S02 Atch H NEPA Construction Project Checklist - 9 pages.pdf

National Environmental Protection Act (NEPA) Department of Veterans Affairs

Nebraska-Western Iowa Health Care System

Project: _______________________________________________________________

In accordance with 38 CFR 26.6 (b) the below criteria is used to determine if the above referenced project is exempt from an Environmental Assessment (EA) and/or and Environmental Impact Statement (EIS) under NEPA.

Check the appropriate colored response and class of action from the categories below.

Actions normally not requiring an EIA or EA (Categorical Exclusion)

� This project does not require an EIS or and EA because it meets on of the following classes of action:

� Repair, replacement, and new installation of primary or secondary electrical distribution system � Repair, replacement, and new installation of components such as windows, doors, roof; and site elements such as sidewalks, patios, fences, retaining walls, curbs, water distribution lines, and sewer lines which involve work totally within the VA property boundaries;

� Routine VA grounds and facility maintenance activities;

� Procurement activities for goods and services for routing facility operations maintenance and support;

� Interior construction or renovation;

� New construction of 75,000 gross square feet or less;

� Development of 20 acres of land or less within an existing cemetery or development on acquired land of five acres or less;

� Actions which involve support or ancillary appurtenances for normal operation;

� Leases, licenses, permits, and easements;

� Reduction in force resulting from workload adjustments, reduced personnel or funding levels, skill imbalances or other similar causes;

� VA policies, actions and studies which do not significantly affect the quality of the human environment � Preparation of regulations , directives, manuals or other guidance that implement but do not substantially change, the regulations, directives, manuals or other guidance of higher organizational levels or another Federal agency; and

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

OR

� This project does not require either an EIS or and EA because it meets specific criteria for typical classes of action with normal do not:

� Minimal or no effect on the environment;

� No significant change to existing environmental conditions � No significant cumulative environmental impact; and � Similarity to Actions previously assessed with a finding of no significant impact

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Actions which normally require EAs (many not need an EIS)

� N/A – based on above selected classes of action � Typical classes of action with normally do require EA but not necessarily EIS

� Acquisition of land of 4 hectares (10 acres) or less for development of a VA medical facility;

� Acquisition of land from 2 to 20 hectares (5 to 50 acres) for development of a VA national cemetery; and, � New construction in excess of 7,000 m2 (75,000 gross square feet)

� Specific criteria for typical classes of action which normally do requires and EA

� Potential minor degradation of environmental quality;

� Potential cumulative impact on environmental quality;

� Presence of hazardous or toxic substances;

� Potential violation of pollution abatement laws;

� Potential impact on protected wildlife or vegetation;

� Potential effects on designated prime farmlands, wetlands, floodplains, or ecologically critical areas;

� Alteration of storm water runoff and retention;

� Potential dislocation of persons or residences;

� Potential increase of average daily vehicle traffic volume on access roads to the site by 10 percent or more but less than 20 percent, or which alters established traffic patterns in terms of location and direction;

� Potential threat or hazard to the public, or highly uncertain risks to the environment;

� Potential conflict with, or significant impact on, official local or regional zoning or comprehensive land use plans; and, � Overloading of public utility with insufficient capacity to provide reliable service and for average and peak periods.

Action which normally require an EIS

� N/A – based on above selected classes of action � Typical classes of action which normally do require EIS

� Proposed legislation (CEQ Regulation, 40 CFR 1508.17);

� Acquisition of land in excess of 4 hectares (10 acres) for development of a VA medical center facility;

� Acquisition of land in excess of 20 hectares (50 acres) for development of a VA national cemetery;

� Promulgation of policies which substantially alter agency programs and which have a significant effect on the quality of the human environment.

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� Specific criteria for typical classes of action which normally do require EIS

� Probable significant degradation of historic or cultural resources, park-lands, prime farmlands, designated wetlands or ecologically critical areas;

� An increase in average daily vehicle traffic volume of at least 20 percent access roads to the site or the major roadway network;

� Probable conflict with Federal, State or local environmental protection laws or regulations;

� Probable threat or hazard to the public, or the involvement of highly uncertain risks to the environment;

� Similarity to previous actions that required an EIS; and � Probable conflict with, or significant effect on local or regional zoning or comprehensive land use plans

Based on the above selected items it is determined this project:

� Is Categorically Excluded

� Requires and EA be completed. Based on the findings of the EA the responsible official(s) shall determine whether it is necessary to prepare and EIS or a finding of no significant impact (FONSI).

� Requires and EIS

A copy of this form will be kept in the corresponding project file.

Comments:

VHA GEMS Coordinator Date

Engineering, Design COR Date

Engineering, Projects Supervisor Date

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Environmental Compliance Checklist

Nebraska-Western Iowa Health Care System

Project: _______________________________________________________________

The purpose of the Environmental Compliance Checklist is to identify potential environmental compliance requirements early in the project life cycle. It is intended for use by the Nebraska Western Iowa Health Care System (NWIHCS) planners, engineers, project coordinators, Contracting Officer Representatives (COR), professional consultants, and facility GEMS Coordinator involved in construction /renovation activities. This checklist is not intended to substitute for activity otherwise required by the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), the National Environmental Policy Act (NEPA), or VA and EPA regulations.

The checklist is organized according to those activities associated with facility construction, demolition and operations. The questions are designed to discover project activities that trigger various environmental requirements.

The Environmental Compliance Checklist should be completed by the NWIHCS GEMS Coordinators and/or other staff knowledgeable of environmental requirements related to construction projects, VHA facility infrastructure and equipment, real property transactions, enhanced use lease and similar projects.

Issue Impact Comments/Supporting Documentation/ Mitigation Measures

AESTHETICS – Would the project:

Have a substantial adverse effect on scenic vista? Yes/No

Substantially damage scenic resources, including, but not limited to, trees, rock outcropping, and historic building within a state scenic highway?

Yes/No

Substantially degrade the existing visual character or quality of the site and its surroundings?

Yes/No

Create a new source of substantial light or glare which would adversely affect day or nighttime views in the area?

Yes/No

AIR QUALITY – Would the project:

Conflict with or obstruct implementation of the applicable air quality plan? Yes/No

Violate any air quality standard or contribute substantially to an existing or projected air quality violation?

Yes/No

Result in a cumulatively considerable net increase of any criteria pollutant for which project region is non-attainment under an applicable federal or state ambient air quality standard (including releasing emissions which exceed quantitative thresholds for ozone precursors)?

Yes/No

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Nebraska-Western Iowa Health Care System

Release toxic substances to the air in quantities that could affect human health or safety, or environmental quality?

Yes/No

Release substances for which there is a National Ambient Air Quality Standard (such as sulfur or nitrogen oxides, carbon monoxide, lead, particulates, etc.)?

Yes/No

Result in the installation of devices including an incinerator that produce air emissions that are regulated by Federal, state or local requirements?

Yes/No

Result in the installation of a permanent generator, turbine or internal combustion engine?

Yes/No

Result in the installation or removal or any refrigeration or air conditioning units? Yes/No

Create objectionable odors affecting substantial number of people? Yes/No

Include a fossil fuel (natural gas, gasoline, diesel fuel, coal, etc.) burning heating system with the total capacity greater than 1 million BTU/hour?

Yes/No

BIOLOGICAL RESOURCES – Would the project:

Have a substantial adverse effect, either directly or through habitat modifications, on rare, threatened, or endangered species, or a critical habitat?

Yes/No

Have substantial adverse effect on any riparian habitat or other sensitive natural community identified in local or regional plans, policies, and regulations or by the US Fish and Wildlife Service?

Yes/No

Have a substantial adverse effect on federally protected wetlands as defined by Section 404 of the Clean Water Act (including, but not limited to, marsh, vernal pool, coastal, etc.)

through direct removal, filling, hydrological interruption, or other means?

Yes/No

Interfere substantially with the movement of any native resident or migratory fish or wildlife species or with established native resident or migratory wildlife corridors, or impede the use of native wildlife nursery sites?

Yes/No

Conflict with any local policies or ordinances protecting biological resources, such as a tree preservation policy or ordinance?

Yes/No

Conflict with the provisions of an adopted Habitat Conservation Plan, Natural Community Conservation Plan, or other approved local, regional, or state habitat conservation plan?

CULTURAL RESOURCES – Would the project:

Cause a substantial adverse change in the significance of the historical resource? Yes/No

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Nebraska-Western Iowa Health Care System

Cause a substantial adverse change in the significance of an archaeological resource? Yes/No

Directly or indirectly destroy a unique paleontological resource or unique geologic feature?

Yes/No

Disturb any human remains including those interred outside of formal cemeteries? Yes/No

GEOLOGY AND SOILS – Would the project:

Result in substantial soil erosion or the loss of topsoil? Yes/No

Be located on the geologic unit or soil that is either unstable or would become unstable as a result of the project and potentially result in on-or off-site landslide, lateral spreading, subsidence, liquefaction or collapse?

Yes/No

Be located on expansive soil, as defined in Table 18-1-B of the Uniform Building Code (1994), creating substantial risks to life or property?

Yes/No

HAZARDS AND HAZARDOUS MATERIALS – Would the project:

Create a significant hazard to the public or the environment through the routine transport use, or disposal of hazardous materials?

Yes/No

Create a significant hazard to the public or the environment through reasonably foreseeable release of hazardous materials to the environment?

Yes/No

Generate more than 100 kilograms of hazardous waste per month during construction or operation?

Yes/No

Create liquid waste that would need to be transported off-site for reuse, recycle or disposal?

Yes/No

Be located on property that state or federal officials have identified as a hazardous or solid waste, or a CERCLA site?

Yes/No

Impair implementation of or physically interfere with an adopted emergency response plan or emergency evacuation plan?

Include the construction or close out of any sold waste management facility such as a landfill?

Involve structures that contain asbestos containing material (for demolition and renovation projects and projects involving transfer or use of structure by non-VA entity)?

Yes/No

Involve structures painted with lead-based paint (for demolition and renovation projects and projects involving transfer or use of structure by non-VA entity)?

Yes/No

Involve renovation or demolition of structure that house laboratory or stored hazardous chemicals or hazardous waste?

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Nebraska-Western Iowa Health Care System

Result in the bulk storage of any hazardous or extremely hazardous substances? Yes/No

Involve the removal/disposal or fluorescent lights, HID lights, or light ballasts? Yes/No

Involve the removal/disposal of batteries (lead-acid, ni-cad, etc.)? Yes/No

Involve the removal/disposal of mercury containing devices? Yes/No

Involve the removal/disposal of building materials that contain lead, silver, or chrome? Yes/No

Involve the storage of any oil-based materials, including lubricants, coolants, and fuels in quantities of 55 gallons or more?

Yes/No

Involve the installation, closing out, removal or an above ground or underground storage tank?

Yes/No

Involve the installation, modification, or removal of a confined space such as a storage bin, pit, tank, manhole, process vessel, or pipeline?

Yes/No

Involve entry into a confined space which may contain a hazardous atmosphere (insufficient ventilation, displaced oxygen, residual chemicals, electricity, high pressure fluids and gases, or mechanical energy)?

Yes/No

HYDROLOGY AND WATER QUALITY – Would the project:

Violate any water quality standards or waste discharge requirements? Yes/No

Degrade water quality in a sole source aquifer? Yes/No

Affect chemical quality of ground or surface waters (pH, dissolved oxygen, nutrients, dissolved solids, pesticides, etc.)?

Yes/No

Discharge into the storm sewer other effluents other than storm water (i.e. fertilizers, detergents, cleaning solvents, petroleum based products, etc.)?

