Attachment_J2(J)_-_NASA_GRC-150_Environmental_Checklist.pdf

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GRC 150 06/16 (1.1)

GRC 150 05/14 (1.0)

PREVIOUS EDITIONS ARE OBSOLETE.

PREVIOUS EDITIONS ARE OBSOLETE.

Page of Page Count NASA Glenn Research Center (GRC) Energy and Environmental Management Office (EEMO) Environmental Checklist NASA Glenn Research Center (GRC) Energy and Environmental Management Office (EEMO) Environmental Checklist

PURPOSE:

This checklist assists in ensuring new programs and actions conducted and/or funded by GRC attain and maintain compliance with applicable Federal, State and local environmental laws and regulations. The earlier this form is utilized in the design and project initiating phases, the sooner adequate funding can be recognized for additional studies, regulatory permits , and alternatives guidance can be planned for when necessary. Completing this checklist will also assist in avoiding project delays later in the process and head off potential conflicts.

Exemptions: See page 2 for a list of actions that do not require this checklist to be filled out and submitted for review.

INSTRUCTIONS:

PURPOSE:

This checklist assists in ensuring new programs and actions conducted and/or funded by GRC attain and maintain compliance with applicable Federal, State and local environmental laws and regulations. The earlier this form is utilized in the design and project initiating phases, the sooner adequate funding can be recognized for additional studies, regulatory permits , and alternatives guidance can be planned for when necessary. Completing this checklist will also assist in avoiding project delays later in the process and head off potential conflicts.

Exemptions: See page 2 for a list of actions that do not require this checklist to be filled out and submitted for review.

INSTRUCTIONS:

The Program or project lead or designee shall complete Sections I–V on pages 3 through 6 of this form with adequate details (e.g. spell out acronyms, limit jargon, and explain in terms that would be understandable to the general public). Send with any attachments (i.e., site maps, drawings, calculations) with the completed GRC 150 by e-mail to the GRC NEPA Manager at

1. The Program or project lead or designee shall complete Sections I - V on pages 3 through 6 of this form with adequate details (e.g. spell out acronyms, limit jargon, and explain in terms that would be understandable to the general public). Send with any attachments (i.e., site maps, drawings, calculations) with the completed GRC 150 by e-mail to the GRC NEPA Manager at robert.f.lallier@nasa.gov The GRC NEPA Program Manger shall review the submitted GRC 150 and supporting documents to determine if additional documentation or review is required.

The GRC NEPA Program Manager shall distribute this form within the GRC Energy and Environmental Management Office (EEMO) for further concurrence as necessary (Page 7, Section VI). The GRC Historic Preservation Officer (GRC HPO), Mr. Les Main, shall also review and provide concurrence (Page 4, Section III).

Upon final review and concurrence, the GRC NEPA Program Manager shall provide signatures and final copies to all associated parties of the action along with any mitigation, monitoring, or additional reviews required and/or recommended. For specific actions, a Record of Environment Consideration (REC) shall also be included with the finalized GRC 150 and at the discretion of the GRC NEPA Manager.

2. The GRC NEPA Program Manger shall review the submitted GRC 150 and supporting documents to determine if additional documentation or review is required.

3. The GRC NEPA Program Manager shall distribute this form within the GRC Energy and Environmental Management Office (EEMO) for further concurrence as necessary (Page 7, Section VI). The GRC Historic Preservation Officer (GRC HPO), Mr. Les Main, shall also review and provide concurrence (Page 4, Section III).

4. Upon final review and concurrence, the GRC NEPA Program Manager shall provide signatures and final copies to all associated parties of the action along with any mitigation, monitoring, or additional reviews required and/or recommended. For specific actions, a Record of Environment Consideration (REC) shall also be included with the finalized GRC 150 and at the discretion of the GRC NEPA Manager.

NASA NEPA POLICY INFORMATION AND GUIDANCE:

NASA NEPA POLICY INFORMATION AND GUIDANCE:

NASA Procedural Requirements (NPR) 8580.1A–NASA National Environmental Policy Act Management Requirements

Environmental Programs Manual, Chapter 2: NEPA

NASA NEPA Web site NASA Procedural Requirements (NPR) 8580.1A - NASA National Environmental Policy Act Management Requirements http://nodis3.gsfc.nasa.gov/displayDir.cfm?t=M[R&c=8580&s=1A

Environmental Programs Manual, Chapter 2: NEPA http://www.grc.nasa.gov.WWW/FTD/EEMO/documents/epmc-2.pdf

NASA NEPA Web site http://www.nasa.gov/agency/nepa/index.html 1.

