Document cayugacounty_gov_doc_814da23476

617.20 Appendix A State Environmental Quality Review Full Environmental Assessment Form Purpose: The Full Environmental Assessment Form (EAF) provides an orderly and comprehensive means for evaluating the potential environmental significance of a proposed action. The question of whether an action may be significant is not always easy to answer. Frequently, there are aspects of a project that are subjective or unmeasurable. It is also understood that those who determine significance may have little or no formal knowledge of the environment or may not be technically expert in environmental analysis. In addition, many who have knowledge in one particular area may not be aware of the broader concerns affecting the question of significance. The lead agency must use the Full EAF for Type I actions and may use it for Unlisted actions. The Full EAF consists of three parts and when completed it will serve as the determination of significance: Part 1 - Is completed by the project sponsor. Part 1 provides basic information including a description of the proposed action, proposed site location and its environmental resources. The information provided in Part 1 is later used by the reviewing agency to complete Parts 2 and 3. The questions in Part 1 are grouped in sections A-G: • Section A gathers information that identifies the project sponsor, the proposed action, and the proposed action’s location. • Section B requests information about government approvals or funding. • Section C requests information about planning, zoning and community services. • Section D requests information about the proposed action. • Section E requests information about resources on or adjacent to the proposed site. • Section F provides the project sponsor the opportunity for supplying additional information including project elements that may avoid or reduce impacts. • Section G is where the certifying signature of the preparer is provided. Part 2 - Is completed by the lead agency. Part 2 is designed to help the lead agency inventory all potential resources that could be affected by a proposed action and to determine the potential size of the impact by providing a series of questions that can be answered using the information found in Part 1. To further assist the lead agency in completing Part 2, the form identifies the most relevant questions in Part 1 that will provide the information needed to answer the Part 2 question. Part 2 is designed to help a reviewer identify any element of a proposed project that may have a potentially significant adverse impact on the environment. Part 3 - Is completed by the lead agency. Part 2 questions where the impact has been identified as potentially moderate to large or where there is a need to explain why a particular element of the proposed action will not, or may, result in a significant adverse environmental impact should be explored in a series of written, well reasoned statements in Part 3. The discussion of impacts in Part 3 will serve as the supporting documentation for the determination of significance. Not effective until October 7, 2013 ---PAGE BREAK--- Page 1 of 13 Full Environmental Assessment Form Part 1 - Project and Setting Instructions for Completing Part 1 Part 1 is to be completed by the applicant or project sponsor. Responses become part of the application for approval or funding, are subject to public review, and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item, please answer as thoroughly as possible based on current information; indicate whether missing information does not exist, or is not reasonably available to the sponsor; and, when possible, generally describe work or studies which would be necessary to update or fully develop that information. Applicants/sponsors must complete all items in Sections A & B. In Sections C, D & E, most items contain an initial question that must be answered either “Yes” or “No”. If the answer to the initial question is “Yes”, complete the sub-questions that follow. If the answer to the initial question is “No”, proceed to the next question. Section F allows the project sponsor to identify and attach any additional information. Section G requires the name and signature of the project sponsor to verify that the information contained in Part 1is accurate and complete. A. Project and Sponsor Information. Name of Action or Project: Project Location (describe, and attach a general location map): Brief Description of Proposed Action (include purpose or need): Name of Applicant/Sponsor: Telephone: E-Mail: Address: City/PO: State: Zip Code: Project Contact (if not same as sponsor; give name and title/role): Telephone: E-Mail: Address: City/PO: State: Zip Code: Property Owner (if not same as sponsor): Telephone: E-Mail: Address: City/PO: State: Zip Code: Not effective until October 7, 2013 ---PAGE BREAK--- Page 2 of 13 B. Government Approvals B. Government Approvals Funding, or Sponsorship. (“Funding” includes grants, loans, tax relief, and any other forms of financial assistance.) Government Entity If Yes: Identify Agency and Approval(s) Required Application Date (Actual or projected) a. City Council, Town Board, 9 Yes 9 No or Village Board of Trustees b. City, Town or Village 9 Yes 9 No Planning Board or Commission c. City Council, Town or 9 Yes 9 No Village Zoning Board of Appeals d. Other local agencies 9 Yes 9 No e. County agencies 9 Yes 9 No f. Regional agencies 9 Yes 9 No g. State agencies 9 Yes 9 No h. Federal agencies 9 Yes 9 No i. Coastal Resources. i. Is the project site within a Coastal Area, or the waterfront area of a Designated Inland Waterway? 9 Yes 9 No If Yes, ii. Is the project site located in a community with an approved Local Waterfront Revitalization Program? 9 Yes 9 No iii. Is the project site within a Coastal Erosion Hazard Area? 9 Yes 9 No C. Planning and Zoning C.1. Planning and zoning actions. Will administrative or legislative adoption, or amendment of a plan, local law, ordinance, rule or regulation be the 9 Yes 9 No only approval(s) which must be granted to enable the proposed action to proceed? • If Yes, complete sections C, F and G. • If No, proceed to question C.2 and complete all remaining sections and questions in Part 1 C.2. Adopted land use plans. a. Do any municipally- adopted (city, town, village or county) comprehensive land use plan(s) include the site 9 Yes 9 No where the proposed action would be located? If Yes, does the comprehensive plan include specific recommendations for the site where the proposed action 9 Yes 9 No would be located? b. Is the site of the proposed action within any local or regional special planning district (for example: Greenway 9 Yes 9 No Brownfield Opportunity Area (BOA); designated State or Federal heritage area; watershed management plan; or other?) If Yes, identify the plan(s): c. Is the proposed action located wholly or partially within an area listed in an adopted municipal open space plan, 9 Yes 9 No or an adopted municipal farmland protection plan? If Yes, identify the plan(s): Not effective until October 7, 2013 ---PAGE BREAK--- Page 3 of 13 C.3. Zoning a. Is the site of the proposed action located in a municipality with an adopted zoning law or ordinance. 9 Yes 9 No If Yes, what is the zoning classification(s) including any applicable overlay district? b. Is the use permitted or allowed by a special or conditional use permit? 9 Yes 9 No c. Is a zoning change requested as part of the proposed action? 