Expand B330 Parking Lot NEPA.pdf

INSTRUCTIONS: This form is to be used for ALL construction projects to conduct an initial environmental assessment NLT than the 35% design review stage. The project Contracting Officer’s Representative (COR) shall complete all Sections 1 – 5 and forward it to the GEMS Program Manager for review.

Project Title:

VHA Facility Name and Address:

Dayton VA Medical Center 4100 W. Third St. Dayton OH 45428

COR Name and Contact Information:

Project Location and Bldg.

Number:

Number of Floors:

Total Sq. Footage – All Floors:

Total Soil Disturbance (Sq.

Feet):

Description Of Project:

Describe Project’s Neighbors:

(VA and Non-VA Land)

List All Environmental Agencies That May Affect the Project:

NEPA ENVIRONMENTAL REVIEW section 1

Points of Contact

EMS – Environmental Management Service Will Large Ext. 2029 Willard.Large@va.gov

Environmental Protection Specialist Brad Herr Ext. 2079 Bradley.Herr@va.gov

GEMS – Green Environmental Management System Megan Shade Ext. 3726 Megan.Shade@va.gov

IH – Industrial Hygiene Tavin Carr Ext. 2084 Tavin.Carr@va.gov Tom Rampley Ext. 3558 Thomas.Rampley@va.gov

Abbreviations

CATEX – Categorical Exclusion EA – Environmental Assessment EIS – Environmental Impact Statement EMS – Environmental Management Service EPCRA – Emergency Planning and Community Right-to-Know Act FONSI – Finding of No Significant Impact GEMS – Green Environmental Management System IH – Industrial Hygiene NESHAP – National Emissions Standards for Hazardous Air Pollutants NPDES – National Pollutant Discharge Elimination System OEPA – Ohio Environmental Protection Agency PPE – Personal Protective Equipment RACM – Regulated Asbestos Containing Material RAPCA – Regional Air pollution Control Agency SDS – Safety Data Sheet SWPPP – Stormwater Pollution Prevention Plan

NEPA ENVIRONMENTAL REVIEW section 22 Y/N Environmental Concern and Regulatory Requirement

1. Soil disturbance will exceed 5,000 square-feet.

Federal law requires the project design to retain the site’s original soil absorption of rainwater. Use “Plan” section below to explain if not feasible.

(ref. 42 U.S.C. 17094)

2. Soil disturbance will exceed 1 acre (43,560 ft²). .

NPDES permit and SWPPP must be approved by Ohio EPA. Coordinate with GEMS IMPORTANT: Must include total work area affected to include, but not limited to, ground disturbance, laydown locations, and site entrance/exit.

Soil disturbances under 1 acre require erosion control measures. Coordinate with GEMS.

3. Onsite use and storage of ANY chemicals and fuels by the construction contractor.

Coordinate review and approval by Environmental Protection, GEMS, and IH.

4. Installation of any type of tank exceeding 1,000 gallons in volume.

Coordinate with GEMS to determine if it requires an environmental permit.

5. New boiler, diesel generator, ethylene oxide sterilizer, or fuel storage tank.

Will require permit through RAPCA. Coordinate with GEMS.

6. Project will cause new use and storage of chemicals and/or gases at the site.

Coordinate with IH to determine possible workplace hazards, required PPE, training, and SDS documentation.

Coordinate with GEMS to determine if it requires a change to the EPCRA report.

7. New site that will generate hazardous waste and/or universal waste.

Coordinate with Environmental Protection for potential changes to hazardous/universal waste contracts, and waste storage.

8. New site that will generate medical waste.

Coordinate with EMS for potential changes to biohazardous waste contract, registration requirements, and waste storage.

9. Demolition areas surveyed for asbestos-containing material (ACM) and lead-based paint. NESHAP testing for asbestos required for all renovated or demo areas.

10-day notification to OEPA and personnel in occupied spaces, must be made for any project involving the demolition of >160 sq. feet surfacing RACM, >260 linear feet of pipping or thermal system insulation, or 35 cubic feet of asbestos-containing debris.