2.

3.

4.

The following activities (also known as Automatic Categorical Exclusions) have been identified as having no potential for significant impacts on the human and natural environment within the scope of NASA missions and Center activities and therefore do not require completion of the Environmental Checklist or undergo additional NEPA evaluation.

The following activities (also known as Automatic Categorical Exclusions) have been identified as having no potential for significant impacts on the human and natural environment within the scope of NASA missions and Center activities and therefore do not require completion of the Environmental Checklist or undergo additional NEPA evaluation.

1. Administrative Activities

1. Administrative Activities Personnel actions, organizational changes, and procurement of routine goods and services.

Issuance of procedural rules, manuals, directives, and requirements.

Program budget proposals, disbursements, and transfer, or reprogramming of funds.

Preparation of documents including design and feasibility studies, analytical supply and demand studies, reports and recommendations, master and strategic plans, and other advisory documents.

Information-gathering exercises such as inventories, audits, studies, and field studies, including water sampling, cultural resources surveys, biological surveys, geologic surveys, modeling or simulations, and routine data collection and analysis activities.

Preparation and dissemination of information, including document mailings, publications, classroom materials, conferences, speaking engagements, web sites, and other educational/informational activities.

Software development, data analysis, and/or testing, including computer modeling.

Interpretations, amendments, and modifications to contracts, grants, or other awards. (Note: For modifications to contracts - notify EEMO for regulatory change impacts to contracts)

i. Personnel actions, organizational changes, and procurement of routine goods and services.

ii. Issuance of procedural rules, manuals, directives, and requirements.

iii. Program budget proposals, disbursements, and transfer, or reprogramming of funds.

iv. Preparation of documents including design and feasibility studies, analytical supply and demand studies, reports and recommendations, master and strategic plans, and other advisory documents.

v. Information-gathering exercises such as inventories, audits, studies, and field studies, including water sampling, cultural resources surveys, biological surveys, geologic surveys, modeling or simulations, and routine data collection and analysis activities.

vi. Preparation and dissemination of information, including document mailings, publications, classroom materials, conferences, speaking engagements, web sites, and other educational/informational activities.

vii. Software development, data analysis, and/or testing, including computer modeling.

viii. Interpretations, amendments, and modifications to contracts, grants, or other awards. (Note: For modifications to contracts - notify EEMO for regulatory change impacts to contracts)

2. Operations and Management Activities

2. Operations and Management Activities Routine maintenance, minor construction or rehabilitation, minor demolition, minor modification, minor repair, and, continuing or altered operations at, or of, existing NASA or NASA-funded or approved facilities and equipment such as buildings, roads, grounds, utilities, communication systems, and ground support systems, such as space tracking and data systems.

i. Routine maintenance, minor construction or rehabilitation, minor demolition, minor modification, minor repair, and, continuing or altered operations at, or of, existing NASA or NASA-funded or approved facilities and equipment such as buildings, roads, grounds, utilities, communication systems, and ground support systems, such as space tracking and data systems.

Note: Exemptions for 2-i apply only to those items listed in following Interior and Exterior Activity Lists:

Note: Exemptions for 2-i apply only to those items listed in following Interior and Exterior Activity Lists:

INTERIOR ACTIVITIES–Routine repair, maintenance, installation, removal or replacement projects:

Heating/Cooling–HVAC systems, AC units, condensing units, exhaust fans, insulation (including minor repair/removal of asbestos insulation), and electric heaters.

Equipment–roll doors, elevators, eyewash stations, shop/office equipment, surveillance cameras, timers, refrigerators, lasers, thermostats, gauges, existing fume hoods (includes equipment calibration, filter replacement, draining/replacing operational fluids).

Electrical–receptacles, outlets, switches, panels, relays (and similar devices), circuits, conduit, wiring, light bulb replacement, general lighting, communications and computer systems, fiber optic cables, projectors, warning lights, emergency/exit lights.

