2. Scope of Work - Fallon SSER Phase II.pdf

Fallon Tribal Health Center Replacement Project Phase II Site Selection and Evaluation Report

PAIHS Project Number PH25SZ01C7 RFP Scope of Work

I. Introduction

This Request for Proposal (RFP) is for professional services to provide a Phase II Site Selection and Evaluation Report (Phase II SSER) summary document.

II. Background

The Fallon Paiute Shoshone Tribe (FPST) is planning to construct a 63,157 gross square feet (gsf) replacement facility for the existing Fallon Tribal Health Center (FTHC). The location of the new replacement facility will be near Williams Avenue and Sherman Street, Fallon, Churchill County, Nevada. Geographical Coordinates: 39°28'24.2"N 118°46'04.9"W.

Figure 1: New Health Facility Location

The Fallon Tribal Health Center serves Native Americans primarily from Churchill, Lander, Lyon, Nye and Humboldt counties. The FTHC is a full-service clinic providing a variety of health and wellness services and programs including Family Medicine, Behavioral Health, Laboratory, Dental, Pharmacy, Optometry, Chiropractic, Podiatry, as well as Nutrition, Diabetes Care and Injury Prevention.

Fallon Tribal Health Center Replacement Project Phase II SSER 4/24/2025

III. Scope of Work

A. Prepare a comprehensive Site Assessment (SA) for the proposed site. The SA shall consist of an Environmental Assessment (EA), Floodplain Assessment, Archeological/Cultural Resources Survey, Geotechnical Survey, Legal Survey, Biological Survey, Traffic Impact Analysis, Dry Barrel Fire Hydrant Test and Inspection, and Will Serve Letters from local utility companies.

1. Environmental Assessment (EA)

The Environmental Assessment shall comply with federal Council on Environmental Quality (CEQ), Department of Health and Human Services (DHHS) and IHS policies and procedures, including 40 CFR 1500-1508, the DHHS General Administration Manual, Part 30, and the IHS Environmental Review Manual. The consultant shall comply with applicable Federal, State of Nevada, County, Tribal and other agency statutes, regulations, codes and ordinances.

Refer to Appendices A, B, C & D for additional guidance and requirements. The Fallon Paiute Shoshone Tribe will participate in the EA review process. This effort will be coordinated by the PAIHS National Environmental Policy Act (NEPA) Coordinator.

2. Floodplain Assessment The Floodplain Assessment shall consist of an analysis to determine if there are any potential floodplain conditions that could adversely impact the construction and operation of the new quarters. The scope of services should include the following:

a. A literature review and site visit to document evidence of flood related erosion hazards.

b. A report that provides estimates of peak discharge rates of the surrounding watercourse ways. Peak discharge rates should be calculated for intervals of 2, 5, 10, 25, 50 & 100 years. All methodology should be consistent with current USGS best practices.

c. A hydraulic floodplain profile shall be developed for each watercourse that is anticipated to surcharge its banks and affect the proposed project site within a 100-yr interval.

d. Annotated aerial and contour maps that delineate the size of the watershed area affecting the project site as well as the surrounding watercourses and their anticipated breakout points and flow paths.

e. A professional assessment summarizing the suitability of this site and any recommendations necessary for the improved conveyance of runoff that could adversely impact the proposed facility.

3. Archeological/Cultural Resources Survey The Archeological/Cultural Resources Survey shall include the following services:

a. Conduct an on-site survey to locate historical or archaeological sites within and adjacent to the proposed construction area. Consult with FPST regarding potential impacts to traditional cultural places.

b. Provide a written assessment of the site including determination of eligibility of any historic or archaeological sites discovered and determination of project related effects.

c. Provide a recommendation to IHS regarding the Area of Potential Effects for this undertaking.

