Environmental Checklist (2)
CITY OF YELM
ENVIRONMENTAL CHECKLIST
Instruct 70ns
The State Environmental Policy Act (SEPA) requires all governmental
agencies to consider the environmental impacts of a proposal before
making decisions The purpose of this checklist is to provide
information to help identify impacts from your proposal, to reduce
or avoid impacts from the proposal if It can be done and to help
the Citl decide whether an EIS is required An environmental
impact statement eElS) must be prepared for any proposal 'tJitn
probable slgnlficant adverse impacts on environmental quality
This environmental checklist asks you to descr,be some bas'c
information about your proposal The City Will use thiS check list
to determine whether the environmental impacts of 'four proposal a'e
Significant and r~qu're preparation of an EIS You must answer
each questlon accurately carefully and to r.ne best of your
kno,..;ledge ,Answer the GUestions br'efl; but give the best
description YOU can In most cases YOU ~hould be able to arswer
the questions from your own ob5er~atlons or project plans Without
the need for experts If YOU do not knO\o/ tr1e an'swer or Ii a
question does not apply to lour proposal write 00 not ~now or
does net apply Complete answers to the questions now may aVOid
delays later If the space provided is too small, feel free to
attach additional sheets
Some questions ask about Governmental regulatlons such as zon,ng
shorel,ne, and landmarf- deslgnations Ans\.jer~ the':3e queS;:'lons 11
you ean If YOU have p'oblems the Clt; staff can assist yOU
The checklist questions apply to all parts of ~our proposa~ even IT
YOU plan to do them over a period of tlme or on different parcels
of land Attach any addltlonal informatlon that wlll help describe
your proposal or its envlronmental effects You may be asked to
explain your answers or provlde additional informatlon for
determining if there may be significant adverse lmpacts
Nonproject Proposals Only
Complete both the check llst (even though many Guest iens may be
answered does not apply) and the Supplemental Sheet for
Nonproject Actions (part D) For nonproJect actions the references
in the cvec~llst to the words proJect, a~pllcant and property
or Site should be read as proposal proposer and affected
geographiC area, respectively
qS(,~561 J
ENVIRONMENTAL CHECKLIST
CITY USE ONLY
FE E______ $ 5 Q_~~______
DATE REC'D
BY
FILE NO
CITY OF YELM
.A. 8.A.CKGROUi':C
Name of proposed proJect, i I any Do\"z.-~ Nb~ AYP'-<r
2
Name of app11cant
J~oY$ tt-4..\ 4- /J~N o~ort
3 Address and phone number of appllcant and oT any other contact
person q 1-).. ~ 60LL~s teoM ~:l!:-
4 P..-t-- 1\'\" lAr:A- OJ "~ C€/l
hb b - (/S y- S l--r )/
4 Date cneck 11 st prepared 01 i11'i V
5 Agency requesting checklist e.t.'ft.t of'1DLtl1
6
Proposed tlming or scnedule
appllC&.ole) DI)i'iJ. No', 1+fr4,
(includl"""1g
phaSIng
1 f
7
Do you have any plans for rut,Jre addit1cns
further acti~lty related to or connected with
If yes, explain N'D
e;<.panSlon or
thiS proposal'"'
8
L1st any envlronmental ,nformation
been preoarec or will be prepared
proposa 1 Do 'vb~ I<.,I\/~
IOU K"GW .3.oout that has
directly ~elated to thiS
9 Do you know whether appl1cations are perc1,g fo~ governmental
approvals of other proposals directly affecting ehe propert~
covered by your proposal? If jes explain ND
10 List any government approvals or permits that will be needed
for your proposa 1 I f ~nown vor I(II.{OI..V~
CITY OF YELM ENVIRONV:ENTAL CHECKLIST
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11 Give brief complete descrlptlon of your oroposal lncluding
the proDosed uses and the size of the project and site There
are several questions later in thlS checklist that ask you to
descrlte certain aspects of your proposal ~ou do not need to
repeat those answers on t~is page
S U ~ 1) I V l~ '% B u \ L DJ Ne.- l,o TS
!1fVJVlt'~A1f.~~~Q llft~. . " '..{~lJ'<Qt.P, I\C~~S
1'/ ~ ~l (, ,4~l['J <1 tJ r,<'r .
0r. / 7Jrr; <!