Plumbing–bathroom fixtures, sinks, water fountain, drain lines (Note: Projects involving new or modifying drain lies are not exempt).

Other Systems–air/compressed gas lines (installing/disconnecting), repairing General Office/Work Area–painting (latex), windows, doors, carpet, flooring, chair railing, ceiling tiles, hanging pictures/white boards/bulletin boards/signage, handrails, minor ADA/safety upgrades.

INTERIOR ACTIVITIES - Routine repair, maintenance, installation, removal or replacement projects:

Heating/Cooling - HVAC systems, AC units, condensing units, exhaust fans, insulation (including minor repair/removal of asbestos insulation), and electric heaters.

Equipment - roll doors, elevators, eyewash stations, shop/office equipment, surveillance cameras, timers, refrigerators, lasers, thermostats, gauges, existing fume hoods (includes equipment calibration, filter replacement, draining/replacing operational fluids).

Electrical - receptacles, outlets, switches, panels, relays (and similar devices), circuits, conduit, wiring, light bulb replacement, general lighting, communications and computer systems, fiber optic cables, projectors, warning lights, emergency/exit lights.

Plumbing - bathroom fixtures, sinks, water fountain, drain lines (Note: Projects involving new or modifying drain lies are not exempt).

Other Systems - air/compressed gas lines (installing/disconnecting), repairing General Office/Work Area - painting (latex), windows, doors, carpet, flooring, chair railing, ceiling tiles, hanging pictures/white boards/bulletin boards/signage, handrails, minor ADA/safety upgrades.

EXTERIOR ACTIVITIES–Routine repair, maintenance, installation, removal or replacement projects:

Painting–parking lots/spaces, roadways, minor building/structure touch up Signage–parking, traffic, building identification Building/Structure–roofing, roof leaks, brick/facade repairs Landscaping–lawn mowing, pruning/trimming, weed control Other–in-kind replacement of heating/cooling piping systems, recertification of pressure vessels containing inert gases, air/compressed gas lines (installing/disconnecting), emergency repairs of potable water lines, natural gas lines, and steam supply/return lines.

EXTERIOR ACTIVITIES - Routine repair, maintenance, installation, removal or replacement projects:

Painting - parking lots/spaces, roadways, minor building/structure touch up Signage - parking, traffic, building identification Building/Structure - roofing, roof leaks, brick/facade repairs Landscaping - lawn mowing, pruning/trimming, weed control Other - in-kind replacement of heating/cooling piping systems, recertification of pressure vessels containing inert gases, air/compressed gas lines (installing/disconnecting), emergency repairs of potable water lines, natural gas lines, and steam supply/return lines.

NASA Glenn Research Center (GRC) Energy and Environmental Management Office (EEMO) Environmental Checklist Exemptions to the GRC 150 review process NASA Glenn Research Center (GRC) Energy and Environmental Management Office (EEMO) Environmental Checklist Exemptions to the GRC 150 review process

i. ii. iii. iv. v. vi. vii. viii.

i.

NASA Glenn Research Center (GRC) Energy and Environmental Management Office (EEMO) Environmental Checklist NASA Glenn Research Center (GRC) Energy and Environmental Management Office (EEMO) Environmental Checklist

SECTION I–PROPOSED PROGRAM OR PROJECT DETAILS

SECTION I - PROPOSED PROGRAM OR PROJECT DETAILS

SECTION II–INITIAL NEPA EVALUATION

SECTION II - INITIAL NEPA EVALUATION

1. Has this action undergone a prior NEPA analysis or Environmental Evaluation?

If yes, state the date and name of action if different than this one.

1. Has this action undergone a prior NEPA analysis or Environmental Evaluation? If yes, state the date and name of action if different than this one.

2. Is this action part of a larger or broader program or procurement?

If yes, state the name of other program or procurement.

2. Is this action part of a larger or broader program or procurement?

If yes, state the name of other program or procurement.

3. Could this action individually or cumulatively result in any of the following:

a) Have significant environmental impacts; b) Result in a high degree of public controversy, or;

c) Cause NASA to be at risk of violating any Federal, State, or local laws?

If yes, please explain.

