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Introduc[ion: The State Envlronmental Policy Act of 1971, Chapter 43.21C, RC4f, requires all <br /> sta[e and local governmental agencles to consider envlronmental values both for their ovn <br /> actions and vhen licensing private proposals. The Act also requires tha[ an EIS be prepared . <br /> for all ma,1or accions significantly aEfecting the quallty oE the environment. The purpose ; <br /> of [his checklist is to help [he agencies involved determine vhether or not a proposal is such <br /> a major action. <br /> Please ansver the follo•.rir.g quPstions as completely as you can cri[h the informati�^ nresently <br /> available to you. HhPre explanations of your ansvers are requi:ed, or vhere you belie�� an <br /> explanation vould be help°ul [o govecnment decision makers, inclu.{e your exr,lanation in .the <br /> spac� provided, or use addi:ional pages if necessary. You should :ncludr eeferences to any <br /> reports or studies of vhich you are avare and vhich are relevant to �:�e ansvers you provide. <br /> Complete ansvers to these questions nov will help�all agencies Invalved vith your proaosal <br /> to undectake the required environmental reviev vithout unnecessary delay. <br /> ihe falloving questians apply to your total proposal, noC just to the license for ahich you <br /> are currently applying or the proposal far which approval is sought. Your ansaera ahould <br /> include [he impac[s vhich vill be caused by your proposal vhen it is campleted, even though <br /> completion may not occur until sometime in the future. This c+i.11'allov all of the agencies <br /> uhich vill'be involved to conplete [heir environmental review aov, erl.thout duplicating <br /> paper work in the future. <br /> vOTE: 14:is is a standard Form being used by all atate and local agencies !n ehe §tate of <br /> Slashington for various types of proposals. Many of ehe questions nap not apply to your proposal <br /> If a question does not apply, just answer it "no" and continue on to. the next question. <br /> "cN�1IR0lRgNTAL CFIECEQ.IST FORM <br /> 1. BACKGROUND . <br /> 1. Naae of Proponent � � �� 1• " %%�r . l�„ .� ' <br /> 2. Address and Phone N�ber of,Proponent: ,."�� �(�7/%, �,,•�:<ic�. •,1�1.1 —�'rj" irr �,��2,-t{',L.' <br /> �._l'i_ GI.:,L`f ,i,�-;1 e Z �� 2� lti r,;ti l',e.e.�.�— :�..L , <br /> 3. Date Checkliat Submitted �:.L 1,1=� .���' ,�i <br /> 4. Agency Bequiring Checklist ' (°_,..r,�.z�-. <br /> 5. Name of Proposal, if applicable: � •_� <br /> 6. Nature and Brief Descrip[ion of the Proposal (icicluding but not limited to ita size, <br /> general design elements, and other fnctors that vill give an accurate underatanding <br /> of its scope and nature): /1.4cN+[+�rr �F hct ,4,vo 6�r.a,oE � �ztfi✓j !t✓E[of f.�A��I'f' <br /> Fw Se,m� oF E74J'�►�7Q+ 9rRua��LC �iiX`/o HA4�r+�E �tt3 HRY �.,uuCf ,ur1GE sW�t.E� <br /> W1hcN .Joill.a�(�JI� �oWL�1?71�16. <br /> 7. Locati�n of Proposal (describe the phyaical setticeg oE [he proposal, as aell as the <br /> ex Len[ of the land area affected by any environmecttal impacts� including any other <br /> infonna[1on needed [o give an accurate unders[anding oE Che environmental aetting� of <br /> [he proposal) ;� ' ' " �r-^ " � I <br /> � t .,r C�i. .i. [I ��+r i � /S • r' cG , I-�Y. � . . .1 <br /> i ' <br /> 8. EstlmaCed Da[e for Completion of the Proposed Action: � Yb�� ��`..:�[�`�=•=d'J • <br /> 3 I <br />