SOW Attachment 08 - NEPA Analysis.pdf

Updated 5/5/2015

Togus Environmental Assessment Form

National Environmental Policy Act (NEPA) Analysis

Type of Project:

Operation and Maintenance Activities Repairs/Renovation Project New Construction Project Lease Other

Level of NEPA Analysis:

Categorical Exclusion Environmental Assessment Needed Environmental Impact Statement Needed

Project Impacts:

Would the proposed activity involve or generate any of the following?

SOURCE YES NO SOURCE YES NO SOURCE YES NO

Air Emissions including GHGs

Liquid Effluent

RCRA or CERCLA Sites

Asbestos Petroleum Storage

Wetlands

Excess Noise Solid Waste Permit Modification

Utility Modification

Hazardous Waste

Chemical Use/Storage

Soil Disturbance Biological Resources

Aesthetics/ Historical

Water Treatment

Radioactive Waste

Water/Well Use

Water Flow Modification

Mixed Waste

Other

I find the proposed project qualifies as a CATEGORICAL EXCLUSION with no extraordinary circumstances. Specify which CATEX:

I find that the proposed project MAY have a significant effect on the environment;

therefore, an ENVIRONMENTAL ASSESSMENT will be prepared.

Environmental Impact Satement (EIS)

Project: Location:

Project Number:

Project Description:

Determination:

Other Environmental Permits/Analysis Needed:

Togus Environmental Assessment Form

NEPA CATEX Categories

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

3. Routine VA grounds and facility maintenance activities;

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

5. Interior construction or renovation;

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

8. Actions which involve support or ancillary appurtenances for normal operation;

9. Leases, licenses, permits, and easements;

11. VA policies, actions and studies which do not significantly affect the quality of the human environment;

13. Actions, activities. Or programs that do not require expenditure of Federal funds.

*38CFR Part 26.6(b)(1)

7. Development of 20 acres of land or less within an existing cemetery, or development on acquired land of five acres or less.

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

12. 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

2. Repair, replacement and new installation of components such as windows doors, roofs, and site elements such as sidewalk, patios, fences, retaining walls, curbs, water distribution line and sewer lines which involve work totally within VA property boundaries;

Togus Environmental Compliance Assessment Form

Compliance Checklist

YES NO

Will construction disturb an area 5000 square feet or more?

Must comply with EISA Section 438 "maintain or restore, to the maximum extent technically feasible, the predevelopment hydrology" for stormwater runoff and management.

CRITERIA NOTES

Will construction disturb an area >1 acre?

A SWPPP must be prepared by the PSC to comply with

NPDES General Permit requirements and an NOI Checklist completed by the Project Manager. When the documents are complete, please forward them to GEMS for review, signatures and agency submittal.

Will there be any activity within 100 feet of a wetland or body of water?

Wetlands Protection Act, may require filing a Notice of

Intent or Determination of Applicability.

Asbestos: will there be any demolition or removal of building material?

A pre-demolition survey is required prior to any removal to test for and identify all asbestos containing material (ACM).

ACM must be removed in accordance with all federal and state regulations. All abatement permits and documents to be submitted to GEMS.

Will there be an addition or alteration of any fuel burning equipment or stationary gasoline tanks?

A permit to construct and update to facility air permit application must be completed and submitted to GEMS for review, signatures and agency submittal. (ex. Emergency generator, boiler)

Will an aboveground storage tank aboveground (AST) be installed?

An apllication for a permit to construct must be completed and submitted to GEMS for review, signatures, and agency submittal. A second application must be completed for a use permit.

Will an undergound storage tank be installed or removed?

A permit application must be completed for construction or removal and submitted to GEMS for review, signatures, and angency submittal.

Are there any areas of identified contamination or other environmental concern at the project site? (ex. AUL)

Work in designated Activity Use Limitation (AUL) areas may require a soil management plan or formal reports

(RAO/RAM) prepared by a Licensed Site Professional and submitted to MADEP. Contaminated material may have special disposal requirements.

Will a sanitary service connection, sanitary sewer main, storm drain, or a potable water main be installed or extended?

Permit by local sewer commission or municipality may be required.

Togus Environmental Compliance Assessment Form

YES NO

Recommended by: Date:

Approved by: Date:

Approved by: Chief, Eng. Service Date:

Will a discharge to sanitary sewer include effluent from other than toilets and sanitary plumbing?

Prior approval or a change in the facility wastewater dischage permit may be required. (ex. Sterilizing equipment, washers, etc.)

CRITERIA NOTES

Will any equipment containing refrigerant be removed/disposed or installed?

Type of equipment and refrigerant. Refrigerant is regulated by the EPA, proper chemical tracking paperwork must be maintained. Submit to GEMS

Will any building materials be removed/ disposed that are coated with lead-based paint?

These waste materials must be handled/removed/disposed of in accordance with the EPA.

Will there be any potential impacts on historic or cultural resources?

NHPA Section 106: Historic resources any district, site, building, structure, or object that is included in or eligible for the National Register of Historic Places. May require project notification to State Historical Preservation Office.

Project Manager

GEMS

Sheet1