3. Could this action individually or cumulatively result in any of the following: a) Have significant environmental impacts; b) Result in a high degree of public controversy, or; c) Cause NASA to be at risk of violating any Federal, State, or local laws? If yes, please explain.

4. What alternatives, including not implementing t his program or project (or no action), have been considered and evaluated?

Please explain the other alternatives and why they were not further considered. (e.g., other locations for building, locations where testing will occur, materials to be used.)

4. What alternatives, including not implementing t his program or project (or no action), have been considered and evaluated? Please explain the other alternatives and why they were not further considered. (e.g., other locations for building, locations where testing will occur, materials to be used.)

SECTION III–HISTORIC AND CULTURAL RESOURCE CONSIDERATIONS

SECTION III - HISTORIC AND CULTURAL RESOURCE CONSIDERATIONS

NASA Glenn Research Center (GRC) Energy and Environmental Management Office (EEMO) Environmental Checklist NASA Glenn Research Center (GRC) Energy and Environmental Management Office (EEMO) Environmental Checklist

1. Will this action alter or modify the exterior of a facility?

1. Will this action alter or modify the exterior of a facility?

2. Will this action alter or modify the interior of a facility?

2. Will this action alter or modify the interior of a facility?

No

3. Will this action change the existing use of a facility?

3. Will this action change the existing use of a facility?

4. Will this action remove or replace equipment or machinery?

4. Will this action remove or replace equipment or machinery?

5. Will this action require ground and soil disturbances deeper than 6 inches?

5. Will this action require ground and soil disturbances deeper than 6 inches?

6. Will this action require alteration of the existing land use?

6. Will this action require alteration of the existing land use?

7. Will this action install something that could be seen from a 1/4 mile or more beyond NASA property boundaries?

7. Will this action install something that could be seen from a 1/4 mile or more beyond NASA property boundaries?

1. Will this action have the potential to impact areas of historic or cultural significance?

(i.e., view-shed, archaeological, architectural, part of Historic District)

1. Will this action have the potential to impact areas of historic or cultural significance? (i.e., view-shed, archaeological, architectural, part of Historic District) GRC HISTORIC PRESERVATION OFFICER (HPO)–CONCURRENCE (Filled out by GRC HPO only.)

GRC HISTORIC PRESERVATION OFFICER (HPO) - CONCURRENCE (Filled out by GRC HPO only.)

2. Consultations with the Ohio Historic Preservation Office required?

2. Consultations with the Ohio Historic Preservation Office required?

3. Is consultation with the public required (i.e., public announcement, scoping)?

3. Is consultation with the public required (i.e., public announcement, scoping)?

4. Will mitigation measures be required to ensure the protection of any significant resources near the location of proposed action?

4. Will mitigation measures be required to ensure the protection of any significant resources near the location of proposed action?

1. Will this action release temporary or ongoing air emissions?

1. Will this action release temporary or ongoing air emissions?

SECTION IV–ENVIRONMENTAL CONSIDERATIONS

SECTION IV - ENVIRONMENTAL CONSIDERATIONS

NASA Glenn Research Center (GRC) Energy and Environmental Management Office (EEMO) Environmental Checklist NASA Glenn Research Center (GRC) Energy and Environmental Management Office (EEMO) Environmental Checklist

AIR EMISSIONS/WATER DISCHARGES

AIR EMISSIONS/WATER DISCHARGES

2. Will this action use, generate, or emit greenhouse gases (i.e., CO2, CH4, CFCs)?

2. Will this action use, generate, or emit greenhouse gases (i.e., CO2, CH4, CFCs)?

3. Will this action have the potential to create objectionable odors and/or smoke?

3. Will this action have the potential to create objectionable odors and/or smoke?

4. Will this action require the use of fume hoods or facility exhaust fans?

4. Will this action require the use of fume hoods or facility exhaust fans?

5. Will this action utilize an interior sink or floor drain?

5. Will this action utilize an interior sink or floor drain?

6. Will this action require the installation or modification of the sanitary and/or storm sewer system?

6. Will this action require the installation or modification of the sanitary and/or storm sewer system?

7. Will this action discharge water into a catch basin, ditch, or swale (e.g., line flushing)?

7. Will this action discharge water into a catch basin, ditch, or swale (e.g., line flushing)?

8. Will this action require efforts along a stream bank and/or in a waterway?

8. Will this action require efforts along a stream bank and/or in a waterway?

9. Does this action have the potential to create polluted run-off or require the storage of material and/or equipment outside, thus exposed to rain or snow?

