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1979, 09-12 County DNS & Environmental Checklist for Acute Care Hospital • .01 .p_ � 41101) FILE # • R ' ;.7,Z v: •• THRESHOLD DETERMINATION ,....�:36•M.1..r.....41.111 Proposed/ Final/ Nonsignificance DECLARATION Of (proposed/final) • Nonsignificance/ Nonsisnificance (significance/nonsignificance) 1. Description of Proposal: 123 bed acute care Hospital for Spokane Valley General Z. Proponent: Spokane Valley General Hospital, E. 12606 Mission 3. Contact Person: Gail Stiltner Phone: 924-6650 4. County Action (s) Requested: Zone Change: Preliminary Plat Approval: Final Plat Approval: Change of Condition other. Building permit 5. Lpcatton of aroposai: On site containing 7.7 acres contiguous to the site of the- present hospital and bounded by Boone Avenue & Vercler Road 6. Lead Agency: SPOKANE COUNTY, WASHINGTON lust proposal has been determined to not have a significant adverse impact on the environment. An EIS is required under RCA 43.21C.020 (2) (c). This decision was made after review by the County of a com- p eced environmental checklist and other information oftfile with the lead agency. 7. Responsible Official: Proposed Declaration: Final Declaration: Name ames L. Manson Name James L. Manson Signature d9y46141 -. Signature $2tUrc? Title Director Title Director Department Building Codes Oeparent Building Codes Date 9-12-79 Data / 0 --2-6 —7 7 • 8. For Declarations of Significance Only: _ /, / Date of Expected Draft EIS Availability (determined by Responsible Official) Date of Issuance • TD BE COMPt—FTED BY RESPONSIBLE OFFICIAL: a. Brief description and listing of those environmental impacts leading to such declaration: b. 3rief explanation of what measures, if any, cculd be taken by the applicant to prevent or mitigate the environmental impact of the proposal to such an extent that the responsible official could consider a revised proposal with a oossibie resulting declaration of nonsignificance: 2 O. 01111 y v a Si�'15r .. �', i:101:'•:,4•:;, Cta'y, `1' 13 _ , BUILDING CODES DEPARTMENT p r. . i BUILDING—SIGNBOARD—GAS—HEATING—PLUMBING k r=i 1 i 1' , 1- too'. > it ,..r... li j',,' 811 North Jefferson Street—Spokane, Washington 99260 •',..4-t el •• •',"'-'.11..—tj L!.. ,,, 1t�` -, Telephone: 456-3675 Janes L. Manson. Director • tSPONANC COUNTY COURT NOUS( MEMORANDUM TO: Community Services Administration County Planning Commission U. S. Dept. of Energy County Prosecuting Attorney U. S. Environmental Protection County Air Pollution U. S. Dept. of Health, Education $ County Utility Dept. Welfare Eastern Wash. Health Systems Agencies Commerce & Economic Development Fire District #1 Dept. of Ecology State Energy Office County Engineer County Health District FROM: Spokane County Building Codes Department North 811 Jefferson Spokane, WA 99260 509-456-3675 Attention: James L. Manson REFERENCE: Lead Agency Designation, Threshold Determination, Staff Review, Environmental Checklist, map; all or some of which are attached. Pursuant to WAC 197-10-203 (3), the Spokane County Building Department, a division of Spokane County, has determined that the County, as an ACTING AGENCY, is the LEAD AGENCY for the following project: 123 bed acute care hospital for Spokane Valley General located on 7.7 acres contiguous to site of present hospital bounded by Boone Avenue 6 Vercler Road This determination was made in accordance with WAC 197-10-220. Information on file concerning this proposed action indicates your agency to be an AGENCY OF JURISDICTION, WAC 197-10-040 (4). Accordingly, if you wish to exercise your option to review and comment as pro- vided in WAC 197-10-340 (5), a proposed Declaration of Nonsignificance was issued on September 12, 1979 . Please respond, if appropriate, at your earliest opportunity. 4111/ • A. V 1ETTIO po-r;-__-\-N a crtrz,r= • '�.• `: AUG 2'71979 File n spo ' • NE p p T?4 CHECKLIST Sec.—Twp (;ours DEPT. Int'^.dvc:I:n: The State Environmental Policy Act of 1971, Chaoter 43.210. RCW. requires all state and local governmental aSenc:es to consider environmental values both for their own actions and when licensing private or000sals. The Ac: also recuires :hat an Environmental :moat: Statement be preoered for all major actions significantly (and 'adversely'. ss ter WAC 197-10) affecting the quality of the onysical environment. The purpose of this gnecklist Is to nlep :he agencies In- volved aeterosne wnether or not a or:posal is sucn a major action. Please answer :re following questions as completely as you can with the information presently available to you. Please answer questions as 'yes' or 'rayae" if. in your opinion, even only slight Impacts will result. The reviewers of the :hecxlfst will be aware of and concern themselves with one dear of impact. asking you for more information, If necessary. where explanations of your answers are reouired, or where you tin= an explanation would be helpful to government decision-makers, include your eaolanation to the sooce provided, or use additional ^1ces, If . ._,sir,. You should Include references :a any reports or studies of wnici ryou are aware and,-w'hic,-are relevant to the answers you provide. Complete answerl to these Questions now will help all agencies Involveo with your prOoosal to undertake the required environmental review without unnecessary delay. The following questions 'poly to your total or000sal, not Just to the license for which you are currently applying or the oro- oosal for wnicn s0 rovai is saugnt. four answers snoula include the impacts IMO will be caused oy your prgoosal wnen ft is co.-oieted, even enough comolecion may not occur until sometime in the future. This will allow all of the agencies wnicn will Oe Involved to complete their environmental,.review now, without duplicating paperwork in the future. No a:olication shalt to processed until the cnecklist has been completed and returned to the sooroOriate County deoartoent. Sta:e taw r--vires exclamations 'or ever./ "•,es" Ind "-avoe" answer on the cnetxlist. The person completing time form may :e redoired to ;r:viCe tx;iandt:crs far 'no" answers, and in sore cases, more petalled information to aid in a thresnold Bete minat:on. • NOTE: This is a stancard form oeing used by all state and local agencies in the State of Washington for various types of prc:osalt. Many of the questions may not apply to your proposal. If a ouestlon does not apply, just answer it 'no' and continue cn to the next question. • ENVIRONMENTAL CHECKLIST FORT 1. 3ACx,;nCCNO 1. Nate of Proponent: Spokane Valley General Hospital Phone ifumcer(509) 924-6650 2. Adcreas of lydponent: East 12606 Mission Avenue, Spokane, WA 99216 3. Oate Checdist Su:mit:ed: 4. Agency Re:usring Checxl is:: Det. of Social and H�d1 th Services E. Mare of Pr':osal, if loplicaoie: pT1lMfeJTlent tori lity tnr Spokane Val ley General Fiosp. 6. 9ature Ana 3r1-f ;escrlot:on of the .rdoosat lin;lud"rl a;t not ltnitea to i:; size, general Design elements, ano other factors that will gave an accurate understanding of its scope sno nature): Replacement facility for 123 bed acute care hospital consisting of approxi- mately 82.6-60 sgi'a-re feet and _gontatninq- services, spaces acrd functions _ typically found in a general hospital . • 7. Location of ar::osal (describe :he onysical setting of the Procosal, as well as the extent of :he land area affected ;y any environmental imoects, inctuaing any other Information needed to give an accurate unaerstanainq of tne environ- mental ;et:Ing of tae prc0osal): On site containing 7.7 acres contiguous to the site of the present hospital . and bounded by Boone Avenue and Vercler Road. 3. :s::mated Cate for C.nnolecaon of the ar000sal: September, 1981 9. List :f all Permits, Licenses or Government Approvals Required for the Proposal (federal, state and local - inc:u:ing rezones,: Department of Social and Health Services and others as may be required, (IF SPACE FOR EXPLaMMTIJ:f IS iNAOEQUATE. PLEASE ATTACH AOOITIGNAL PAGES.) 1Oa. :o you, or the owner in the event you dg not.cwn the suojcc: land, neve Any plans for future additions. expansion, or further activity related :o or connec:ea with this propose'? If,yes, explain: Possibility of future bed 'adlition, antil- dry and support service expansion with Certificate of Need and as census and market conditions should dictate. lCb. :0 you own or nave Ooticns an land nearoy or adjacent to this cr000sal's location? If yes, explain: no An option on two additional acres may be exercised after purchase of site .notd .1. 7inuen' .oy any' plans oy-otneri incLdcing°,tnis.,dwner whtcsi'mapytfec;,aha.Orocerry =overed by Your oroosa' or land tdj3Cent or nearoy? If yes, exolain: no 12. ..t:acn any other a:plication,form that has been completed regarding the Proposal; if none nas been c:moleceo. but IS excec:ed to :e (ilea at some future aata. Gescrlbe the nature of such application form: Certificate of Need previously filed. • II. EIiVIAONYENT% IMPACTS (Exolaneticns of all "yes' And 'nayoe" answers are required) yes Mavee No '111) the proposal result in: • (a) Uns:aole earth conoltions or in changes In geologic structures/ _ X (b) 71sruotions, disolacti.ents, c:moection or overcovering of :he soil? r X• .._ (c) Chance in :opagropny or ;round surface relief features? X (a) The :es:ruc::on, •::vering or modification of in. ..nlcue :eoiogic — ar :nf.ica) features' _ X (.) any increase in wind or water erosion of soils, •liner on or off one site' alt.132 i, � • • . ' 'r x..17 - (11111Fz FCR EZPLANAT1C3 IS IN.UCECUATE. PLEASE 3T7%•CH :l.% Ptc.£S.) (f) Cnan;e1 in deposition or erosion of'beaC? 13n01. Or CharCes in siltation. :ecosition or erosion .nick may ivdify the channel of a river or stream X or the _ea of the ocean or any bay, inlet or lake? _ — E•Oii'+itl^n: b) As would normally occur with project development: r c) As may be .required for relief of surface drainage. 2. 31r. 4111 the procasal result in: Yes Mavre `+o (a) Air emissions or deterioration of arroient air quality? — AX (b) The creation of ooject1onaole odors? — f X (c) Alteration of air movement, moisture or temperature. or any change In climate, either locally or regionally? — X E.o l a n i t'r n: 1 O« .'S>�i> - ..GA'VC �.C1�1 — • 3. pater. 4111 the proposal result In: Yes MaYee NO (a) Change in currents. or the course or direction of water movements, V In either marine or fresh waters? — — (b) Changes in aosorotion rates. drainage patters, or the rate and amount of surface water runoff? X (c) Aiterations to t.:e course or flow of flood waters? — X (1) Change In tr.e octant of surface water in any water body? X (e) Olscharge into surface water, or in any alteration of surface water duality, tncluatnq tut hoc limited to temperature, dissolved oxygen or turbidity? X (f) Alteration of the direction or rate of flow of ground waters? • X (g) Change in one quantity of gound waters. eigner througn direct acaitlons or withdrawals, or through interception of an aquifer ay cuts or excavations? - X • (h) Deterioration in ground water quality, either througn direct infection. or througn the seepage of leecnate. onosoates. • detergents, wateroorne virus or bacteria, or other Substances X Into the sound waters? — (i) Reduction In the amount of water otherwise avallaoie for — puoliC water supplies? Exolanatl:n: • A u. • be necessar to accommodate building and Barking requirements. S. Flcri. '4111 the proposal result in: Yes :4avbe NO (a) Change In the dtvers,lty of ,aoeeies, or nurser of any species of flora (Including trees, shruos, grass. Crops. microflora aha X aquatic plants)? _ _ . (b) Reduction of ore n urcers of any unique, rare or endangered species of flora? X (c) Introduction of new species of flora into an area, or X to a oarrter to the normal repienishr.onc of existing species? (d) Reeuc:Ion In acreage of any agricultural -.rop? X Exp%i^oticn: S. =mune. '4111 tht proposal result in: Y•s Mavoe 4o (a) Changes in the diversity of species, or Wormer of any species of fauna (biros, lana animals including reptiles, fish and X shellfish, bentnlc organisms, Insects or microfauna)? _ (b) Reouc:ton of the nursers of any unique, rare, or endangered X species of faunal — -- CO) (c) Intr.:ductIOn of new species of faura Into an area, or result In i oarritr :o the migration or movement of faunal --- X "� (d) Cetericrattcn of existing fish or wildlife habitat? X — txolanaticn: l S. Norse. Yes Maws �Yo- (a) '4111 the proposal increase existing noise levels? _Y,��•jlX r--/C,_....1;)k* 7. II'nt ind flirt. Yes Mavo.: No (a) ' 111 ;r,^ proposal produce new iIcht or glare' . — >‹, X Exolinat!On: Fts-p k- u r-r L[4,,ik lf-) cis 2 I • ►___lir._ ---- ••—•„.. :.e 11, 411 (IF Spa:. FC;Z E;iPLs3AT.C3 IS MICE:LAT,,, ;LEASE ITT:.CH ACoIT:.'+AL PAGES.) 