HomeMy WebLinkAboutSEPA EPIC-239-84 - DOCHNAHL CONSTRUCTION COMPANY - OFFICE AND WAREHOUSEBOWERS MFG
13032 INTERURBAN AV S
F.PIG 239 -84
WAC 197 -11 -1350
DECLARATION OF NONSIGNIFICANCE
Description of proposal Construction of Warehouse and Office Building
Proponent Dochnahl Construction Co.
Location of proposal 13032 Interurban Ave. S.
Lead Agency City of Tukwila File No. EPIC - 239 -84
This proposal has been determined not to have a probable significant
adverse impact on the environment. An environmental impact statement (EIS)
is not required under RCW 43.21C.030(2)(c). This decision was made after
review by the lead agency of a completed environmental checklist and other
information on file with the lead agency. This information is available to
the public on request.
There is no comment period for this DNS.
Responsible official
Brad Collins
Position /title Planning Director
Address and phone 6200 Southcenter'Blvd., Tukwila, WA 98188 433 -1845
Date 7/2e /e y
Signature
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WilsonJones
GRAYLINE FORM 44-900 2-PART
C1983 • PRINTED IN U.S.A.
.ORDER NO. 371451
EXHIBIT "I"
JUN 21 1984
CITY OF TUKV!,LA
PLANNING DEPT.
That portion of the Stephen Foster Donation Claim No. 38 and of the C.
C. Lewis Donation Claim No. 37, in Sections 10, 11, 14, and 15, Township
23 North, Range 4 East, W. " 1., in King County, Washington, described as
follows:
Beginning at a point which bears north 40 °01'05'. West 920.15 feet from a
monument at the point of intersection of a curve on the centerline of
the Duwamish- Renton Junction Road, said point of intersection being
approximately 1,000 feet east and 20 feet south of the quarter corner
• between said Sections 14 and 15; thence north 49 °24'00" West 835.00 feet
on a line.parallel to and 150.00 feet northeasterly of the centerline of
said Duwamish- Renton junction road, to a point which bears north 81 °44'55"
.East'199.17 feet from the point of curve on the centerline of the said
Duwamish- Renton junction road, said point of curve being approximately
1,200 feet north and 440 feet west of the quarter corner between said
Sections 14 and 15, thence south 40 °36'00" West 20 feet to the northeasterly
margin of the right -of -way of'the Puget Sound Electric Railway; thence
north 49 °2!00" West along said rightof -way, 980.29 feet; thence south
49 °24.'-: East'340" feet ; - thence north 40 °36' East 185 feet, to the true
• ' ��-point,; of;;beginning of this description; thence North 40 °36' East 185
`: ;`feet,.'tJence north 49 °24'_•west 340 feet, thence south 40 °36'west 185
feet, then00outh'.49 °24':East 340 feet, to the true point of beginning;
• EXCEPT the southeasterly 115 feet,thereof; ALSO
That portion of. the Stephen Foster Donation Claim No. 33 and of the C.
C. Lewis Donation Clain Rio. 37, in Sections 10, 11, 14 and 15, Township
t3 Nortito Range 4 East, IL. , in King County, Washington, described as
follows:
Beginning at a point which bears north 40 °1'05" west 920.15 feet from a
monument at the point of Intersection of a curve on a centerline of the
Duwamish- Renton Junction Road, said point of Intersection being approximately
1,000 feet east and 20 feet south of the quarter corner between said
Sections 14 and 15; thence north 49 °24'00" west 835.00 feet on a line
parallel to and 150.00 feet northeasterly of the centerline of said
•Duwamish- Renton Junction Road, to a point which bears north 81 °44'55"
east 199.17 feet from the point of curve on the centerline of the said
Duwamish- Renton Junction Road, said point of curve being approximately
1,200 feet north and 440 feet west of the quarter corner between said
Sections 14 and 15; thence south 40 °36'00" west 20 feet to the northeasterly
margin of the right -of -way of the Puget Sound Electric Railway; thence
North 49°24'00" west along said right -of -way, 980.29 feet, thence south
49 °24' east 340 feet; thence north 40 °36' East 185 feet, to the true
ORDER N0. 371451
Exhibit "I" Continued
point of beginning of this description; thence north 40 °36' east 185
feet; thence north 49 °24' west 115 feet, thence south 40 °36' west 185
feet; thence south 49 °24' east 115 feet, to THE TRUE POINT OF BEGINNING
Together with an easement for ingress, egress, and underground utilities
over the following described tract:
That portion of the Stephen Faster ionation Claim t !o. 33 and of the C.
