Annex-A_-_ERAC.docx

Environmental Review and Assessment Checklist

ENVIRONMENTAL REVIEW AND ASSESSMENT CHECKLIST

Location: (Attach a location map as well as site photos in color)

Type of Project/Activity:

Project/Activity Description: (One or two paragraphs to present activity description for impact analysis purpose)

Name of reviewer: (attach a letter to show that this person has been approved by the MEO) Date of Review:

Baseline Condition: (use the Baseline Identification Checklist presented in Attachment 4.)

The purpose of this Environmental Assessment Checklist (EA Checklist) is to determine whether the proposed action (scope of work) encompasses the potential for environmental pollution or damage and, if so, to determine the scope and extent of additional environmental evaluation, mitigation, and monitoring necessary to fulfill federal U.S. environmental requirements. The EA Checklist is intended to be used by Cognizant Technical Officer (CTO) to ensure that environmental consequences are taken into account.

A. CHECKLIST FOR ENVIRONMENTAL CONSEQUENCES: Check appropriate column as Yes (Y), Maybe (M), No (N) or Beneficial (B). Briefly explain Y, M and B checks in next Section, "Explanations". A "Y" response does not necessarily indicate a significant effect, but rather an issue that requires focused consideration.

Y. M. N or B

1. Earth Resources

8. Planning and Land Use

9. Traffic, Transportation and Circulation

10. Hazards

11. Other Issues (to be used for categories not captured under1 through 10 above)

B. EXPLANATION OF ENVIRONMENTAL CONSEQUENCES: explain Y, M and B responses

C. RECOMMENDED ACTION (Check Appropriate Action):

1. The project has no potential for substantial adverse environmental effects. No further environmental review is required.

2. The project has potential for adverse environmental effects; however the recommended Standard Conditions for Small Scale Construction (less than USD 50,000) will be integrated into design, and construction. A monitoring report to the MEO will be provided to document these conditions have been implemented and that there is no residual environmental impact.

3. The project has substantial but mitigable adverse environmental effects and required measures to mitigate environmental effects including social environmental impacts. Mitigation and Monitoring (M&M) Plan must be developed and approved by the MEO and/or his designee prior to implementation. Alternatively EDF and EMMP used during the past may be used. M&M Plan (or EDF and EMMP) is to be attached to the Scope of Work.

4. The project has potentially substantial adverse environmental effects, but requires more analysis to form a conclusion. A Scoping Statement must be prepared and be submitted to the BEO for approval. Following BEO approval an Environmental Assessment (EA) will be conducted. Project may not be implemented until the BEO approves the final EA.

5. The project has potentially substantial adverse environmental effects, and revisions to the project design or location or the development of new alternatives is required.

6. The project has substantial and unmitigable adverse environmental effects. Mitigation is insufficient to eliminate these effects and alternatives are not feasible. The project is not recommended for funding.

D. IDENTIFIED SIGNIFICANT ENVIRONMENTAL IMPACTS (including physical, biological and social), if any: (Use ER tools such as Leopold Matrix to identify significant environmental impacts)

E. RECOMMENDED MITIGATION MEASURES (if any):

F. RECOMMENDED MONITORING MEASURES (if any):

APPROVAL:

Implementer Project Director/COP: _________________________ Date: __________

USAID/ Project COTR/AOTR ____________________________ Date: __________

USAID Mission Environmental Officer:_____________________ Date: __________