~ ~f
12 Locatlon of the proposal Give sufficient lnformation for a
per'son to understand the precise locatlon of your proposed
project including a street address If any and sectlon
township and range if known If a proposal would occur over
E. range of area provide the range or boundar les of the
site(s) Provlde a legal descr',ptlon site plan vlc'nlt"
map and topographic map ,f reasonab'; availab'e You need
not duplicate maps or detai lee plans :='ubmitted ,<nth any pernlit
applicat10ns related to this checklist
q .s- (X;)
4-~ tvcO- 0 N
e-dL LtAVS Q ()~ 0 S\ E (
B ENVI~ONMENTAL ELEMENTS
Earth
flat
other
of tne s,te (Circ e o~e;
a
~~eneral
h ill
steep slopes
mountainous
b
Wna tis
percent
the steepest slope
slope)? s-o/o
on
the
site
(approximate
c What general types of SOils aie faun:] on the SH,e (for'
example clay sand, giave1 peat m~ck)? If you know the
classification or agricultuial SO'iS speclfy ~nem anc
note any pr lme rarmlard S'\\-~\\\ I ~\t.J\-l)st'- '\-~ c..kf.
d
Are there surfaoe indications or
SOliS in the immedlate vlClnlty~
history of unstable
If so, descrlbe ~O
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e Describe the purpose type and approximate quantities of
any fi 11 ing or grading proposed Indicate source of
f 111 uN k'~O\k.n..\
f
Could erosion
construction, or
occur as a result of clearing
use~ If so, generally descr,be 1)/'1)
g
About what
,mperV10US
asphalt or
percent of the site will be covered wi':h
surfaces after project construction such as
b u, 1 din 9 s ? ~O cr/~
h Proposed measures to reduce or control erosion, or other
i mpac t s to t he ear t h if any lJ ~ k M.~N., A-" 7H,~ 'T/"'RJ
2 Air
a What types of em1SS1ons to the a,r would result from tne
proposal (, e dust automob;le exhaust odors
industrial wood smoke) during construct'on and when ~ne
proJect 1S completed" If any' ~ienerally describe snd
give approximate cuantitles if knmm No'-{Ii.
b
p-,re
may
there any off-slte sources
affect your proposal? ~f
+
0,
emlss,ons or odor tnat
generally describe
so
NO
c proposed measures to reduce or control emissions or other
impacts to a I r I f any VOIl..-5. NeT P.r1lt:>L.~
3 Water
a Surface Water
1) Is there any surface water body or wet'and on or ,n tne
Immediate v,c,nitj of the slte (,ncluding year-round and
seasonal streams s2ltwater lakes ponds)" If ves
descrlbe type and provide n2mes State what stream or
rlver it flO\-Js 1nte? NO
CITY OF YELM ENVIRONMENTAL CHECKLIST
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2 )
Will the project require any work over In or
to (within 300 feet) the described waters?
please describe and attach available plans
Nt>
adjacent
I f yes
3) Estimate the amount of f,l' and dredge material the.t
would be placed In or removed from surface water cr
wetlands and ,nd,cate the area of the site that would be
affected Indicate the source of fill material
N bN IV
4)
Wi 11 the propof:;al require surfaoe \-Iater
diverSions? G,ve general descrlotlon
aoproxlmate quantitles 11' known ~D
withdr~awals or
purpose and
5) Does the proPos3i lle wiLhln 2 1CO-year floodpialn0 If
so note elevation on the slte plan ~/o
6) Does the proposal lnvolve any dlscnarges of waste
materlals to surface waters~ If so describe the tlpe of
waste and antlcioated volume of d-'scharge ND
b Groundwater
1) IHill groundwater- 1:e withejra'"m or wil' water se
dlscharged to groundwate"~ Gl\le general descrlptlon
purpose and appro~imate quantities if known ND
~ ,
L J
Descrlbe the
and Quantity
eto
underlYlng aquifer with regard to qual1ty
sensltivity protection recharge areas
3) Descrlbe waste material that will be d-'scharged into or
onto the ground from sept1c tan~s or other sources 1T
any (such as domestic sewage. lndustrlal ovproducts.
ag r i cu 1 t Lira 1 chem I oa IS) V()M r.:..S7' JL S ii:--u..H~.~fi:.