Coordinate with IH for asbestos and lead-based paint testing and remediation oversight. Provide IH OEPA NESHAP notification and ACM disposal manifests.

10. Addition of secondary treatment of drinking water.

OEPA drinking water permits must be obtained prior to installation and operation.

Coordinate with GEMS.

11. Concrete washout?

Plan to complete the applicable requirements:

(Explain how each item marked YES will be addressed. Use additional pages, as needed.)

NEPA ENVIRONMENTAL REVIEW section 3

Instructions: If any YES is checked, provide details below and an EA is required.

Y/N Complete an Environmental Assessment if Any of the Following Applies:

New building construction or a new lease is >75,000 ft². Use the gross sum of all levels.

New construction or new lease will increase building size to >75,000 ft².

Use the gross sum of all floor levels.

More than 5 acres of existing land will be newly developed, regardless of the building size. Or more than 10 acres will be acquired.

Potential or actual penetration of groundwater or an aquifer.

Installation of a photo-voltaic cell energy system, ground source heat exchange system, wind-powered generator, or any other energy generation system. Exception: If the site has installed a similar system and the EA resulted in a FONSI. A copy must be attached.

Site soil or groundwater has known or suspected hazardous waste contamination.

Traffic on nearby roadways leading into the site will increase by >10%.

Site has known toxic or hazardous substances.

Site has protected wildlife or vegetation.

Site has existing, or may impact adjoining, regulated wetlands or an ecologically critical area.

The site will or may violate environmental laws after acquisition, during the construction phase, or when complete.

Any other reason that may result in a “public concern”.

Provide details for any YES answer:

ASSESSMENT OF SIGNIFICANT ENVIRONMENTAL IMPACTS section 4

Instructions: The Project COR shall evaluate each of the potential Environmental Concerns listed below and fill in a code that estimates the project’s possible impact during construction activities and for the completed project. Use the Comments section to explain any item marked with a O, X, C, or S.

Impact Codes:

NA = Not applicable O = Possible significant change to existing environmental conditions may occur X = Minimal effect to the environment and temporary during construction C = Minimal effect, but no significant long-term environmental impact (explain in Comments) S = Effect is similar to previous project with an environmental assessment that resulted in a

FONSI. A copy of the FONSI must be attached for justification.

Code Environmental Concerns

Significant Environmental Impact Thresholds (An impact would be significant if it meets any of the following conditions)

Aesthetics Exterior appearance of the project could be offensive to nearby residents or substantially impede their scenic views.

Air Quality

Project will produce emissions that would impede the area’s conformity with the State Implementation Plan under the Clean Air Act.

Unacceptable levels of dust expected from construction activities that cannot be controlled.

Community Services Public services, facilities, or utilities would be altered that could affect the local community. Includes bus stops and access to community services.

Cultural Resources The project will be installed on or near any building listed, or is eligible for listing, on the National Register of Historic Places.

Economic Activity

The construction phase or finished project will have a significant adverse impact to the local economy. Effect of construction workers and site’s new occupants to the local economy is not expected to offset the impact.

Energy Resources (new)

The site will have a new source of renewable energy, such as solar panels, ground heat source pump, windmill, E85 Fuel Station, etc.

Environmental Justice Negatively impact minority and low-income populations disproportionally relative to negative impacts to the general population as a whole

Environmental Regulatory Compliance

The construction phase or the finished project will not comply with ALL applicable environmental regulations.

Code Environmental Concerns

Significant Environmental Impact Thresholds (An impact would be significant if it meets any of the following conditions)

Endangered or Threatened Species

Project will affect a federally listed species, or its critical habitat, or would have a measurable or perceptible consequence to the protected species or its local population.

A negligible effect must equate to a “No Effect” determination as defined by the U.S. Fish and Wildlife Service.