4. Geotechnical Survey The Geotechnical Survey shall consist of a preliminary soils analysis to determine if there are any soil conditions that might make the construction of the new quarters cost prohibitive. The scope of services should include the following:

a. A literature review of available information on existing geologic and soil conditions near the site.

b. A truck mounted drill rig shall execute a minimum number of borings equally spaced within the project boundaries in order to develop a representative soil profile of the site as determined by the geotechnical engineer.

c. Each boring should go down to a depth of 30 feet or to refusal (whichever is less).

d. Basic laboratory testing for soil classification to verify visual classifications made in the field.

e. A written report based on the results of the investigation including a brief description of the geologic setting, seismicity and geologic hazards, general soil and groundwater conditions. The report shall determine the bearing pressure value in pounds per square feet (psf) of the soil and provide recommendations for the use of appropriate foundation types for the proposed structure.

f. The report shall provide a professional opinion as to the suitability of the site with an emphasis as to how the conditions are expected to affect the proposed future construction.

5. Legal Survey A Legal Survey of the site shall be completed. The Legal Survey shall consist of a boundary survey with legal description of the site and with the following minimum requirements:

a. AutoCAD (CAD) drawing stamped by a Registered Land Surveyor (RLS).

b. The CAD drawing should consist of a graphical and narrative description of all survey hubs, sectional corners and control points used to describe the parcel.

c. Identify all corners of the site in a permanent manner, such as rebar with an aluminum cap and a metal fence post marker adjacent to it.

d. The signed plat shall comply with all state statues and local ordinances at the time of approval and shall provide a graphical and narrative description of the project site.

e. Provide an electronic (AutoCAD 2021 or later) of the completed drawing. The legal description shall also be provided in MS Word and PDF (stamped) documents, 8-½” x 11” format.

f. All deliverables are to be in English units (AutoCAD data files and finished plots).

g. A representative drawing of the RLS’ recent work (1 or 2 sheets reduced to 8-½” x

11” format) should be submitted for elevation with the proposal.

6. Biological Survey

The Biological Survey shall include the following services:

a. Conduct an on-site survey and regulatory review to determine if species or critical habitat listed under the Endangered Species Act (ESA) could be impacted by the federal action.

b. Provide a written assessment of the anticipated biological effects on ESA listed species and critical habitat, in accordance with US Fish & Wildlife Service standards.

7. Traffic Impact Analysis

The Traffic Impact Analysis shall the following services:

a. Prepare a Traffic Impact Analysis in accordance with the standard requirements of

Nevada Department of Transportation (NDOT) for the proposed new healthcare facility.

Due to the anticipated trip generation of the proposed development, this project qualifies as a Category I development. The requirements for this type of development include analysis of all major intersections adjacent to the site and within a half‐mile radius for the existing year, opening year, and 3 years after the opening year.

b. Obtain weekday approach and departure traffic counts for 24 hours in 15‐minute intervals on the adjacent road segments.

c. Obtain turning movement counts during the peak two‐hour period for the weekday morning and evening at the adjacent intersections.

d. Analyze the operation, and recommend traffic control, lane configurations, and turn‐lane lengths, for the one (1) existing intersection included in Task (7-b) during the weekday morning and evening peak hour with existing 2025 traffic volumes only.

e. Estimate future non‐site traffic volumes for the opening year (assumed to be 2027), and future horizon year of 2028 for the one (1) existing intersection included in Task (7-b).

f. Analyze the operation; and recommend traffic control, lane configurations, and turn‐lane lengths, for the one (1) existing intersection included in Task (7-b) with future non‐site 2027 and 2028 traffic volumes only.

g. Estimate new traffic generated by the proposed development at the one (1) existing intersection included in Task (7-b), and one (1) new site access intersection, utilizing the most recent version of the Trip Generation Manual, published by the Institute of Transportation Engineers (ITE).

h. Analyze the operation; and recommend traffic control, lane configurations, and turn‐lane lengths, at the one (1) existing intersection included in Task (7-b), and one (1) new site access intersection, for the future years 2027 and 2028 with the proposed development.

i. Conduct traffic signal warrant analysis for all full access arterial intersections utilizing the criteria contained in the Manual on Uniform Traffic Control Devices (MUTCD).

j. Prepare a report, including appendix, documenting the procedures, conclusions, and recommendations of the study. A draft report will be provided for Owner review prior to submittal.

