Attachment VII - NEPA Documentation.pdf

VA

RLR VAMC NEPA Documentation

Project: Location: Date:

Project Num.

Type of Project:

Operation and Maintenance Activities

Repairs/ Renovation Project

New Construction Project

Lease

Other

Project Description:

Level of NEPA Analysis:

Categorical Exclusion

Environmental Assessment Needed

Environmental Impact Statement Needed

Other Environmental Permits/Analysis Needed:

PROJECT IMPACTS

Would the proposed activity involve or generate any of the following?

SOURCE YES NO SOURCE YES NO SOURCE YES NO

Air Emissions including GHGs

Liquid Effluent

RCRA or CERCLA Sites

Asbestos Petroleum Storage

Wetlands

Excess Noise Solid Waste Permit Modification

Utility Modification

Hazardous Waste

Chemical Use/Storage

Soil Disturbance Biological Resources

Aesthetics

Water Treatment Radioactive Waste

Water/Well Use

Water Flow Modification

Mixed Waste Other:

DETERMINATION

I find the proposed project qualifies as a CATEGORICAL EXCLUSION with no extraordinary circumstances. Specify which CATEX: ____________________________________________________

I find that the proposed project MAY have a significant effect on the environment; therefore, an ENVIRONMENTAL ASSESSMENT will be prepared.

EIS

Additional Information:

Approved by GEMS Coordinator: Yes No Date: _________________

Modernize existing A and D wing Elevators which are suffering from control related issues and modify the elevators to meet current criteria and surpass expected life range. The extent of the elevator modernization includes but not limited to the following Control Systems, Electrical Wiring, Door Equipment, Operating Fixtures, Elevator Hoisting Machines with required Deflector Sheaves, Governors and Tail Sheaves, Roller Guides, Elevator Cabs on S11 and S12, Hoistway Door Panels on Elevators P8, P9, P10 and S7, Complete Replacement of the Blood Work DW elevator.

Upgrade A Wing and D Wing Elevators

WTS - Building 1

583-22-101 1/16/2024

National Historic Preservation Act Review (All CSR Projects)

Well field impact assessment (All CSR Projects)

1/16/2024

Approved by GEMS Manager:

Veteran Health Indiana NEPA Documentation

Ensure that applicable VA Master Construction Specifications referenced in the GEMS Construction Specification (23REVA) are added to the contracting package and the expectations from the GEMS Construction Specification are communicated with the contractor at the contract kickoff meeting (attached for reference). Contractor non-conformance with environmental regulations and VA sustainability requirements will delay payment for contract service (i.e., Project COR shall not certify invoice payment until validation that contractor has followed applicable contract specification requirements). Follow the requirements outlined in the preconstruction risk assessment and exposure control checklist (PCRA). All chemical usage and storage shall follow all requirements of the facilities Spill Prevention Control and Countermeasures (SPCC) plan (e.g., Chemicals shall be stored in a manner to prevent product from being released (i.e., secondary containment, etc.), chemicals must be segregated appropriately to ensure that chemical reactions do not occur, chemicals shall be secured when not in use, etc.). Encountering asbestos containing material is probable during this project.

Project must be performed in accordance with the proper notification (Notification of Demolition and Renovation Operations, State Form 44593 - available on the IDEM Forms page), and emission control requirements (326 IAC 14) for asbestos. Ensure that asbestos building materials are abated by licensed personnel and disposed of according to local, state and federal regulations. Encountering lead based paint is probable and if impacted lead safe worker practices shall be utilized. Encountering PCB is probable and if impacted shall be handled and disposed of in accordance to federal regulations. As identified identified in the SOW, the selected A/E is required to provide a survey to identify any possible asbestos, lead and PCB hazards in the area of work. This survey should be provided to the facilities GEMS Manager. Any changes to the capacities of the hydraulic systems shall be communicated to the GEMS Manager. These hydraulic systems are within the SPCC program and changes to hydraulic capacities (i.e., increase or decrease in oil quantities) must be articulated accurately within the SPCC plan. Based upon the chemical products utilized during this project may create hazardous waste and this waste must be evaluated and properly disposed of (IAW 40 CFR 261). Contractor shall provide a copy of the standard hazardous waste manifest (i.e. EPA Form 8700-22) to COR for all hazardous waste disposed of during the course of this project. COR shall provide a copy of all manifests to the facilities GEMS Manager for all hazardous wastes disposed of during the course of this project.

