HomeMy WebLinkAbout046-161-028APPENDIX F
ENV-ROVENTA ; AI'CKLIST FORM
(o be Completed by Lead. AgenCy)
,Rb Zo '
1. l3ACKGR iUND ' g' _0_05 0-bl.
1. Name of Proponent JanL,oe Si. �doK�.nney
Address and Phone
Num er';o ProponeriG
i77i� A1iE.-
—chin rrtr.m.
.
3,bate of ted�
Agency Requiring'; CheCklist
S . Name .of Proposal;' zf aPPlca . e Sed tic _sysem,
a ? "dLttilex 2. Y�ouse d veto me �3n r to 7o�r
II. ENV,IRQNMENTAL IMPACTS qfi pp t .../0-
(Explanations of a17. "yids" and "rnagbe1P answers are:
on attached sheet's
" • �>
required;�
YES MAYBE NO .,
l.' Earth. WiIJ: the proposal resU:lt iL signant c
a.IL Unstable earth coxid;Itions 'or in
changes itt geologicsubstructures?
b. Dsruptiols, displacements, coni-
pac ion pr overcovering of the soil?
c . Cfiange a.n11 ;toporaphy 0 ground Sur -
fa er.elie features
or removal of.
t;opso.il?
_
d, bestrtic .ori, CoVering Or fiOC1 f,3;Cc3"
tion of, any uniq o gealoga.c or
physiCal features
.
e. Increase :4 wind or water erosion
Q_ soils, eithar on o off the site?
r
f. Changes in ciepasi tioia Or e� onion_
of beach sands ; or changes in s� ],ta« "
tion, deposition cir ,erosion ralich
may' Modify` the channe], o°" a xirer, ar
s,ream ar the bed o the ocean air
any bay, :%nle,t or aC?Admk
_
Lass �
of prime a gra.culturolly`pro-
duct.i^ve sox s ouC,sic�e des
ttban f ignated,
areas
r
'Ag endix ;' : a e �.;
g�_
,of q
MAYBE Np
h. BXposure of people or property t9
001091d hazards such as earthquakes,,
landsl,.ides, mudslides, ground failure,
or similar hazards?
2, p p
A GJ11 the r,c osa.Z result in
a. Substantial' dett6rioratJib' it. of
ambient or focal ajr, quality?
b. The creation of objectionable
odors, smoke.or fumes?
C Sgr,ifcant a aeration of air
movement, moistur1. e or,temperature,
o:r any, charge in cl�,inata, either
locally arregonal'ly?
3. Water, t+lJAI the proposal result iri substantial:
a. Changes in currezlts, or ,the course
or direction of water
movements?
b. Changes inabsarptiori gates dra.inap
patterns,
or the rare and amount of
.;
surface water runoff?
c, Need for alf--site surface drainage
iznpravements,
;mc luding vegetation
removal, channel.izatinn'or culvert
installation 9
d: Alterations. to the course or -flow
of flood
water,4,
Change'in the amount;oi surface
water inariy water body? 0�t:"rr'
. isoharge into surface waters, or
in; any ;al teratiorn. of surface
water quality, ncluding'but'not
limited to
teinperatuxe, Ej�.S30� VP.C�
Oxy or turbidity?;
:': Alteration, of `the
gdirects an it
rate ofZow of ,ground waters?
_.
h: Change -in the quantity or quafity
of
'ground waters ; either through
direct additions or wit�hdrawals
or through Int,ercep 4.on o an
aquifer by Out$ or excavations? '
I
Appendix"
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,'I
o f
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i
Y nJ: 1 ab;
MY -Mr, IJo
Aeduction ih the a mOurit of water
othorwis.e.- a'aailable for public
water ,suP;P:1ies?
1r
j. Exposure of eu le or p y
ro water relayed hazardrr�such a s
f Lo, di
P7 antT�ife. Wl'1 the proposal result
in stztial s
_
a; Loss cif ve eta 3on or change in the
diversityof
spedies or .number
of
any species of plants .(nc:ludng,
trees; shrubs,grass, drops
m1crof lora and; a"quaticplan.,ts) ?�
b. Reduction of the numkses of.,any
unique, rare or, endai,�gered species
Of plants?
C. Introduction of new species:'
plants ifttole an area,. or in a barrier
to the normal, r,eplenislinent of
existing species?
d.Reduction ,n acreage of any, agri-
cultural crop? ;
5,4 AnimalLife , G1ill -the proposal result
%n substlantials;
a. Change in the diversity of sec3es,
ar -numbers of any species of
animals (bird,;,; land animals
'
including reptiles, fish and, shell=
fish,, benthio
organisms, insects or
ro f aunts ?'
ti: Reduction 0,f ,the numbers of any.
unique, rare lor exidangered species
of .anirials`7`
c, Introductionof'new'species of
animals a.nto an'area, or result in
a barrier to the mi ratan or
movementcif` animalsg
dKeduction oft encrachinent upon, or
deferiorat ( to existing fa,sli or
11. WL: feAsk
i 'hah�.t"
at?
tk '
a t.