8. Dry Barrel Fire Hydrant Test and Inspection Provide Dry Barrel Fire Hydrant Test and Inspection results from all adjacent hydrants.

a. Identify all nearby fire hydrant locations and record static pressure (prior to flow), flow test, static pressure (during flow) supply of each location.

b. Identify water supply source and location.

c. Testing shall be performed based on 2023 NFPA 25, 7.3 and AWWA Manual M17.

9. Will Serve Letters from Utility Companies Will Serve Letters from Utility companies requesting whether they have the existing capacity and facilities in place to provide the level of service as calculated in the PJDQ.

B. Provide the Phase II Site Selection and Evaluation Report summary document for the project:

1. Provide a comprehensive engineering evaluation of the selected site as it pertains to its viability and utilization as an IHS healthcare facility site, based on applicable assessments completed as part of this contract (listed in Section III A of this document), and the 2023 SAP Application (Fallon Paiute Shoshone Tribe) (Attachment A) and IHS - Phoenix Area Master Plan - Fallon documents (Attachment B). The Phase II SSER summary document shall convey the Contractor’s comprehensive engineering site analysis, conclusions and recommendations for the use of the selected site as the site for the future Fallon Tribal Health Center. This document shall adequately describe the information that will be used for the Engineer’s Cost Estimate, design and project supporting documentation. The amount of detail depicted depends on how much impact the particular area of concern will have on the project design, costs and construction.

2. The template for the Phase II SSER document shall be based on the following:

a. Attachment C: Phase II Site Selection and Evaluation Report, for the Whiteriver template. The document shall follow the format of this document (font, margins, headers, spacing, footers, etc.) and the sequence of required sections as described in the Table of Contents. A graphic file of the Tribal Seal of FPST (for the Title Page) will be provided to you in a separate email.

b. Attachment D: IHS-OEHE Technical Handbook for Environmental Health and Engineering, Part 13 – Site Selection and Evaluation Process, Phase II (Selected Site Evaluation SSER) Prototype/Template Report. Follow instructions provided in this document, in coordination with Attachment C.

C. In the development of the Phase II Site Selection and Evaluation Report summary document, please email the COR/Project Manager with requests for and information/documents that might be needed.

IV. Deliverables

A. In coordination with the site assessments being performed as part of this contract, provide the following:

1. Provide Draft #1 (65%) of the Phase II Site Selection and Evaluation Report summary document, with all required site assessments, TABS and additional information.

a. Send Draft #1 to COR/Project Manager: Dustin Grandbois. This will require a minimum

21 calendar day review by the Owner. The format shall be electronic (PDF).

2. Provide Draft #2 (100%) – Final Draft of the Phase II Site Selection and Evaluation Report summary document, with all required site assessments, TABS and additional information.

a. Send Draft #2 to COR/Project Manager: Dustin Grandbois. This will require a minimum

21 calendar day review by the Owner for final acceptance. The format shall be digital

(PDF).

3. Provide Final version of the Phase II Site Selection and Evaluation Report summary document, with all required site assessments, TABS and additional information. The format shall be electronic (PDF) and one (1) hard copy.

V. Additional Project Information

A. The selected project site being assessed is for the purposes of locating the future Fallon Tribal Health Center and auxiliary land development, including supporting items such as: roadways, resident parking, grading/drainage, utilities (underground and overhead as deemed necessary), site lighting, site signage, landscaping, concrete walkways and service/delivery access.

B. Proposals shall include: List of qualifications, similar experience, key technical staff, examples of recent environmental reviews, and approach to quality. The consultant shall conduct public meetings (at FPST/FTHC provided facilities) necessary to complete the Site Assessment (SA).

The consultant shall contact all governmental entities that may have an interest in the project as required to complete the required assessments and surveys.

C. Attachments (attached electronic files):

1. Fallon Tribal Health Center Staff Quarters

Attachment ‘A’: 2023 SAP Application Fallon Paiute Shoshone Tribe Attachment ‘B’: IHS - Phoenix Area Master Plan - Fallon Documents Attachment ‘C’: Phase II Site Selection and Evaluation Report (Whiteriver Template) Attachment ‘D’: Part 13 - Planning Documents and Reports, Section 13-4 Site Selection Evaluation Report (SSER), Section 13.4 App B SSER Ph II Template FINAL 2.6.24 508

D. Justification

1. The IHS requires the services outlined in the Scope of Work above in order to complete appropriate due diligence for site selection.

E. Points of Contact:

1. Indian Health Service (IHS) Contract Officer

Dale Clark Phoenix Area Indian Health Service Division of Acquisition Management Two Renaissance Square 40 N. Central Avenue, Suite 507, Phoenix, AZ 85004-4424 Phone: 602-364-5024 Email: Dale.Clark@ihs.gov

2. IHS Contracting Officer’s Representative (COR/Project Manager) Dustin Grandbois Phoenix Area Indian Health Service Division of Facilities Engineering Two Renaissance Square 40 N. Central Avenue, Suite 720, Phoenix, AZ 85004-4424 Phone: 602-245-3149 Email: Dustin.Grandbois@ihs.gov

F. Appendices:

Appendix A: Department of Health and Human Services (DHHS) Policy Summary and Reference Appendix B: Suggested Guidelines for Preparation of an Environmental Assessment (EA) Appendix C: Environmental Review Documentation Table

Proposals shall include: List of qualifications, similar experience, key technical staff, examples of recent environmental reviews, and approach to quality. The consultant shall conduct public meetings (at Fallon Paiute Shoshone Tribe provided facilities) necessary to complete the Site Assessment (SA). The consultant shall contact all governmental entities that may have an interest in the project as required to complete the required assessments and surveys. Two (2) copies of a draft SA shall be submitted to the PAIHS for review and comment. A total of two (1) hard copy and one (1) electronic copy shall be provided to the PAIHS after review and final approval of the document. An additional one (3) hard copy shall be provided to the designated Fallon Paiute Shoshone Tribe representative.

Appendix A: Department of Health and Human Services (DHHS) Policy Summary and Reference

In February 2000, DHHS issued the revised General Administration Manual (GAM) Part 30, which details environmental protection and NEPA policy for the Department.

The revised GAM provides updated policy for NEPA implementation including:

A. The Secretary approves Environmental Impact Statement’s (EIS)’s and EA/Finding of No Significant Impact’s (FONSI)’s for new construction in wetlands and only for an EIS for floodplains activities.

B. EA’s include a brief description of the proposed action, pollution prevention considerations and environmental impacts for both the proposed action and alternatives, list agencies consulted and references, describe benefits and risks, reference and consider the CEQ regulations, 40 CFR 1500-1508.

C. EA’s should be distributed to the public, tribe, and agencies having an interest or expertise in environmental issues addressed.

D. FONSI includes the reasons why the proposed action will not significantly affect the environment, considering the context (geographic area) and intensity of impacts, reference CEQ 40 CFR 1508.27. The regulation includes ten factors to consider with respect to intensity of impacts, including adverse effects on National Register eligible properties, threatened or endangered species, controversial projects and cumulative impacts.

E. The FONSI should reference the EA and CEQ regulations; include mitigation measures, and the signature of the approving official.

F. The draft FONSI can be routed 30 days for comments if there are controversial issues or if the project approaches the EIS threshold. The final FONSI must be routed to agencies, the Tribe and made available to the public.

Appendix B: Suggested Guidelines for Preparation of Environmental Assessment (EA)

The following elements should be considered in the preparation of an environmental assessment (EA).

Also, a cover sheet, a table of contents and an executive summary should be included as part of the document. The EA document should be in narrative form.

I. Purpose and need

A. Proposed project (describe the healthcare facilities that will be constructed and any pertinent operational data), how are services presently provided.