C. Lewis Donation Claim `';o. 17 in Sections 10, 11, 14 and Township
23 North, Range 4 East, W.M., in King County, Washington, described as
follows:
Beginning at a point which bears North 40.01'05" west 920.15 feet from a
monument at the point of intersection of a curve on the centerline of
the Juwamish- Renton Junction Road, said point of intersection being
approximately 1,000 feet east and 20 feet South of the quarter corner
between said Sections 14 and 15; thence North 49 °24'00' West 835.00 feet
on a line parallel to and 150.00 feet Northeasterly of the centerline of
said ►;uwamisii- Renton junction Road, to a point which bears north 31 °44'15'
Last 199.17 feet from the poirtt of curve on the centerline of said
C'uwamish- Renton Junction Road, said point of curve being approximately
:':1,200 ,feet 'i'forth and -440 feet West of the quarter corner between said
'Sections-:14 and 15;.thence South 40 °36'00" West 20 feet to the northeasterly
• "Imaryin of the right -of -way of the Puget Sound Electric Railway; thence
Forth 49 °24:.'.00" West along said right -of -way, 640.29 feet to the True
Point of beginning of this description; thence South 49 °24' East 60
feet; thence North 40 °36' East 370 feet; thence +forth 49 °24' West GO
feet; thence `south 40 °36' West 370 feet to the true point of beginning.
ORDER NO. 371451
EXHIBIT "I"
Jib L., 1��; _01 ,1 Fi
JUN 2 1.1994.
PL�if�MNG DEPT.
That portion of the Stephen Foster Donation Claim No. 38 and of the-C..
C. Lewis Donation Claim 4o. 37, in Sections 10, 11, 14, and 15, Township
23 North, Range 4 East, W. t4., in King County, Washington, described as
follows:
Beginning at a point which bears north 40 °01'05" West 920:15 feet from a
monument at the point of intersection of a curve on the centerline of
the Dumpish- Renton Junction Road, said point of Intersection being
approximately 1,000 feet east and 20 feet south of the quarter - corner:
between said Sections 14 and 15; thence north 49 °24'00" West 835.00 feet
on a line parallel to and 150.00 feet northeasterly of the centerline of
said Uuwamish- Renton junction road, to a point which bears north.81 °44'55
East 199.17 feet from the point of curve on the centerline of.the said.:.
Duiaamish- Renton junction road, said point of curve being approximately •
1,200.feet north and 440 feet west of the quarter corner between said:
Sections 14 and 15, thence south 40 °36'00" West 20 feet to the northeasterly
margin of the right -of -way of -the Puget Sound Electric Railway; thence
north 49 °24,!.00" West along said rightof -way, 980.29 feet; thence south
49 °24' East' 340'fet;• thence north 40 °36' East 185 feet, to the true ,
,'..•polnt:.of :,beginning of this description; thence North 40 °36' East 185
:`±feet, thence north 49 °24' west 340 feet, thence south 40 °36'west 185
feet, thence.•south'49 °24':East 340 feet, to the true point of beginning;
EXCEPT the southeasterly 115 feet thereof; ALSO
That portion of the Stephen Foster Donation Claim No. 313 and of the C.
