AFP-JSC-EXP-2026 - Attachment E - Env. NEPA Checklist JF1138 1.pdf

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Please read the attached instructions before completing this form.

Mark below any of the areas that the action (project) will impact. Please provide clarification for responses in the comments section below.

Will the action (project) involve installation, removal, replacement, or alteration of (including tying into an existing system):

Please check one option for each question below:

Yes No Maybe

2. Will soil be disturbed? (including hydroexcavation, digging, land/tree clearing, grading, excavation, trenching, boring or any other activity requiring a dig permit)

2. Will soil be disturbed? (including hydroexcavation, digging, land/tree clearing, grading, excavation, trenching, boring or any other activity requiring a dig permit)

3. Will a survey to assess the possibility of disturbing Asbestos Containing Materials and/or lead based paint be performed?

3. Will a survey to assess the possibility of disturbing Asbestos Containing Materials and/or lead based paint be performed?

4. Will any products or services listed on https://sftool.gov/greenprocurement be needed to fulfill the project scope?

4. Will any products or services listed on https://sftool.gov/greenprocurement be needed to fulfill the project scope?

5. Will the project create construction and/or demolition debris?

5. Will the project create construction and/or demolition debris?

6. Will the project involve any further environmental issues not in this checklist?

6. Will the project involve any further environmental issues not in this checklist?

A. Form Instructions

1. Insert Project Name and/or a Unique Identifying Number (or Work Order (WO)/Work Authorization Database (WAD) Number).

2. Insert Site/Building Number and Room/Area.(e.g., JSC B45/751, JSC Avenue C).

3. Provide a description of the work being performed.

4. Insert Name/Email address of individual completing checklist.(Provide in the form of an email address so that the Environmental Office's review/response can be directed to the initiator.)

5. Insert Date that the checklist was prepared.

6. Insert NASA Project Manager Name, Organization and Phone Number.Insert the NASA project proponent's name, organization, and phone number for a task/project that is not being performed by COD. For COD only, insert the NASA FMOD Project Manager's name and phone number for a WAD, or insert the name and phone number of the Functional Lead for maintenance tasks.

7. Insert Estimated Start and End Date.

8. Indicate whether coordination of this project is being done with another NASA Center

9. Insert an X in the appropriate boxes for question on the checklist.

10. Provide clarification for each affirmative response in the comments section.

B. What do I do with the completed JF 1138 Checklist?

You must submit the form to the JSC Environmental Office by E-mail: JSC-Environmental-Office@nasa.gov. If you are unsure how to answer a question or need help completing the form, you may request technical assistance by contacting the environmental info-line at X36207.

C. Background: Why is this Checklist necessary?

This JSC Environmental Planning Checklist (JF 1138) and the Environmental Office's response (when applicable) documents conformance to the project planning and environmental coordination process described in JPR 8550.1. Each JF1138 becomes a U.S. Government record, and must be managed per NPR 1440.1, Records Retention.The JSC Environmental Planning Checklist is a management tool for the Design Engineer, Construction Superintendent, or NASA Project Manager to ascertain whether environmental requirements or constraints are required for discrete projects or maintenance tasks.

Coordination with the Environmental Office early in the planning stage can save both time and money, and substantially reduce the potential for delays or noncompliance with federal, state, or local regulations, which can lead to fines and other potential penalties. Even small tasks or routine maintenance activities can require coordination with the regulatory agencies or otherwise require modifications to required environmental documents (e.g., oil-containing equipment and air emissions inventories.)

Reminder: This JF 1138 does not substitute for the Record of Environmental Consideration (JF1119) for projects or tasks that require written documentation to substantiate compliance with the NEPA, per 14 CFR 304, et. seq. Based on the project description and how the checklist is completed, the EO may contact you to complete a JF1119. If requested, the JF1119 must be completed and approved before funds are committed for installation, renovation, modification or removal of facilities or components.

What do I do with the completed JF 1138 Checklist?

You must submit the form to the JSC Environmental Management Office (EMO) through e-mail at JSC-Environmental-Office@nasa.gov. If you are unsure how to respond or need help completing the form, you may request technical assistance by contacting the Environmental Info Line at x36207 or the e-mail above.

Why is this checklist necessary?

This JSC Environmental Planning Checklist (JF 1138) and the JSC EMO's response (when applicable) documents conformance to the project planning and environmental coordination process described in JSC Procedural Requirement (JPR) 8550.1, Environmental Compliance Procedural Requirements. Each JF 1138 becomes a U.S. Government record and must be managed per NASA Procedural Requirements 1440.1, Records Retention. The JSC Environmental Planning Checklist is a management tool for the Design Engineer, Construction Superintende3nt, or NASA Project Manager to ascertain whether environmental requirements or constraints are required for discrete projects or maintenance tasks.

Coordination with the EMO early in the planning stages can save both time and money and substantially reduce the potential for delays or non-compliances with federal, state, or local regulations, which can lead to fines and other potential penalties. Even small tasks or routine maintenance activities can require coordination with the regulatory agencies or otherwise require modifications to required environmental documents (e.g., oil-containing equipment and air emission inventories).

Reminder: This JF 1138 does not substitute for the Record of Environmental Consideration (JF 1119) for projects or tasks that require written documentation to substantiate compliance with the National Environmental Policy Act, per 14 CFR 304, et. seq. Based on the project description and how the checklist is completed, the EMO may contact you to complete a JF 1119. If requested, the JF 1119 must be completed and approved prior to installation, renovation, modification, or removal of facilities or components.

1.3 JSC Form 1138, Environmental Planning Checklist Rev. v.1.3, 07/25 06/18/2025 NASA Agency Forms Office JSC Form 1138, Environmental Planning Checklist 07/25 John P. Herrmann

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