9. Does this action have the potential to create polluted run-off or require the storage of material and/or equipment outside, thus exposed to rain or snow?

10. Will this action require the addition or removal of soil by digging, grading, or trenching?

10. Will this action require the addition or removal of soil by digging, grading, or trenching?

11. Will this action increase the footprint of a facility by 5,000 square feet or more (i.e., roads, building additions, parking)?

11. Will this action increase the footprint of a facility by 5,000 square feet or more (i.e., roads, building additions, parking)?

12. Will this action disturb more than 1 acre of soil (include staging areas)?

12. Will this action disturb more than 1 acre of soil (include staging areas)?

13. Will this action require the use of pesticides, herbicides, or fertilizers?

13. Will this action require the use of pesticides, herbicides, or fertilizers?

14. Will this action involve the use, transportation, storage, or generation of hazardous, toxic, biological or radiological wastes?

14. Will this action involve the use, transportation, storage, or generation of hazardous, toxic, biological or radiological wastes?

CHEMICAL AND WASTE MANAGEMENT

CHEMICAL AND WASTE MANAGEMENT

15. Will this action require the handling, removal, or storage of contaminated soils, wastewater, or demolition debris?

15. Will this action require the handling, removal, or storage of contaminated soils, wastewater, or demolition debris?

16. Will this action require the use or installation of an Oil Water Separator?

16. Will this action require the use or installation of an Oil Water Separator?

17. Will this action use any chemical, including but not limited to oils, lubricants, organic solvents, metals, corrosives, and fuels?

17. Will this action use any chemical, including but not limited to oils, lubricants, organic solvents, metals, corrosives, and fuels?

18. Will this action require the use of ionizing or non-ionizing radiation?

18. Will this action require the use of ionizing or non-ionizing radiation?

OCCUPATIONAL AND EQUIPMENT MANAGEMENT

OCCUPATIONAL AND EQUIPMENT MANAGEMENT

NASA Glenn Research Center (GRC) Energy and Environmental Management Office (EEMO) Environmental Checklist NASA Glenn Research Center (GRC) Energy and Environmental Management Office (EEMO) Environmental Checklist

19. Will this action require the use of lasers?

19. Will this action require the use of lasers?

20. Will this action require any amount or type of radioactive material?

20. Will this action require any amount or type of radioactive material?

21. Will this action generate high noise at levels above 80 dBA (i.e., gas lawn mower)?

21. Will this action generate high noise at levels above 80 dBA (i.e., gas lawn mower)?

22. Will equipment require the use of water or glycol for cooling purposes?

22. Will equipment require the use of water or glycol for cooling purposes?

23. Will this action utilize fuels (i.e., jet fuel, gasoline, diesel, other) from underground storage tanks, above ground storage tanks, or 55 gallon drums?

23. Will this action utilize fuels (i.e., jet fuel, gasoline, diesel, other) from underground storage tanks, above ground storage tanks, or 55 gallon drums?

24. Will the action required the use of mobile fuel tanks or tankers?

24. Will the action required the use of mobile fuel tanks or tankers?

25. Will the action requires the use of a back-up generator(s)?

25. Will the action requires the use of a back-up generator(s)?

26. Will the action require the use of equipment with oil reservoirs with capacities of 55 gallons or more?

26. Will the action require the use of equipment with oil reservoirs with capacities of 55 gallons or more?

27. Will this action install or utilize renewable sources of energy (e.g., wind turbine)?

27. Will this action install or utilize renewable sources of energy (e.g., wind turbine)?

SUSTAINABILITY–SOCIOECONOMICS–ENVIRONMENTAL JUSTICE

SUSTAINABILITY - SOCIOECONOMICS - ENVIRONMENTAL JUSTICE

28. Will this action consume more than 15,000 KCUFT of natural gas per year?

28. Will this action consume more than 15,000 KCUFT of natural gas per year?

29. Will this action require more than 3,500 MWH of electricity per year?

29. Will this action require more than 3,500 MWH of electricity per year?

30. Will this action require the use of water for process loads?

30. Will this action require the use of water for process loads?

You have completed your section of the form requirements, email to Bethany M. Eppig at You have completed your section of the form requirements, email to Robert F. Lallier at robert.f.lallier@nasa.gov

31. Will this action require the removal of trees?

31. Will this action require the removal of trees?

32. Will recycle content or bio-based products be viable for use with this action?

32. Will recycle content or bio-based products be viable for use with this action?

33. Will this action result in an increase or decrease in personnel at Lewis Field or Plum Brook Station or have other local fiscal impacts?