B. Population basis for capacity determinations (include source and number).

C. Design capacity, and increase over present capacity (state the capacity increase needed to serve existing development and the capacity allowed for growth).

D. Proposed project relationship with other planning other community planning.

II. Analysis of alternatives

A. Describe equally all project alternatives, including the no action alternative.

B. Discuss the no action alternative and what would the environment be without the implementation of the project.

C. If appropriate, state why alternatives were rejected (include environmental reasons; discuss cost-effectiveness, not cost alone).

III. Present Environment

A. Community location (Describe location [attach map], type of community, major economic activities, land use, utilities, transportation and access, and housing type and mix [if applicable]).

B. Service area (Describe and list any other communities within service area [name, incorporated, unincorporated, neighborhood, etc.]).

C. Population (Give total and approximate date and source of information).

D. Topography (Describe and list major features such as rivers, lakes, and mountains).

E. Geology (Describe any seismic activity, major geological faults, and erosion potential).

F. Climate and air quality (Describe).

G. Environmental inventory:

List if the following are present in or nearby the service area, facilities and disposal/irrigation site(s)Wetlands (list sizes and locations) [U.S. Army Corps of Engineers] Groundwater resources (including sole source aquifers as designated by EPA) Floodplain [FEMA] Wild and scenic rivers [National Park Service] Major botanical Important fish and wildlife (list major species, economically or recreationally important species that occur in service area, facilities site(s), and disposal/irrigation site) Endangered or threatened species [U.S. Fish and Wildlife], including critical habitats Environmental sensitive areas National natural landmarks [Natural Park Service] Historic, prehistoric, architectural, archaeological, and cultural sites [SHPO] Aesthetic resources Hazardous materials

H. Present land status and related facilities.

Water quality problems (describe any violations of health department violations, cease and desist order, non-conformance with basin plan or 208 plan, etc. Violation of NPDES permit is not sufficient).

M. Characteristics of air basin (State if the area is considered a non-attainment area, if so list for what parameter [O3, NO2, SO2, CO, Particulates, Pb]).

IV. Evaluation of direct and indirect impacts as a result of the proposed action, and alternatives as well as mitigation measures considered

A. Describe the impact and mitigation measures (if impact expected) for each alternative on the following areas:

1. Wetlands (Executive Order 11990, Protection of Wetlands)

2. Floodplain (Executive Order 11988, Floodplain management)

3. Significant and/or important farmlands (Farmland Protection Policy Act)

4. Coastal zones (Coastal Zone Management Act)

5. Wild and scenic rivers (Wild and Scenic Rivers)

6. Coastal barrier resources (Coastal Barrier Resources Act)

7. Air quality (Clean Air Act 176(c), 40CFR Part 93)

8. Important vegetation types

9. Endangered or threatened species and critical habitats (Endangered Species Act, Fish and Wildlife Coordination Act)

10. Topography (include major features such as rivers, lakes and mountains)

11. Groundwater (including sole source aquifers as designated by EPA), storm water

12. Hazardous materials

13. Environmental sensitive areas (include surface waters)

14. Geology/seismic considerations/soils

15. National natural landmarks (Historic Sites Act)

16. Historical, architectural, archaeological, and cultural sites (National Historic

Preservation Act, Executive Order 11593, Aesthetic resources

17. Land use and zoning (including open space recreation)

18. Socioeconomic impacts (schools, housing, business activity, etc.)

19. Utilities

20. Transportation and access

21. Climate

22. Noise considerations

23. Environmental justice considerations

24. Tribal issues

25. Other (geologic stability, etc.)

27. Public safety, socioeconomic

B. Summary of any significant impacts and mitigation measures.

C. Discuss short-term use of the environment versus long-term productivity.

D. Discuss irreversible and irretrievable commitment of resources.

V. Cumulative impacts

Identify the combined impacts of other activities besides those recommended by the proposed project (the activities do not have to be necessarily Federally funded).

VI. Documentation

Provide a list of documentation and sources contacted and used.