C. Lewis Donation Claim uo. 37, in Sections 10, 11, 14 and 15, Township
i3 'North, Range 4 East, W.t . , in King County, Washington, described as
follows:
beginning at a point which bears north 40 °01'05" west 920.15 feet from a
monument at the point of Intersection of a curve on a centerline of the
Duwamish- Renton Junction Road, said point of intersection being approximately
1,000 feet east and 20 feet south of the quarter corner between said •
Sections 14 and 15; thence north 49'24'00" west 835.00 feet on aline
parallel to and 150.00 feet northeasterly of the centerline of said
Duwamish- Renton Junction Road, to a point which bears north 81 °44'55"
east 199.17 feet from the point of curve on the centerline of the said
Duwamish- Renton Junction Road, said point of curve being approximately
1,200 feet north and 440 feet west of the quarter corner between said
Sections 14 and 15; thence south 40 °36'00" west 20 feet to the northeasterly
margin of the right -of -way of the Puget Sound Electric Railway; thence
North 49 °24'00" west along said right -of -way, 980.29 feet, thence south
49 °24' east 340 feet; thence north 40 °36' East 185 feet, to the true
ORDER NO. 371451
Exhibit "I" Continued
point of beginning of this description; thence north 40 °36' east 185
feet; thence north 49 °24' west 115 feet, thence south 40 °36' west 185
feet; thence south 49 °24' east 115 feet, to THE TRUE POINT OF BEGINNING
Together with an easement for ingress, egress, and underground utilities
over the following described tract:
That.portion of the Stephen Foster Donation Claim £!o. 33 and of the C.
C. Lewis Donation Claim No. 37 in Sections 10, 11, 14 and 15, Township
23 North, Range 4 East, W.M., in King County, Washington, described as
.follows:.
Beginning at a point which bears North 40.01'051' west 920.15 feet from a
monument at the point of intersection of a curve on the centerline of
the Duwamish- Renton Junction Road, said point of intersection being
approximately 1,000 feet east and 20 feet South of the quarter corner
between.said Sections 14 and 15; thence North 49 °24'00" West 835.00 feet
on a line parallel to and 150.00 feet Northeasterly of the centerline of
said Duwamish- Renton Junction Road, to a point which bears north 81 °44'15"
East 199.17 feet from the point of curve on the centerline of said
.0uwamish -futon Junction Road, said point of curve being approximately
1,700 -feet North and -440 feet West of the quarter corner between said
-, Sections1 4.and 15; thence South 40 °36'00" West 20 feet to the northeasterly
',: nargin'•.,pf the right -of -way of the Puget Sound Electric Railway; thence
`' North 49°4O0. " ='West along said right -of -way, 640.29 feet to the True
Point of beginning of this description; thence South 49 °24' East 60
feet; thence North 40 °36' East 370 feet; thence North 49 °24' West GO
feet; thence South 40 °36' West 370 feet to the true point of beginning.
"CITY OF TUKWILA
CENTRAL PERMIT SYSTEM
1/f Agp.L-
411 zy‘-wvo
ENVIRONMENTAL REVIEW ROUTING FORM
II
TO; BLDGPLNG P.W.
PROJECT . / V yI'j2,
LOCATION ge ,2] j4
DATE TRANSMITTED LPAZ /'y
FIRE
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EPIC
FILE
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POLICE
P &R
FILE NO. 2 G (?-gy
RESPONSE REQUESTED BY IbCJ`8y
STAFF COORDINATOR ,e/e.k.)_,e9V1W RESPONSE RECEIVED
THE ATTACHED ENVIRONMENTAL CHECKLIST WAS RECEIVED REGARDING THIS PROJECT. PLEASE
REVIEW AND COMMENT BELOW TO ADVISE THE RESPONSIBLE OFFICIAL REGARDING THE THRESHOLD
DETERMINATION. THE ENVIRONMENTAL REVIEW FILE IS AVAILABLE IN THE PLANNING DEPART-
MENT THROUGH THE ABOVE STAFF COORDINATOR. COMMENTS REGARDING THE PROJECT YOU WISH
CARRIED TO THE PLANNING COMMISSION, BOARD OF ADJUSTMENT, AND CITY COUNCIL SHOULD BE
MADE ON THE ATTACHED CENTRAL PERMIT SYSTEM ROUTING FORM.
ITEM COMMENT
DATE COMMENTS PREPARED BY .
C.P.S. Form 11
• CITY OF TUKWILA
CENTRAL PERMIT SYSTEM
ENVIRONMENTAL REVIEW ROUTING FORM
TO: ( BLDG PLNG 1 P.W.
PROJECT w
LOCATION 13 Mg ,Tfiten r-i-
DATE TRANSMITTED 6/�2.#
STAFF COORDINATOR'
FIRE
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FILE
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FILE NO. 6624 C x.39%
RESPONSE REQUESTED BY 4% OV
RESPONSE RECEIVED
THE ATTACHED ENVIRONMENTAL CHECKLIST WAS RECEIVED REGARDING THIS PROJECT. PLEASE
REVIEW AND COMMENT BELOW TO ADVISE THE RESPONSIBLE OFFICIAL REGARDING THE THRESHOLD
DETERMINATION. THE ENVIRONMENTAL REVIEW FILE IS AVAILABLE IN THE PLANNING DEPART-
MENT THROUGH THE ABOVE STAFF COORDINATOR.. COMMENTS REGARDING THE PROJECT YOU WISH
CARRIED TO THE PLANNING COMMISSION, BOARD OF ADJUSTMENT, AND CITY COUNCIL SHOULD BE
MADE ON THE ATTACHED CENTRAL PERMIT SYSTEM ROUTING FORM.
ITEM COMMENT
DATE
COMMENTS PREPARED BY
C.P.S. Form 11
CITY OF TUKWILA
CENTRAL PERMIT SYSTEM
ENVIRONMENTAL REVIEW ROUTING FORM
TO; 1 BLDG PLNG P.W.
PROJECT . &L()`[1/,
LOCATION 10632 Tka
DATE TRANSMITTED toi v1 i./
STAFF COORDINATOR g/ Qlre eve-
FIRE
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EPIC x,44%
FILE
POLICE P & R
FILE NO. IG .25q L�
RESPONSE REQUESTED BY igQ186/
RESPONSE RECEIVED
THE ATTACHED ENVIRONMENTAL CHECKLIST WAS RECEIVED REGARDING THIS PROJECT. PLEASE
REVIEW AND COMMENT BELOW TO ADVISE THE RESPONSIBLE OFFICIAL REGARDING THE THRESHOLD
DETERMINATION. THE ENVIRONMENTAL REVIEW FILE IS AVAILABLE IN THE PLANNING DEPART-
MENT THROUGH THE ABOVE STAFF COORDINATOR. COMMENTS REGARDING THE PROJECT YOU WISH
CARRIED TO THE PLANNING COMMISSION, BOARD OF ADJUSTMENT, AND CITY COUNCIL SHOULD BE
MADE 'ON THE ATTACHED CENTRAL PERMIT SYSTEM ROUTING FORM.
ITEM COMMENT
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DATE
122- V7F 7 COMMENTS PREPARED BY
C.P.S. Form 11
CI-TY OF TUKWILA
CENTRAL PERMIT SYSTEM '1' .. !JUN 2 2 1984 EPIC
BY
CUJSWILA FIRE PREVENTION BUREAU FILE
RECd117) •N 2Lj02
ENVIRONMENTAL REVIEW ROUTING FORM
TO; I l BLDG I PLNG ( P.W. •FIRE
PROJECT. ALL2 iL9) WW.
