Expiration Date: 03/31/2027 OMB No. 2132-0529

Federal Transit Administration Categorical Exclusion Worksheet

Purpose: To assist FTA project sponsors in providing sufficient documentation to support a categorical exclusion (CE) determination for certain “c-list” or “d-list” construction projects in compliance with the National Environmental Policy Act

(NEPA) and FTA’s environmental regulation (23 CFR § 771.118). Small construction projects (e.g., bus shelters) and non-construction projects that qualify for a c-list CE are exempt from this worksheet; instead, the project sponsor will submit a sufficient project description to FTA via email or FTA’s grant management software, the Transit Award Management

System (TrAMS).

In addition to NEPA compliance, this worksheet documents determinations, findings, and concurrence received from appropriate Federal and State agencies to comply with other environmental requirements, as applicable. Based on the submitted project description, FTA may request additional documentation for certain small construction projects to meet the requirements of other environmental laws. Project sponsors should discuss whether to complete this worksheet with FTA Regional staff prior to assuming NEPA class of action.

For all projects, property acquisition and project construction may not begin until FTA issues a CE determination or approval of this document in writing (Sec. VI). Populate Project information in Sec. I, below. For Sec. II through V, follow the provided instructions, then select and populate the applicable box/text field.

I. Project Information

Project Sponsor and Contact Information

Name:

Title:

Organization Name:

Phone Number:

Email:

State Transportation Improvement Program (STIP)/Transportation Improvement Program (TIP) Item/Project ID Number (if available):

STIP/TIP Approval Date (if available):

Anticipated FTA Funding Source(s):

Project Title:

https://www.ecfr.gov/current/title-23/chapter-I/subchapter-H/part-771/section-771.118 https://www.transit.dot.gov/funding/grantee-resources/teamtrams/transit-award-management-system-trams https://www.transit.dot.gov/regulations-and-programs/environmental-programs/fta-real-property-acquisition-and-national

Project Location and Zoning (physical address and maps depicting location; project boundary/footprint;

land uses allowed under applicable zoning ordinances [2-3 sentences]):

Property Acquisition (Describe if real property acquisition or easement is required; Describe temporary easement/construction staging, if applicable):

Project Description (scope of work; age of structures/buildings involved; extent of ground disturbance;

estimated start date and project duration):

II. Categorical Exclusion Determination

The project is categorically excluded from further NEPA review under 23 CFR § 771.118:

☐ Select one from 118(c) or 118(d):

118(c):

118(d):

☐ General exclusion under 118(d) (no specific activity category applies, but the project is exempt per the conditions of 23 CFR 771.118(a) and (b))

☐ Per 23 CFR 771.118(e), the project is categorically excluded per Federal Railroad Administration

(FRA) categorical exclusion under 23 CFR 771.116 or Federal Highway Administration (FHWA) categorical exclusion under 23 CFR 771.117.

List applicable categorical exclusion:

III. Evaluation of Potential Reasonably Foreseeable Environmental Effects

Visit the FTA environmental resources information webpage for a list of resource impact areas for additional information. Text fields below are limited to 400 words. Project sponsors may attach supplemental information/responses that do not fit in the space provided and may provide weblinks to existing public documents or previous environmental documents to supplement the evaluation, as applicable.

A. Natural and Physical Environment

A.1 Biological Resources

FTA Standard Operating Procedure (SOP) No. 23 provides information on agency roles, responsibilities, and consultation procedures for biological resources under numerous requirements.

Select and populate the following prompts and attach supporting documentation, as applicable.

Project sponsors should coordinate with FTA prior to completing this section.

Endangered Species Act

☐ The project will have no effect on listed, threatened, endangered, proposed, or candidate species or designated USFWS or NOAA Fisheries.

Species analyzed and rationale for “no effect” determination:

https://www.ecfr.gov/current/title-23/chapter-I/subchapter-H/part-771/section-771.118 https://www.ecfr.gov/current/title-23/part-771/section-771.118#p-771.118(c) https://www.ecfr.gov/current/title-23/part-771/section-771.118#p-771.118(d) https://www.ecfr.gov/current/title-23/part-771/section-771.118#p-771.118(a) https://www.ecfr.gov/current/title-23/chapter-I/subchapter-H/part-771/section-771.118#p-771.118(e) https://www.ecfr.gov/current/title-23/chapter-I/subchapter-H/part-771/section-771.116 https://www.ecfr.gov/current/title-23/chapter-I/subchapter-H/part-771/section-771.117 https://www.transit.dot.gov/regulations-and-guidance/environmental-programs/environmental-resources-information https://www.transit.dot.gov/regulations-and-programs/environmental-programs/biological-resources-standard-operating-procedures https://www.fws.gov/project/critical-habitat https://www.fisheries.noaa.gov/national/endangered-species-conservation/critical-habitat

Endangered Species Act, continued

☐ The project may affect but is not likely to adversely affect listed, threatened, endangered, proposed, or candidate species or adversely modify designated critical habitat. Species analyzed and rationale for determination:

Date of US Fish and Wildlife Service (USFWS) concurrence:

Date of National Marine Fisheries Service (NMFS) concurrence:

☐ The project may adversely affect listed, threatened, endangered, proposed, or candidate species or may adversely modify designated critical habitat. Species analyzed, effects, and rationale for determination:

Date of USFWS concurrence:

Date of NMFS concurrence:

Magnuson-Stevens Fishery Conservation and Management Act

☐ The project will have no effect on essential fish habitat (EFH). Rationale for “no effect” determination:

https://www.fisheries.noaa.gov/national/habitat-conservation/essential-fish-habitat

Magnuson-Stevens Fishery Conservation and Management Act, continued

☐ The project may affect but is not likely to adversely affect EFH.

Rationale for determination:

☐ The project may adversely affect EFH.

Rationale for determination:

Date of NMFS concurrence:

Other Biological Resources

Describe effects on any other wildlife and species of concern and habitat, as applicable (e.g., Tribal sensitive species/habitat concerns, migratory birds, take (including harassment) of marine mammals under the Marine Mammal Protection Act):

A.2 Coastal Zones

☐ The project is not located near the Atlantic Ocean, Caribbean Sea, Gulf of America, Pacific Ocean, or Great Lakes or certain connected coastal waters.

☐ The project is located near the Atlantic Ocean, Caribbean Sea, Gulf of America, Pacific Ocean, or Great Lakes or certain connected coastal water but it is not located in or within the vicinity of a designated coastal zone management area

☐ The project is located near the Atlantic Ocean, Caribbean Sea, Gulf of America, Pacific Ocean, or Great Lakes or certain connected coastal waters and it is in or within the vicinity of a designated coastal zone management area. Identify the applicable coastal plan and the project’s consistency with that plan, and attach/enclose documentation of coordination with local coastal zone management agency:

A.3 Prime or Unique Farmlands

☐ Not applicable. The project does not feature farmland.

☐ The project involves farmlands, but does not involve prime or unique farmlands present on the National Resources Conservation Service (NRCS) soil map. ArcGIS users can also access the NRCS data at this location.

☐ The project involves prime or unique farmlands present on the NCRS map. Describe potential effects on these farmlands and any coordination with the U.S. Department of Agriculture NRCS.

Attach documented coordination, if applicable:

A.4 Water Resources

FTA’s SOP 22 for Water Resources provides guidance on identifying water resources and assessing project impacts. Select and populate the following prompts, as applicable.

Wetlands and Other Waters of the United States (WOTUS) / Clean Water Act Section 404 and 401 Compliance

☐ Wetlands or other waters of the U.S. are not present per review of the National Wetlands Inventory and site visit(s).

Survey Date:

https://oceanservice.noaa.gov/tools/czm/ https://oceanservice.noaa.gov/tools/czm/ https://www.ecfr.gov/current/title-7/subtitle-B/chapter-VI/subchapter-F/part-657/subpart-A/section-657.5 https://websoilsurvey.nrcs.usda.gov/app/ https://www.transit.dot.gov/regulations-and-guidance/environmental-programs/water-resources-0 https://www.arcgis.com/home/item.html?id=9708ede640c640aca1de362589e60f46

Water Resources, continued

☐ Wetlands or other waters of the U.S. are present at the proposed project site, but they will not be impacted by the proposed project.

☐ Wetlands or other waters of the U.S. will be impacted by the discharge of dredged or fill material.

Describe the nature and extent of such activities, including location and amount. Identify the type of Clean Water Act Section 404 permit required [Nationwide Permit; Regional General Permit, or Individual Permit]. Identify the Section 401 certification (and issuing authority) and any relevant mitigation measures that would be required for the project:

Clean Water Act Section 402: National Pollutant Discharge Elimination System Stormwater Permit

Use of a Section 402 permit is:

☐ Not required. Less than one acre of ground disturbance would occur

☐ Required; the project involves more than one acre of ground disturbance. Name the authority issuing the permit(s) and attach documentation, if available:

Navigable Waterways

☐ The proposed project would not cross or affect a navigable waterway.

☐ The proposed project crosses or otherwise affects a navigable waterway. Describe the nature of such effects and provide permit information under Section 9 or Section 10 of the Rivers and Harbors Act, as applicable:

Floodplains

Federal Emergency Management Agency (FEMA) Flood Insurance Rate Map numbers and effective date (See FEMA Maps):

☐ The project is not located in a 100-year floodplain.

https://www.epa.gov/cwa-404/clean-water-act-section-402-national-pollutant-discharge-elimination-system https://www.epa.gov/wotus/waters-qualify-traditional-navigable-waters-under-section-a1-agencies-regulations https://www.charts.noaa.gov/InteractiveCatalog/nrnc.shtml https://www.fema.gov/flood-maps

Water Resources, continued

☐ The project is in floodplain that is not delineated or is within a 100-year floodplain. Describe how the project would impact the base flood elevation and results of coordination with the local floodplain manager. Attach concurrence/support letters, no-rise certification, etc.

Sole-Source Aquifer

☐ The proposed project is not located near an EPA-designated sole source aquifer (SSA).

☐ The proposed project is located near an SSA. Describe the outcome of consultation with EPA and attach an SSA worksheet as applicable for the project region:

A.5 Air Quality

Air Quality Conformity

Review the EPA Greenbook to determine National Ambient Air Quality Standards (NAAQS) designations, classifications and nonattainment status for each of the following criteria pollutants;

Carbon Monoxide (CO), Ozone (O3), Nitrogen Dioxide (NO2), Sulfur Dioxide (SO2), Particulate Matter (PM10 or PM2.5), Lead (Pb) and populate the following prompts.

The project is:

☐ Exempted from conformity analysis under 40 CFR 93.126

Located in an:

☐ Attainment area

☐ Maintenance area for (list criteria pollutants):

☐ Non-attainment area for (list criteria pollutants):

https://www.epa.gov/dwssa/map-sole-source-aquifer-locations https://www.epa.gov/green-book https://www.ecfr.gov/current/title-40/chapter-I/subchapter-C/part-93/subpart-A/section-93.126

Air Quality, continued

Located in a Metropolitan Area and was included in an air quality conformity analysis and Transportation Improvement Program (TIP). Date of US Department of Transportation (USDOT) conformity finding:

Hot Spot Analysis

Refer to the EPA PM Hot-Spot Analysis Frequently Asked Questions (FAQs) available at the EPA Project-Level Conformity Hot-Spot Analyses site which provides examples of the types of projects that would and would not require a hot-spot analysis.

Construction emissions would:

☐ Not be substantial and would not require a hot spot analysis. Explain why the nature of the project will not result in an increase in traffic volumes or factors that would cause an increase in emissions:

☐ Be substantial and require a hot-spot analysis. Summarize project emissions and hot-spot findings (and attach memo):

Sensitive Receptors (e.g., residences, schools, hospitals, nursing homes)

☐ Construction diesel emissions are not substantial and are not adjacent to sensitive receptors.

Attach evidence of this finding, as applicable.

☐ The project would involve substantial diesel emissions adjacent to sensitive receptors. Identify and describe sensitive receptors within the project area:

https://www.epa.gov/state-and-local-transportation/project-level-conformity-and-hot-spot-analyses https://www.epa.gov/state-and-local-transportation/project-level-conformity-and-hot-spot-analyses

A.6 Geology and Soils

☐ The project is not located in an area that would involve any specific construction considerations, including fault lines, fault zones, or an active landslide area.

☐ The project is located in an area that would involve special construction considerations, but would comply with all relevant requirements (e.g., local building codes). Describe what special considerations have been incorporated into the project plan:

A.7 Hazardous Materials and Brownfields

Refer to FTA’s SOP. No. 19 Consideration of Contaminated Properties including Brownfields for guidance on assessment and acquisition considerations. Indicate the presence of existing hazardous materials and proposed project components:

☐ No existing hazardous materials are present onsite. Attach supporting documentation, as applicable.

