• 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 applicant or project sponsor to verify that the information contained in Part 1is accurate and complete.

    A.Project and Applicant/Sponsor Information.

  • B. Government Approvals

  • B.Government Approvals, Funding, or Sponsorship. (“Funding” includes grants, loans, tax relief, and any other forms of financial assistance

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  • i. Coastal Resources.

  • C. Planning and Zoning

  • C.1. Planning and zoning actions.

    • 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.

  • C.3. Zoning

  • C.4. Existing community services.

  • D. Project Details

  • D.1. Proposed and Potential Development

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  • D.2. Project Operations

  • ii. How much material (including rock, earth, sediments, etc is proposed to be removed from the site?

  • Does the existing public water supply have capacity to serve the proposal?

    Is the project site in the existing district?

    Do existing lines serve the project site?

    iii.Will line extension within an existing district be necessary to supply the project? If Yes:

  • Date application submitted or anticipated:

  • iii.Will the proposed action use any existing public wastewater treatment facilities? If Yes:

  • Does the existing wastewater treatment plant have capacity to serve the project?

    • Is the project site in the existing district?

    • Is expansion of the district needed?

  • Do existing sewer lines serve the project site?

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  • g. Will any air emission sources named in D.2.f (above), require a NY State Air Registration, Air Facility Permit, 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 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 (short tons) of Sulfur Hexafluoride (SF) 6 Tons/year (short tons) of Carbon Dioxide equivalent of Hydroflourocarbons (HFCs)

    Tons/year (short tons) of Hazardous Air Pollutants (HAPs)

  • h. Will the proposed action generate or emit methane (including, but not limited to, sewage treatment plants, landfills, composting facilities)? If Yes: Estimate methane generation in tons/year (metric): i. ii. Describe any methane capture, control or elimination measures included in project design (e.g., combustion to generate heat or electr icity, flaring):

  • j. Will the proposed action result in a substantial increase in traffic above present levels or generate substantial new demand for transportation facilities or services? If Yes: ng Evening Weekend i.When is the peak traffic expected (Check all that apply): Morni Randomly between hours of to ii.For commercial activities only, projected number of truck trips/day and type (e.g., semi trailers and dump trucks):

  • k. Will the proposed action (for commercial or industrial projects only) generate new or additional demand for energy? If Yes: i.Estimate annual electricity demand during operation of the proposed action:

  • l. Hours of operation. Answer all items which apply. i. During Construction:

  • . iiWill proposed action remove existing natural barriers that could act as a light barrier or screen? Describe:

  • ii.Will the proposed action use Integrated Pest Management Practices?

    r. Will the proposed action (commercial or industrial projects only) involve or require the management or disposal of solid waste (excluding hazardous materials)? If Yes: i.Describe any solid waste(s) to be generated during construction or operation of the facility:

    • Describe any proposals for on-site minimization, recycling or reuse of materials to avoid disposal as solid waste: ii.

  • iii.Proposed disposal methods/facilities for solid waste generated on-site:

  • s. Does the proposed action include construction or modification of a solid waste management facility? If Yes: Type of management or handling of waste proposed for the site (e.g., recycling or transfer station, composting, landfill, or i. other disposal activities): ii.Anticipated rate of disposal/processing:

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  • Meadows, grasslands or brushlands (non-

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  • e. Does the project site contain an existing dam? If Yes: i.Dimensions of the dam and impoundment:

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  • g. Have hazardous wastes been generated, treated and/or disposed of at the site, or does the project site adjoin property which is now or was at one time used to commercially treat, store and/or dispose of hazardous waste? If Yes:

  • h. Potential contamination history. Has there been a reported spill at the proposed project site, or have any 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 Remediation database? Check all that apply:

  • iii.Is the project within 2000 feet of any site in the NYSDEC Environmental Site Remediation database? If yes, provide DEC ID number(s):

  • E.2. Natural Resources On or Near Project Site

    a. What is the average depth to bedrock on the project site?

  • d. What is the average depth to the water table on the project site? Average:

  • 0-10%: 9 10-15%: 9 15% or greater:

  • iv.For each identified regulated wetland and waterbody on the project site, provide the following information:

  • l. Is the project site located over, or immediately adjoining, a primary, principal or sole source aquifer? If Yes: i.Name of aquifer:

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  • Gain or loss (indicate + or -):

  • c. Does the project site contain all or part of, or is it substantially contiguous to, a registered National 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:

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  • 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.

    I certify that the information provided is true to the best of my knowledge.

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  • Should be Empty: