NEPA_Categorical_Exclusion_4.pdf

MAO 600-1

Appendix 2 rage 1

CATEJORICAL EXCLUSION CHECKLIST

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Date:

aAtion: /A/"- L7' ji2JC'

NO.____ i__ Topic 7'TJ j S

Instructions: For the above, action(s) under the subject project or group of ogeneous projects, check the appropriate answer to each f the questions below. If all the answers on this list are checked "No," then the action(s) meet the criteria for categorical exclusion. If any answer is checked "Yes" or "Uncertain," then an environmental assessment will be prepared unless there is no doubt that an environmental impact statement is required.

1. This action would have No____ Uncertain_____ Yes significant adverse effects on public health or safety.

2. This action would have 8igntf1c2nt effect on wildlife resources or would affect unique geographical features auth as: wetlands, wild or scenic rivers, refuges, floodplains, etc., or lands protected by section L(f) of the DOT Act.

3. This action will have highly controversial, environmental effects.

I. This action will have highly uncertain environmental effects or involve unique Or unknown environmental risk.

No'-"Uncertain______ Yes_____

No_____ Uncertain_____ Yes

No_____ Uneertain_

Yes

5. This action will establish a precedent for future actions.

6. This action is related to other actions with inflvidwUy ini rt.cen but cumulatively significant effects.

No_____ Uncertain____ Yes_____

No Uncertain Yes

MAO O0-i Apperdix P

Page

?. Thi3 action will afteo properties 1 tsed or eligible. tot listing in the NattonM Register of Historic Places, or otherwise protected by section 1O of th t4ationn).

HiStoric Pre rvstion Act,

8. This action will nftect.

a species listed or proposed to be listed as Endangered or Threatened.

L This action .s ifla)ñ5i5te8t.

with Federei StatG, J.ccM or tribal lay or requirements imposed for protection o' the environment.

10. This 'action or group of 50t10n5 would involve unresolved conflicts concerning alternative uses of available resources.

No,_ Unoertein_____

Uncertain Toe____

No i/uncertin_. ea____

Uncertath_, Yes____

Conclusion;

14PA Aotion-.Categorioal Eitotsio i' EA Required .,,., -.

EIS Required explanation andtof b arer's Hasme nd Tttle #4i?O J& .'s2

L1 E 7i frti'? E )

Concur;

nate:__________ tonaur _________ Date:________

AntivitieS r tor)

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