LOCATION / t 9 0-a ,T er
DATE TRANSMITTED 0/A241/
STAFF COORDINATOR 6
POLICE
P &R
FILE NO. £;2 G- 07 3Q 9'
RESPONSE REQUESTED BY (0089
RESPONSE RECEIVED
THE ATTACHED ENVIRONMENTAL CHECKLIST WAS RECEIVED REGARDING THIS PROJECT. PLEASE
REVIEW AND COMMENT BELOW TO ADVISE THE RESPONSIBLE OFFICIAL REGARDING THE THRESHOLD
DETERMINATION. THE ENVIRONMENTAL REVIEW FILE IS AVAILABLE IN THE PLANNING DEPART-
MENT THROUGH THE ABOVE STAFF COORDINATOR. COMMENTS REGARDING THE PROJECT YOU WISH
CARRIED TO THE PLANNING COMMISSION, BOARD OF ADJUSTMENT, AND CITY COUNCIL SHOULD BE
MADE ON THE ATTACHED CENTRAL PERMIT SYSTEM ROUTING FORM.
ITEM COMMENT
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71/01 5-1 S/ `M
DATE ff � -44
COMMENTS PREPARED BY
C.P.S. Form 11
'CITY--.CIF TUKWILA
CENTRAL PERMIT SYSTEM
ENVIRONMENTAL REVIEW ROUTING FORM
TO: I [ BLDG 1 PLNG ( ( P.W.
PROJECT 4,07,v,„1 %%9,
L0CATI0N /4 2 i1 '- z(rt,tJ
DATE TRANSMITTED 6/.va1 y
STAFF COORDINATOR At) Q ifii4J
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EPIC 2,38 AI
FILE
FIRE VA- POLICE
P & R
FILE NO.G- �,�CJ -�y
RESPONSE REQUESTED BY (AV /jfiG�
RESPONSE RECEIVED
THE ATTACHED ENVIRONMENTAL CHECKLIST WAS RECEIVED REGARDING THIS PROJECT. PLEASE
REVIEW AND COMMENT BELOW TO ADVISE THE RESPONSIBLE OFFICIAL REGARDING THE THRESHOLD
DETERMINATION. THE ENVIRONMENTAL REVIEW FILE IS AVAILABLE IN THE PLANNING DEPART-
MENT THROUGH THE ABOVE STAFF COORDINATOR. COMMENTS REGARDING THE PROJECT YOU WISH
CARRIED TO THE PLANNING COMMISSION, BOARD OF ADJUSTMENT, AND CITY COUNCIL SHOULD BE
MADE ON THE ATTACHED CENTRAL PERMIT SYSTEM ROUTING FORM.
ITEM CO ENT
ac osEh
Only S-rfLOCT IOA) (,JILL 1-1A YE A. v -S19aysF�CAnuT
m ?Ae'i oN 91 VFau 1412.E4S •
DATE , , aS g y COMMENTS PREPARED BY
C.P.S. Form 11
•
CITY OF TUKWILA F rn
Lftl 0 L _I ftl[tii
ENVIRONMENTAL CHECKLIST FORM F _..__...,� ..- _..._w...
2 1 1984
ciTY OF TUKI ALA
This questionnaire must be completed and submitted with the a Xj -j Taal
permit. This questionnaire must be completed by all persons applying for a
permit from the City of Tukwila, unless it is determined by the Responsible
Official that the permit is exempt or unless the applicant and Responsible
Official previously agree an Environmental Impact Statement needs to-be completed.
A fee of $60.00 must accompany the filling of the'Environmental Questionnaire
to cover costs of the threshold determination.
I. BACKGROUND
1. Name of Proponent: 1-1r.1,60AL_ C vauct to 1
. 2. Address and Phone Number.of Proponent: ‘534,..0 L. -i- sa a Te. D,
\n.. 9B05(Q
3. Date Checklist Submitted: v �r Z) 1c18 4
4. Agency Requiring Checklist: �ul k-VA 7 �,�e.:r r-kaw..11-
5. Name of Proposal , if applicable: 1:5,13sel, jvkpck, I■1Ac..k‘,..k Co.
6. Nature and Brief Description of the Proposal (including but not limited
to its size,• general design elements, and other factors that will give
an accurate.understanding of its scope and nature):
Ivr�t- t� \Vr us,
F\G T..) L..01K.SC
7. Location of Proposal (describe the physical setting of the proposal, as
well as the extent of the land area affected by any environmental im-
pacts, including any other information needed to give an accurate under-
standing of the environmental setting of the proposal):
ous-r-iz 1 oa.L
b3"Ll�; ) x1ST1I. AS�4 �,T U 1Te.
8. Estimated Date for Completion of the Proposal: - 56- 84
9. List of all Permits, Licenses or Government Approvals Required for the
Proposal (federal, state and local):
(a) Rezone, conditional use, shoreline permit, etc. YES NO )(
(b) King County Hydraulics Permit YES NO ".
(c) Building permit YES X NO
(d) Puget Sound Air Pollution Control Permit YES NO X
(e) Sewer hook up permit YES X NO
(f) Sign permit YES NO X
(g) Water hook up permit YES X NO
(h) Storm water system permit YES NO X
(i) Curb cut permit YES NO s
(j) Electrical permit (State of Washington) YES X NO
(k) Plumbing permit (King County) YES X NO
(1) Other:
10. Do you have any plans for future additions, expansion, or futher activity
related•to or connected with this proposal? If yes, explain:
Yl /&`r" {CTV 2r Ti_ 'V14lS T5L xl .
MA, ,2:-NDn a ep
11. Do you.know of any plans by others which may affect the property covered by
your proposal? If yes, explain:
12. Attach any other application form that has been completed regarding the pro-
posal; if none has been completed, but is expected to be filed at some future
date, describe the nature of such application form:
II. ENVIRONMENTAL IMPACTS
(Explanations of all "yes" and "maybe" answers are required)
1. Earth. Will the proposal result in:
(a) Unstable earth conditions or in changes in geologic
substructures?
(b) Disruptions, displacements, compaction or overcover-
ing of the soil?
(c) Change in topography or ground surface relief fea-
tures?
(d) The destruction, covering or modification of any
unique geologic or physical features?
YES MAYBE NO
• •
(e) Any increase in wind or water erosion of soils,
either on or off the site?
(f) Changes in deposition or erosion of beach sands, or
changes in siltation, deposition or erosion which
may modify the channel of a river or stream or the
bed of the ocean or any bay, inlet or lake?
Explanation:
2. Air. Will the proposal result in:
(a) Air emissions or deterioration of ambient air
quality?
(b) The creation of objectionable odors?
(c) Alteration of air movement, moisture
or temperature, or any change in climate, either
locally or regionally?
Explanation:
3. Water. Will the proposal result in:
(a) Changes in currents, or the course or direction
of water movements, in either marine or fresh
waters?
(b) Changes . in absorption rates, drainage patterns,
or the rate and amount of surface water runoff?
(c) Alterations to the course or flow of flood waters?
(d) Change in the amount of surface water in any water
body?
(e) Discharge into surface waters, or in any alteration
of surface water quality, including but not limited
to temperature, dissolved oxygen or turbidity?
(f) Alteration of the direction or rate of flow of
ground waters?
(g) Change in the quantity of ground waters, either
through direct additions or withdrawals, or through
interception of an aquifer by cuts or excavations?
-3-
YES MAYBE NO
(h) Deterioration in ground water quality, either
through direct injection, or through the seepage
of leachate, phosphates, detergents, waterborne
virus or bacteria, or other substances into the
ground waters?
(i) Reduction in the amount of water otherwise avail-
able for public water supplies?
Explanation:
4. Flora. Will the proposal result in:
(a) Change in the diversity of species, or numbers
of any species of flora (including trees, shrubs,
grass, crops, microflora and aquatic plants)?
(b) Reduction of the numbers of any unique, rare or
endangered species of flora?
(c) Introduction of new species of flora into an area,
or in a barrier to the normal replenishment of
existing species?
(d) Reduction in acreage of any agricultural crop?
Explanation:
YES MAYBE NO
5. Fauna. Will the proposal result in:
(a) Changes in the diversity of species, or numbers
of any species of fauna (birds, land animals
including reptiles, fish and shellfish, benthic
organisms, insects or microfauna)?
(b) Reduction of the numbers of any unique, rare or
endangered species of fauna? X
(c) Introduction of new species of fauna into an
area, or result in a barrier to the migration
or movement of fauna?
(d) Deterioration to existing fish or wildlife
habitat?
Explanation:
•
6. Noise. Will the proposal increase existing noise
levels?
Explanation:
7. Light and Glare. Will the proposal produce new
light or glare?
Explanation:
8. Land Use. Will the proposal result in the altera-
tion of the present or planned land use
of an area?
Explanation:
9. Natural Resources. Will the proposal result in:
(a) Increase in the rate of use of any natural
resources?
(b) Depletion of any nonrenewable. natural
resource?
Explanation:
10. Risk of Upset. Does the proposal involve a risk of an
explosion or the release of hazardous
substances (including, but not limited
' to, oil, pesticides, chemicals or radi-
ation) in the event of an accident or
upset conditions?
Explanation:
YES MAYBE NO
• •
11. Population. Will the proposal alter the location,
distribution, density, or growth rate
of the human population of an area?
Explanation:
12. Housing. Will the proposal affect existing housing,
or create a demand for additional housing?
Explanation:
13. Transportation /Circulation. Will the proposal result in:
(a) Generation of additional vehicular movement?
(b) Effects on existing parking facilities, or
demand for new parking?
(c) Impact upon existing transportation systems?
(d) Alterations to present patterns of circulation
or movement of people and /or goods?
(e) Alterations to waterborne, rail or air traffic?
(f) Increase in traffic hazards to motor vehicles,
bicyclists or pedestrians?
Explanation:
14. Public Services. Will the proposal have an effect upon,
or result in a need for new or altered
governmental services in any of the
following areas:
(a) -Fire protection?
(b) Police protection?
(c) Schools?
(d) Parks or other recreational facilities?
(e) Maintenance of public facilities, including
roads?
YES MAYBE NO
(f) Other governmental services?
Explanation:
15 Energy. Will the proposal result in:
(a) Use of substantial amounts of fuel or energy?
(b) Demand upon existing sources of energy, or
require the development of new sources of
energy?
Explanation:
16. Utilities. Will the proposal result in a need for
new systems, or alterations to the
following utilities:
(a) Power or natural gas?
(b) .Communications systems?
(c) Water?
(d) Sewer or septic tanks?
(e) Storm water drainage?
(f) Solid waste and disposal?
Explanation:
17. Human Health. Will the proposal result- in the crea-
tion of any health hazard or potential
health hazard (excluding mental health)?
Explanation:
YES MAYBE NO
• •
YES MAYBE NO
18. Aesthetics. Will the proposal result in the obstruc-
tion of any scenic vista or view open to
the public, or will the proposal result
in the creation of an aesthetically of-
fensive site open to public view?
Explanation:
19. Recreation. Will the proposal result in an impact
upon the quality or quantity of exist-
ing recreational opportunities?
Explanation:
20. Archeological /Histroical.* Will the proposal result in
an alteration of a signifi-
cant archeological or his -
torical site, structure,
object or building?
Explanation:
CERTIFICATION BY APPLICANT:
I, the undersigned, state that to the best of my knowledge the above
information is true and complete. It is understood that the lead agency
may withdraw any declaration of non - significance that it might issue in
reliance upon this checklist should there be any willful misrepresentation
or willful lack of full disclosure on my part.
(r) Fc 21 . ) 915 47
Signature and Title V,P. Date .
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