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WAC 197-10-3E5 ENVIRONMENTAL CHECKLIST. (1) The form in subsection (2) hereof is the environmental checklist. Agencies may at their option revise the format of this form; however, the language of the questions shall not be changed. The iuestions appearing in the environmental checklist are exclusive, and considerations which do not appear ir, it or in WAC 197-10-360 shall not be used in making a threshold determination. This checklist does not supersede or void application forms required under any other federal or state statute or local ordinance, but rather is supplementary thereto. (2) Environmental checklist form: Introduction: The State Environmental Policy Act of 19%1, Chapter 43.21C, R Wes, requi—res all state arc local governmental agencies to consider en- vironmental values both for their own actions and when licensing private proposals. The Act also requires that an EIS be prepared for all major act- ions significantly affecting the c-:ality of the environment, The purpose of this check list is to help thr .3encies involved determine whether or not a proposal is such a major action. Please answer the following questions as completely as you can with the in- formation presently available to you., Where explanations of your answers are required, or where you believe an explanation would be helpful to gov- ernment decision makers, include your explanation in the space provided, or use additional pages if necessary. You should include references to any reports or studies of which you are aware and which are relevant to the answers you provide. Complete answers to these questions ',ow will help all agencies involved with your proposal to undertake the required environmental review without unnecessary delay. The following questions apply to your total proposal, not just to the lic- ense for which you are currently applying or the proposal for which ap- proval is sought. Your answers should include the impacts which will be caused by your proposal when it is completed, even though completion may not occur until sometime in the future. This will allow all of the agencies which will be involved to complete their environmental review now, without duplicating paperwork in the future.. NOTE: This is a standard form being used by all state and local agencies in the State of Washington for various types of proposals. Many of the questions may not apply to your proposal. If a question does not apply, just answer it "no" and continue on to the next question. ENVIRONMENTAL CHECKLIST FORM I. BACKGROUND 1. Name of Proponent L.D.S. Church 2. Address and Phone Number of Proponent: 10103 21st Drive S.E. - Everett, TIA 98204 Home Phone - 337-3098 Work Phone - 259-9435 3. ate C eck ist Suomitted October 31, 1978 0-,