Fish, Wildlife or Plants/Vegetation

Changes to fish, wildlife, or native vegetation affects more than a small portion of the population and impacts the viability of the species.

Full recovery cannot occur in a reasonable amount of time.

Mitigation, proven to be effective in other previous applications, cannot be implemented.

Floodplains, Wetlands, and Coastal Zones

Regulated wetland areas or water bodies are located within the project site and will be impacted.

Site will be subject to flooding.

Stormwater impacts cannot be confined to the site and will impact adjacent properties.

Geology and Soils Significant changes to soil stability or permeability will occur.

Mitigation measures cannot be implemented.

Land Use

Changes in land use cannot be limited to a small area and will noticeably alter land use at the project site or in adjacent areas.

The affected areas cannot fully recover in a reasonable time after the project is completed.

Noise

Construction phase or the finished project will significantly increase the site’s generation of noise.

Noise levels during construction cannot be mitigated by scheduling loud activities during normal work hours.

Background noise of the completed project will not comply with the local noise ordinance.

Public Concern

Public concern for the construction project and finished project is expected to inhibit or prevent the completion of the project.

The project, with current and planned mitigation measures, may be perceived to be more than a minimal risk to the health and safety of the local population.

Real Property The construction phase and the finished project are expected to significantly affect the values of adjacent properties.

Resident Population

Changes to the normal or routine functions of the affected community will be impacted significantly or will alter existing social or economic conditions in a way that is disruptive or costly to the local community.

Significant Environmental Impact Thresholds (An impact would be significant if it meets any of the following conditions)

Solid Waste or Hazardous Waste

The construction project and finished project will significantly increase the site’s generation of solid waste, hazardous waste, or biohazardous waste and could be a health risk to the local community.

Project could cause water or soil to be contaminated with a hazardous material or could disturb a current contaminated site.

Assessment for asbestos, lead-based paint or walls, mercury, or other hazardous materials is required for buildings built prior to 1990, all labs, all radiology areas, or other uses involving hazardous materials.

Stormwater

Construction phase will have an impact on stormwater management site because >1 acre of soil will be disturbed. (An approved Stormwater Pollution Prevention Plan will be required.)

Or if more than 5,000 square-feet of soil will be disturbed and it has been determined that it is not feasible to maintain the site’s previous ability to absorb rainwater into the ground.

Transportation and Parking

Finished project is expected to have an impact on traffic for adjacent and nearby roadways (>10% increase in traffic).

The construction phase or finished project will cause the site’s patients, visitors, and staff to park off-site.

Utilities and Infrastructure

Project is expected to have a significant impact on the site’s use of electrical power, water, or natural gas and would noticeably affect or disrupt the availability of public utilities and services for the local community.

Water (groundwater, aquifer)

Groundwater or an aquifer will be penetrated.

Wastewater will be stored or treated onsite.

Changes to groundwater hydrology cannot be confined to the immediate project area.

Full recovery will not occur in a reasonable amount of time.

Water (surface, discharge)

The construction project or finished project will have an adverse effect on surface water.

Contaminated wastewater will be discharged from the site into a waterway or onto the site.

NPDES discharge permit will be required.

Significant Environmental Impact Thresholds (An impact would be significant if it meets any of the following conditions) COMMENTS: (explain any item marked with a O, X, C, or S)

ASSESSMENT OF CATEGORICAL EXCLUSIONS section 5

Instructions: Sections 1 -4 are used to assess/document if a project meets requirements for a CATEX, EA, or an EIS. Per the directive this form must be signed and approved by the Project’s COR, GEMS Program Manager, and Chief of Engineering. The signed copy of this form will be kept in the Project File and a copy shall be provided to GEMS.

Y/N Criteria:

Minimal or no effect to the environment

No significant change to existing environmental conditions

No significant cumulative environmental impact (i.e., long term effects)

Similar to a previous project with an environmental assessment that resulted in a FONSI (attach a copy for reference)

Y/N Classes Of Action:

Repair, replacement, or new installation of primary or secondary electrical distribution systems.