9 Yes 9 No If Yes, i. What is the proposed new zoning for the site? C.4. Existing community services. a. In what school district is the project site located? b. What police or other public protection forces serve the project site? c. Which fire protection and emergency medical services serve the project site? d. What parks serve the project site? D. Project Details D.1. Proposed and Potential Development a. What is the general nature of the proposed action residential, industrial, commercial, recreational; if mixed, include all components)? b. a. Total acreage of the site of the proposed action? acres b. Total acreage to be physically disturbed? acres c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? acres c. Is the proposed action an expansion of an existing project or use? 9 Yes 9 No i. If Yes, what is the approximate percentage of the proposed expansion and identify the units acres, miles, housing units, square feet)? % Units: d. Is the proposed action a subdivision, or does it include a subdivision? 9 Yes 9 No If Yes, i. Purpose or type of subdivision? residential, industrial, commercial; if mixed, specify types) ii. Is a cluster/conservation layout proposed? 9 Yes 9 No iii. Number of lots proposed? iv. Minimum and maximum proposed lot sizes? Minimum Maximum e. Will proposed action be constructed in multiple phases? 9 Yes 9 No i. If No, anticipated period of construction: months ii. If Yes: • Total number of phases anticipated • Anticipated commencement date of phase 1 (including demolition) month year • Anticipated completion date of final phase month _____year • Generally describe connections or relationships among phases, including any contingencies where progress of one phase may determine timing or duration of future phases: Not effective until October 7, 2013 ---PAGE BREAK--- Page 4 of 13 f. Does the project include new residential uses? 9 Yes 9 No If Yes, show numbers of units proposed. One Family Two Family Three Family Multiple Family (four or more) Initial Phase At completion of all phases g. Does the proposed action include new non-residential construction (including expansions)? 9 Yes 9 No If Yes, i. Total number of structures ii. Dimensions (in feet) of largest proposed structure: ________height; and length iii. Approximate extent of building space to be heated or cooled: square feet h. Does the proposed action include construction or other activities that will result in the impoundment of any 9 Yes 9 No liquids, such as creation of a water supply, reservoir, pond, lake, waste lagoon or other storage? If Yes, i. Purpose of the impoundment: ii. If a water impoundment, the principal source of the water: 9 Ground water 9 Surface water streams 9 Other specify: iii. If other than water, identify the type of impounded/contained liquids and their source. iv. Approximate size of the proposed impoundment. Volume: million gallons; surface area: acres v. Dimensions of the proposed dam or impounding structure: height; length vi. Construction method/materials for the proposed dam or impounding structure earth fill, rock, wood, concrete): D.2. Project Operations a. Does the proposed action include any excavation, mining, or dredging, during construction, operations, or both? 9 Yes 9 No (Not including general site preparation, grading or installation of utilities or foundations where all excavated materials will remain onsite) If Yes: i .What is the purpose of the excavation or dredging? ii. How much material (including rock, earth, sediments, etc.) is proposed to be removed from the site? • Volume (specify tons or cubic yards): • Over what duration of time? iii. Describe nature and characteristics of materials to be excavated or dredged, and plans to use, manage or dispose of them. iv. Will there be onsite dewatering or processing of excavated materials? 9 Yes 9 No If yes, describe. v. What is the total area to be dredged or excavated? vi. What is the maximum area to be worked at any one time? acres vii. What would be the maximum depth of excavation or dredging? feet viii. Will the excavation require blasting? 9 Yes 9 No ix. Summarize site reclamation goals and plan: b. Would the proposed action cause or result in alteration of, increase or decrease in size of, or encroachment 9 Yes 9 No into any existing wetland, waterbody, shoreline, beach or adjacent area? If Yes: i. Identify the wetland or waterbody which would be affected (by name, water index number, wetland map number or geographic description): Not effective until October 7, 2013 ---PAGE BREAK--- Page 5 of 13 ii. Describe how the proposed action would affect that waterbody or wetland, e.g. excavation, fill, placement of structures, or alteration of channels, banks and shorelines. Indicate extent of activities, alterations and additions in square feet or acres: iii. Will proposed action cause or result in disturbance to bottom sediments? 9 Yes 9 No If Yes, describe: iv. Will proposed action cause or result in the destruction or removal of aquatic vegetation? 9 Yes 9 No If Yes: • area of vegetation proposed to be removed • expected acreage of aquatic vegetation remaining after project completion • purpose of proposed removal (e.g. beach clearing, invasive species control, boat access): • proposed method of plant removal: • if chemical/herbicide treatment will be used, specify product(s): v. Describe any proposed reclamation/mitigation following disturbance: c. Will the proposed action use, or create a new demand for water? 9 Yes 9 No If Yes: i. Total anticipated water usage/demand per day: gallons/day ii. Will the proposed action obtain water from an existing public water supply? 9 Yes 9 No If Yes: • Name of district or service area: • Does the existing public water supply have capacity to serve the proposal? 9 Yes 9 No • Is the project site in the existing district? 9 Yes 9 No • Is expansion of the district needed? 9 Yes 9 No • Do existing lines serve the project site? 9 Yes 9 No iii. Will line extension within an existing district be necessary to supply the project? 9 Yes 9 No If Yes: • Describe extensions or capacity expansions proposed to serve this project: • Source(s) of supply for the district: iv. Is a new water supply district or service area proposed to be formed to serve the project site? 9 Yes 9 No If, Yes: • Applicant/sponsor for new district: • Date application submitted or anticipated: • Proposed source(s) of supply for new district: v. If a public water supply will not be used, describe plans to provide water supply for the project: vi. If water supply will be from wells (public or private), maximum pumping capacity: gallons/minute. d. Will the proposed action generate liquid wastes? 9 Yes 9 No If Yes: i. Total anticipated liquid waste generation per day: gallons/day ii. Nature of liquid wastes to be generated sanitary wastewater, industrial; if combination, describe all components and approximate volumes or proportions of each): iii. Will the proposed action use any existing public wastewater treatment facilities? 9 Yes 9 No If Yes: • Name of wastewater treatment plant to be used: • Name of district: • Does the existing wastewater treatment plant have capacity to serve the project? 9 Yes 9 No • Is the project site in the existing district? 9 Yes 9 No • Is expansion of the district needed? 9 Yes 9 No Not effective until October 7, 2013 ---PAGE BREAK--- Page 6 of 13 • Do existing sewer lines serve the project site? 9 Yes 9 No • Will line extension within an existing district be necessary to serve the project? 