CITY OF YELM ENVIRONMENTAL CHECKLIST
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P A.GE 4
c Water Runoff (,ncluding storm water)
1 ) Describe the sou r ceo f runoff (including s tor m wa t e r ) and
method of collection and disposal 'T any (include
quartities. If !--nm.;n) Where wlll this water flow'; Will
this water flow ,nto other waters0 If so desc~lbe
S 1'c> Illtw.. W l\-'\1:-'f<. - AI e.. ~ CE S"4-~ ~ l I cr~. ";-1- / A1~
2) Coulc waste materlals enter ground or surface waters0 :f
so genera 11 v desc r i be ND
d Prooosed measures to reduce or control 5G~face ground
and runoff water Impacts If any AS ~4!i:fU)5:-0
4 Plants
a Check or clrcle t/pes of \ege~a~l=~ fOLr~G on the 'slte
deCiduous tree
~ evergreen tree
~:;h;~ ubs
"F- grasses
'f.--.. pa5ture
a~der map e o~~ aspen other
f;n cedar nine )t~er
crops or gralns
,o/et 5011 plants cattail out-:ercup bulrush
skunk cabbage other
water plants water lil/ eelgrass milfoil other
other types of vegetation
b What ",-,nd and amount of '/egetatltJn \..Jll' be removed or
, L., '....
a; ,.erea'
G-~ ASS - 4~ 6 \.) NT \) \f ok; IV OlA>>\f
c List threatened or endangered species known to be on or
ne2.,- the site t7l..Iot\/1L
d
Proposed
mes.sures
landscaping
to presen e
use of native plants or other
or enhance vegeta~lon on the site
'FrT ;+1/5 'II ~ - J) F..f EN~ '''''1 ~ c:> rJ
i fan Y I\J 0<1 kAt\, 0 \).)V''-\
tR: ti'..... ~ l.> , 1(.1;:. ~M fi.A{~
5 Animals
a Clrcle anv blrds and anlmals which have been observed on
or near the slte or are known to be on or near the sIte
birds
other
mammals
flSh bass
hawk heron ducks eagle songbirds
C, ~ow S ) ~ L ~4-tj J ~o~ IN "<- snW:.tlNS!-<; .
deer, bear e!k beaver other ryON 1l-
salmon, trout shellfIsh other NeNt.
CITY OF YELM ENVIRONMENTAL CHECKLIST
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b List any priority, threatened or endangered speCles known
to be on or near the site ~t:>"\~
c Is the slte part of a migratlon route~ If so explain
\\\~
d
Proposed
any
11 t:l;'''-
measures to oreserve
N~T- MP~
or
enhance
'-'illdlife
- ~
: !
6 Energy and Natural Resources
a What klnds of energy (e'ectrlc natural gas g3.s01ine, heating
oi 1 wood solar etc ) wlll be useo to meet the completed
proJect's energy needs? Descr,be whether it wlll be used for
h eat 1 n 9 man u f act u r 1 n g t ran s p or' tat '1 0 net c E.. L ~ <:..T-Iq, 1(:.... IJ.-N {)
..,.., ~.:t\.;) ~At.. ~S
b Woulc your or-o~ect affect the ~c-::ent:2! use of SC!3r
energy bv aC1acent
deser' be ~ D
propert~es)
1..;
30
.",enera i I
e What ~lnds of energy conservation features are lncl~ced
In the plans of thiS proposal? '-1St other' proposed
measures to reduce or control energy Impacts !, an
U.l ~ e-'1 ~FlF f e f E-M. t:kfVl\ J2S;
7
Environmental Health
a Are there any'
e pOSLire to to'lC chemlcals
en'! 1 ronmenc:a l,ea 1 th hazards,
risk of f re and
thai:. oould occur
oeser, be \.f 0
i n c 1 .~ d - n 9
eyr:;loslcn
as a resu't
spills of hazardous waste
of this proposal? If so
1 )
Describe
required
speclal emergency
N.O\v\lV
services
that
.; ~.1-
m, g" l.
be
2)
Proposed meas'-,res
health hazards ,f
to reduce or control envlronmer,;:.ai
any 'Do c":. N ~'1 f\-yfll1
b
1)
Noise
What types of nOlse eXlst
your project (for e(amole
other)? N~"'1t
In the
traffic
area which may affect
eqUipment operat1on
CITY OF YELM ENVIRONMENTAL CH~CKLIST
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P AC-E 6
2)
What types and levels of nOlse would be created by or
associated with the project on a short-term or a long-
term basis (fer e~ample traffic, construct'or
00eration other)"'" Indlcate what hours nOise would ceme
from the site
N C:> ~ fi.-
3)
Preposed measures te ~educe or control nOise Impacts
an I L>->'~D-\''fU>~ R~~OIRt:M7Z-.V~ -~c.