3. La-s ':s res ravne *in (a) '4111 :he arc:osal result in :no alteration of :ne or-sent or ;ianreo 'Ana use or an arts? _ X E•7I.rsc1- va:•irsl a-S:ur:-s. 4)11 the proposal result In: r-s "svice Yo (a) Increase in the rite of use of any natural resources? X _ (0) Ceolecton of any nonrenewable natural resource? X E,olanati:n: As will be.required for domestic water and fuel usage. 10. 41st ;f ;:oset. Coes the pr000sal involve a rest of an eiolosion or the Yes. Mevbe ve release or nsa roots suostances (including, but not limited to. oil. pesticices. ereniCals. or 'natation) in the event of an acclaent or unset conatcions? X — E.oltnation: 11. Pooulatinn. res isavce Nd will :ne :r000sal alter the location. distribution. density, or growth rate of the human Copulation of an arta? Explanation: 12. uOVSirq. 4111 tine orocosal affect existing housing, or create a demand for loolticnal noustr.g? X Ea:lanat:on: —• —"" • 13. Trims:or:a:ton/C'r:ulation. Will the pr000sal result in: Yes Mavbe .'lo • (a) ;enersttcn of aedltional venicular movement? 2 (b) Effects on exis:ing•;arting facilitie . or demand for new parking' X (c) ?road noon existing transportation systems/ - X • (d) Alterations tp present patterns of circulation or movement of :ecole and/or goods? X (e) Altera:tons to .ateroorne, rail or sir traffic? • (f) increase In traffic hazaros to motor vehicles, bicyclists Jr pedestrians? — X b) On site parking will be provided as required by applicable codes. d) As may occuras a result of construction of new entrance at Vercler Road or Boone Avenue. la. ?',otic Services. 4111 the pr000sal nave in effect upon, or result Yes Ravbe Mo in a need for new or altered governmental services in any of of ::te following areas: ;a) Fire Protection? ' 14 (b) police oritec:ion' z[ � -- (c) Schools? �L X (a) parts or other recreational facilities' /� X (a) •"4in:enance of public facilities, including roacs? u 'S X (f) )timer ;overrnental services? u..: X dl✓ X11 I� � Exolenatton' � ��J/11 ,�� i �+ �,Q,T/O •91_ 5 fr1I (IF SPACE FCR SAPLA:UT:C:1 IS (UACECLIATE. PLEASE Af'.1CH iCo1TtO I. ?AGES.; IE. Ent,—:v. 4111 tate pr000sal result in: Yes MV/Ce YO (a) use of suOstantiai amounts of fuel or energy? X (b) Je-rana upon existing sources of ener7Y, or reouire the develocment of new sources of energy? X Explanation: a) Building will consume less fuel/energy than is reseetl -- required for existing facility. 16. 'Jtilit'es. 4111 the pr000sal result in a :teed for new systems. Yes wavice ro or alterations :o tae foilowing utilities: (a) ?ower or natural gas? _ _ X (b) Cc-,7unicatson system? _ 4, X (c) Water' (a) Sewer or septiC'tanes? X '9 (ei Storm ,a:er 4ralnage? :�.X / 3 CE FOR EIP;.i.RAr;c:i IS :NAM 'LEASE a IrauL pocES.) . • (f) So11d .as:a and 41s:osai7 X d) A new sewage treatment plant will be constructed on•site.� r�1 4 vc,• y1 11. >''r.n Vlll the proposal result In the creaticn of sny health natar's • or ;ocont:si `eal:.n ha;ara (eecluoinq renc.l neslth)l _ X E•'.ianntic n: 18. aest-st:cs- '4111 the orcoosal result In the oostructien of any scenic vista or view a:en to the ouollc. or will the proposal result in the creation of an • aesthetically offensive site open to oublie view► • X — E•olarst':n:e: 19. ;oc-'atscn, 'dill the oraoosal result in an impact upon the Quality or v �w nes:y of existing recreactonal opportunitiest . X _ £. lanetfen: • 20. lr-r.piccscal/WI,tcrtcal. 4111 the or000sai result in in alteration of a Yes !'evbe No signiricant arcnediogscal or historical site. structure. object or building? EAolarat•cn: III. SI,'tT E f, :.he JncersiSned, swear under the penalty of perjury that the above responses it .de truthfully and co the test of -y kna.lecce. I also understand that, snould trere Pe any willful misrep on or willful lack of full :isclosure on my ;arc.Sookane County may withdraw any declaration of non e tnat it a. :'sue in reliance uccn this checklist. Oats: 8/24/79P —nente. Executive Director (Please Print or Type) Spokane Valley General Hospital Proponent: Spokane Valley General Hosnitai,sddress: E. 12606 Mission Avenue Phone: 509/924-6650 Spokane, WA 99216 Person c:-oleting fora: Gail Stiltner Phone: 924-6650 pate: `8/'24/79' Ce:ar-ant or Office of County Reviewing r.ec list: 2t 'a 21r_'t Staff .e-mer(s) Reviewing Checklist: illIP. 1111• • • r. • • • • '1 • 4 AA