Appendix C: Environmental Review Documentation Table

Considerations Consultation and Documentation required for Determination

1. Wetlands/Water Resources Will the project adversely affect wetlands/water resources or will there be construction in wetlands, except in conformance with a Corps of Engineers Section 404 Permit?

Contact/Enforcing Agency: Corps of Engineers (COE), State, Tribe, Environmental Protection Agency (EPA), City, Tribe Documentation: Clean Water Act (CWA) Section 404 permit or nationwide permit. The agency may also have to obtain applicable permits to meet Storm Water regulation.

2. Floodplains, Executive Order 11988 Will the project involve construction in a floodplain (except for actions excluded as a class) or impact floodplain development

Contact/Enforcing Agency: Regulatory Agencies, and ACOE, Federal Emergency Management Agency (FEMA), City, Tribe Documentation: Floodplain assessment and statement from enforcing agency or agency determination based on review of and citation from official source documents.

3. Endangered Species Act, as amended Is the project likely to adversely affect a species listed on the Federal list of endangered or threatened species or the specific critical habitat.

Contact/Enforcing Agency: Fish and Wildlife Service (FWS), National Marine Fisheries Service (NMFS), State, City, Tribe Documentation: Biological report and agency determination based on review of and citation from official source documents.

Requires qualified professional.

4. Historic Preservation Act and Related Acts and Executive Orders Will the project adversely affect properties listed, or eligible for listing, on the National Register of Historic places (buildings, archaeological sites & objects of significance)?

Contact/Enforcing Agency: State Historic Preservation Officer (SHPO)/Tribal Historic Preservation Officer (THPO), Tribes, Advisory Council on Historic Preservation (ACHP) Documentation: National Historic Preservation Act (NHPA) Section 106 review Requires qualified professional.

5. Wild and Scenic Rivers Act Is the project a "Water Resources Project" which will impact a wild, scenic or recreational river area and create conditions inconsistent with the character of the river?

Contact/Enforcing Agency: ACOE, Bureau of Land Management (BLM), National Park Service (NPS), U.S. Forest Service (USFS), FWS, States, City, Tribe Documentation: Statement from enforcing agency or agency determination based on review of and citation from official source documents.

6. Coastal Zone Management Act Will the project directly affect a Coastal Zone in a manner inconsistent with the Coastal Zone Management Plan?

Contact/Enforcing Agency: State, National Oceanic and Atmospheric Administration (NOAA) Documentation: Consistency determination from enforcing agency or agency determination based on review of and citation from official source documents.

7. Wilderness Act Will the project adversely impact a Wilderness Area?

Contact/Enforcing Agency: USFS, NPS, EPA, State Documentation: Statement from enforcing agency or agency determination based on review of and citation from official source documents.

8. Farmland Protection Act Will the project convert significant Agricultural Lands to non-agricultural uses?

Contact/Enforcing Agency: USDA, Natural Resources Conservation Service (NRCS) Documentation: Statement from enforcing agency or agency determination based on review of and/or citation from official source documents.

9. Safe Drinking Water Act Will the project impact a sole source aquifer?

Contact/Enforcing Agency: EPA, State, Tribe Documentation: Statement from enforcing agency or agency determination based on review of and citation from official source documents.

10. Clean Air Act The project will result in violation of a conformity rule; i.e., the project will not comply with the air quality goals and purposes of the applicable or appropriate state implementation plan (SIP) or tribal implementation plan.

Contact/Enforcing Agency: EPA, State, Tribe, City, Regional Documentation: Conformity determination from enforcing agency or agency determination based on review of and citation from official source documents.

11. NEPA Will the project result in a known violation or continuance of a violation of applicable (Federal, Tribal, State or local) law or requirements imposed for protection of environment or public health and safety?

Documentation: Determination from enforcing agency or agency determination based on review of and/or citation from official source documents.

12. NEPA - Is there a controversy with respect to environmental effects of the project based on reasonable and substantial issues?

