A10 Attachment 3 NEPA PPDT.pdf

Oklahoma City Area Indian Health Service

Environmental Information and Documentation

Project Name: OK22PAA01C4 Two Lane Drive Through Pharmacy

Location: Pawnee Indian Health Center Pawnee, OK

Consideration Y/N Will the proposed action/activity affect the Consideration?

Provide supporting information for your responses and explain any mitigations to be implemented.

1. Will the proposed action result in a known violation or continuance of a violation of applicable (Federal, Tribal, State or local) laws or requirements for protection of environment or public health and safety?

N PRINTED MATERIAL: Project Summary Document

2. Will the proposed action result in a conflict with existing or proposed Federal, Tribal, state, and local land use plans?

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

3. Is there a controversy with respect to environmental effects of the proposed action based on reasonable and substantial issues?

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

4. Is the proposed action significantly greater in scope than normal for the area or does it have significant unusual characteristics?

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

5. Does the proposed action establish a precedent for future action or represent a decision in principle about future actions with potentially significant environmental effects?

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

6. Does the proposed action have significant adverse direct or indirect effects on parkland, other public lands, or areas of recognized scenic or recreational value? (For example, consider how your activity will affect the view?)

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

7. Does the proposed action include construction of a new municipal solid waste landfill at a new solid waste disposal site?

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

8. Will the proposed action create a need for additional capacity at solid waste disposal facilities?

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

9. Does the proposed action include construction of a new wastewater treatment facility that will discharge treated sewage effluent to the waters of the U.S.?

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

75H70123R00047

Environmental Information and Documentation

Project Name: OK22PAA01C4 Two Lane Drive Through Pharmacy

Location: Pawnee Indian Health Center Pawnee, OK

10. Will the proposed action create a need for additional capacity at wastewater treatment facilities?

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

11. Will the proposed action create a need for additional capacity in the drinking water supply?

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

12. Are there other considerations about the proposed action that could adversely affect the environment and/or public health and safety?

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

13. Will the proposed action create a need for additional capacity in health care facilities and for health care services?

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

14. Will the proposed action create a need for additional energy supply or generation?

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

15. Will the proposed action create a need for additional capacity in educational facilities?

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

16. Will the proposed action create a need for additional capacity in transportation systems?

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

17. Historic Preservation:

a. Does the proposed action involve the purchase, construction, alteration, renovation, or lease of real property or portion of real property that is more than 50 years old?

N PRINTED MATERIAL: Project Summary Document - The proposed action is within

b. Will the proposed action adversely affect properties listed, or eligible for listing, on the National Register of Historic Places?

[Buildings, archaeological sites, National Historic Landmarks;

objects of significance to a Tribe including graves, funerary objects, and traditional cultural properties. For assistance, consult with the State Historic Preservation Officer (SHPO) or the Tribal Historic Preservation Officer (THPO)]

Environmental Information and Documentation

18. Endangered Species Act: Is the proposed action likely to adversely affect a plant or animal species listed on the Federal or applicable state list of endangered or threatened species or a specific critical habitat of an endangered or threatened species? (Consult with Fish & Wildlife Service or NOAA Fisheries Service. Discovering an endangered or threatened species in the project area will stop the project, and the Endangered Species Act has significant fines and penalties for violations

19. Will the proposed action require major sedimentation and erosion control measures? (Consider earth disturbing activities including construction or expansion of a parking lot.)

20. Will the proposed action violate a storm water permit or a wastewater discharge permit either for construction or on-going operations? (Earth disturbing activities may require a Notice of Intent (NOI) to be covered under a storm water general permit or individual permit from the EPA or other agency and a storm water control plan, including some parking lot construction activities. A discharge of wastewater to the environment may require a permit from Tribal, local or state authorities, or EPA.)

21. Safe Drinking Water Act: Will the proposed action impact an EPA designated sole source aquifer? (Designation of sole source aquifer puts restrictions and conditions on Federal expenditures, projects, and grants.)

22. Wetlands and Water Resources (lakes, rivers, ponds, streams, etc.): Will the proposed action violate a Section 404 (Clean Water Act) permit for actions in a wetland and/or Section 10 (Rivers and Harbors Act) permit for actions in a stream or river? (Activities in or near a wetland or river may require a permit from the U.S. Army Corps of Engineers or U.S. Coast Guard. Includes: construction in or near any wet or dry waterway, stream crossings, intake structures, outfalls, etc.)

Environmental Information and Documentation

23. Floodplains:

a. Is the proposed action located in either a 100-year or, for critical actions, a 500-year floodplain? (If Flood Insurance Rate Maps do not exist for the project site, a floodplain survey or consultation may be required. Also may need to consider if the facility will require flood insurance).

b. Will the proposed action adversely impact flood flows in a floodplain or support development in a floodplain?

24. Existing site: Would the proposed action, involving the purchase, construction or lease of new facilities (including portable facilities and trailers), substantially increase the capacity of an existing health care facility?

25. New site: Does the proposed action involve purchase, construction, or lease of new facilities (including portable facilities and trailers) where such action is for buildings equal to or more than 12,000 square feet (1080 square meters) of useable space when more than 5 acres (2 hectares) of surface land area are involved at a new site?

26. New site: Does the proposed action involve purchase, construction, or lease of health care facilities (other than buildings) for projects equal to or more than 5 acres (2 hectares) of surface land area at a new site?