33. Will this action result in an increase or decrease in personnel at Lewis Field or Plum Brook Station or have other local fiscal impacts?

34. Does this action have the potential to disproportionately affect low-income or minority populations in the surrounding areas?

34. Does this action have the potential to disproportionately affect low-income or minority populations in the surrounding areas?

1. Will this action be located in a floodplain or wetland?

1. Will this action be located in a floodplain or wetland?

SECTION V–ENERGY AND ENVIRONMENTAL MANAGEMENT OFFICE (EEMO) CONCURRENCE

SECTION V - ENERGY AND ENVIRONMENTAL MANAGEMENT OFFICE (EEMO) CONCURRENCE

NASA Glenn Research Center (GRC) Energy and Environmental Management Office (EEMO) Environmental Checklist NASA Glenn Research Center (GRC) Energy and Environmental Management Office (EEMO) Environmental Checklist

2. Will this action affect threatened or endangered species of flora or fauna?

2. Will this action affect threatened or endangered species of flora or fauna?

3. Will ground water be impacted by this action?

3. Will ground water be impacted by this action?

4. Will this action require the submittal of a GRC Facility Change Request (FCR)?

4. Will this action require the submittal of a GRC Facility Change Request (FCR)?

5. Will this action require an air permit or inclusion into the Title V permit?

5. Will this action require an air permit or inclusion into the Title V permit?

6. Will this action require a NPDES permit?

6. Will this action require a NPDES permit?

7. Will this action require a BUSTR permit?

7. Will this action require a BUSTR permit?

8. Will this action require a Permit to Install (PTI)?

8. Will this action require a Permit to Install (PTI)?

9. Will this action require the further coordination with other regulatory agencies?

9. Will this action require the further coordination with other regulatory agencies?

10. Will this action affect a prior CERLCA site or known site of contamination?

10. Will this action affect a prior CERLCA site or known site of contamination?

11. Will this site require additional soil sampling?

11. Will this site require additional soil sampling?

12. Will this project require documentation gathered of the recycled content or bio-based products it will install or utilize?

12. Will this project require documentation gathered of the recycled content or bio-based products it will install or utilize?

13. Are there training requirements the action initiator should be aware of?

13. Are there training requirements the action initiator should be aware of?

14. Will this action require usage constraints or additional metering of the natural gas, electricity or water use?

14. Will this action require usage constraints or additional metering of the natural gas, electricity or water use?

15. Should NASA HQ–Environmental Management Division (EMD) be notified?

15. Should NASA HQ - Environmental Management Division (EMD) be notified?

1.1 Bethany M. G. Eppig 05/08/2014

FE00

GRC Energy and Environmental Management Office (EEMO) Environmental Checklist M. Aponte GRC150.pdf 06/27/2016

2. The building will be demolished so facility will no longer exist. Potential asbestos containing materials (ACM) in drywall system, flooring system, and pipe insulation. Potential lead based paint may exist in all interior and exterior portions of the building. Potential mercury containing devices may exist throughout the building. Potential hazardous materials may exist in the building lighting systems.

3. The building will be demolished so facility will no longer exist.

4. We will be removing all equipment for excess that is usable and scarping all others. Potential oil contamination of equipment and concrete floors.

5. The building will be demolished, we will need to dig below frost line to remove footers also the fuel tank. Potential of contaminated soil around fuel storage and distribution system.

6. The area that the building and paved parking area occupy will become green space.

6. The building will be demolished so facility will no longer exist along with the tie ins for the sanitary and storm sewers.

9. Demo equipment will be stored outside.

10. Potential of contaminated soil removal from around fuel tank and building.

12. Between the size of the building, parking area and underground tank we will be disturbing over an acre of land.