Mathis Sub 2012-0002 SEPA Chklst SEPA CHECKLIST
SfÔkane SVMC 21 .20
Va11eyx Community Development— Planning Division
11703 E Sprague Ave Suite B-3 ♦ Spokane Valley WA 99206
509.720.5310 ♦ Fax: 509.688.0037♦planning@spokanevalley.org
STAFF USE ONLY
Date Submitted: Received by: Fee:
PLUS #: File#:
PART I - REQUIRED MATERIAL
"*THE APPLICATION WILL NOT BE ACCEPTED IF THE REQUIRED MATERIALS ARE NOT PROVIDED"*
❑ Completed SEPA Checklist
❑ Application Fee
❑ Reduced Site Plan of proposal in 81/4" by 11" or 11" by 17" size
• Trip Distribution and Generation Letter, if requested by Development Engineering.
PURPOSE OF CHECKLIST:
The State Environmental Policy Act (SEPA), chapter 43.21C RCW, requires all governmental agencies to
consider the environmental impacts of a proposal before making decisions, An environmental impact
statement (EIS) must be prepared for all proposals with probable significant adverse impacts on the quality of
the environment. The purpose of this checklist is to provide information to help you and the agency identify
impacts from your proposal (and to reduce or avoid impacts from the proposal, if it can be done) and to help
the agency decide whether an EIS is required.
INSTRUCTIONS FOR APPLICANTS:
This environmental checklist asks you to describe some basic information about your proposal. Governmental
agencies use this checklist to determine whether the environmental impacts of your proposal are significant,
requiring preparation of an EIS. Answer the questions briefly, with the most precise information known, or give
the best description you can.
You must answer each question accurately and carefully, to the best of your knowledge. In most cases, you
should be able to answer the questions from your own observations or project plans without the need to hire
experts. If you really do not know the answer, or if a question does not apply to your proposal, write "do not
know"or"does not apply." Complete answers to the questions now may avoid unnecessary delays later.
Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations.
Answer these questions if you can. If you have problems, the governmental agencies can assist you.
The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of time or
on different parcels of land. Attach any additional information that will help describe your proposal or its
environmental effects. The agency to which you submit this checklist may ask you to explain your answers or
provide additional information reasonably related to determining if there may be significant adverse impact.
USE OF CHECKLIST FOR NON-PROJECT PROPOSALS:
Complete this checklist for non-project proposals, even though questions may be answered "does not apply."
IN ADDITION, complete the SUPPLEMENTAL SHEET FOR NON-PROJECT ACTIONS (Part D).
PL-22 V1.0 Page 1 of 14
Sikikane SEPA CHECKLIST
.0.101FValley
12. Location of the proposal. Give sufficient information for a person to understand the precise
location of your proposed project, including a street address, if any, and section, township, and
range, if known. If a proposal would occur over a range of area, provide the range or
boundaries of the site(s). Provide a legal description, site plan, vicinity map, and topographic
map, if reasonably available. While you should submit any plans required by the agency, you
are not required to duplicate maps or detailed plans submitted with any permit applications
related to this checklist.
i- !rcpc---y i 114 ciE -he SW y4..oP 5- 35 T,
R,4 ') EW' . 4:. n 4hc_ So6.14-' 5 I'd e cP tc,yvkc.r Q8, e. ,v,c1 44'e-
5iird, 0-P
13. Does the proposed ction lie within the Aquifer Sensitive Area (ASA)? `1C'2 The general
Sewer Service Area? Kt o Priority Sewer Service Area? y<=., (See: Spokane County's
ASA Overlay zone Atlas for boundaries).
14. The following questions supplement Part A.
a. Critical Aquifer Recharge Area (CARA) I Aquifer Sensitive Area (ASA).
1. Describe any systems, other than those designed for the disposal of sanitary
waste, installed for the purpose of discharging fluids below the ground surface
(includes systems such as those for the disposal of Stormwater or drainage
from floor drains). Describe the type of system, the amount of material to be
disposed of through the system and the types of material likely to be disposed
of(including materials which may enter the system inadvertently through spills
or as a result of firefighting activities). Occ35 ()CA'
2. Will any chemicals (especially organic solvents or petroleum fuels) be stored
in aboveground or underground storage tanks? If so, what types and
quantities of material will be stored? Doe 5 no+ c-pp 1 y
3. What protective measures will be taken to insure that leaks or spills of any
chemicals stored or used on site will not be allowed to percolate to
groundwater? This includes measures to keep chemicals out of disposal
systems. DOLS mac-- 41.ppi 1)
4. Will any chemicals be stored, handled or used on the site in a location where
a spill or leak will drain to surface or groundwater or to a Stormwater disposal
system discharging to surface or groundwater? D06s no-I- CL) )\)
PL-22 V1.0 Page 3 of 14
Spokane SEPA CHECKLIST
Walley
h. Proposed measures to reduce or control erosion, or other impacts to the
earth, if any: Thvbu 'h Zoe Pov,.c! 5 ..r Dryt:..<L 1(s co. ►" )
C
ecz. Lk VirU m �-� S-�r�c-,- L.)1,4--)A C u v 65 co•cl EVALUATION FOR
2) Air �si mss' AGENCY USE ONLY
a. What types of emissions to the air would result from the proposal (i.e.,
dust, automobile, odors, industrial wood smoke) during construction and
when the project is completed? If any, generally describe and give
approximate quantities if known. Cc,n 5-1-ruG tov1� hco.�ty
mai H d i93A -e"- Co 1+1 S r c4 u►1
r c-u-e 0`5 rsi Cc „v-5 Tv t)�y..s Ao u 5 e eve L S S1
b. Are there any off-site sources of emissions or odor that may affect your
proposal? I)N A If so, generally describe.