☐ Hazardous materials are present:

☐ Aboveground or underground storage tanks; describe:

☐ Lead-Based Paints/ Asbestos; describe:

☐ Other; describe:

https://www.usgs.gov/tools/interactive-us-fault-map https://www.usgs.gov/tools/interactive-us-fault-map https://www.usgs.gov/tools/us-landslide-inventory-and-susceptibility-map https://www.transit.dot.gov/regulations-and-guidance/environmental-programs/consideration-contaminated-properties-including

Hazardous Materials and Brownfields, continued

Describe the types of activities to be conducted involving hazardous materials (i.e., a structure will be modified or altered through the project):

Summary of records review for hazardous materials:

Date of review:

Populate the following prompts if a Phase I Environmental Site Assessment was conducted for applicable property acquisition.

Date completed:

Summary of results/findings:

Phase 1 Recommendation:

A.8 Transportation

Refer to the FTA Transportation Impacts web page for guidance and populate the following prompts.

Traffic/Parking

☐ The project would not temporarily or permanently increase traffic volumes or worsen the level of service, change local/regional circulation patterns, and would not result in the loss of parking spaces. Describe why the project would have no effects:

☐ The project would temporarily or permanently affect road traffic or parking demand. Describe potential effects to existing services, capacity constraints, and summarize the results of coordination with relevant transportation authorities. Attach a traffic analysis memo if one has been conducted.

Transit/Rail

☐ The project would have no effects on transit or railway operations. Describe why the project would have no effects:

☐ The project would affect transit or railway service/operations. Describe potential effects to existing services, capacity constraints, and summarize the results of coordination with relevant transportation authorities.

https://www.transit.dot.gov/regulations-and-programs/environmental-programs/transportation-impacts

Transportation, continued

Bicycle/Pedestrian Facilities

☐ The project would have no effects on bicycle or pedestrian facilities. Describe why the project would have no effects:

☐ The project would affect bicycle or pedestrian facilities. Describe any potential effects to existing services, the duration of such changes, and summarize the results of coordination with relevant transportation authorities.

If there are any other potential impacts to systems used to transport goods and provide transportation services, describe them below.

A.9 Noise and Vibration

Refer to Sections 2, 4, and 6 of FTA’s Transit Noise and Vibration Impact Assessment manual to identify potential noise and vibration impacts and the level of such impacts. Utilize the FTA Noise Impact Assessment Spreadsheet, as applicable.

☐ No sensitive land uses (e.g., schools, hospitals, hotels, or residences) are located within the vicinity of the project area.

☐ Sensitive land uses are present and will experience temporary noise or vibration impacts due to construction activities. Describe temporary noise or vibration impacts, affected properties, and any measure, as applicable, to control or mitigate temporary impacts:

https://www.transit.dot.gov/research-innovation/transit-noise-and-vibration-impact-assessment-manual-report-0123 https://www.transit.dot.gov/regulations-and-guidance/environmental-programs/noise-impact-assessment-spreadsheet https://www.transit.dot.gov/regulations-and-guidance/environmental-programs/noise-impact-assessment-spreadsheet

Noise and Vibration, continued

☐ Sensitive land uses are present and will be impacted by the project. Summarize the results of the noise or vibration analysis (e.g., moderate impact), affected properties, and identify mitigation measures that would eliminate or reduce impact, if any. Attach a general noise or vibration assessment if applicable.

A.10 Utilities

Select and populate the following prompts, as applicable.

Name(s) of utility provider(s) present:

☐ Utility work is not anticipated.

☐ Utility work is not anticipated at this time, but it will be investigated during the design phase.

☐ Utility work is involved in the project. Describe the nature of the work (relocation, temporary service disruption), the type of entity performing the work (e.g., contractor, utility company), and how the affected customers would be notified.

B. Human Environment

B.1 Historic Properties and Cultural Resources/Section 106 Compliance

Document compliance with Section 106 of the National Historic Preservation Act (NHPA) (Refer to FTA’s SOP No. 21 for Section 106 Process). Project sponsors should coordinate with FTA prior to completing this section.