27. Does the proposed action involve the sale or transfer of real property, on which any hazardous substance was stored for one year or more, known to have been released, or disposed of?

(Provide relevant documentation for any hazardous substance releases. See 40 CFR 373.2(b), 302.4, and 261.30 for reportable quantities.)

Environmental Information and Documentation

28. Does the proposed action involve the sale or transfer of real property, on which underground or above ground storage tanks are located?

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

29. Will the proposed action violate Tribal, local, state, or Federal law on the use and storage of hazardous substances or the transportation, storage, and disposal of hazardous wastes or medical wastes? (Activities that may generate reportable quantities include air conditioning repair and service, pesticide application, motor pools, automobile repair, welding, landscaping, agricultural activities, print shops, hospitals, clinics, medical centers, etc. Repair, renovation, or demolition activities can generate waste that has asbestos-containing materials, asbestos, lead-based paint, PCBs, CFCs, etc.)

N PRINTED MATERIAL: Project Summary Document - The proposed action is within an existing healthcare facility

30. Will the proposed action adversely affect community air pollution for a long period of time? (Consider if your activity must conform to an applicable air quality implementation plan.)

31. If the proposed action is implemented, will it have a disproportionately high and adverse human health or environmental impact on the Tribe, low-income populations, or minority populations?

32. Will the proposed action adversely affect community noise levels?

33. Wilderness Act: Will the proposed action adversely impact a Wilderness Area? (Wilderness Areas are specifically designated areas of land.)

34. Farmland Protection Policy Act: Will the proposed action convert significant agricultural lands to non-agricultural uses and exceed 160-point score on the farmland impact rating?

Environmental Information and Documentation

35. Coastal Zone Management Act: Will the proposed action directly affect a Coastal Zone in a manner inconsistent with the State Coastal Zone Management Plan? (All Federal programs or projects in the coastal zone must comply with the consistency provisions of the Act. Each coastal state should have a state office to manage its coastal zone development and use.)

NO There are no costal zones located within the scope of this actions PRINTED MATERIAL: Project Summary Document -

36. Wild and Scenic Rivers Act: Will the proposed action adversely affect a wild, scenic, or recreational river area or create conditions inconsistent with the character of the river? (A consideration for activities that are in or near any wild and scenic waterway including construction of stream/river crossings, intake structures, outfalls, etc.)

NO There are no wild or scenic rivers within the scope of this action

PRINTED MATERIALS:

https://www.rivers.gov/oklahoma.php#:~:text=Oklahoma%20has%20approximately %2078%2C603%20miles,not%20have%20any%20designated%20rivers.

Environmental Information and Documentation

Environmental Determination

Background

This project is to construct a two lane Drive Through Pharmacy at the Pawnee Indian Health Center in Pawnee Oklahoma. The Drive Through will be located on the North East side of the facility, near the exit door for Dental employees.

Environmental Review

This project was reviewed to identify any extraordinary or exceptional circumstances that would invalidate the Department of Health and Human Services, Indian Health Service, categorical exclusion.

Findings

No extraordinary or exceptional circumstances exist which would require an environmental assessment.

Determination This project falls within the scope of actions that have been categorically excluded from further review under the National Environmental Policy Act in accordance with the Department of Health and Human Services policies and procedures in General Administration Manual, Part 30, the Council of Environmental Quality regulations at 40 CFR 1500-1508, and procedures the Indian Health Service published in the Federal Register, Vol. 58, No. 3, page 569, Subpart I. No further environmental review is required.

Discovery

In the event of an unforeseen discovery, construction activity will stop in the area of the discovery. The appropriate authorities will be notified in conformance the Indian Health Service policy.

Environmental Information and Documentation

I certify that to the best of my knowledge and ability the information presented herein is true and correct (enter appropriate information in the shaded blanks):

(1) Timothy Jim

Signature Facility Manager, Maintenance Department Pawnee Indian Health Center Oklahoma City Area Indian Health Service

Date

(2) Seneca Smith

Signature Chief Executive Officer, Pawnee Indian Health Center Oklahoma City Area Indian Health Service Date

(3) Joseph Jones

Signature Director, Division of Facilities Management Oklahoma City Area Indian Health Service Date

(4) Joseph Jones

Signature Area NEPA Coordinator, Division of Facilities Management Oklahoma City Area Indian Health Service

Date

(5) Harold Cully

Signature Assistant Area Director, Office of Environmental Health & Engineering Oklahoma City Area Indian Health Service

Date

Timothy N. Jim -S Digitally signed by Timothy N. Jim -S Date: 2022.07.11 09:43:33 -05'00'

Seneca M. Smith - S

Digitally signed by Seneca M.

Smith -S Date: 2022.07.11 12:01:00 -05'00'

CDR Joseph L.

Jones, PE, CHFM

Digitally signed by CDR Joseph L.

Jones, PE, CHFM Date: 2022.07.12 15:55:59 -05'00'

CDR Joseph L.

Jones, PE, CHFM

Digitally signed by CDR Joseph L.

Jones, PE, CHFM Date: 2022.07.12 15:56:12 -05'00'

Harold A. Cully -S Digitally signed by Harold A. Cully - S Date: 2022.07.12 16:00:45 -05'00'

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