9 Yes 9 No If Yes: • Describe extensions or capacity expansions proposed to serve this project: iv. Will a new wastewater (sewage) treatment district be formed to serve the project site? 9 Yes 9 No If Yes: • Applicant/sponsor for new district: • Date application submitted or anticipated: • What is the receiving water for the wastewater discharge? v. If public facilities will not be used, describe plans to provide wastewater treatment for the project, including specifying proposed receiving water (name and classification if surface discharge, or describe subsurface disposal plans): vi. Describe any plans or designs to capture, recycle or reuse liquid waste: e. Will the proposed action disturb more than one acre and create stormwater runoff, either from new point 9 Yes 9 No sources (i.e. ditches, pipes, swales, curbs, gutters or other concentrated flows of stormwater) or non-point source (i.e. sheet flow) during construction or post construction? If Yes: i. How much impervious surface will the project create in relation to total size of project parcel? Square feet or acres (impervious surface) Square feet or acres (parcel size) ii. Describe types of new point sources. iii. Where will the stormwater runoff be directed (i.e. on-site stormwater management facility/structures, adjacent properties, groundwater, on-site surface water or off-site surface waters)? • If to surface waters, identify receiving water bodies or wetlands: • Will stormwater runoff flow to adjacent properties? 9 Yes 9 No iv. Does proposed plan minimize impervious surfaces, use pervious materials or collect and re-use stormwater? 9 Yes 9 No f. Does the proposed action include, or will it use on-site, one or more sources of air emissions, including fuel 9 Yes 9 No combustion, waste incineration, or other processes or operations? If Yes, identify: i. Mobile sources during project operations heavy equipment, fleet or delivery vehicles) ii. Stationary sources during construction power generation, structural heating, batch plant, crushers) iii. Stationary sources during operations process emissions, large boilers, electric generation) g. Will any air emission sources named in D.2.f (above), require a NY State Air Registration, Air Facility Permit, 9 Yes 9 No or Federal Clean Air Act Title IV or Title V Permit? If Yes: i. Is the project site located in an Air quality non-attainment area? (Area routinely or periodically fails to meet 9 Yes 9 No ambient air quality standards for all or some parts of the year) ii. In addition to emissions as calculated in the application, the project will generate: • ___________Tons/year (metric) of Carbon Dioxide (CO2) • ___________Tons/year (metric) of Nitrous Oxide (N20) • ___________Tons/year (metric) of Perfluorocarbons (PFCs) • ___________Tons/year (metric) of Sulfur Hexafluoride (SF6) • ___________Tons/year (metric) of Carbon Dioxide equivalent of Hydroflorocarbons (HCFS) • ___________Tons/year (metric) of Hazardous Air Pollutants (HAPs) Not effective until October 7, 2013 ---PAGE BREAK--- Page 7 of 13 h. Will the proposed action generate or emit methane (including, but not limited to, sewage treatment plants, 9 Yes 9 No landfills, composting facilities)? If Yes: i. Estimate methane generation in tons/year (metric): ii. Describe any methane capture, control or elimination measures included in project design combustion to generate heat or electricity, flaring): i. Will the proposed action result in the release of air pollutants from open-air operations or processes, such as 9 Yes 9 No quarry or landfill operations? If Yes: Describe operations and nature of emissions diesel exhaust, rock particulates/dust): j. Will the proposed action result in a substantial increase in traffic above present levels or generate substantial 9 Yes 9 No new demand for transportation facilities or services? If Yes: i. When is the peak traffic expected (Check all that apply): † Morning † Evening †Weekend † Randomly between hours of to ii. For commercial activities only, projected number of semi-trailer truck trips/day: iii. Parking spaces: Existing Proposed Net increase/decrease iv. Does the proposed action include any shared use parking? 9 Yes 9 No v. If the proposed action includes any modification of existing roads, creation of new roads or change in existing access, describe: vi. Are public/private transportation service(s) or facilities available within ½ mile of the proposed site? 9 Yes 9 No vii Will the proposed action include access to public transportation or accommodations for use of hybrid, electric 9 Yes 9 No or other alternative fueled vehicles? viii. Will the proposed action include plans for pedestrian or bicycle accommodations for connections to existing 9 Yes 9 No pedestrian or bicycle routes? k. Will the proposed action (for commercial or industrial projects only) generate new or additional demand 9 Yes 9 No for energy? If Yes: i. Estimate annual electricity demand during operation of the proposed action: ii. Anticipated sources/suppliers of electricity for the project on-site combustion, on-site renewable, via grid/local utility, or other): iii. Will the proposed action require a new, or an upgrade to, an existing substation? 9 Yes 9 No l. Hours of operation. Answer all items which apply. i. During Construction: ii. During Operations: • Monday - Friday: • Monday - Friday: • Saturday: • Saturday: • Sunday: • Sunday: • Holidays: • Holidays: Not effective until October 7, 2013 ---PAGE BREAK--- Page 8 of 13 m. Will the proposed action produce noise that will exceed existing ambient noise levels during construction, 9 Yes 9 No operation, or both? If yes: i. Provide details including sources, time of day and duration: ii. Will proposed action remove existing natural barriers that could act as a noise barrier or screen? 9 Yes 9 No Describe: Will the proposed action have outdoor lighting? 9 Yes 9 No If yes: i. Describe source(s), location(s), height of fixture(s), direction/aim, and proximity to nearest occupied structures: ii. Will proposed action remove existing natural barriers that could act as a light barrier or screen? 9 Yes 9 No Describe: o. Does the proposed action have the potential to produce odors for more than one hour per day? 9 Yes 9 No If Yes, describe possible sources, potential frequency and duration of odor emissions, and proximity to nearest occupied structures: p. Will the proposed action include any bulk storage of petroleum (over 1,100 gallons) or chemical products 9 Yes 9 No (over 550 gallons)? If Yes: i. Product(s) to be stored ii. Volume(s) per unit time month, year) iii. Generally describe proposed storage facilities q. Will the proposed action (commercial, industrial and recreational projects only) use pesticides herbicides, 9 Yes 9 No insecticides) during construction or operation? If Yes: i. Describe proposed treatment(s): ii. Will the proposed action use Integrated Pest Management Practices? 9 Yes 9 No r. Will the proposed action (commercial or industrial projects only) involve or require the management or disposal 9 Yes 9 No of solid waste (excluding hazardous materials)? If Yes: i. Describe any solid waste(s) to be generated during construction or operation of the facility: • Construction: tons per (unit of time) • Operation : tons per (unit of time) ii. Describe any proposals for on-site minimization, recycling or reuse of materials to avoid disposal as solid waste: • Construction: • Operation: iii. Proposed disposal methods/facilities for solid waste generated on-site: • Construction: • Operation: Not effective until October 7, 2013 ---PAGE BREAK--- Page 9 of 13 s. Does the proposed action include construction or modification of a solid waste management facility? 9 Yes 9 No If Yes: i. Type of management or handling of waste proposed for the site recycling or transfer station, composting, landfill, or other disposal activities): ii. Anticipated rate of disposal/processing: • Tons/month, if transfer or other non-combustion/thermal treatment, or • Tons/hour, if combustion or thermal treatment iii. If landfill, anticipated site life: years t. Will proposed action at the site involve the commercial generation, treatment, storage, or disposal of hazardous 9 Yes 9 No waste? If Yes: i. Name(s) of all hazardous wastes or constituents to be generated, handled or managed at facility: ii. Generally describe processes or activities involving hazardous wastes or constituents: iii. Specify amount to be handled or generated tons/month iv. Describe any proposals for on-site minimization, recycling or reuse of hazardous constituents: v. Will any hazardous wastes be disposed at an existing offsite hazardous waste facility? 