Environmental Checklist
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CITY OF YELM
ENVIRONMENTAL CHECKLIST
Instructions
The State Environmental Pol,CY Act (SEPA) requires all governmental
agencies to consIder the environmental impacts or a proposal before
mak ing decisions The purpose of th,s check 1 ist IS to provide
,nformation to help ident1fy impacts from your prooosal, to reduce
or avoid impacts from the proposal If It can be done and to help
the Cit; decide whether an EIS is requIred .An environmental
Impact statement eElS) must be prepared for any wroposal 't/H.h
probable significant adverse Impacts on envIronmental quality
Th i s env i ronmen ta 1 cheCK 1 is task s you to deser 1 be some bas - c
information about your orooosa1 The City wi 11 use th,s check list
to determ,ne whether the environmen~ai impacts of your proposa" a'e
sign,ficant and requ~re preGaratlon cf an EIS You must answer
each question accurateij careful:1 and to .,.,..,"" best of /cur
i<nm.Jledge ,il,ns...Jer the c:..;estlors tro.efly but 91,/e the best
descrlptlon YOU csn In most case~ YOU 2houlc be ab~e to answer
the questions from your own observa:lons or project plans ~ithout
the need for experts If you do rot ~ now the a",swer or 1 i a
quest,on does no~ apol; to /our procosal wr,te cc no~ ~now or
does not apply Complete answer'S to the questions now may aVOId
aelays later If the space provided 1S too small, feel free to
attach additional sheets
Some questions ask about Governmental reou !a~10n3 s~cn as zenlrg
shoreline. and lanamarr' des,or,atoons .f.\nswer these QUeS:'lons ~r
you can If YOU have p'co:erns the c-:. I sta~f car, ass,st IOU
The checkl ist questiors ape'>, to (3, \1 par:s of your- GrGpesai even ii
you plan to do them ever a perIod of time or on different parcels
of land Attach any addltionaJ Information that W'l' he:p describe
your proposal or its enVironmental effects You may be askea to
explca},.in your ans'..Jers or provlde additional information for
deterMinlng if there may be signif1cant adverse impacts
Nonproject Proposals Only
Comp 1 ete both the check list (even though many c:..;es: 1 ens may be
answered does not app!!) and the Supplemental Sheet for
Nonproject Act ions (par t D) For nonoro Jeet ae t ions t he-', e f er eneBS
in the ckecklist to the words proJect. a~piicant and"- proce.-ty
or site shouid be read as proposal proposer and affected
geqgrap,hic area, respecti\/ely
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CITY OF YELM
CITY USE ONL Y
FEE. $5Q~O,O!l t~
DA TE REC' 0 !F lA'. li t....!
BY
FILE NO
ENVIRONMENTAL CHECKLIST
BEe 15 ~~~:
A
BA.CKGFOUND
2
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\ \~~'-~
~J \, f . .
!,ame 0 proposea oroJec;:, iT any
~Wu~ ~
Name of applicant ~ f'\: ~
cnVOl~V[EIU~ll
3 Address and phone number of appllcant and of any other con:act
person ~ ~
I' 22 t./ ?kt~. ~I S/k-: -,; W~ I
8f:(1-c:lL/~ L/ - ~
Oat e c h e c k 1 i s t pre par e d ~ t I 3/ I ? 9...j
,\ ._.ein c y ~ <:>r<: I':> Co .. in"'" c h Qr ..- 1 " c: t r; in J ~
f""\"" ' ~ '-1 '-'...... -'~ . ''''' ' , '- ~ I' - ,-,-- r - ~ 0 '
),p ,,5\ \' \ : "d~\ . }" .u,-~~ . - (' - .
", ropose. \ ;:-lm"1'ng-\..J-"c.r. sc/ecu:e j,e ;uolng
appllC2.o1e) '1iJ-~ e-->v-~
4
5
6
cr.asinq
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7
Do you have an'/
further activity
If yes, exclain
c"ans Tor future additions
re-ated to or connected wich
expans lon 0,
this proposai'"
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8
,,- ,
r. +-(,. ~ '- .~ "" '"
awou ",'-.t)J,p '" .__
i-elated tc tnls
Llst any envircnmen:a:
been preoared or wl:l
proposal ~
informa:ion
be prepared
/ou k '!GW
directly
\., _. ~,
;')..1:1,(' '\ ..it Jj,j,
t:
9 Do you know whetrer aQ~licaticns are cencing for governmer:~l
approvals of other proDo~a13 directly af~ectlng the ~rocer:/
, . \' c~v",~redf.by your prec:osa i?" I f~ jes exp! a 1 n ~
~., ~
l
10
List any government
for your proposal
approvals or permits
if l<:nown ~~
that will be
neeced
CITY OF YELM ENVIRONVENTAL C~ECKLIST
forms\sepa
PAGE
11 Give brief~ complete descrlption of your proposal lncludi~g
the proposeq uses and :he size of the preJect and site There
are seve~al,-'qtuestions later in this check11st that ask you to
describe certain aspects of your proposal Yeu do not need to
repeat those answers on th,s page ~ ~ ~
,
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12 Location of the proposal Give sufficlent ,nformation for a
per son t 0 un de r s tan d the pre cis ~\ 1 ~c a t~9 n 'j c f r,""X 0 u r pre p 0 sed
J- I' . .. t . d .", t~,,\ \ \ , \, (~' ;,.
pro,jec,- lnc uOlng a st.-ree 3d ress',' 1..d' an.j.)', "an€l' BE;:'c~il\on
townshlp and range 1f known :!:f a proposal \1o.\",,),d oC~F~~over
2. range of area provlde the range or boundarles of) the
site(s) Provide a legal ceSoilptlon site plan violnls"
map a, n d top 0 9 r 3. 0 h I C ,fT a 0 i !~r e,a son a b 1 y a val ! aD e You nee d
" , ' '-'; j . '... \ '\. \ , ' \ ,. . . , ,
noe oupllcaee maps cr oet.al-lec pl!ans suoml-:te'J disn 2ny Derml:::'
appllcations related to thid: checklist ~ t~
/J I 0 _ Il A', ~ ... .. . 1\ ' " . t- -.
~ '\~~ -~ t<-.\'_)J.i~ -~.l\~
/6;2 2.. 0 te o-J~Jt~-e ~ . '-
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~ ENVIRONMENTAL ELEMENTS
1\.....
Earth
a
descr1=tlon of t~e s'te
, . -
\ClrC e c~e)
roiling
hllly
steep slopes
iTlOunta1nous
b What 1S the steepest slope on the site (approximate
percent slope)? tJ~ ~
c What general types of SOliS are found on the Sl:::.e (fer
ey-ample clay sand, grave' pe3t muck)":f you know t~e
classlJ,jcation of agr-icultural SO" 1s specif\, them an,.G '/'1~~ULlO.,
note'a'r{~-~"r-,me farmland ~ ~ ~9-'f'~----'
d
Are 1:nere surface indications or
SOlis in the immediate V1Glnity~
history of unstable
If so describe ~
CITY OF YELM ENVIRONMENTAL CYEO<.LIST
forms\sepa
PAGE 2
~,
e Describe the purpose type and approximate quantities of
any fill ing or grading prooosed Indicate source of
'H ll&-\t;~ ~ ~
f
g
h
2
Air
a
Cou I d eros i on occur
construction or use?
a result of clearing
generally describe ~
as
If so,
~~
3 t \
About what
impervious
asphalt or
percent of the site will be covered with
surfaces after project construction such as
bui idings? ~.~ wtc!
Proposed measures to
imoacts to the earth
1\ \'
reduce or ffntr~l erosion, or other
1 f any 1tJd.i.4 ~ ~
It/hat types':"'-b1r emissions to the 31r would resuJ: from the
proposa 1 I I e dust automob, 1 e exhaust, odors
industrial wood sr.oke) curing construct"on and when ~he
project 15 ccmp~eted? If any generally describe and
give approximate quantities if known ftJ~~~
~"}j \' -- -/ r d--
bAre tnere ant off-site sources of emissions or odor that
may affect your =rcoosa'? If so genera-;y descrice
fi9<LU- ~ ~
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3
'Proposed measures to redun or contro 1.. eml ss. i o..ns or
impacts to alr If any {):::}~'-~,\~" ,\_
other
Water
a Surface Water
-.J ~ .. I, ~)
1) Is there any surface water bodY or wetland on or ,n ene
lmmedlate vie'~;ty of the site (including year-'ounc and
seasonal stree,ms saltwater lakes ponds)? If les
deser ,be tY12e 2.'"1d pro\llde names State what stream or
~ 1 · ~ · t ~
r i ver\-\,,:i t ': .o~~.,\_ ;1rl 0 r ~
,
CITY OF YELM E~NIRONMENIAl CHeCKLIST
forms\sepa
PAGE 3
..---- ~."_._..~_.~,.....~~--
. '
2) Will the project require any work over in or adjacent
to (within 300 feet) the described waters,? If yes
please descr i be and a t tach ava i 1 abJ e plans .~
,\ 1 < -s
3 )
Estimate
would be
',.Jet lands
affected
the amount of fil' ::ind drecge material that
placed In or removed from surface water or
and ,ndicate the area of the site that would be
Indicate the source cf fill material ~
4)
Will the proposal require surfaoe \vater
dlversionsQ Give general descriotion
aoo'r'O'x i'ma t e quant'i t. i es 1 f k nO\vn _11 1'-
'\ ' (" ''-\.1
withdralNals or
purpose 3nd
5) Does the proposal lie wi~hin a .OO-year f10odp:aln~ If
so note elevation on the slte ~ an ~
6, ~ ~ Doe.s . t he pr"oposa I In vol 'Ie
"",~\...,..,J) .i...(\.~,-- .1;',(\,1\'\\ 1.\, ',",
,., \: ,materl'a I..S......t'o-.;surtace waters
V waste and anticipated volume
any
If so
discnarges of
describe the
waste
tr-pe of
of discharge ~
b 3rounawater"
1) Will groundwater be wltndtta:~:NO or"'wiill\{~,w;,kter be
d ; s c h a r g e d tog I" 0 U n d w ate: ? \i3 1 V e g e n era 1 des c r 1 p t ion
purpose, and apDroximate quantities If known ~~ ~
~~~,
2) Descrfbe the underlying aqUITer with regard to quallty
and q?antit sensitivity protection rec~arge areas
etc
,
3) Describe waste material that Will be discharged i~to or
onto the ground from septic tanks or other sources lT
any (such as domestic sewage, lrdustrlal byproduc:s.
agrlcultural chemlcalsl .~~ ~~
CITY OF YELM ENVIRONMENTAL CHECKLIST
forms\sepa
PAG: 4
\....,
it',
c
Water Runoff (including storm water)
Describe the source of runoff (including storm water) and
method of collection and cisposal if any (include
quar'tities if hnO'.'I'n) Where will this w2,ter fio\.o/~ Will
this water fiow into other w3~ers' If sc cescribe
I(~~~~~
Could ~3ste materials en~r ground or surface waters? ~f
so generalrY cescribe ~
2)
d Proposed ~e9SLlres tc reduce or contrel sLirface grot~nd
and runoff water impacts
if any ~
4 Plants
a Check or circle types o~ \egetaticn fCLnc en tre,s,te
dec i dUOt.Js
~"..~~
l.. '-'_
, '
a rJer
lac e
OSi'
=~SDen
othe.....
't..
evergreen tree
shrub~
i
cedar
p,ne ,:;;:-,er
f.... Jr2.sse:::
pas 'Cure
crops or grains
wet Sail plants cattall, but:ercup
skunk cabbage other
water plants water 1i1/ eelgrass milfoil
other types cf vegetation
bulrush
'h
o\:"er
o 'N hat "i n d and 2. moL.: n t c f 'j e get at, 0 n w 1 1: be rem 0 v e d 0 r
altered?
tJ 0 ;J Q../
c Llst threatened or endangered speCles known :0 be on or
near the slte
1Jo 10.e-
d
Proposed landscaplng L.:se 0.0 native plants
measures to preserve or ennance vegeta:l:;r en
or other
the site
i, any
~ vf\.. cu '^'- Q S
IS
5 Animals
a Circle any bircs and anima's which have been observed cn
or near the sit~ or are kncwn to be on or near the site
birds
other
mammals
fish bass
hawk, heron ducks eagle~gbird~
deer. bear elk beaver other
salmon, trout shellfish other
~~
t:htf'
CITY OF YELM ENVIRO~~ENTAL CHECKLIST
forms\sepa
PAGE 5
b List any priority, threatened or endangered species known
to be on or near the site
11,10 IV L-.
c
Is
the site part of
a migration
rO:Jte''"'l
..Ll
so
e/,p
~ ., 1'-.
Ji1IO
d
Proposed measures
any
AI 0' J1! -L--.,
to
'r
, ,\ ~,-\.
oreserve
. . ,
, 1 ~J~
or enhance
J";) \.1)"
'.o/l!dllfe
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~
(3
Energy and Natural Resources
What kinds of energy (electriC ratural gas gasoline, heating
oil ""ood. solar etc\) will be used to meet the completec
proJect's energy needs? Describe whether it will be used for
hee;;;;~ng;:;:7;i~"* G~~J
'0 Wou~-' 0"[' o"'o---~ --=-=--" -n- -0""--"---" ~e 0": ~O"-"
,'-..; Y ,-, " _'='_'. c. "=\..~ ., = L' '.'="'L, ';=< (~ ' 5 'c.'
energy by adJacent prooer:"es? jP so genera'ly
desc~r 1 be
/'fD
c What ~lnds of energy conservatlon features are lncluced
in the plans of th,s orooosal? List other proposed
measures to reduce or control energy Impacts it any
jJorlL-
7 Environmental Health
a Are tnere any environmen:a ,ealth ha22.ros. i'lclud"ng
e'posure to tO~lC chemicals risk of fire and explOSion
spill~ of hazardous waste that could occur as a resu"t
of this proposal? If so describe
}Jo
1 )
Describe seeclal
required
emergency services that might
te
tJ6 f ~
2)
Proposed meas'-,res
health hazards if
to
;o""~,.-.! "".-..;=.
I _ __'-'_
cr
control
en'l ~ ronmenta
an\/
rJ 0 yJ fL-
b
1 )
Noise
What types of nOise eXist
your project (for examole
other)?
)II 0 tV e-
In tne area which may affect
traffic, equipment operation
CITY OF YELM ENVlRONJv1ENT AL CHEO<LISi
forms\sepa
PAGE 6
measures
If any'
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CITY OF YELM ENVIRONMENTAL G-iEO<LIST
forms\sepa
3)
a
Land
a
2) What types and levels of n01se would be created b~ cr
assocIated with the project on a short-term or a lcng-
term basis (for example traff,c cors~~uct"~~
ooeration other)0 Indicate what hours nOise would co~e
from the sIte
/ff6 rJ JL---
Proposed measures to ~educe or control nOise l~pacts
any
)/6 rJ -L-.
and Shoreline Use
What 's tne current
oroperties~ h'
. . {t- tv r I S i w... ct.;' ./T r/' -e-P
and
s~te
use or ;:ne
-'- v If^-
2~rJ J acen 'C.
b
Has the site been used fer minerai excavaticn
~r1cu'tu~cr forestry? _- so descr,be
. po.. S T () rI' -e. of -r;.-e -'1.-.. J:t:fL P" ~
~,e~:c> i~b/: : ~ \~ ~ :~ u;;:~- e s c; ~:: ~t ~ c2 ~.Q ('00 rv - / ,ga-r~
/ /.8 a. f" yV' r:LCf ~ ~ ~
Will any 5tructL:res be demol~shed~ If sa what~
c
d
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e What is the cL.r,~ent comprehensive alan de=:,;nation cf the
~i~e?
:;, , -jrJ do 91 ria (
i What is t:~e CL..r""rent. zanlng c;a:=:slficat~cn of 'C:le '31:e?
1-f'J~O 'j( fa II
g .L~ appl1cab;e what 1S the current sho:eline master
program designation of the site~
/tJccf af pIle ti L /~
h Has any Dart of the site been classified as a natural
resouroe critical or env1ronmental', sensl~i e
area? If so specify
frO
Acproximatel; ho~ many people would res1de or wcrK in t~e
completed project~
4-..6- LL.-I oj e- )
.J Aporoxlmately how many people wouid the comp'eted Qro]ect
d~spiaoe?
11/ (j jI/ .~..
k
Proposed
lmoacts
to
avo,d
reduce
displacement
or
PAGE 7
Proposed measures to ensure the proposal is compatible
with existing and projected l5nd uses and plans, if any
fJo rJ L
9 Housing
a Approximately how many unlts would be provided if any?
Indlcate whether high ~dc:lV or low-income housing
~~~
b
Approxlmately how many un~:s
eliminated? :=ndlcate whether high
housing
No ,J ~
if any
middle or
I,-/ould be
low-income
c Proposed measures to reduce or control housing lmoacts
if any
;J tf yrJ ~
10 Aesthetics
a What is the tallest he;ght c~ ani proposed structure's)
not includlng antennas. "';:E',: ,:=, the principal exterior
bUlldina materialls) o~opcseG~
tvd;;;'.f r;. 0 #1) $ .p ~
b Wha: views in the lmmed'ate lClnlCY wou'd be altered or
obstructed?
JVo tv e.---
c Proposed measures to reCL.ce c consro- aest0etic lmpac'::;:;
If any
tf 0 .1/-L--
1 1
Light and Glare
a What type Oi
What time of
lign-:: or glare .Nlll the pro;:osal
day would it mainly occur?
;,)l"'OCuce'J
jI t' pi -e-----
b
Could light or glare from t::e
safety hazard or interfere with
flnished
vie'^,s')
pro,ject
te
a
JVO
CITY OF YELM ENVIRONMENTAL CHEO<.LIST
forms\sepa
P,A.GE 8
-~.~~--~"':"~_':'''''-'-'''-~''-
c What existing off-site sources of light or glare may
affect your proposal?
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d
Proposed
im::acts,
measures
if any
to reCuce or
control
i i ~n t
and
G,are
;VtJ rI ~
12 Recreation
a What designated and informal recreatic:a C~Dortun't"~s
are in the 'mmediate vicin!ty~
jc/ () I"'--e.-
Would the proposed p'oJect G1S0'2Ce
resreational uses? If so describe
b
an'l
exi-=~:!-,.;;
/V~
c Proposed measures to reduce or ccntro' 'mo2cts or pro'v i::e
recreation opportunities
j/tJ y() e.-
! 3
Historic and Cultural Preservation
a Are there any places or c=Jects
! 1 S te.:
..........-
.~,
proposed
registers
generallY
kr:o\.Jn to be en
describe
or ne < t
.t.~
l...W
leca: oresE:'lstlon
the slte? -'-, so
fer" national
.-..L......l- _
~'-:='.i...~
0:
AI P 11I-f..-
b Gener'ally eescrlbe any landmar\<s or' eVlcence of historiC
archeological scientific or cultural imoortance hnown
to be on or next to the Site
jlo rV '<-.
c
PrCDosec messures to reduce or cortrcl
. "":":r..:::"" '!" c:
'1""""'--"'"-'
if ani
),;6 w e-
14 Transportation
a Identify sidewalks trails public streets and highways
serv i ng the site and des~r i be proposed aocess to the
evisting street system Show on site o-ans if anv
) p". I veJ Wd-J IJ IV J?d.. r / ;-oa.ci ';ppe,.
b
Is s~te current"i:
mears~ If rot wnat
served by publ~c tr~nsit..., B'/ '.tln5t
clans e^ist for trs~s-t service?
,Alo
c
~ow mBGV park lng soaces wou"d the completed
Hcw many would the project eliminate?
jtJo+ t2 f f Itd (,.-Ie-
~\'~\\~
project have?
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CITY OF YELM ENVlROi'fvENT AL CHEO<LIST
forms\sepa
PAGE 9
"
d Will the proposal reauire any new sidewalks trails
roads or streets or inprove~ents to existing sidewa1hs,
trails, roads or streets not includi~g dr,vewavs0 If
so, generally descrlbe ('rdlcate whether publ ie or
private)
111'&'
e
Itli 11 the project
of) ',Jater r.::i i'
describe
use (or CCCLr in the lmmedlate
or air transp:lrtatlon0 If so
v,ei;!;ty
generally
No
T"
_1
day wculd be generated by
~ nown ! nd, ca t e whsn peah
f
How many vehicular tr,os
the completed project0
volumes would occur
'/V 0 jV-e...
per
g Proposed :-neasures to reCLce or C'Jntrol transocrt.3.tloii
lmpacts ,..0 any
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Public Services
a Would the project result in
serv,ces (for e.<.2,rr10,e
protection health care
generally descr'be
3!'l l,creased need ~or public
",re protectlon police
schools other)? _~ so
)/0
b Proposed measures to reduce or centrol direct Impacts on
publlC services if any
tV 0 ~ -e-.
16
a
,lit'es currently
natural
san, ,.ary sewer
at
l-b -';'Q
serVice
b Describe the ut"llties the.t
the utility oroviding the service ana ~hA ~eneral
construction activ,t,es on the Site or ,n t,e lmmeo'ate
viclnity whlcn m,ght be neeced
)/p N f...;-
C SIGNATURE
The above answers are true and complete
knowledge I understand that the City of
them to make its decision ~
Signature (2, - , j ~
Date Submi t~~~-"'.P'lA..t' .I q 93
to the best cf my
Ye1m is relying on
CIIY OF YELM ENVIRONMENTAL a-1EO<LIST
forms\sepa
PAGE 10
" 4"
SUPPLEMENTAL ENVIRONMENTAL CHECKLIST FOR NONPROJECT ACTIONS
(Do not use this sheet for project act,ons
When answering these Questions be a'...tare of the extent of ;:re
proposal, or t.ne types of activities likely to resuit from the
proposal, would affect the item at a greater intensity or at a
faster rate than if the proDosal were not implemented Respond
briefly and in general terms
1
How would the proposal be likel/ to increase discharge
water emissions to air production, storage or release
tOXiC or ha=ardous substances, or production of nOise?
to
........-:=
'...J i
)J rl jrl- ~/ I
Proposed measures to avoid or reduce such increases are
jr/CJ re.-
2
Ho~ would the proposal be likely to affect plants
fish. or marine ',fe?
animals
JvA
Proposed measures to protect or conser've 0 I ants
fish or marine life are.
anima's
IV (jrJ-L
3 How would the proposal be likel! to deDlete energy or natura'
resources?
# AJ;:! Off J I a- f.JJL
Proposed measures to protect or conserve energy and natural
resources are
jilotl r,/' (,'~ t.-~
4 How would the proposal be l,kely to use or affect critica or
environmentally senSitive areas or areas designated (or
eligible or under study) for governmental protection sucn as
parks, wilderness I,'illd and scenic rivers threatened or
endangered soecies nabitat historic or cultLral Sites
wetlands. floodpla,ns or natural resource areas?
/tIr?f 0/ P lia-' (e-
CITY OF YELM ENVIRONMENTAL CHECKLIST
forms\sepa
PAGE 11
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Proposed measures to protect such resources or
reduce imoacts are
to avo i.d or
> .
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5 How would the proposal De likely to affect land and shoreline
use i n c 1 LI d 4 n 9 y.J h e the r 1 two u 1 d a I low 0 r e nc 0 LI rag e 1 and 0 r
shoreline uses incomoatibie with existing plans?
jl/Ppe-
Prooosed measures
lmpacts are
to avoid or
reduce
shoreline and
land
, :':::,c:::t.
'-'--
/!Jo'tf a )0 I,r/... (y ~
/'
6
How would the
transportation
prooosal
or pub 1 i c
be ll~(ely to lnc~ease
services and utilit"8s0
aemands
on
j!CJY fi/P lIeF ?/~
Proposed measures to ~educe or re~pond to SUCh demand(s)
~~o
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)/() vJ~'
'7
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Identify if posslble ~heth8r the
local state or fede,a-, lal./5
protection of the en/ironment
proposal may confllct
or requ~rements for
'1'1 it h
:ne
11/0 )tJ e,.,
CITY OF YELM ENVIRONMENTAL ChECKLIST
forms\sepa
P,AC~ '12