~ f
a
8 Land and Shoreline Use
. .
aC.J3cenr:
b
c
What IS the current use of
!: r' oper ties"'" ~ 8-'=::''1' 0 \R, 1!...
the s'ta and
Has the slte
3grlcu1t'_H"e or
been used
forestry? l I
for
mineral
describe
excavat10n
so
No
Descnbe an" str"uetu'es en the site +-~~(;L. Dw .:.LliN~ tJ-MO
~ G-\,-\)\.g, IIVI t+- T I () eN ) -#to i "'\- ~~ 4- &J~--
G \J.j111 an\- ~tructL.:('e3 be demol"ished--' If so \'..;hat~tYD
e What IS tile current comorehensl.;e alan desl:;;nat '.:In cf :ne
site?
NO~\fi-
r What lS t~e currenJ zonlng clasSlf'cat~on of the Sl:e
9
If applicable "niat
program designation
lS the current shor""'etlne master
of the site? j)c fL'S Nr:::,'I" I9-f(JL'f
h Has any Dart of the site been classlfled as a natural
resource crltlcal or environmentally senslt~)e
area? If so, speCl TY NO
J
k
Appro~imately how many people ~ould reside or work 1,
_.
cerna 1 Bted prOject <" Fe>' ~ fo -- ley::::,
....>-..C).
I.. I ........
Appro~lmately how ~anY oeoole would the comoleted oro]ect
displace? Nt>NrZ- '
Proposed
Impacts
measures to
I fan y 1> 0 6:.-'1
avoid
/"{bl
or reduce
~f1..7
displacement
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P A(;E:: 7
Proposed measures to ensure the proposal is compatible
wlth eXlsting and projected land uses and plans lf any
I\( b~\ Ii- A- T 7l+-IS T 1i'kE..
9 Housing
a Approximately how many units would be provided lf any?
Indicate whether hlgh middle or low-income houslng
1-.'-1- UNITS - fW\l\)DLt-'r{~CIM~
b
Approximately how many units
eliminated? ::;:ndlcate \.;hether high
hous i ng Nb "-I E..
if an/
mlddle or
\.;ould be
'] ow- 1 noome
c proposed measures to reduce or control housing imoacts
if any P'{DU 12:.-
"10 Aesthetics
a What is the tallest helght of ani Droposed structure s)
not includlng antennas
~!~=. t
1S the orlncioal
1-5"" '? '
e'l.terior
bUl1dirg material{s) p'opcsed~
b What Vle~s In tre immed'ste lClnlt/ wo~'j be altered or
oostructed? NDNfL-
c Proposed measures to re,jL.;ce er contra aestret ic lmpacts
1 f any No \vl1Z...
1 1
Light and Glare
a What type of
What t~me of
llght or glare wl11 the proposal
daf would it ma"nly occur'? NOtf'il_
p('CdUCe0
b Could light or glare from the finished project be a
safety hazard or interfere with views'" fY'Ot-.(E-
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P,L.GE 8
c What existirg off-site sources of light or glare may
affect your proposal? rNO^-/~
d Proposed measures to reduce or control 1 ight and glare
impacts, If any Nt>r-...(f'i:.
12 Recreation
a What designated and infermal recreationa opoortunlties
are In the lmmedia.te \/lclnlt/' "-!{)l'v\l2...
uses?
pr~oJect dlsplace
50 descr 1 be NO
any
ex:is1:
~ ...,
'd
b
Would the
recreational
p r'" oposed
c
Proposed measures tJ reduce
recreation opportunities
or control
^f D4 12-
lm03.Cr,s or
prOVl-:e
13
Historic and Cultural Preservation
a Are there arv places or cojects 11sted ~n or
for national st3.te or lcca"'; presE:\lstion
known to be on or neAt to the site? If so
descr 1 be f'f 0
propcsed
registers
generallY
b Gene~'ally describe any landmarf<'s or evi(~ence of hlstor'c
archeologlcal sCientific or cultural lrnoortance hnown
to be on 0; next to the slte NDNtZ:-
c Proposed measures t~ reduce or control imoacts lf an/
1:> 0 iLs M b r A-(' pLy
14 Transportation
a Identify sidewalks tra,ls publ ic streets and hlgh\-v'3"S
serv i ng the site and deser 1 be proposed access to the
e~lstlng street system Show on site plans If any
t. ~ 'L L R-N S f(. b fJ.-'j) ~ u ~ fl..- f I{ fi:.:S tZ-N .,. r8- e... c R-S. S
b
Is s'te currentlY
mears~ If not wnat
No
served by publ'c tr3.nslt':l 8" v!h3.t
plans exist for trars,t service~
c How many par~ 1 ng soaces wou I d the comp 1 eted project have?