9 Yes 9 No If Yes: provide name and location of facility: If No: describe proposed management of any hazardous wastes which will not be sent to a hazardous waste facility: E. Site and Setting of Proposed Action E.1. Land uses on and surrounding the project site a. Existing land uses. i. Check all uses that occur on, adjoining and near the project site. 9 Urban 9 Industrial 9 Commercial 9 Residential (suburban) 9 Rural (non-farm) 9 Forest 9 Agriculture 9 Aquatic 9 Other (specify): ii. If mix of uses, generally describe: b. Land uses and covertypes on the project site. Land use or Covertype Current Acreage Acreage After Project Completion Change (Acres • Roads, buildings, and other paved or impervious surfaces • Forested • Meadows, grasslands or brushlands (non- agricultural, including abandoned agricultural) • Agricultural (includes active orchards, field, greenhouse etc.) • Surface water features (lakes, ponds, streams, rivers, etc.) • Wetlands (freshwater or tidal) • Non-vegetated (bare rock, earth or fill) • Other Describe: Not effective until October 7, 2013 ---PAGE BREAK--- Page 10 of 13 c. Is the project site presently used by members of the community for public recreation? 9 Yes 9 No i. If Yes: explain: d. Are there any facilities serving children, the elderly, people with disabilities schools, hospitals, licensed 9 Yes 9 No day care centers, or group homes) within 1500 feet of the project site? If Yes, i. Identify Facilities: e. Does the project site contain an existing dam? 9 Yes 9 No If Yes: i. Dimensions of the dam and impoundment: • Dam height: feet • Dam length: feet • Surface area: acres • Volume impounded: gallons OR acre-feet ii. Dam=s existing hazard classification: iii. Provide date and summarize results of last inspection: f. Has the project site ever been used as a municipal, commercial or industrial solid waste management facility, 9 Yes 9 No or does the project site adjoin property which is now, or was at one time, used as a solid waste management facility? If Yes: i. Has the facility been formally closed? 9 Yes 9 No • If yes, cite sources/documentation: ii. Describe the location of the project site relative to the boundaries of the solid waste management facility: iii. Describe any development constraints due to the prior solid waste activities: g. Have hazardous wastes been generated, treated and/or disposed of at the site, or does the project site adjoin 9 Yes 9 No property which is now or was at one time used to commercially treat, store and/or dispose of hazardous waste? If Yes: i. Describe waste(s) handled and waste management activities, including approximate time when activities occurred: h. Potential contamination history. Has there been a reported spill at the proposed project site, or have any 9 Yes 9 No remedial actions been conducted at or adjacent to the proposed site? If Yes: i. Is any portion of the site listed on the NYSDEC Spills Incidents database or Environmental Site 9 Yes 9 No Remediation database? Check all that apply: 9 Yes – Spills Incidents database Provide DEC ID number(s): 9 Yes – Environmental Site Remediation database Provide DEC ID number(s): 9 Neither database ii. If site has been subject of RCRA corrective activities, describe control iii. Is the project within 2000 feet of any site in the NYSDEC Environmental Site Remediation database? 9 Yes 9 No If yes, provide DEC ID number(s): iv. If yes to (ii) or (iii) above, describe current status of site(s): Not effective until October 7, 2013 ---PAGE BREAK--- Page 11 of 13 v. Is the project site subject to an institutional control limiting property uses? 9 Yes 9 No • If yes, DEC site ID number: • Describe the type of institutional control deed restriction or easement): • Describe any use limitations: • Describe any engineering controls: • Will the project affect the institutional or engineering controls in place? 9 Yes 9 No • Explain: E.2. Natural Resources On or Near Project Site a. What is the average depth to bedrock on the project site? feet b. Are there bedrock outcroppings on the project site? 9 Yes 9 No If Yes, what proportion of the site is comprised of bedrock outcroppings? c. Predominant soil type(s) present on project site: d. What is the average depth to the water table on the project site? Average: feet e. Drainage status of project site soils: 9 Well Drained: of Site 9 Moderately Well Drained: of site 9 Poorly Drained of Site f. Approximate proportion of proposed action site with slopes: 9 0-10%: of site 9 10-15%: of site 9 15% or greater: of site g. Are there any unique geologic features on the project site? 9 Yes 9 No If Yes, describe: h. Surface water features. i. Does any portion of the project site contain wetlands or other waterbodies (including streams, rivers, 9 Yes 9 No ponds or lakes)? ii. Do any wetlands or other waterbodies adjoin the project site? 9 Yes 9 No If Yes to either i or ii, continue. If No, skip to E.2.i. iii. Are any of the wetlands or waterbodies within or adjoining the project site regulated by any federal, 9 Yes 9 No state or local agency? iv. For each identified wetland and waterbody on the project site, provide the following information. • Streams: Name Classification • Lakes or Ponds: Name Classification • Wetlands: Name Approximate Size Wetland No. (if regulated by DEC) v. Are any of the above water bodies listed in the most recent compilation of NYS water quality-impaired 9 Yes 9 No waterbodies? If yes, name of impaired water body/bodies and basis for listing as impaired: i. Is the project site in a designated Floodway? 9 Yes 9 No j. Is the project site in the 100 year Floodplain? 9 Yes 9 No k. Is the project site in the 500 year Floodplain? 9 Yes 9 No l. Is the project site located over, or immediately adjoining, a primary, principal or sole source aquifer? 9 Yes 9 No If Yes: i. Name of aquifer: ii. Source of information: Not effective until October 7, 2013 ---PAGE BREAK--- Page 12 of 13 m. Identify the predominant wildlife species that occupy or use the project site: n. Does the project site contain a designated significant natural community? 9 Yes 9 No If Yes: i. Describe the habitat/community (composition, function, and basis for designation): ii. Source(s) of description or evaluation: iii. Extent of community/habitat: • Currently: acres • Following completion of project as proposed: acres • Gain or loss (indicate + or acres o. Does project site contain any species of plant or animal that is listed by the federal government or NYS as 9 Yes 9 No endangered or threatened, or does it contain any areas identified as habitat for an endangered or threatened species? If Yes: i. Species and listing (endangered or threatened): ii. Nature of use of site by the species resident, seasonal, transient): p. Does the project site contain any species of plant or animal that is listed by NYS as rare, or as a species of 9 Yes 9 No special concern? If Yes: i. Species and listing: ii. Nature of use of site by the species resident, seasonal, transient): q. Is the project site or adjoining area currently used for hunting, trapping, fishing or shell fishing? 9 Yes 9 No If yes, give a brief description of how the proposed action may affect that use: E.3. Designated Public Resources On or Near Project Site a. Is the project site, or any portion of it, located in a designated agricultural district certified pursuant to 9 Yes 9 No Agriculture and Markets Law, Article 25-AA, Section 303 and 304? If Yes, provide county plus district name/number: b. Are agricultural lands consisting of highly productive soils present? 