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ENViRONMENT9L CHECKLIST � <br />� ($�.00 Fee Required) <br />Introduction: The Str,2e Environmental Policy Act of 1971, <br />Chapter 43.21C , RC'N , requires all state and local governmental <br />agencies to consider environmentul values both for their own <br />actions and when licensing private proposals. The Act also <br />requires that an EIS be prepared for all major actions significantly <br />affecting the quality of the environment. The purpose of this <br />checklist is to help the agencies involved determine tvhether or not <br />a�roposai is such a major action. <br />Please snswer the following questions as completely as you can <br />with the infarmation presently available to you. Where explanations <br />of your answers are required, or where you believe an explanaticr, <br />would,be helpful to government decision makers, include your <br />explanarion in the space provided, or use additional pages if <br />necessary. You shauld include references to any reports or studies <br />of which you are aware and which are relevant to the answers you <br />psovide. Complete answers to these questions now will help all <br />agencies involved with your proposal to undert:lce the required <br />environmental review without unnecessary delay. <br />The following questions apply to your total proposal, not just to the <br />license for which you are currently applying or the proposal for <br />which approval is sought. Your answers should inciude the impacts <br />which will be caused by your proposal when it is completed, even <br />though complerion may not occur until sometime in the future. This <br />will al7ow nll of the agencies which will be involved to complete <br />their environmental review now, without duplicnting paperwork in <br />the future. � <br />NOTE: This 9s a standard form being used by all state tmd locai <br />egencies in Uie State of Washington for various rypes of proposuls. <br />Many of the questions may not appiy tu your proposal. If a question <br />dces not apply, just answer it "no" and continue on to the nett <br />question . <br />E1dVIRONMENTAL CHECKLIST FORM <br />I, BACHGROUND <br />1.• Name of Proponent The aran3vola comoanv <br />2. Address and Phone Number of 1'roponent: , <br />7600 Evergreen Way, P.O. Box 3066, Everett, WA 98203 <br />PH: 355-1135 <br />3. Date Checklist Submitted 3-28-79 <br />