Yes/No

Substantially deplete groundwater supplies or interfere substantially with groundwater recharge such that there would be a net reduction in aquifer volume or a lowering of the local groundwater table level?

Yes/No

Substantially alter the existing drainage pattern of the site or area, including through the alteration of the course of a steam or river?

Yes/No

Substantially alter the existing drainage pattern of the site or area in a manner which would result in flooding on or off site?

Yes/No

Create or contribute runoff water which would exceed the capacity or existing or planned storm water drainage systems or provide substantial additional sources of polluted runoff?

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Nebraska-Western Iowa Health Care System

Place a structure within a 100 year flood hazard area as mapped on a federal Flood Hazard Boundary or Flood Insurance Rate Map or other flood hazard delineation map?

Yes/No

Expose people or structures to a significant risk of loss, injury or death involving flooding? Yes/No

Include the installation, or extension of a sanitary service connection, sanitary sewer main or potable water main?

Yes/No

LAND USE AND PLANNING – Would the project:

Conflict with any applicable land use plan, policy, or regulation of an agency that has jurisdiction over the project?

Yes/No

NOISE – Would the project result in:

Exposure of persons to or generation of noise levels in excess of standards established in the local general plan or noise ordinance, or applicable regulations and standards?

Yes/No

Exposure of persons to or the generation of excessive groundborne vibration or groundborne noise levels?

Yes/No

A substantial temporary or permanent increase in ambient noise levels in the project vicinity above levels existing without the project?

Yes/No

POPULATION AND HOUSING – Would the project:

Induce substantial population growth in an area, either directly or indirectly? Yes/No

Displace substantial number of existing housing or persons, necessitating the construction of replacement housing elsewhere?

Yes/No

PUBLIC SERVICES – Would the project:

Would the project result in substantial adverse impacts associated with changes in infrastructure needed to maintain acceptable levels of public service associated with:

� Fire protection � Police protection � Schools � Parks � Other public facilities (specify)

Yes/No

TRANSPORTATION/TRAFFIC – Would the project:

Cause and increase in traffic which is substantial when compared to the existing traffic load and capacity of the street?

Yes/No

UTILITIES AND SERVICE SYSTEMS – Would the project:

Have soils incapable of adequately supporting the use of septic tanks or alternative wastewater disposal systems where sewers are not available?

Yes/No

Exceed wastewater treatment requirements or

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Nebraska-Western Iowa Health Care System capacity of the applicable state, regional or local water pollution agency?

Result in the construction of new water or wastewater treatment facilities or the expansion of existing facilities that could result in significant environmental impacts?

Yes/No

Result in the installation of a new septic system? Yes/No

Result in the discharge of industrial waste to wastewater treatment facility? Yes/No

Require or result in the construction of new storm water drainage facilities or the expansion of existing facilities, the construction of which could cause significant environmental effects?

Yes/No

Require the installation or removal of above ground or underground storage tanks. Yes/No

Be served by a landfill or other solid waste disposal facility with sufficient permitted capacity to accommodate the project’s solid waste disposal needs?

Yes/No

Be able to obtain sufficient drinking water from existing sources and entitlements? Yes/No

Result in the disturbance of >1 acre and need to obtain storm water discharge permit? Yes/No

ENVIRONMENTAL PERMITTING – Does the project involve:

Installation or modification of new equipment or infrastructure that would require a federal, state, or local environmental permit. This would include equipment or infrastructure that produces air emissions (e.g., boiler or incinerator); wastewater, industrial wastewater, storm water discharge; solid or hazardous waste; or otherwise impacts on environmental media?

Yes/No

*Any environmental items identified in the above checklist will have a plan in place to address and/or mitigate prior to the start of construction. A copy of this checklist will be kept in the project file.

Additional Comments:

VHA GEMS Coordinator

Date

Engineering, Design COR Date

Engineering, Projects Supervisor Date

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