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_..._ ____ -----.._---__ _._ ---__. . _ _ <br />ENVIROtRtf•.N'CAL CIIBCKLIST. <br />.� . . �...._ <br />,� ` • (550.00 Fcc'Required) , <br />Incroductinn: The Sta[e Environmen[al Policy Act of 1971,�Chapter 43.21C, RG1d, requires all <br />state ani� local governmental agencies to consider environmental values both for their own <br />nctions .7n3 when licensing private proposals. The Act also requires that an EIS be prepared <br />for all ma,jor :�ctSons significantly affecting the quality of the environment. The purpose <br />of this r.hecklist is to help -the agencies involved determine vhether or not a proposal is such <br />a major accion. ' ' <br />Please answer the folloWing questions as completely as you can with [he infotmation presen[ly <br />available to ynu. S.fiere explanations of your anscrers are required, or where you believe an <br />explanation �:ould be helpful to government decision makers, include your explanation in the <br />spac� provided, or use additional pages if necessary. You should include references to any <br />reports or studies of vhich you are ar:are and c:hich are relevant [o the answers you provide. <br />Comple[e ansuers to thesc questions now will help all agencies involved with your proposal <br />Co undeztake the required environmental review �aithout unnecessary delay. , <br />The foll.owing questions apply to your [o[al proposal, not just to the license for which you <br />are currently applying or the proposal for which approval is sought. Your anscaers should <br />include [he inpacts which•will be caused by your proposal when it is completed, even thaugh <br />completion may not occur until sometic�e in the future. This will allow all of the agencies <br />which will be involved to conplete their environnental review now, without duplicating <br />paper crork in the future. <br />NOTC: This is a standard form being.used by all state and local agencies in the State of <br />4!ashington for var3ous t��pes of proposals: Many of the questions may not apply to your pr.oposal. <br />If a question does not apply, just answer it "no" and continue on [o the next question. <br />ENVIFO�^.iEIQTAL CNECF:LIST FORP[ <br />1. BACRGROUi:D <br />1. Name of Proponent � ��^� � <br />2. Address and Phone Number of Proponent: P O �x �%�} <br />EDi%lof-1 C�Sr VYA `3P�'�21� �71i, - �5�� . <br />3. Date Checklist Submitted�frx_�� ��C�_J <br />� <br />5 <br />I�qency Requiring Checklisr�� <br />Name of Propesal, if applicable: <br />6. Nature and Brief Description of the Froposal (including but not limited to its size, <br />general design elemen[s, and other factors that will give an accura[e unders[anding <br />of its scope and nature) :��� SC.� F T c� �'pr""'��� T� LT� <br />• - •- - • •- - - - - ,�� �.,._ c �-n�. <br />7. Location of Proposal (describe [he physic�l setting of the proposal, as �aell as the <br />exten[ of the'land area affec[ed by nny environmental impacts, including any other <br />infocr.i�tion needed [o give an accurate understanding oE [he environmental setting oE <br />ihc propusal):��r� 17 7y9'o p� '(��n WI�=�L 12�^1aJN�- <br />8. Estimated Datc for Completiun of the Proposed Action: <br />i ' <br />-- ' � <br />� <br />� <br />