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STATE OF WASHINGTON JUSTICE ASSISTANCE GRANT <br />DEPARTMENT OF COMMERCE FORM 4 <br />NATIONAL ENVIRONMENTAL POLICY ACT (NEPA) <br />The following information is required from each federal grant recipient. The Department of <br />Commerce will consolidate all responses and submit a consolidated response to the U.S. <br />Department of Justice as required. <br />Please check one of the blanks to the left of each item below to indicate whether or not the activity <br />described is being undertaken to support or facilitate the federally funded activity by the grant <br />recipient or any other party. <br />(Note —the source of funds utilized is irrelevant to your response.) <br />(Note —if the activity is being undertaken without regard to the presence or operation of a federally <br />funded activity, the item should not be checked.) <br />Yes <br />Activity N/A <br />❑ ❑ <br />1. New Construction <br />2. Minor renovation or remodeling of a property either: <br />a. listed or eligible for listing on the National Register of Historical Places <br />b. located within a 100-year flood plain <br />3. Renovation, lease, or any proposed use of a building or facility that will <br />either: <br />a. result in a change in its basic prior use (between industrial, office, <br />residential, etc.) <br />b. significantly changes its size (total structure, not program's portion <br />thereof) <br />4. Implementation of a new program involving use of chemicals other than: <br />a. chemicals purchased as an incidental component of the funded activity <br />b. traditionally used (e.g., for office, household, recreational, educational <br />environments) <br />If any item above is checked, a clarification of the activity may be requested. <br />Response is made related to the following Byrne funded program/project: <br />Project: <br />Signature: Date: <br />Typed Name: Title: <br />Representing: <br />13 <br />