Refer to the Advisory Council on Historic Preservation’s web page for available program alternatives (36 CFR § 800.14) that may be applicable to the project and populate the following prompt.

☐ There is no applicable program alternative to the project.

☐ A program alternative applies to the project. Identify the specific program alternative and provide documentation demonstrating compliance with its terms:

https://www.transit.dot.gov/regulations-and-guidance/environmental-programs/section-106-process-standard-operating-procedures https://www.transit.dot.gov/regulations-and-guidance/environmental-programs/section-106-process-standard-operating-procedures https://www.achp.gov/program_alternatives

Historic Properties and Cultural Resources/Section 106 Compliance, continued

Presence of Historic Properties/NHPA Compliance

☐ No National Historic Register Places (NRHP) properties or eligible properties are present in the project’s area of potential effect (APE).

Records search/Survey data/document:

Date of FTA’s finding of no historic properties affected:

State Historic Preservation Officer (SHPO)/Tribal Historic Preservation Officer (THPO) concurrence/no objection date:

☐ The project’s APE has been surveyed and the following historic property/properties are located within the APE. Records search/Survey data/document:

Historic site name(s), NRHP status (listed, eligible, ineligible) and Criterion (A, B, C, D):

Attach a table to Section VII if there are too many properties to list in the space below.

Briefly describe the nature of the effect and mitigation commitments, if applicable:

https://www.nps.gov/subjects/nationalregister/index.htm

Historic Properties and Cultural Resources/Section 106 Compliance, continued

FTA’s Finding or Determination under Section 106:

☐ No adverse effect

☐ Adverse effect

SHPO/THPO concurrence date:

Programmatic Agreement or Memoranda of Agreement execution date (for adverse effect) (Note: attach agreement):

B.2 Section 4(f) Requirements

See FTA’s SOP for Section 4(f) Evaluations to determine Section 4(f) applicability. Select and populate the following prompts, as applicable.

☐ No properties protected by Section 4(f) are present.

☐ A public park or recreation area is present.

☐ A publicly owned wildlife or waterfowl refuge is present.

☐ A public or private historic site is present.

If any of the resources noted above are checked, describe these resources, including their location and ownership, and results of coordination with the owner of these resources:

☐ The project is exempt from Section 4(f) approval per 23 CFR 774.13(a)-(c). Describe the applicable exception and attach supporting documentation, as applicable, including compliance with applicable conditions:

☐ There is temporary occupancy of land that is minimal; therefore, there is no “use” of land as defined in 23 CFR 774.13(d). Attach documented agreement from the officials with jurisdiction (OWJs) including compliance with applicable conditions.

https://www.transit.dot.gov/regulations-and-guidance/environmental-programs/section-4f-evaluations https://www.ecfr.gov/current/title-23/chapter-I/subchapter-H/part-774/section-774.13#p-774.13(a) https://www.ecfr.gov/current/title-23/chapter-I/subchapter-H/part-774/section-774.13#p-774.13(d)

Section 4(f) Requirements, continued

If a Section 4(f) exception does not apply, then determine if the project would result in use of a Section 4(f) property, attach appropriate evidence of coordination as applicable, and populate the following prompts:

☐ There is no permanent (direct) use of a Section 4(f) resource. Provide justification for this finding:

☐ De minimis impact (historic site). There is a “no effect” or “no adverse effect” determination on a historic site listed in or eligible for listing in the NRHP. Attach letters or concurrence from SHPO/THPO. Refer to documentation requirements at 23 CFR 774.7(b) and coordination requirements at 23 CFR 774.5(b).

☐ De minimis impact (public parks, recreation areas, and wildlife and waterfowl refuges). Describe the use and provide justification. Attach public notice, comments received, if any, and concurrence from OWJs to support this finding per coordination requirements at 23 CFR 774.5(b)(2).

☐ There is permanent (direct) use of a Section 4(f) resource that is not de minimis. Attach an Individual Section 4(f) evaluation and associated correspondence:

If the project would have a use of a Section 4(f) resource, review the Nationwide Net Benefit Programmatic Evaluation and the Nationwide Historic Bridges Programmatic Evaluation for additional efficiency options.

B.3 Section 6(f) Resources

Protections state that no property acquired or developed with assistance under Section 6(f) shall, without the approval of the Secretary, be converted to other than public outdoor recreation uses.