9 Yes 9 No i. If Yes: acreage(s) on project site? ii. Source(s) of soil rating(s): c. Does the project site contain all or part of, or is it substantially contiguous to, a registered National 9 Yes 9 No Natural Landmark? If Yes: i. Nature of the natural landmark: 9 Biological Community 9 Geological Feature ii. Provide brief description of landmark, including values behind designation and approximate size/extent: d. Is the project site located in or does it adjoin a state listed Critical Environmental Area? 9 Yes 9 No If Yes: i. CEA name: ii. Basis for designation: iii. Designating agency and date: Not effective until October 7, 2013 ---PAGE BREAK--- Page 13 of 13 e. Does the project site contain, or is it substantially contiguous to, a building, archaeological site, or district 9 Yes 9 No which is listed on, or has been nominated by the NYS Board of Historic Preservation for inclusion on, the State or National Register of Historic Places? If Yes: i. Nature of historic/archaeological resource: 9 Archaeological Site 9 Historic Building or District ii. Name: iii. Brief description of attributes on which listing is based: f. Is the project site, or any portion of it, located in or adjacent to an area designated as sensitive for 9 Yes 9 No archaeological sites on the NY State Historic Preservation Office (SHPO) archaeological site inventory? g. Have additional archaeological or historic site(s) or resources been identified on the project site? 9 Yes 9 No If Yes: i. Describe possible resource(s): ii. Basis for identification: h. Would the project site be visible from any officially designated and publicly accessible federal, state, or local 9 Yes 9 No scenic or aesthetic resource? If Yes: i. Identify resource: ii. Nature of, or basis for, designation established highway overlook, state or local park, state historic trail or scenic byway, etc.): iii. Distance between project and resource: miles. i. Is the project site located within a designated river corridor under the Wild, Scenic and Recreational Rivers 9 Yes 9 No Program 6 666? If Yes: i. Identify the name of the river and its designation: ii. Is the activity consistent with development restrictions contained in Part 666? 9 Yes 9 No F. Additional Information Attach any additional information which may be needed to clarify your project. If you have identified any adverse impacts which could be associated with your proposal, please describe those impacts plus any measures which you propose to avoid or minimize them. G. Verification I certify that the information provided is true to the best of my knowledge. Applicant/Sponsor Name Not effective until October 7, 2013 ---PAGE BREAK--- Page 1 of 10 Full Environmental Assessment Form Part 2 - Identification of Potential Project Impacts Part 2 is to be completed by the lead agency. Part 2 is designed to help the lead agency inventory all potential resources that could be affected by a proposed project or action. We recognize that the lead agency=s reviewer(s) will not necessarily be environmental professionals. So, the questions are designed to walk a reviewer through the assessment process by providing a series of questions that can be answered using the information found in Part 1. To further assist the lead agency in completing Part 2, the form identifies the most relevant questions in Part 1 that will provide the information needed to answer the Part 2 question. When Part 2 is completed, the lead agency will have identified the relevant environmental areas that may be impacted by the proposed activity. If the lead agency is a state agency and the action is in any Coastal Area, complete the Coastal Assessment Form before proceeding with this assessment. Tips for completing Part 2: • Review all of the information provided in Part 1. • Review any application, maps, supporting materials and the Full EAF Workbook. • Answer each of the 18 questions in Part 2. • If you answer “Yes” to a numbered question, please complete all the questions that follow in that section. • If you answer “No” to a numbered question, move on to the next numbered question. • Check appropriate column to indicate the anticipated size of the impact. • Proposed projects that would exceed a numeric threshold contained in a question should result in the reviewing agency checking the box “Moderate to large impact may occur.” • The reviewer is not expected to be an expert in environmental analysis. • If you are not sure or undecided about the size of an impact, it may help to review the sub-questions for the general question and consult the workbook. • When answering a question consider all components of the proposed activity, that is, the Awhole action@. • Consider the possibility for long-term and cumulative impacts as well as direct impacts. • Answer the question in a reasonable manner considering the scale and context of the project. 1. Impact on Land Proposed action may involve construction on, or physical alteration of, † NO † YES the land surface of the proposed site. (See Part 1. D.1) If “Yes”, answer questions a - j. If “No”, move on to Section 2. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur a. The proposed action may involve construction on land where depth to water table is less than 3 feet. E2d 9 9 b. The proposed action may involve construction on slopes of 15% or greater. E2f 9 9 c. The proposed action may involve construction on land where bedrock is exposed, or generally within 5 feet of existing ground surface. E2a 9 9 d. The proposed action may involve the excavation and removal of more than 1,000 tons of natural material. D2a 9 9 e. The proposed action may involve construction that continues for more than one year or in multiple phases. D1e 9 9 f. The proposed action may result in increased erosion, whether from physical disturbance or vegetation removal (including from treatment by herbicides). D2e, D2q 9 9 g. The proposed action is, or may be, located within a Coastal Erosion hazard area. B1i 9 9 h. Other impacts: 9 9 Not effective until October 7, 2013 ---PAGE BREAK--- Page 2 of 10 2. Impact on Geological Features The proposed action may result in the modification or destruction of, or inhibit access to, any unique or unusual land forms on the site cliffs, dunes, † NO † YES minerals, fossils, caves). (See Part 1. E.2.g) If “Yes”, answer questions a - c. If “No”, move on to Section 3. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur a. Identify the specific land form(s) attached: E2g 9 9 b. The proposed action may affect or is adjacent to a geological feature listed as a registered National Natural Landmark. Specific feature: E3c 9 9 c. Other impacts: 9 9 3. Impacts on Surface Water The proposed action may affect one or more wetlands or other surface water † NO † YES bodies streams, rivers, ponds or lakes). (See Part 1. D.2, E.2.h) If “Yes”, answer questions a - l. If “No”, move on to Section 4. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur a. The proposed action may create a new water body. D2b, D1h 9 9 b. The proposed action may result in an increase or decrease of over 10% or more than a 10 acre increase or decrease in the surface area of any body of water. D2b 9 9 c. The proposed action may involve dredging more than 100 cubic yards of material from a wetland or water body. D2a 9 9 d. The proposed action may involve construction within or adjoining a freshwater or tidal wetland, or in the bed or banks of any other water body. E2h 9 9 e. The proposed action may create turbidity in a waterbody, either from upland erosion, runoff or by disturbing bottom sediments. D2a, D2h 9 9 f. The proposed action may include construction of one or more intake(s) for withdrawal of water from surface water. D2c 9 9 g. The proposed action may include construction of one or more outfall(s) for discharge of wastewater to surface water(s). D2d 9 9 h. The proposed action may cause soil erosion, or otherwise create a source of stormwater discharge that may lead to siltation or other degradation of receiving water bodies. D2e 9 9 i. The proposed action may affect the water quality of any water bodies within or of the site of the proposed action. E2h 9 9 j. The proposed action may involve the application of pesticides or herbicides in or around any water body. D2q, E2h 9 9 k. The proposed action may require the construction of new, or expansion of existing, wastewater treatment facilities. D1a, D2d 9 9 Not effective until October 7, 2013 ---PAGE BREAK--- Page 3 of 10 l. Other impacts: 9 9 4. Impact on groundwater The proposed action may result in new or additional use of ground water, or † NO † YES may have the potential to introduce contaminants to ground water or an aquifer. (See Part 1. D.2.a, D.2.c, D.2.d, D.2.p, D.2.q, D.2.t) If “Yes”, answer questions a - h. If “No”, move on to Section 5. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur a. The proposed action may require new water supply wells, or create additional demand on supplies from existing water supply wells. D2c 9 9 b. Water supply demand from the proposed action may exceed safe and sustainable withdrawal capacity rate of the local supply or aquifer. Cite Source: D2c 9 9 c. The proposed action may allow or result in residential uses in areas without water and sewer services. D1a, D2c 9 9 d. The proposed action may include or require wastewater discharged to groundwater. D2d, E2l 9 9 e. The proposed action may result in the construction of water supply wells in locations where groundwater is, or is suspected to be, contaminated. D2c, E1f, E1g, E1h 9 9 f. The proposed action may require the bulk storage of petroleum or chemical products over ground water or an aquifer. D2p, E2l 9 9 g. The proposed action may involve the commercial application of pesticides within 100 feet of potable drinking water or irrigation sources. E2h, D2q, E2l, D2c 9 9 h. Other impacts: 9 9 5. Impact on Flooding The proposed action may result in development on lands subject to flooding. † NO † YES (See Part 1. E.2) If “Yes”, answer questions a - g. If “No”, move on to Section 6. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur a. The proposed action may result in development in a designated floodway. E2i 9 9 b. The proposed action may result in development within a 100 year floodplain. E2j 9 9 c. The proposed action may result in development within a 500 year floodplain. E2k 9 9 d. The proposed action may result in, or require, modification of existing drainage patterns. D2b, D2e 9 9 e. The proposed action may change flood water flows that contribute to flooding. D2b, E2i, E2j, E2k 9 9 f. If there is a dam located on the site of the proposed action, the dam has failed to meet one or more safety criteria on its most recent inspection. E1e 9 9 Not effective until October 7, 2013 ---PAGE BREAK--- Page 4 of 10 g. Other impacts: 9 9 6. Impacts on Air The proposed action may include a state regulated air emission source. † NO † YES (See Part 1. D.2.f., D,2,h, D.2.g) If “Yes”, answer questions a - f. If “No”, move on to Section 7. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur a. If the proposed action requires federal or state air emission permits, the action may also emit one or more greenhouse gases at or above the following levels: i. More than 1000 tons/year of carbon dioxide (CO2) ii. More than 3.5 tons/year of nitrous oxide (N20) iii. More than 1000 tons/year of carbon equivalent of perfluorocarbons (PFCs) iv. More than .045 tons/year of sulfur hexafluoride (SF6) v. More than 1000 tons/year of carbon dioxide equivalent of hydrochloroflurocarbons emissions vi. 43 tons/year or more of methane D2g D2g D2g D2g D2g D2h 9 9 9 9 9 9 9 9 9 9 9 9 b. The proposed action may generate 10 tons/year or more of any one designated hazardous air pollutant, or 25 tons/year or more of any combination of such hazardous air pollutants. D2g 9 9 c. The proposed action may require a state air registration, or may produce an emissions rate of total contaminants that may exceed 5 lbs. per hour, or may include a heat source capable of producing more than 10 million BTU=s per hour. D2f, D2g 9 9 d. The proposed action may reach 50% of any two or more of the thresholds in through above. D1g, D2k 9 9 e. The proposed action may result in the combustion or thermal treatment of more than 1 ton of refuse per hour. D2s 9 9 f. Other impacts: 9 9 7. Impact on Plants and Animals The proposed action may result in a loss of flora or fauna. (See Part 1. E.2. † NO † YES If “Yes”, answer questions a - j. If “No”, move on to Section 8. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur a. The proposed action may cause reduction in population or loss of individuals of any threatened or endangered species, as listed by New York State or the Federal government, that use the site, or are found on, over, or near the site. E2o 9 9 b. The proposed action may result in a reduction or degradation of any habitat used by any rare, threatened or endangered species, as listed by New York State or the federal government. E2o 9 9 c. The proposed action may cause reduction in population, or loss of individuals, of any species of special concern or conservation need, as listed by New York State or the Federal government, that use the site, or are found on, over, or near the site. E2p 9 9 d. The proposed action may result in a reduction or degradation of any habitat used by any species of special concern and conservation need, as listed by New York State or the Federal government. E2p 9 9 Not effective until October 7, 2013 ---PAGE BREAK--- Page 5 of 10 e. The proposed action may diminish the capacity of a registered National Natural Landmark to support the biological community it was established to protect. E3c 9 9 f. The proposed action may result in the removal of, or ground disturbance in, any portion of a designated significant natural community. Source: E2n 9 9 g. The proposed action may substantially interfere with nesting/breeding, foraging, or over-wintering habitat for the predominant species that occupy or use the project site. E2m 9 9 h. The proposed action requires the conversion of more than 10 acres of forest, grassland or any other regionally or locally important habitat. Habitat type & information source: E1b 9 9 i. Proposed action (commercial, industrial or recreational projects, only) involves use of herbicides or pesticides. D2q 9 9 j. Other impacts: 9 9 8. Impact on Agricultural Resources The proposed action may impact agricultural resources. (See Part 1. E.3.a. and † NO † YES If “Yes”, answer questions a - h. If “No”, move on to Section 9. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur a. The proposed action may impact soil classified within soil group 1 through 4 of the NYS Land Classification System. E2c, E3b 9 9 b. The proposed action may sever, cross or otherwise limit access to agricultural land (includes cropland, hayfields, pasture, vineyard, orchard, etc). E1a, Elb 9 9 c. The proposed action may result in the excavation or compaction of the soil profile of active agricultural land. E3b 9 9 d. The proposed action may irreversibly convert agricultural land to non-agricultural uses, either more than 2.5 acres if located in an Agricultural District, or more than 10 acres if not within an Agricultural District. E1b, E3a 9 9 e. The proposed action may disrupt or prevent installation of an agricultural land management system. El a, E1b 9 9 f. The proposed action may result, directly or indirectly, in increased development potential or pressure on farmland. C2c, C3, D2c, D2d 9 9 g. The proposed project is not consistent with the adopted municipal Farmland Protection Plan. C2c 9 9 h. Other impacts: 9 9 9. Impact on Aesthetic Resources The land use of the proposed action are obviously different from, or are in † NO † YES sharp contrast to, current land use patterns between the proposed project and a scenic or aesthetic resource. (Part 1. E.1.a, E.1.b, E.3.h.) If “Yes”, answer questions a - g. If “No”, go to Section 10. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur Not effective until October 7, 2013 ---PAGE BREAK--- Page 6 of 10 a. Proposed action may be visible from any officially designated federal, state, or local scenic or aesthetic resource. E3h 9 9 b. The proposed action may result in the obstruction, elimination or significant screening of one or more officially designated scenic views. E3h, C2b 9 9 c. The proposed action may be visible from publicly accessible vantage points: i. Seasonally screened by summer foliage, but visible during other seasons) ii. Year round E3h 9 9 9 9 d. The situation or activity in which viewers are engaged while viewing the proposed action is: i. Routine travel by residents, including travel to and from work ii. Recreational or tourism based activities E3h E2q, E1c 9 9 9 9 e. The proposed action may cause a diminishment of the public enjoyment and appreciation of the designated aesthetic resource. E3h 9 9 f. There are similar projects visible within the following distance of the proposed project: 0-1/2 mile ½ -3 mile 3-5 mile 5+ mile D1a, E1a, D1f, D1g 9 9 g. Other impacts: 9 9 10. Impact on Historic and Archeological Resources The proposed action may occur in or adjacent to a historic or archaeological † NO † YES resource. (Part 1. E.3.e, f. and If “Yes”, answer questions a - e. If “No”, go to Section 11. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur a. The proposed action may occur wholly or partially within, or substantially contiguous to, any buildings, archaeological site or district which is listed on or has been nominated by the NYS Board of Historic Preservation for inclusion on the State or National Register of Historic Places. E3e 9 9 b. The proposed action may occur wholly or partially within, or substantially contiguous to, an area designated as sensitive for archaeological sites on the NY State Historic Preservation Office (SHPO) archaeological site inventory. E3f 9 9 c. The proposed action may occur wholly or partially within, or substantially contiguous to, an archaeological site not included on the NY SHPO inventory. Source: E3g 9 9 d. Other impacts: 9 9 e. If any of the above (a-d) are answered “Yes”, continue with the following questions to help support conclusions in Part 3: i. The proposed action may result in the destruction or alteration of all or part of the site or property. ii. The proposed action may result in the alteration of the property’s setting or E3e, E3g, E3f E3e, E3f, E3g, E1a, 9 9 9 9 Not effective until October 7, 2013 ---PAGE BREAK--- Page 7 of 10 integrity. iii. The proposed action may result in the introduction of visual elements which are out of character with the site or property, or may alter its setting. E1b E3e, E3f, E3g, E3h, C2, C3 9 9 11. Impact on Open Space and Recreation The proposed action may result in a loss of recreational opportunities or a † NO † YES reduction of an open space resource as designated in any adopted municipal open space plan. (See Part 1. C.2.c, E.1.c., E.2.q.) If “Yes”, answer questions a - e. If “No”, go to Section 12. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur a. The proposed action may result in an impairment of natural functions, or “ecosystem services”, provided by an undeveloped area, including but not limited to stormwater storage, nutrient cycling, wildlife habitat. D2e, E1b E2h, E2m, E2o, E2n, E2p 9 9 b. The proposed action may result in the loss of a current or future recreational resource. C2a, E1c, C2c, E2q 9 9 c. The proposed action may eliminate open space or recreational resource in an area with few such resources. C2a, C2c E1c, E2q 9 9 d. The proposed action may result in loss of an area now used informally by the community as an open space resource. C2c, E1c 9 9 e. Other impacts: 9 9 12. Impact on Critical Environmental Areas The proposed action may be located within or adjacent to a critical † NO † YES environmental area (CEA). (See Part 1. E.3.d) If “Yes”, answer questions a - c. If “No”, go to Section 13. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur a. The proposed action may result in a reduction in the quantity of the resource or characteristic which was the basis for designation of the CEA. E3d 9 9 b. The proposed action may result in a reduction in the quality of the resource or characteristic which was the basis for designation of the CEA. E3d 9 9 c. Other impacts: 9 9 13. Impact on Transportation The proposed action may result in a change to existing transportation systems. † NO † YES (See Part 1. D.2.j) If “Yes”, answer questions a - g. If “No”, go to Section 14. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur a. Projected traffic increase may exceed capacity of existing road network. D2j 9 9 Not effective until October 7, 2013 ---PAGE BREAK--- Page 8 of 10 b. The proposed action may result in the construction of paved parking area for 500 or more vehicles. D2j 9 9 c. The proposed action will degrade existing transit access. D2j 9 9 d. The proposed action will degrade existing pedestrian or bicycle accommodations. D2j 9 9 f. The proposed action may alter the present pattern of movement of people or goods. D2j 9 9 g. Other impacts: 9 9 14. Impact on Energy The proposed action may cause an increase in the use of any form of energy. † NO † YES (See Part 1. D.2.k) If “Yes”, answer questions a - e. If “No”, go to Section 15. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur a. The proposed action will require a new, or an upgrade to an existing, substation. D2k 9 9 b. The proposed action will require the creation or extension of an energy transmission or supply system to serve more than 50 single or two-family residences or to serve a commercial or industrial use. D1f, D1q, D2k 9 9 c. The proposed action may utilize more than 2,500 per year of electricity. D2k 9 9 d. The proposed action may involve heating and/or cooling of more than 100,000 square feet of building area when completed. D1g 9 9 e. Other Impacts: 15. Impact on Noise, Odor, and Light The proposed action may result in an increase in noise, odors, or outdoor lighting. † NO † YES (See Part 1. D.2.m., and If “Yes”, answer questions a - f. If “No”, go to Section 16. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur a. The proposed action may produce sound above noise levels established by local regulation. D2m 9 9 b. The proposed action may result in blasting within 1,500 feet of any residence, hospital, school, licensed day care center, or nursing home. D2m, E1d 9 9 c. The proposed action may result in routine odors for more than one hour per day. D2o 9 9 d. The proposed action may result in light shining onto adjoining properties. D2n 9 9 e. The proposed action may result in lighting creating sky-glow brighter than existing area conditions. D2n, E1a 9 9 f. Other impacts: 9 9 16. Impact on Human Health The proposed action may have an impact on human health from exposure † NO † YES Not effective until October 7, 2013 ---PAGE BREAK--- Page 9 of 10 to new or existing sources of contaminants. (See Part 1.D.2.q., E.1. d. f. g. and If “Yes”, answer questions a - m. If “No”, go to Section 17. Relevant Part I Question(s) No,or small impact may cccur Moderate to large impact may occur a. The proposed action is located within 1500 feet of a school, hospital, licensed day care center, group home, nursing home or retirement community. E1d 9 9 b. The site of the proposed action is currently undergoing remediation. E1g, E1h 9 9 c. There is a completed emergency spill remediation, or a completed environmental site remediation on, or adjacent to, the site of the proposed action. E1g, E1h 9 9 d. The site of the action is subject to an institutional control limiting the use of the property (e.g. easement, deed restriction) E1g, E1h 9 9 e. The proposed action