Interior construction or renovation.

New construction of <7,000 m2 (<75,000 square feet). Sum of all levels, except the roof.

Development on existing land (<5 acres) or acquisition of <10 acres of land.

Actions which involve support or ancillary appurtenances for normal operation.

Leases, licenses, permits, and easements.

Actions, activities, or programs that do not require the expenditure of Federal funds.

Repair, replacement, and new installation of components such as windows, doors, roofs;

and site elements such as sidewalks, patios, fences, retaining walls, curbs, water distribution lines, and sewer lines which involve work totally within VA property boundaries.

Y/N Extraordinary Circumstances:

Greater scope or size than normally experienced for this type of project for Categorical Exclusion.

In highly populated or congested area.

Potential for degradation, although slight, of existing poor environmental conditions.

Use of unproven technology (i.e. photovoltaic panels, ground heat pumps).

Potential presence of an endangered species, archeological remains, or other protected resources.

Potential presence of hazardous or toxic substances (assess previous use).

Y/N CATEGORICAL EXCLUSION:

This project meets the requirements of the Department of Veterans Affairs to be excluded from conducting an environmental assessment because it meets one of the Criteria, at least one of the Classes Of Action, and none of the Extraordinary Circumstances listed.

Y/N PROJECT DOES NOT MEET CATEGORICAL EXCLUSION:

This project will require the preparation of an Environmental Assessment and/or an Environmental Impact Statement.

APPROVALS

PERSONNEL Electronic SIGNATURE (which contains name and date)

Project COR

GEMS Program Manager

Chief, Engineering

CARL JOHNSON Digitally signed by CARL JOHNSON Date: 2025.07.24 15:22:53 -04'00'

VHADAYShadeM Highlight

ASSESSMENT OF EA or EIS section 6

***This section is only required if an EA or EIS is required for the project.

ENVIRONMENTAL ASSESSMENT TRACKING COMPLETION

DATE

Preparation of draft environmental assessment

Notice of Availability (NOA) published in local newspaper

Minimum 30-day public comment period (document comments review)

Finding Of No Significant Impact (FONSI) published in local newspaper

Determination if an EIS is required

Final EA Signed by DVAMC Director Project NEPA Document (pdf) posted in project file and provided to gems manager

ENVIRONMENTAL IMPACT STATEMENT TRACKING COMPLETION

DATE

Notice of Intent published in the local newspaper

Draft EIS prepared

Draft EIS sent to EPA Office of Federal Activities (OFA)

NOA published in Federal Register, 45-Day comment period begins

Final EIS incorporates comments, sent to EPA OFA Notice of Availability published in Federal Register, 30-Day comment period begins Final version of EIS approved

Record of Decision Issued

APPROVAL for ENVIRONMENTAL ASSESSMENT PERSONNEL Electronic SIGNATURE (which contains name and date)

Medical Center Director

APPROVAL for ENVIRONMENTAL IMPACT STATEMENT PERSONNEL Electronic SIGNATURE (which contains name and date)

VISN Director

Plan to complete the applicable requirements Explain how each item marked YES will be addressed Use additional pages as needed 7KHZRUNZLOOLQFOXGHEXWLVQRWOLPLWHGWRVLWHSUHSDUDWLRQJUDGLQJJUDYHOLQVWDOODWLRQDQG SODFLQJSDUNLQJEORFNVLQSDUNLQJVSDFHV:

A NPDES permit will be required. No other requirements per OEPA.

COMMENTS explain any item marked with a O X C or S 7KHQRLVHOHYHOIRUKHDYHTXLSPHQWHFDYDWLRQZLOOEHGRQHGXULQJQRUPDOKRXUV 0RUHWKHDFUHRIODQGZLOOEHHFDYDWHG6WRUPGUDLQVDUHWREHSURWHFWHGIURP VRLOHQWHULQJ:

A NPDES permit will be required. No other requirements per OEPA.