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. -:: . - <br /> t. _ . <br /> , , ' - MAIVIRONMEN>AL CHECKLiSTM <br /> . �01 f�: r , <br /> ($25.00 b'ec Itequired) I � ti � <br /> . � i� <br /> . , , . <br /> �";+! 1 �? �J; + <br /> Introduction: The State rnvi^onmental Policy Act of 1971, ( J <br /> Chnpter 43.21C, E2CW , rcquires all stnte nnd ]ocal governmentiiI � � ���' E1 I.;.;,_ � �� <br /> ngencies to consider environmentnl velues both for lheir own <br /> actions and tivhen llcensing private proposnls. The Act n15o <br /> requires thnt nn EfS bc prepared [o.r nll mnjor c�ctions significnntly <br /> nffecHng the quality of the environmenL 'fhe purpose of this <br /> checklist is to help the ngencics involved determine whethcr ar nut <br /> a propo�nl is cuch a major action. <br /> Plense anstvcr Ure fullowing questions as completely ns you cnn <br /> with thr. in(orm:.tion presenUy a��uilnblc to you. �Vhere explanations <br /> of your nnswers ore required, or where you Uelieve en expinnation <br /> would be helpful to governmrnt decision mekers, include your <br /> explanetion in the space pro�•ided, or use additional pagec if . <br /> necessnry. You should +'nclude reterences to nny reports or studies <br /> of which you nre aware nnd wnich ure relevant to the uns:vers you <br /> provide. Cornplete answers to these questions now will helEi nll <br /> agencies im-olved with your proposul to undertake the rcquired <br /> environmentaI review without unnecesenry delny. <br /> The folloiving questions apply ;o your total proposal, not just to the <br /> Iicense for which you are currently applying or tlie proposcl for <br /> which npproval is sought. Yuur answers shoul�l include the impacts <br /> which will be enused Uy your proposal when it is completed, even <br /> though completion may not occur until sometime in the Culurc. This �' <br /> will nllo�v nll of the iigencies �vhich wil] be involved to complete <br /> their environm�ntnl review now , wiU�out duplicating paperwork in <br /> Ihe future. <br /> NOTE: This is n standard form Ueing used Uy all state nnd local <br /> ngeneies in the State at Wnsh{ngton for vnrious types of proposnls. <br /> Many of the questions mny not apply to your proposnl. It a qurstion <br /> does not npply, just nnswer it "no" nnd continue on to tlie next <br /> question . <br /> IiNVIRONi11ENTAL CfiECKLIST FORM <br /> I. BACKGROUND <br /> I. NUIDC' OfPPO�OI7BII! lair: Rrnr�hal � �"fil<,= I4i�I:•a.�� :�iy : ,� Isi�n .'.;;. <br /> 2. Addr�ss und Phone 1VurnUer ut Proponent: <br /> c7ary A. ;;el ,�.�n � <br /> '�71U hhar� SL. � <br /> Gd��iand;� :dashi.�r_[on ihouc 778-83b2 � `'�� -. !� <br /> 3. Dute Checklist Submitted May t�i, t�+7,� <br />