may affect institutional control measures that were put in place to ensure that the site remains protective of the environment and human health. E1g, E1h 9 9 f. The proposed action has adequate control measures in place to ensure that future generation, treatment and/or disposal of hazardous wastes will be protective of the environment and human health. D2t 9 9 g. The proposed action involves construction or modification of a solid waste management facility. D2q, E1f 9 9 h. The proposed action may result in the unearthing of solid or hazardous waste. D2q, E1f 9 9 i. The proposed action may result in an increase in the rate of disposal, or processing, of solid waste. D2r, D2s 9 9 j. The proposed action may result in excavation or other disturbance within 2000 feet of a site used for the disposal of solid or hazardous waste. E1f, E1g E1h 9 9 k. The proposed action may result in the migration of explosive gases from a landfill site to adjacent off site structures. E1f, E1g 9 9 l. The proposed action may result in the release of contaminated leachate from the project site. D2s, E1f, D2r 9 9 m. Other impacts: 17. Consistency with Community Plans The proposed action is not consistent with adopted land use plans. † NO † YES (See Part 1. C.1, C.2. and C.3.) If “Yes”, answer questions a - h. If “No”, go to Section 18. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur a. The proposed action’s land use components may be different from, or in sharp contrast to, current surrounding land use pattern(s). C2, C3, D1a E1a, E1b 9 9 b. The proposed action will cause the permanent population of the city, town or village in which the project is located to grow by more than C2 9 9 c. The proposed action is inconsistent with local land use plans or zoning regulations. C2, C2, C3 9 9 d. The proposed action is inconsistent with any County plans, or other regional land use plans. C2, C2 9 9 e. The proposed action may cause a change in the density of development that is not C3, D1c, 9 9 Not effective until October 7, 2013 ---PAGE BREAK--- Page 10 of 10 supported by existing infrastructure or is distant from existing infrastructure. D1d, D1f, D1d, Elb f. The proposed action is located in an area characterized by low density development that will require new or expanded public infrastructure. C4, D2c, D2d D2j 9 9 g. The proposed action may induce secondary development impacts residential or commercial development not included in the proposed action) C2a 9 9 h. Other: 9 9 18. Consistency with Community Character The proposed project is inconsistent with the existing community character. † NO † YES (See Part 1. C.2, C.3, D.2, E.3) If “Yes”, answer questions a - g. If “No”, proceed to Part 3. Relevant Part I Question(s) No, or small impact may occur Moderate to large impact may occur a. The proposed action may replace or eliminate existing facilities, structures, or areas of historic importance to the community. E3e, E3f, E3g 9 9 b. The proposed action may create a demand for additional community services (e.g. schools, police and fire) C4 9 9 c. The proposed action may displace affordable or low-income housing in an area where there is a shortage of such housing. C2, C3, D1f D1g, E1a 9 9 d. The proposed action may interfere with the use or enjoyment of officially recognized or designated public resources. C2, E3 9 9 e. The proposed action is inconsistent with the predominant architectural scale and character. C2, C3 9 9 f. Proposed action is inconsistent with the character of the existing natural landscape. C2, C3 E1a, E1b E2g, E2h 9 9 g. Other impacts: 9 9 Not effective until October 7, 2013 ---PAGE BREAK--- Full Environmental Assessment Form Part 3 - Evaluation of the Magnitude and Importance of Project Impacts and Determination of Significance Part 3 provides the reasons in support of the determination of significance. The lead agency must complete Part 3 for every question in Part 2 where the impact has been identified as potentially moderate to large or where there is a need to explain why a particular element of the proposed action will not, or may, result in a significant adverse environmental impact. Based on the analysis in Part 3, the lead agency must decide whether to require an environmental impact statement to further assess the proposed action or whether available information is sufficient for the lead agency to conclude that the proposed action will not have a significant adverse environmental impact. By completing the certification on the next page, the lead agency can complete its determination of significance. Reasons Supporting This Determination: To complete this section: • Identify the impact based on the Part 2 responses and describe its magnitude. Magnitude considers factors such as severity, size or extent of an impact. • Assess the importance of the impact. Importance relates to the geographic scope, duration, probability of the impact occurring, number of people affected by the impact and any additional environmental consequences if the impact were to occur. • The assessment should take into consideration any design element or project changes. • Repeat this process for each Part 2 question where the impact has been identified as potentially moderate to large or where there is a need to explain why a particular element of the proposed action will not, or may, result in a significant adverse environmental impact. • Provide the reason(s) why the impact may, or will not, result in a significant adverse environmental impact • For Conditional Negative Declarations identify the specific condition(s) imposed that will modify the proposed action so that no significant adverse environmental impacts will result. • Attach additional sheets, as needed. Determination of Significance - Type 1 and Unlisted Actions SEQR Status: † Type 1 † Unlisted Identify portions of EAF completed for this Project: † Part 1 † Part 2 † Part 3 Not effective until October 7, 2013 ---PAGE BREAK--- Upon review of the information recorded on this EAF, as noted, plus this additional support information and considering both the magnitude and importance of each identified potential impact, it is the conclusion of the as lead agency that: † A. This project will result in no significant adverse impacts on the environment, and, therefore, an environmental impact statement need not be prepared. Accordingly, this negative declaration is issued. † B. Although this project could have a significant adverse impact on the environment, that impact will be avoided or substantially mitigated because of the following conditions which will be required by the lead agency: There will, therefore, be no significant adverse impacts from the project as conditioned, and, therefore, this conditioned negative declaration is issued. A conditioned negative declaration may be used only for UNLISTED actions (see 6 617.d). † C. This Project may result in one or more significant adverse impacts on the environment, and an environmental impact statement must be prepared to further assess the impact(s) and possible mitigation and to explore alternatives to avoid or reduce those impacts. Accordingly, this positive declaration is issued. Name of Action: Name of Lead Agency: Name of Responsible Officer in Lead Agency: Title of Responsible Officer: Signature of Responsible Officer in Lead Agency: Date: Signature of Preparer (if different from Responsible Officer) Date: For Further Information: Contact Person: Address: Telephone Number: E-mail: For Type 1 Actions and Conditioned Negative Declarations, a copy of this Notice is sent to: Chief Executive Officer of the political subdivision in which the action will be principally located Town / City / Village of) Other involved agencies (if any) Applicant (if any) Environmental Notice Bulletin: http://www.dec.ny.gov/enb/enb.html Not effective until October 7, 2013