Documentation: Agency determination based on review of and/or citation from official source documents and consultation with Tribe and community.

13. NEPA - Is the project significantly greater in scope than normal projects for the Area or does the project have significant unusual characteristics?

Documentation: Agency determination based on review of previous project documents compared to proposed project.

14. NEPA - Does the project establish a precedent for future action or represent a decision in principle about future actions with potentially significant environmental effects? (cumulative impact based on current information)

Documentation: Agency determination based on review of previous project documents compared to proposed project. Also, state the cumulative effect (beneficial or adverse) of the project on the human environment.

15. NEPA - Does the project have significant adverse direct or indirect effects on park land, other public lands, or areas of recognized scenic or recreational value?

Documentation: Determination from enforcing agency or agency determination based on review of and/or citation from official source documents and consultation with Tribe and community.

16. NEPA - Will the project provide for the construction of a sanitary landfill at a new solid waste disposal site?

Documentation: Agency determination based on review of and/or citation from project or other documents.

17. NEPA - Will the project include construction of a new wastewater treatment facility with direct discharge of treated sewage to surface waters?

Documentation: National Pollutant Discharge Elimination System (NPDES) permit and/or agency determination based on review of and/or citation from project or other documents.

18. CERCLA - Does the project involve the use, transfer, or lease of real property which has been used as storage for hazardous waste and/or petroleum products or their derivatives for more than one year?

Documentation: Agency determination based on review of and/or citation from official source documents and consultation with property owner, Tribe, and community. May require consultation with EPA, State, City and Tribe.

19. Is an assessment required for other known reasons?

Documentation: Agency determination based on review of and/or citation from project and official source documents and consultation with Tribe, and community.

20. NEPA - Does the project include building alteration or renovation that substantially changes the function or general appearance of a building?

Contact/Enforcing Agency: State Historic Preservation Officer (SHPO)/Tribal Historic Preservation Officer (THPO), Tribes, Advisory Council on Historic Preservation (ACHP) Documentation: National Historic Preservation Act (NHPA) Section 106 review Requires qualified professional for projects adversely affecting properties eligible for the National Register of Historic Places.

21. NEPA - Will the project include construction or lease of new facilities (including portable facilities) at an existing health care facility site, which will substantially increase facility capacity?

Documentation: Agency determination based on review of and/or citation from project or other documents.

22. NEPA - Will the project include construction or lease of new facilities of over 1080 square meters (12,000 square feet)?

Documentation: Agency determination based on review of and/or citation from project or other documents. EA may be required if criteria is exceeded; consult the Area NEPA/Environmental Coordinator.

23. NEPA - Will the project include construction or lease of new facilities on a parcel of land in excess of 2 hectares (5 acres)?

Documentation: Agency determination based on review of and/or citation from project or other documents. EA may be required if criteria is exceeded; consult the Area NEPA/Environmental Coordinator.

24. NEPA - Does the project include acquisition, lease, release, closure, abandonment, or transfer of real property that will conflict with an applicable master plan, zoning regulations, land use ordinances, local, state, or federal environmental protection, or historic preservation law?

Documentation: Determination from enforcing agency and agency determination based on review of and/or citation from project or other documents.

25. NEPA - Does the project include acquisition of equipment without federal, state, or locally required permits, registrations, or licenses?

Documentation: Determination from enforcing agency and/or agency determination based on review of and/or citation from project or other documents.

26. NEPA - Does the scope of construction during routine maintenance activities exceed the replacement-in-kind of building components or associated utilities?

Documentation: Agency determination based on review of and/or citation from project or other documents.

Attachment ‘A’: 2023 SAP Application Fallon Paiute Shoshone Tribe

Attachment ‘B’: IHS - Phoenix Area Master Plan - Fallon Documents

Attachment ‘C’: Phase II Site Selection and Evaluation Report (Whiteriver Template)

Attachment ‘D’: Part 13 - Planning Documents and Reports, Section 13-4 Site Selection Evaluation Report (SSER), Section 13.4 App B SSER Ph II Template FINAL