c. Proposed measures to reduce or control emissions or other impacts to air,
if any: DriA
3) Water
a. Surface:
1) Is there any surface water body on or in the immediate vicinity of the
site (including year-round and seasonal streams, saltwater, lakes,
ponds, wetlands)? If yes, describe type and provide names. If
appropriate, state what stream or river it flows into. Dkt,
2) Will the project require any work over, in, or adjacent to (within 200
feet) the described waters? If yes, please describe and attach
available plans. DNA
3) Estimate the amount of fill and dredge material that would be placed
in or removed from surface water or wetlands and indicate the area of
the site that would be affected. i I•i A Indicate the source of fill
material.
4) Will the proposal require surface water withdrawals or diversions?
Give general description, purpose, and approximate quantities
if known. })fq A
PL-22 V1.0 Page 5 of 14
Spokane SEPA CHECKLIST
Valley
EVALUATION FOR
4) Plants AGENCY USE ONLY
a. Check or circle types of vegetation found on the site:
❑ deciduous tree: alder, maple, aspen, other
❑ evergreen tree: fir, cedar, pine, other
❑ shrubs
'R grass
❑ pasture
❑ crop or grain
❑ wet soil plants: cattail, buttercup, bullrush, skunk
cabbage, other
❑ water plants: water lily, eelgrass, milfoil, other
❑ other types of vegetation
b. What kind and amount of vegetation will be removed or altered? i he L ►1 9 r s s
c. List threatened or endangered species known to be on or near the
site. DNA
d. Proposed landscaping, use of native plants, or other measures to
preserve or enhance vegetation on the site, if any: i7 Kt I`
5) Animals
a. Circle any birds and animals which have been observed on or near the
site or are known to be on or near the site:
i birds: hawk, heron, eagle, songbirds, other:
is mammals: deer, bear, elk, beaver, other:
❑ fish: bass, salmon, trout, herring, shellfish, other:
b. List any threatened or endangered species known to be on or near the
site. DNA
c. Is the site part of a migration route? i'J If so, explain.
d. Proposed measures to preserve or enhance wildlife, if any: Nv Y)�=
PL-22 V1.0 Page 7 of 14
Spokane SEPA CHECKLIST
,�. Valley
EVALUATION FOR
AGENCY USE ONLY
8). Land and shoreline use
a. What is the current use of the site and adjacent properties?
V .co t 4-/ i'24b c,s.1 40 Near 4-hi CI,o yc.1, �o -��-► e-
So t•h, Re s)de. -s tv 11� b&31- exv,d Z'c -I-
b. Has the site been used for agriculture? If so, describe.
c. Describe any structures on the site. l7 N. A
d. Will any structures be demolished? l'. C If so, what?
e. What is the current zoning classification of the site? S2- T 3
f. What is the current comprehensive plan designation of the site? L (2) i
g. If applicable, what is the current shoreline master program designation of
the site? p A
h. Has any part of the site been classified as an "environmentally sensitive"
area? 171.1
If so, specify.
i. Approximately how many people would reside or work in the completed
project? 73-
j. Approximately how many people would the completed project displace?
DNA
k. Proposed measures to avoid or reduce displacement impacts, if
any: p N A
I. Proposed measures to ensure the proposal is compatible with existing
and projected land uses and plans, if any: 412 u rd e r g cvn 4o Y
PL-22 V1.0 ac4-1Ne C 11""f GC 5p6k L,n v.o_i 1 eJ„ Page 9 of 14
Sf okane SEPA CHECKLIST
Valley;
Date Submitted:
D. SUPPLEMENTAL SHEET FOR NON-PROJECT ACTIONS
(Do not use this sheet for project actions)
Because these questions are very general, it may be helpful to read them in conjunction with the list of
the elements of the environment.
When answering these questions, be aware of the extent the proposal, or the types of activities likely
to result from the proposal, would affect the item at a greater intensity or at a faster rate than if the
proposal were not implemented. Respond briefly and in general terms.
1. How would the proposal be likely to increase discharge to water; emissions to air; production,
storage, or release of toxic or hazardous substances; or production of noise?
a. Proposed measures to avoid or reduce such increases are:
2. How would the proposal be likely to affect plants, animals, fish, or marine life?
a. Proposed measures to protect or conserve plants, animals, fish, or marine life are:
3. How would the proposal be likely to deplete energy or natural resources?
a. Proposed measures to protect or conserve energy and natural resources are:
4. How would the proposal be likely to use or affect environmentally sensitive areas or areas
designated (or eligible or under study) for governmental protection; such as parks, wilderness, wild
and scenic rivers, threatened or endangered species habitat, historic or cultural sites, wetlands,
floodplains, or prime farmlands?
a. Proposed measures to protect such resources or to avoid or reduce impacts are:
5. How would the proposal be likely to affect land and shoreline use, including whether it
would allow or encourage land or shoreline uses incompatible with existing plans?
PL-22 V1.0 Page 13 of 14