasonably Foreseeable Impacts Construction Impacts Environmental Mitigation

Section V) Required Attachments*

• These items MUST BE submitted by the times shown below

By the time of federal NEPA approval for project:

• Project mapping

• Project photolog

• Pre-coordination letters with permitting agencies (OEPA, Army Corps, Floodplain Coordinator, etc.)

• Documentation of Public Involvement

• External resource agency coordination letters showing final agency concurrence with project (SHPO, USFWS, OHPO, ODNR, etc.), which includes completion and agency approval of all requested additional resource studies by any resource agency

Prior to construction for all projects, please provide:

• Copies of all waterway permits

• Copies of all floodplain permits

• Evidence of all environmental commitments as shown in project plans and specifications

Section VI) Class of Action Determination 23 CFR 771.117

• Consult with FHWA if uncertain.

Select a Categorical Exclusion from the drop-down menu below based upon the scope of the project:

Select additional Categorical Exclusion, if needed from the drop-down menu below:

If categorical exclusions (c)(26), (c)(27), or (c)(28) were selected above, do any of the following circumstances apply? If yes, the project must be completed as a d-listed CE, an Environmental Assessment or Environmental Impact Statement as appropriate.

Consult with FHWA for a final determination.

1. An acquisition of more than a minor amount of right-of-way or that would result in any residential or non-residential displacements;

2. An action that needs a bridge permit from the U.S. Coast Guard, or an action that does not meet the terms and conditions of a U.S. Army Corps of Engineers nationwide or general permit under section 404 of the Clean Water Act and/or section 10 of the Rivers and Harbors Act of 1899;

3. A finding of “adverse effect” to historic properties under the National Historic Preservation Act, the use of a resource protected under 23 U.S.C. 138 or 49 U.S.C. 303 (section 4(f)) except for actions resulting in de minimis impacts, or a finding of “may affect, likely to adversely affect” threatened or endangered species or critical habitat under the Endangered Species Act;

4. Construction of temporary access, or the closure of existing road, bridge, or ramps, that would result in major traffic disruptions;

5. Changes in access control;

6. A floodplain encroachment other than functionally dependent uses (e.g., bridges, wetlands) or actions that facilitate open space use (e.g., recreational trails, bicycle and pedestrian paths); or construction activities in, across or adjacent to a river component designated or proposed for inclusion in the National System of Wild and Scenic Rivers.

Section VI) Approval This section must be signed by all parties and approved by FHWA prior to federal authorization of the next phase of the project.

After reviewing the current status of this project, the Applicant considers that the NEPA process and documentation to be completed.

The applicant confirms that there are not unusual circumstances associated with the project as defined by 23 CFR 771.117 (b) that would require completion of either an Environmental Assessment or Environmental Impact Statement.

Unusual circumstances include:

• Significant environmental impacts;

• Substantial controversy on environmental grounds;

• Significant impact on properties protected by section 4(f) of the DOT Act or Section 106 of the National Historic Preservation

Act; or inconsistencies with any Federal, State, or local law, requirement or administrative determination relating to the environmental aspects of the action.

The applicant acknowledges that a reevaluation of the approval will occur if there are any changes to the proposed action. Changes may include 1) changes in scope or location, 2) changes in ability of project to deliver environmental commitments as promised to agencies and/or parties, 3) identification of new environmental impacts not considered in the NEPA document, 4) new information or circumstances relevant to environmental concerns with bearing on the proposed action or its impacts, which would result in substantial environmental impact not considered in the NEPA document.

Form Prepared By:

Applicant Name/Organization Date

Applicant Acceptance of Project:

Project or Program Manager Name and Organization Date

FHWA has reviewed the proposed action and it is our assessment that implementation of the proposed action will not result in any significant impacts to the human and/or natural environment. If during further development of the project there is a substantial change in the impacts of or the scope of the proposed action, the environmental effects need to be reevaluated.

Approval of CE:

For:

FHWA Kentucky Division Administrator

Date

__ Planning or Preliminary Engineering leading to NEPA Approval.

__ Final Design leading to Construction contract documents.

__ Construction.

Description of Work: