HomeMy WebLinkAboutSEPA EPIC-ND-32 - ASH LAWRENCE - ASH BUILDINGASH COVIVIERCIAL BLDG
EPIGND -32
CERTIFICATION BY APPLICANT:
June 24, 191S
CITY OF TUKWILA
I hereby certify that the information furnished in this environmental checklist
sheet is true and accurate to the best of my knowledge.
Signature and Title
' Project Name:
Project Address:
•
BELOW THIS LINE FOR CITY USE ONLY
ACTION BY OTHER.DEPARTMENTS:.
1. Date of Review: Building .by:
Planning G�D • 65.2 1 by'
Engineering • by:
Police by:
Fire by:
2. Agency review of environmental checklist determined that:
".The project is exempt by definition.
The project has no significant environmental act aenvironmentalnaffects
should be processed without further consideration
The project has significant environmental
xioxctoafurther actionefox pexmi
mental impact statement must be p p prior
specific information is needed to determine impact. .
*CIO
=Check one
CO or ( -)
CO 0
( +) or ( -)
CO or (-)
CO ox ( -)
•
nature and. T" le of Responsible Official
3. Applicant was notified of decision on:
by
Date
In accordance with Washington State Environmental Policy Act and City of Tukwila
Ordinance No. 759.
(d -) Means recommend a full environmental impact statement be-done.
(_) Means recommend a full environmental impact statement not-be done;
Staff Person
by
Letter, phone
CITY OF TUKWILA
ENVIRONMENTAL QUESTIONNAIRE
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 an environmental assessment or full impact statement is required. Other
forms have been developed for single- family home applications and legislation
proposals.
BACKGROUND DATA:
1. Name of applicant
2. Address and phone of Applicant:
3. Project .name:
4. Project location: bgrr e7 . 4
5. Nature and brief description df proposal:
6. Estimated completion date.; `' 77
7. Do you have any plans for future expansion', if yes please explain: t4
What other ove nmental permits are required prior to completion of this
project?
Rezone, conditional use, substantial development, etc.
King County Hydrolics Permit
Building permit
Puget Sound Air Pollution Control Permit -
(a)
(b)
(c)
(d)
(e) Sewer. hookup permit
(f) Sign permit
(g) Water hook up permit
(h) Storm water system permit 0
(i) Curb cut permit
(j) Electrical permit (State of Washington)
(k) Plumbing permit (King County)
(1) Other
YES NO
YES- NO
YES .NO
YES NO 4..."-'7
YES 0
YES ✓ NO
YES-4°°-NO
YES ✓ NO
YES NO
YES '4.°1-10 •
YES 1..e..4.1:0.
9. Do you know of any plans by others which may affect the property covered by
your proposal? If yes, explain:
10. Agency requiring checklist: City of Tukwila, Department .- FLAW/WA/6
11. Accepted by agency on: Z02:411 .. 111( by: 6• OyafGit&fe'
(to be filled in by city upob receipt of checklist)
ENVIRONMENTAL IMPACTS
(Explanations of all "yes" and "maybe" answers are required.)
Earth. Will the proposal result in:
(a) Unstable earth conditions or in
-any changes in geologic sub -
structures:
(b) .Disruptions, displacements
or overcovering of the soils:
(c) Change in topography or ground
surface relief features?
(d) The destruction, covering, or
modification of any unique
geologic or physical features?
(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
in 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:
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
in any change in climate, -
either locally or regionally?
Explanation: -
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
amount of surface water run-
off?
(c) Alterations to the course or
flow of flood waters?
(d) Change in the amount of surface
water in any watercourse?
(e) Discharge into surface waters,
or in any alteration of sur-
face.water quality, including .
temperature 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
acquifer by cuts or excavations?
(h) Deterioration in ground water
quality, either through direct
injection, or through the seep -
age of leachate, phosphates,
detergents, waterborne virus
or bacteria, or other substances
.into the ground waters?
(i) Reduction in the amount of water
otherwise available for public
water supplies?
Explanation:
• Yes Maybe' • No
e tVL o US 6w✓lotee-s ..
•
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, micro -flora 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 bar -
rier to the normal replenishment of
existing species?
Explanation:
6x's -' i/43 sus , 4,k, 0.440.<4 - -
ow).
Fauna... Will the proposal result in: .
• Yes "Maybe No
(a)
i
Changes in the diversity of species,
or numbers of any species of fauna
(birds, land animals including rep -.
tiles, fish and shellfish, benthic
organisms, insects, or micro- fauna)?
(b) Reduction of the numbers of any
unique, rare or endangered species
of fauna?
(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 wildlife
habitat?
Explanation:
5 1 o.c-e,w * 0,s s�e'`s. )71nyosod
Noise.. Will the proposal increase exist
ing noise levels?
Explanation:
4 .
tJ
•
Light and Glare. Will the proposal produce
new light or glare?
Explanation::'
Land Use. Will the proposal result in the
alteration of the present or planned land
use of an area?
Explanation:
r.
Natural Resources. Will the proposal- re-
sult in:
(a) Increase in the rate of use of any
natural resource?
(b) Depletion of any nonrenewable nat-
ural resource?
Explanation:.,
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
radiation) in the event of an accident or .
upset conditions?
Explanation:
Population. Will the proposal alter the
location, distribution, density, or growth
rate of the human population of an area?
Explanation:
Yes Maybe •
•
Housing. Will the proposal affect existing
housing availability, or create a demand for
additional housing?
Explanation:
Transportation /Circulation. Will the pro-
posal 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 or air
traffic?
Explanation: ge dvAt tst.E al t.#&('c id a .a..1 V Sl f .
Yes Maybe
Local Services. Will the ' proposal have an
.effect upon, or result in a need for new
services in any of the' following areas:
•
(a) Fire protection?
(b) Police protection?
(c) Schools?
(d) Parks?
(e) Maintenance of public facilities,
including roads?
(f) Other'governmental services?
Explanation:
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:
Utilities. Will the proposal result in a need
for new systems, or alterations to the follow-
ing 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;.
• Yes Maybe No
Human Health. Will the proposal result in the
creation of any health hazard or potential .
health hazard (excluding mental health)?
Explanation:
Aesthetics. Will the proposal result in the
obstruction of any scenic vista or view open
to the public, or will the proposal result
in the creation of an aesthetically offensive
site open to public view?
Explanation:
Recreation. Will the proposal result in an
impact upon the quality or quantity of ex-
isting recreational opportunities?
Explanation:
Archeological /Historical. Will the proposal
result in an alteration of a significant
archeological or historical site?
Explanation:
Revenue. Will the proposal cause a signifi-
cant increase in city revenues?
Explanation:
Employment. Will the proposal create.a
significant amount of new jobs?
Explanation:
Yes Maybe • No