Section 6(f) applies to outdoor recreational properties funded by the Land and Water Conservation Fund (LWCF). Review the map of places funded by LWCF and populate the following prompts, as applicable.

☐ The project does not involve land acquired or developed with LWCF grant money.

https://www.ecfr.gov/current/title-23/chapter-I/subchapter-H/part-774/section-774.7#p-774.7(b) https://www.ecfr.gov/current/title-23/chapter-I/subchapter-H/part-774/section-774.5#p-774.5(b) https://www.ecfr.gov/current/title-23/chapter-I/subchapter-H/part-774/section-774.5#p-774.5(b)(2) https://www.ecfr.gov/current/title-23/chapter-I/subchapter-H/part-774/section-774.5#p-774.5(b)(2) https://www.transit.dot.gov/sites/fta.dot.gov/files/2022-06/Nationwide-Net-Benefit-Programmatic-Evaluation.pdf https://www.transit.dot.gov/sites/fta.dot.gov/files/2022-06/Nationwide-Net-Benefit-Programmatic-Evaluation.pdf https://www.transit.dot.gov/sites/fta.dot.gov/files/2022-06/Nationwide-Historic-Bridges-Programmatic-Evaluation.pdf https://www.nps.gov/subjects/lwcf/protection.htm https://lwcf.tplgis.org/mappast/

Section 6(f) Resources, continued

☐ Land acquired or developed with LWCF grant money is involved, but the project will not convert recreational areas to non-recreational uses. Describe the property:

☐ Land acquired or developed with LWCF grant money is involved and will be converted to non-recreational purposes. Describe the property and coordination/written approval from the National Park Service, and any applicable mitigation measures.

Attach supporting documentation of the LWCF funding (deed, agreement, 6(f) grant) for the affected property to this form.

B.4 Community Impacts

Community Cohesion/ Neighborhood Continuity

☐ No established communities or planned developments will be disrupted, and the project is consistent with applicable plans and goals. Describe the justification for this finding:

☐ The project would result in the disruption of an established community or planned development or is inconsistent with applicable plans and goals. Describe the affected community and potential disruption or inconsistency and any applicable mitigation measures:

Community Impacts, continued

Permanent/Temporary Access

☐ The project would not result in permanent or temporary effects on access to services. Describe the justification for this finding:

☐ The project would have permanent or temporary effects on access to services (community organizations, healthcare centers, educational institutions, public services, etc.). Describe any potential effects to existing community services or their capacity and coordination with relevant service authorities as applicable.

Displacement(s)

☐ No residents, businesses or institutions (e.g., community centers, schools) will be relocated.

☐ The project requires relocation of residents, businesses, or institutions. Describe the number and type (residence, business, other) of relocations associated with the project:

Coordinate with the Bureau of Indian Affairs if the project involves tribal lands.

☐ No right-of-way action by the Bureau of Indian Affairs is required.

☐ Right-of-way action by the Bureau of Indian Affairs is required. Describe the affected tribal land and tribe:

https://www.bia.gov/service/rights-of-way-individually-owned-indian-and-tribal-lands/apply-right-of-way

B.5 Safety and Security (including Resilience)

Describe measures that would need to be taken and that have been included for the safe and secure operation of the project (e.g., pedestrian and traffic hazards, as well as user and employee security issues), as applicable (see FTA’s Transit Safety and Oversight webpage for more information):

Identify measures involved in the project that will be taken to address extreme weather events, as applicable:

C. Other

As applicable, describe impact areas and associated permits (e.g. wild and scenic rivers, Section 408 permit) not discussed above.

https://www.transit.dot.gov/regulations-and-guidance/safety/transit-safety-oversight-tso https://www.usace.army.mil/Missions/Civil-Works/Section408/ https://www.usace.army.mil/Missions/Civil-Works/Section408/

IV. Mitigation Measures, Project Commitments, and Permits

List mitigation measures and permits applicable to the project and identify responsible parties:

V. Submitted by:

Name:

Title:

Project Sponsor: Date:

VI. FTA Concurrence:

Name: Date:

VII. Attachments

Insert list of agency correspondence, location map(s), technical memos, site plans, renderings, etc.

This section may also be used to attach supplemental information or tables that do not fit in the corresponding fields.