How many would the project el iminate? .2. ~~~ sA-(j.t t!/L.5f'(iW~
CITY OF YELM ENVIRO~~ENTAL CHECKLIST
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PAGE 9
d W1l1 tne proposal require any new sidewalks trails
roads or streets, or inprove~ents to eXlst1ng sldewal~s,
trails roads or streets not Including drlVeWaYS~ ,~
so generally describe (,ndicate whether public or
p r 1'1 ate ) LutJ.~ "au ~ \ tf-r: ;( K ~ 0 i A. t:. t\11 S-t--1T'" s
e
Will the project use (or cccur In the Immed1ate
of) .",ater rail or air transportation0 If so
des c r 1 be]) 0 l2.-~ AI oJ' IJ,-ffJL Y
vicinity
general,>
f
Hew many vehlcular trios per day would be generated by
the completed project,..., If ~nown lrdlcate when Dea~
volumes would occur
'h:.s'\"' ,t\II4l-7t:- A- "f c '" 6" 0
g Precosed measures to reduce or control tranSDOt"tat '()n
lmpacts I f any NC I\,( ~
~ ~
1_'
Public Services
a Would the project result In
services (for exE.enD Ie
protection health care
generally describe 4 ~s
3n lncreasea need for public
fire protectIon
schools cther)?
po lice
.1..1
so
b ProDosed measures to reduce or control direct 1mpac:s on
public serv,ces If any NDN..E--
16 Utilities
a Cn:..e-:1-e illties currenc:1y available a-~the SILe
"'J....e.c-t..r:.-'LC i t Y- , n a t u r a 1 gas w.a..t.-e'1--;- ref u -=~) s e r V ' c e
~~ep one sanitary sewer sept1c system. oEher
b Oescr 1 be the ut ell ties that 3re proposed for the project
the utility prOViding the service and the general
construction activities on the site or ln the lmneolate
v'iclnity which might be needed 1U:lli:.-ijfJc\\..\t./ tl..:LC.:T'VOC.;
\.;.II\- \' ~_ i S \ZoO ~ ~ ~ S It iii-M Ii-N p N 1-\'1"0 Ie,u". ~ S
C SIGNATURE
The above answers are true and complete
~nowledge I understand that the City of
them to make its decision
12~ a- c/f~~0)L
to the best of my
Yelm IS relYing on
Signature
Date Submitted
CITY OF YELM ENVIRONMENTAL CHECKLIST
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PAGE 10
SUPPLEMENTAL ENVIRONMENTAL CHECKLIST FOR NON PROJECT ACTIONS
(Do not use this sheet for project act10ns )
When answer i ng these ouest 1 ons, be a'...;are of the extent of the
proposal, or the types of actlvities lively to result from the
proposal, woulj affect the item at a greater lntenslty or' at a
faster rate than if the proDosal were not Implemented Respond
briefly and in general terms
How would the proposal be llkel, to 1ncrease discharge to
water emissions to air production storage or release of
tOX1C or hazardous substances. or product10n of nOlse?
Proposed measures to avoid or reduce such lncreases are
"
L
How wo~ld the proposal be llhely to affect plants
fish, or marine llfe?
animals
Proposed measures to protect or conset've plants
fish or marlne 11fe are
3nlma's
3 How would the proposal De li~elv to deplete energy or natural
resources?
Proposed measures to protect or conserve energy and natural
resources are
4 How would the proposal be llkely to use or affect critlcai or
env1ronmentallv sensitive areas or areas designated (or
eligible or under studY) for governmental protect10n such as
parks, Wilderness \.nld and scenlC rivers threatened or
endangered soecies habitat histor,c or cultGral SlteS
wetlands floodplalns or natural resource areas?
CITY OF YELM ENVIRONMENTAL C~ECKLIST
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PAGE 11
Proposed measures to protect such resources or to avoid or
reduce Impacts are
5
How would the proposal be likely to affect
use including v-Jhether it would allow or
shorellne uses lncomoat1ble wlth existing
land and shorel1ne
encourage I and or
plans"'"
Proposed measures to av01d or reduce shorellne anj land use
lmpacts are
6
HO\.J would the prooosal
transportat10n or public
be 1 ikely to Increase
serV1ces and utllit'es~
demands
~~
'-, ( :
Proposed measures to reduce or respond to such cemand (s) ",-, c
7 Identify if possible whether the proposal may conflict wltn
local state or rederal laws or requirements for tre
protection of the en/Ironment
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PAC.:c '12