Jeff Abshire, MPA GEMS Manager Facility Sustainability Officer RLR VA Medical Center Office: (317) 988-2101 Jeffrey.Abshire@va.gov

IAW 38 CFR 26.6(b)(1)(viii) - (viii) Actions which involve support or ancillary appurtenances for normal operation

JEFFREY

ABSHIRE

Digitally signed by JEFFREY

ABSHIRE

Date: 2024.01.16 14:57:40 -05'00'

January 13, 2023 Version: 23REVA

RICHARD L. ROUDEBUSH VA MEDICAL CENTER

GREEN ENVIRONMENTAL MANAGEMENT SYSTEM (GEMS)SPECIFICATION

A. The following is the Green Environmental Management System (GEMS) mission statement and environmental policy for the Richard L. Roudebush VA Medical

Center. Contractors are required to the greatest extent possible to meet the requirements set forth within our mission statement and environmental policy.

“The primary mission of our VA Medical Center is to be a vibrant part of the Veterans in Partnership Integrated Healthcare Network delivery system that improves the health of the Veteran population by providing primary care, specialty care, extended care, and related services. The medical center also provides an environment that promotes high-quality medical affiliate education and training, research, and DOD services in support of the Veteran.

It is the Environmental Policy of the Richard L. Roudebush VA Medical Center to:

Conduct our mission in a manner to protect human health and the environment

Promote the principles of environmental stewardship within our communities

Strive for continuous environmental performance improvement in our processes

Comply with all applicable Agency, Federal, State, and Local environmental laws, regulations, and directives governing our activities

Establish environmental performance objectives and implement programs to prevent pollution by reducing the environmental impacts of our activities, products, and services”

B. Being a good steward of the environment by complying with federal, state and local environmental laws and other requirements, preventing pollution, minimizing waste, conserving cultural and natural resources and continually improving environmental programs. While working on station it is the contractor’s responsibility to follow all the same environmental laws and requirements.

C. It is the contractor’s responsibility to abide by VA Master Construction

Specifications that are related to conducting contractual work in accordance with environmental regulations and VA sustainability requirements. These requirements can be accessed through VA Office of Construction and Facility Management

January 13, 2023 Version: 23REVA

Technical Information Library at https://www.cfm.va.gov/til/spec.asp#02.

Depending on the scope of work can require different VA specifications that would apply. Below are referenced specifications that generally apply to all contract work in relation to environmental and sustainability.

Construction Waste Management (01 74 19)

Sustainable Construction Requirements (01 81 13)

Temporary Environmental Controls (01 57 19)

VA specifications require submittals to validate conformance with requirements.

Below are referenced submittals that are required for the beforementioned VA

Specifications.

Demolition Debris Management Plan; Monthly Summary of Construction and Demolition Debris Diversion and Disposal; Target Waste Diversion

Rate by Material and an Overall Diversion Rate; Final Report Documenting

Results of Management Plan

Sustainability Action Plan; Low Pollutant-Emitting Materials Tracking

Spreadsheet; Indoor Air Quality Management Plan; Product Submittals;

Sustainability Construction Progress Reports

Environmental Protection Plan

D. Questions regarding the GEMS Program can be obtained by contacting the facility

GEMS Manager / Facility Sustainability Officer (FSO) - Mr. Jeff Abshire at (317)988-

2101.

E. Approval

GEMS Manager / FSO Chief Engineer

JEFFREY

ABSHIRE

Digitally signed by JEFFREY

ABSHIRE

Date: 2023.01.13 14:28:00 -05'00'

JAMES

WALLACE

Digitally signed by JAMES

WALLACE

Date: 2023.01.19 09:44:22 -05'00'