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Instructions•
CITY OF YELM
ENVIRONMENTAL
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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 City decide whether an EIS is required. An environmental
impact statement (EIS) must be prepared for any proposal with
probable significant adverse impacts on environmental quality.
This environmental checklist asks you to describe some basic
information about your proposal. The City will use this checklist
to determine whether the environmental impacts of your proposal are
significant and require preparation of an EIS. You must answer
each question accurately, carefully and to the best of your
knowledge. Answer the questions briefly, but give the best
description you can. In most cases, you should be able to answer
the questions from your own observations or project plans without
the need for experts. If you do not know the answer, or if a
question does not apply to your proposal, write "do not know" or
"does not 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 regulations, such as zoning,
shoreline, and landmark designations. Answer these questions if
you can. If you have problems, the city staff can assist you.
The checklist questions apply to all parts of your proposal even if
you plan to do them over a period of time or on different parcels
of land. Attach any additional information that will help describe
your proposal or its environmental effects. You may be asked to
explain your answers or provide additional information for
determining if there may be significant adverse impacts.
Nonproject Proposals Only:
Complete both the checklist (even though many questions may be
answered "does not apply") and the Supplemental .Sheet for
Nonproject Actions (part D). For nonproject actions, the references
in the ckecklist to the words "project," "applicant," and "property
or site" should be read as "proposal," "proposer," and "affected
geographic area," respectively.
CITY OF YELM
ENVIRONMEATTAL CHECKLIST
A BACKGROUND
1. Name of proposed project, if any:
CITY USE ONLY
FEE: 50.00
DATE C'D %/
SY:
FILE NO. D
2. Name of applicant: ~~~~ie~~ Mp(~t~_ ~L(~j~/
3. Address and phone number of applicant and of any other contact
person:
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4. Date checklist prepared: ~~~ J~.~
5. Agency requesting checklist:
6. Proposed timing or schedule (including phasing, if
applicable):
7. Do you have any plans for future additions, expansion, or
further activity related to or connected with this proposal?
If yes, explain.
8. List any environmental information you know about that has
been prepared, or will be prepared, directly related to this
proposal.
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9. Do you know whether applications are pending for governmental
approvals of other proposals directly affecting the property
covered by your proposal? If yes, explain.
10. List any government approvals or permits that will be needed
for your proposal, if known.
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11. Give brief, complete description of your proposal, including
the proposed uses and the size of the project and site. There
are several questions later in this checklist that ask you to
' ° ~describ~e certain aspects of your proposal:._.• You do notneed _ao
repeat~thos"e~answers on this page. =. ._.
12. Location of the proposal. Give sufficient. information for a
>person to'- und~ersLan'd~- the- precise - locaton:~.of _,youur. r:proposed
project, including a street address, if any, and section,
township, and range, if known. If a proposal would occur over
a range of area, provide the range or boundaries of the
site(s). Provide a legal description, site plan, vicinity
map, and topographic map, if reasonably available. You need
not duplicate maps or detailed plans submitted with any permit
• applications related to this checklist. -.~
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B. ENVIRONMENTAL ELEMENTS
1. Earth
a. Ge al description of the
lat rolling, hilly,
er
site {circle one):
steep slopes, mountainous,
b. What is the steepest slope on the site (approximate
percent slope)? ~
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c. What general types of soils are found on the site (for
example, clay, sand, gravel, peat, muck)? If you know the
classification of agricultural soils, specify them and
note any prime farmland.
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d. Are there surface indications or history 'of.~unstable
soils in the. immediate vicinity? If so, describe.
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e. Describe the purpose, type, and approximate quantities of
any filling or grading proposed. Indicate source of
fill.
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f. Could erosion occur as a result of clearing,
construction, or use? If so, generally describe.
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g. About what percent of the site will be covered with
impervious surfaces after project construction such as
asphalt or buildings?
h. Proposed measures to-reduce or control erosion, or-other
impacts to the earth, if any:
2. Air
a. What types of emissions to the air would result from the
proposal (i.e., dust, automobile exhaust, odors,
industrial wood smoke) during construction and when the
project is completed? If any, generally describe and
give approximate quantities if known.
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b. Are there any off-site sources of emissions or odor that
may affec`t~your proposal? If so, generally describe.
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c. Proposed measures to reduce or control emissions or other
impacts to air, if any:
3. Water
a. Surface Water
1) Is there any surface water body or wetland on or in the
immediate vicinity of the site (including year-round and
seasonal streams, saltwater, lakes, ponds)? If yes,
describe type and provide names. State what stream or
river it flows into?
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2) Will the project require any work over, in, or adjacent
to (within 300 feet) the described waters? If yes,
please describe and attach available plans.
3) Estimate the amount of fill and dredge material that
would be placed in or removed from surface water or
wetlands and indicate the area of the site that would be
affected. Indicate the source of fill material.
4) Will the proposal require surface water withdrawals or
diversions? Give general description, purpose, and
approximate quantities if known.
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5) Does the proposal lie within a 100-year floodplain? If
so, note elevation on the site plan.
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6) Does the proposal involve any discharges of waste
materials to surface waters? If so, describe the type of
waste and anticipated volume of discharge.
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b. Groundwater:
1) Will groundwater be withdrawn, or will water be
discharged to groundwater? Give general description,
purpose, and approximate quantities if known.
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2) Describe the underlying aquifer with regard to quality
and quantity, sensitivity, protection, recharge areas,
etc.
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3) Describe waste material that will be discharged into or
onto the ground from septic tanks or other sources, if
any (such as domestic sewage; industrial byproducts;
agricultural chemicals).
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c. Water Runoff (including storm water):
1) Describe the source of runoff (including storm water) and
method of collection and disposal, if any (include
quantities, if known). Where will this water flow? Will
this water flow into other waters? If so, describe.
2) Could waste materials enter ground or surface waters? If
so, generally describe.
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d. Proposed measures to reduce or control surface, ground,
and runoff water impacts, if any:
4. Plants
a. Check or circle types of vegetation found on the site:
deciduous tree: alder, maple, oak, aspen, other
evergreen tree: fir, cedar, pine, other
shrubs
v- grasses
~ , pasture
crops or grains
wet soil plants: cattail, buttercup, bulrush,
skunk cabbage, other
water plants: water lily, eelgrass, milfoil, other
' other types of vegetation
b. What kind and amount of vegetation will be removed or
altered?
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c. List threatened or endangered species known to be on or
near the site.
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d. Proposed landscaping, use of native plants, or other
measures to preserve or enhance vegetation on the site,
if any:
5. Animals
a. Circle any birds and animals which have been observed on
or near the site or are known to be on or near the site:
birds: hawk, heron, ducks, eagle, ongbirds,
other: l)
mammals: deer, bear, elk, beaver, other: rk~a~~,fS
fish: bass, salmon, trout, shellfish, other:
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b. List any priority, threatened or endangered species known
to be on or near the sites:
~~c~:"- ~=Is=the •ste~~part ofU1`a/~Umi\"g'~`ration route?._ If so,~.explain.
d. Proposed measures to preserve or enhance wildlife, if
any: ~ .. - .- ..
6. Energy and Natural Resources
a. What kinds of energy (electric, natural gas, gasoline,
heating oil, wood, solar etc.) will be used to: meet the
completed project`s energy needs? Describe whether it
will be used for heating, manufactu(ringJ, transportation,
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b. Would your project affect the potential use of solar
energy by adjacent properties? If so, generally
describe.
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c. What,k.inds of energy conservation features are included
in the plans of this proposal? List other proposed
. ~.: ~ measures ,to reduce or control energy impacts,, if any:
7. Environmental Health
a. Are there any environmental health hazards,~including
exposure to toxic chemicals, risk of fire and explosion,
spills, of hazardous waste, that could occur as a result
of this proposal? If so; describe.
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1) Describe special emergency services that might be
required.
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2) Proposed measures to reduce or control., environmental
health hazards, if any: -
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b. Noise
1) What types of noise exist in the area which may affect
your`projec.t (for example.: traffic,~equipment operation,
other)?
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2) What types and levels of noise would be created by or
associated with the project on a short-term or a long-
term basis (for example: traffic, construction,
operation, other)? Indicate what hours noise would come
from the site.
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3) Proposed measures to reduce or control noise impacts, if
any:
properties?
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b. Has the site been used for
agriculture or forestry? If so,
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Land and Shoreline Use
a. What is the current use of the site and adjacent
mineral excavation,
describe.
c. Describe any structures on the site.
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d. Will any structures be demolished? If so, what?
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e. What is the current comprehensive plan designation of the
site? ~
f. What is the current zoning classification of the site?
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g. If applicable, what is the current shoreline master
program designation of the site?
h. Has any part of the site been classified as a "natural
resource", "critical" or "environmentally sensitive"
area? If so, specify.
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i. Approximately how many people would reside or work in the
completed .project?
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j. Approximately how many people would the completed project
displace?.
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k. Proposed measures to avoid or .reduce displacement
impacts, if any:
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1. Proposed measures to ensure the proposal is compatible
with existing and projected land uses and plans, if any:
9 . Housing (~ h ~ v101~ ~'1 Gt,7~ TV1 ~ S ~~ ~.
a. Approximately how many units would be provided, if any?
Indicate whether high, middle, or low-income housing.
b. Approximately how many units, if any, would be
eliminated? Indicate whether high, middle, or low-income
housing. - .- , _. -~ - -
c. Proposed measures to reduce or control housing impacts,
if any:
10. Aesthetics
a. What is the tallest height of any proposed structure(s),
not including antennas; what is the principal exterior
building material(s) proposed?
b. What views in the immediate vicinity would be altered or
obstructed? -
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c. Proposed measures to reduce or control aesthetic impacts,
if any:
11. Light and Glare
a. What type of light or glare will the proposal produce?
What time of day would it mainly occur? I I f
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b. Could light or glare from the finished project be a
safety hazard or interfere with views?
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c. What existing off-site sources of light or glare may
affect your proposal?
d. Proposed measures to reduce or control light and glare
impacts, if any:
12. Recreation
a. What designated and informal recreational opportunities
are in the immediate vicinity? ~ ~._
b. Would the proposed project displace any existing
recreational uses? If so, describe. n~
c. rroposed measures to reduce or control impacts or provide
recreation opportunities:
13. Historic and Cultural Preservation
a. Are there any places or objects listed on, or proposed
for, national, state, or local preservation registers
known to be on or next to the site? If so, generally
describe. ~
b. Generally describe any landmarks or evidence of historic,
archeological, scientific, or cultural importance known
to be on_ or next to the site.
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c. Proposed measures to reduce or control impacts, if any:
14. Transportation
a. Identify sidewalks, trails, public streets and highways
serving the site, and describe proposed access to the
existing street system. Show on site plans, if any.
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b. Is site currently served by public transit? By what
means? If not, what plans exist for transit service?
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c. How many parking spaces would the completed project have?
How~many would the project eliminate?
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d. Will the proposal require any new sidewalks, trails,
roads or streets, or improvements to existing sidewalks;
trails, roads or streets, not including driveways? If
so, ,.generally describe,: (indicate whether public or
private). ~~/
e. Will the project use (or occur in,the immediate vicinity
of) water, rail, or air transportation? If so, generally
describe.
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f. How many vehicular trips per day would be generated by
the completed project? If known, indicate when peak
volumes would occur.
g. Proposed measures to reduce or control transportation
impacts, if any:
15. Public Services
a. Would the project result in an increased need for public
services (for example: fire protection, police
protection,, health care, schools, other)? If so,
generally .describe: ~ .:
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b. -Proposed-measures to reduce or control direct impacts on
public services, if. any.
16. Utilities
a. Cir_c~:e--utilities currently available at-~t~e-s- te•
electricity natural gas, water, efuse service•
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telephones sanitary sewer, septic system; other.. - - .~..~
b. Describe the utilities that are proposed for the project,
the.~utility providing the service, and the general
construction activities on the site or in the immediate
vicinity which might be needed.
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C. SIGNATURE .. .
The above answers are true and complete
knowledge. I understand that the City of
them to make its ,decision. -
Signature :~~-~
Date Submitted:
CITY OF YELM ENVIRONMENTAL CHECKLIST
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to the best of my
Yelm is relying on
PAGE 10
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SUPPLEMENTAL ENVIRONMENTAL CHECKLIST FOR NONPROJECT ACTIONS
4
(Do not use this sheet for project actions.)
When answering these questions, be aware of the extent of the
proposal, or the types of activities likely to result from the
proposal, would affect the item at a greater intensity or at a
faster rate than if the proposal were not implemented. Respond
briefly and in general terms.
1. How would the proposal be likely to increase discharge to
water; emissions to air; production, storage, or release of
toxic or hazardous substances; or production of noise?
Proposed measures to avoid or reduce such increases are:
2. How would the proposal be likely to affect plants, animals,
fish, or marine life?
Proposed measures to protect or conserve plants, animals,
fish, or marine life are:
3. How would the proposal be likely to deplete energy or natural
resources?
Proposed measures to protect or conserve energy and natural
resources are:
4. .How would the proposal be likely to use or affect critical or
environmentally sensitive areas or areas designated (or
eligible or under study) for governmental protection, such as
parks, wilderness, wild and scenic rivers, threatened or
endangered species habitat, historic or cultural sites,
wetlands, floodplains, or natural resource areas?
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Proposed measures to protect such resources or to avoid or
.reduce impacts are:
5. How would-the proposal be likely to affect land_and shoreline
use, including whether it would allow or encourage land or
shoreline uses incompatible with existing plans?
Proposed measures to avoid or reduce shoreline and land use
impacts are:
6. How would the proposal be likely to increase demands on
transportation or public services and utilities?
Proposed measures to reduce or respond to such demand(s) are:
7. Identify, if possible, whether the proposal may conflict with
local, state, or federal laws or requirements for the
protection of the environment._-
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