Apex,dix �'' page 3 of ..`9
Y nJ: 1 ab;
,
YES MAS
6.
Noise, Will the -proposal result in
substantial.:
a,. increases 1n noise levers?
b. Expbsvre of "people to oevere ,noise
7.
;!_iht, ,and Clare. Will; the proposal:
r-�--
i?r s,gncant '
light or glare?
$i.
Land U�.ae: �4iil the proposal result
in a .sign;.f.q'.cant;
a A'i;te—atiton, o.f the panned land use
of; an area,, or establish a trend `
which will demonstrably leach to such
al"terat,in
o.
Conflict cv`th uses an a o,%n3 ng
praper�.es, ar conflict Vith ;
established recreational-, educ:a-
tional .religious or scientific
uses,
of an area;?
9 .
Natura;l Resources . Iq,l7 the proposa];
result , in,
subst�antis:
A. Demand for, Orn the rate
of"use,of any natura resources?
#
b,: DOetion of any noir, enewable
natural resource?
10;s-
Risk ote Does the: proposal
invoIve a r3.sk of an explosion or
the release of bazar ous substances
"ir�cluda.ng, but; not 'lxmi'ed to o'"i,
pesticides.; ,ch"emicals or'' radiation),
w
in f -he event o an, accident or upset
conditional
!:oj,ulation, will tte proposal'
sa.gn� cantly alter .:;ie lo
distributinn,.den"si,ty, or grow th,
Fate off, the human popc�laticin of air
area OX, physically divide an
`
.
establi led, "coinznunity?
;,
"
2.
HOUsfn ;. Wi.11 tXie" proposal
Sig n�L ;cantly affect> existing:. housing, .
or create a; demand for additional
hOUSing;,
�
a
A` ezaclic F page
� �
__
N� ,
YES `
MAYBE NO'°
# 13.,
Trans`ortation/Circulation;, Wil1'the
p`roposal r' e-sujt
a Generation of siibstant'ia;l additional.
vehicular movement?
b 8 34 g1:1 if cant effects on existing
'Patktng,
faell.itjes, or demand for
new parking?
c; Substantial impact upon existing
transportations m�?
Y's stMWe
d.' Significant alterations to present
pa�tterris of �circula,'bion or, movement
o'f'pe(Dple tinct/or 'gcio;cis?
e; Alterations td'waCerborne rail.'or
air traffic,?
lift
.C1 C. 1
f , Tncr ,ce intraf ic hazards to motor
vehicles, 41,cyc7 Csts' or pedes trxans?
14.
Public Serv;�c:.s G1i.,L1 the proposal have
a.n e. ect upon, or restil* ina substantial
meed for` neer 0r< alt red g.=vernmental
. ; i of the °following areas
services �n an
a.` Fire protection?
b . Police pro'tection?
c._ Schools?
d. Parks or other recreational "`
£adilities't
e, Maintenance fac
Of public l„lities;
#
including roads?
f. Other governmental services?
r
1�
i✓ner Will the proposal result `in; '
tlSee of substantial: amounts o
or enery7t
b. Substantial increase :n demand upon,
existing sources of.energy, o
require the development bf new.
sources ,of energy?
l6.
ttJ,IIt3,es, GJ111 th e ,:pro,bsa]:res�a'lt
Vire a
nerfor neta systems, or, 'sub
stahti.al al.eratohs to follo'ng
,tile,
3.
„f;
gipp`
r
APW- - d x .F page 5 of
4q
AUDL
i
YES.
MAYBE NO
sustaining levels, threaten to
eliminate a ,plant or animal com-
muni ty,"reduce the number 0" res',rict,
th:e range
(11 a ;rare or endangered
plant or animal or eliminate important
examples of the major periods of;
California his tor y prehistory?
cr
(
b , I)aes the project have the potential
to achitv'' short term benefits
to
the detriment of public3_y adapted
long-term environmental goals?
c,'Doe's the project havO impacts which
are iri 34 V31' l
•imited, but
Gumulat�ve y Considerable? (a project
triay, impact on two or more Separate
resources where the impact
on each
resource is relativel'1y sms1: but
whore the effect o. the 'total of
those impacts
on the envlran.ment is
significant.}
ds hoes the project haveenvironmental
effects; which will ta.use- substantial
adverse effects on` human beings,
either,directly;or indirectly?
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