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ECR_Illicit_Discharge_Env_Checklist_171109
PLANNINGDIVISIONENVIRONMENTALCHECKLISTCityofRentonPlanningDivision1055SouthGradyWay-Renton,WA98057Phone:425-430-7200Fax:425-430-7231PURPOSEOFCHECKLIST:TheStateEnvironmentalPolicyAct(SEPA),Chapter43.21CRCW,requiresallgovernmentalagenciestoconsidertheenvironmentalimpactsofaproposalbeforemakingdecisions.AnEnvironmentalImpactStatement(EIS)mustbepreparedforallproposalswithprobablesignificantadverseimpactsonthequalityoftheenvironment.Thepurposeofthischecklististoprovideinformationtohelpyouandtheagencyidentifyimpactsfromyourproposal(andtoreduceoravoidimpactsfromtheproposal,ifitcanbedone)andtohelptheagencydecidewhetheranEISisrequired.INSTRUCTIONSFORAPPLICANTS:Thisenvironmentalchecklistasksyoutodescribesomebasicinformationaboutyourproposal.Governmentalagenciesusethischecklisttodeterminewhethertheenvironmentalimpactsofyourproposalaresignificant,requiringpreparationofanEIS.Answerthequestionsbriefly,withthemostpreciseinformationknown,orgivethebestdescriptionyoucan.Youmustanswereachquestionaccuratelyandcarefully,tothebestofyourknowledge.Inmostcases,youshouldbeabletoanswerthequestionsfromyourownobservationsorprojectplanswithouttheneedtohireexperts.Ifyoureallydonotknowtheanswer,orifaquestiondoesnotapplytoyourproposal,write“donotknow”or“doesnotapply”.Completeanswerstothequestionsnowmayavoidunnecessarydelayslater.Somequestionsaskaboutgovernmentalregulations,suchaszoning,shoreline,andlandmarkdesignations.Answerthesequestionsifyoucan.Ifyouhaveproblems,thegovernmentalagenciescanassistyou.Thechecklistquestionsapplytoallpartsofyourproposal,evenifyouplantodothemoveraperiodoftimeorondifferentparcelsofland.Attachanyadditionalinformationthatwillhelpdescribeyourproposaloritsenvironmentaleffects.Theagencytowhichyousubmitthischecklistmayaskyoutoexplainyouranswersorprovideadditionalinformationreasonablyrelatedtodeterminingiftheremaybesignificantadverseimpact.USEOFCHECKLISTFORNONPROJECTPROPOSALS:Completethischecklistfornonprojectproposals,eventhoughquestionsmaybeanswered“doesnotapply.”INADDITION,completetheSUPPLEMENTALSHEETFORNONPROJECTACTIONS(partD).Fornonprojectactions(actionsinvolvingdecisionsonpolicies,plansandprograms),thereferencesinthechecklisttothewords“project,”“applicant,”and“propertyorsite”shouldbereadas“proposal,”“proposer,”and“affectedgeographicarea,”respectively.-1-06/09H:\CED\Planning\TitleIV\OtherTitleIVCodeAmendments\lIlicitDischarge\SEPA\EnviroChecklistIllicitDischarge.doc A.BACKGROUND1.Nameofproposedproject,ifapplicable:IllicitDischargeCodeAmendments2.Nameofapplicant(s):CityofRenton3.Addressandphonenumberofapplicantandcontactperson:ChipVincent,CommunityandEconomicDevelopmentAdministrator,425-430-6575,cvincent@rentonwa.gov4.Datechecklistprepared:November9,20175.Agencyrequestingchecklist:CityofRenton6.Proposedtimingorschedule(includingphasing,ifapplicable):N/A7.Doyouhaveanyplansforfutureadditions,expansion,orfurtheractivityrelatedtoorconnectedwiththisproposal?Ifyes,explain.N/A8.Listanyenvironmentalinformationyouknowaboutthathasbeenprepared,orwillbeprepared,directlyrelatedtothisproposal.N/A9.Doyouknowwhetherapplicationsarependingforgovernmentalapprovalsofotherproposalsdirectlyaffectingthepropertycoveredbyyourproposal?Ifyes,explain.N/A10.Listanygovernmentalapprovalsorpermitsthatwillbeneededforyourproposal,ifknown.CityCouncilapprovaloftheAmendment.11.Givebrief,completedescriptionofyourproposal,includingtheproposedusesandthesizeoftheprojectandsite.TheCityholdsaWesternWashingtonPhaseIIMunicipalStormwaterPermit(Permit)issuedbytheWashingtonStateDepartmentofEcology.ThePermitrequiresthatthepermitteeadoptanordinanceorregulatorymechanismtoeffectivelyprohibitillicitdischargesintotheCity’sstormsewersystem.RMC4-6-030regulatesillicitstormwaterdischargestothemunicipalseparatestorm-2- sewersystemtopreventcontaminationofsurfacewater,groundwaterandwatercourses.ThissectionregardingillicitdischargesneedstobeamendedtomeetthePermitrequirements.TheproposeddraftcodeamendmentsupdatethedefinitionsinRMC4-6-100andclarifyprohibited,allowable,andconditionallyallowabledischargesinRMC4-6-030tobeconsistentwiththecurrent2013-2018Permit.TheproposeddraftcodeamendmentsalsoupdatedefinitionsforconsistencywiththePermit.Definitionsforillicitconnection,illicitdischarge,andmunicipalseparatestormsewersystemareproposedtobeamendedandthedefinitionofstormwaterisproposedtobeaddedforconsistencywiththePermitdefinitions.Finally,proposedamendmentstoRMC4-6-030sectionJ.DischargeProhibitionincludeexamplesofillicitdischarges,definitionofallowabledischargesanddefinitionofconditionallyallowabledischarges.12.Locationoftheproposal.Givesufficientinformationforapersontounderstandthepreciselocationofyourproposedproject,includingastreetaddress,ifany,andsection,township,andrangeifknown.Ifaproposalwouldoccuroverarangeofarea,providetherangeorboundariesofthesite(s).Providealegaldescription,siteplan,vicinitymap,andtopographicmap,ifreasonablyavailable.Whileyoushouldsubmitanyplansrequiredbytheagency,youarenotrequiredtoduplicatemapsordetailedplanssubmittedwithanypermitapplicationsrelatedtothischecklist.Citywide.B.ENVIRONMENTALELEMENTS1.EARTHa.Generaldescriptionofthesite(circleone);flat,rolling,hilly,steepslopes,mountainous,other________________NotApplicable,Non-projectaction.b.Whatisthesteepestslopeonthesite(approximatepercentslope?)NotApplicable,Non-projectaction.c.Whatgeneraltypesofsoilsarefoundonthesite(forexample,clay,sand,gravel,peat,muck)?Ifyouknowtheclassificationofagriculturalsoils,specifythemandnoteanyprimefarmland.NotApplicable,Non-projectaction.d.Aretheresurfaceindicationsorhistoryofunstablesoilsintheimmediatevicinity?Ifso,describe.NotApplicable,Non-projectaction.e.Describethepurpose,type,andapproximatequantitiesofanyfillingorgradingproposed.Indicatesourceoffill.NotApplicable,Non-projectaction.f.Coulderosionoccurasaresultofclearing,construction,oruse?Ifso,generallydescribe.NotApplicable,Non-projectaction.-3- g.Aboutwhatpercentofthesitewillbecoveredwithimpervioussurfacesafterprojectconstruction(forexample,asphaltorbuildings)?NotApplicable,Non-projectaction.h.Proposedmeasurestoreduceorcontrolerosion,orotherimpactstotheearth,ifany:NotApplicable,Non-projectaction.2.AIRa.Whattypesofemissionstotheairwouldresultfromtheproposal(i.e.,dust,automobile,odors,industrialwoodsmoke)duringconstructionandwhentheprojectiscompleted?Ifany,generallydescribeandgiveapproximatequantitiesifknown.NotApplicable,Non-projectaction.b.Arethereanyoff-sitesourcesofemissionorodorthatmayaffectyourproposal?Ifso,generallydescribe.NotApplicable,Non-projectaction.c.Proposedmeasurestoreduceorcontrolemissionsorotherimpactstoair,ifafly:NotApplicable,Non-projectaction.3.WATERa.SurfaceWater:1)Isthereanysurfacewaterbodyonorintheimmediatevicinityofthesite(includingyear-roundandseasonalstreams,saltwater,lakes,ponds,wetlands)?Ifyes,describetypeandprovidenames.Ifappropriate,statewhatstreamorriveritflowsinto.NotApplicable,Non-projectaction.2)Willtheprojectrequireanyworkover,in,oradjacentto(within200feet)thedescribedwaters?Ifyes,pleasedescribeandattachavailableplans.NotApplicable,Non-projectaction.3)Estimatetheamountoffillanddredgematerialthatwouldbeplacedinorremovedfromsurfacewaterorwetlandsandindicatetheareaofthesitethatwouldbeaffected.Indicatethesourceoffillmaterial.NotApplicable,Non-projectaction.4)Willtheproposalrequiresurfacewaterwithdrawalsordiversions?Givegeneraldescription,purpose,andapproximatequantitiesifknown.-4- NotApplicable,Non-projectaction.5)Doestheproposalliewithina100-yearfloodplain?Ifso,notelocationonthesiteplan.NotApplicable,Non-projectaction.6)Doestheproposalinvolveanydischargesofwastematerialstosurfacewaters?Ifso,describethetypeofwasteandanticipatedvolumeofdischarge.NotApplicable,Non-projectaction.b.GroundWater:1)Willgroundwaterbewithdrawn,orwillwaterbedischargedtogroundwater?Givegeneraldescription,purpose,andapproximatequantitiesifknown.NotApplicable,Non-projectaction.2)Describewastematerialthatwillbedischargedintothegroundfromseptictanksorothersources,ifany(forexample:Domesticsewage;industrial,containingthefollowingchemicals...;agricultural;etc.).Describethegeneralsizeofthesystem,thenumberofsuchsystems,thenumberofhousestobeserved(ifapplicable),orthenumberofanimalsorhumansthesystem(s)areexpectedtoserve.NotApplicable,Non-projectaction.c.WaterRunoff(includingstormwater):1)Describethesourceofrunoff(includingstormwater)andmethodofcollectionanddisposal,ifany(includequantities,ifknown).Wherewillthiswaterflow?Willthiswaterflowintootherwaters,Ifso,describe.NotApplicable,Non-projectaction.2)Couldwastematerialentergroundorsurfacewaters?Ifso,generallydescribe.NotApplicable,Non-projectaction.3)Proposedmeasurestoreduceorcontrolsurface,ground,andrunoffwaterimpacts,ifany:NotApplicable,Non-projectaction.4.PLANTSa.Checkorcircletypesofvegetationfoundonthesite:_____deciduoustree:alder,maple,aspen,other____evergreentree:fir,cedar,pine,other_____shrubs_____grass_____pasture____croporgrain_____wetsoilplants:cattail,buttercup,bullrush,skunkcabbage,other_____waterplants:waterlily,eelgrass,milfoil,other-5- ____othertypesofvegetationNotApplicable,Non-projectaction.b.Whatkindandamountofvegetationwillberemovedoraltered?NotApplicable,Non-projectaction.c.Listthreatenedorendangeredspeciesknowntobeonornearthesite.NotApplicable,Non-projectaction.d.Proposedlandscaping,useofnativeplants,orothermeasurestopreserveorenhancevegetationonthesite,ifany:NotApplicable,Non-projectaction.5.ANIMALSa.Circleanybirdsandanimals,whichhavebeenobservedonornearthesiteorareknowntobeonornearthesite:Birds:hawk,heron,eagle,songbirds,other______________________Mammals:deer,bear,elk,beaver,other_________________________Fish:bass,salmon,trout,herring,shellfish,other__________________NotApplicable,Non-projectaction.b.Listanythreatenedorendangeredspeciesknowntobeonorneatthesite.NotApplicable,Non-projectaction.c.Isthesitepartofamigrationroute?Ifso,explainNotApplicable,Non-projectaction.U.Proposedmeasurestopreserveorenhancewildlife,ifany:NotApplicable,Non-projectaction.6.ENERGYANDNATURALRESOURCESa.Whatkindsofenergy(electric,naturalgas,oil,woodstove,solar)willbeusedtomeetthecompletedproject1senergyneeds?Describewhetheritwillbeusedforheating,manufacturing,etc.NotApplicable,Non-projectaction.b.Wouldyourprojectaffectthepotentialuseofsolarenergybyadjacentproperties?Ifso,generallydescribe.NotApplicable,Non-projectaction.-6- c.Whatkindsofenergyconservationfeaturesareincludedintheplansofthisproposal?Listotherproposedmeasurestoreduceorcontrolenergyimpacts,ifany:NotApplicable,Non-projectaction.7.ENVIRONMENTALHEALTHa.Arethereanyenvironmentalhealthhazards,includingexposuretotoxicchemicals,riskoffireandexplosion,spill,orhazardouswastethatcouldoccurasaresultofthisproposal?Ifso,describe.NotApplicable,Non-projectaction.1)Describespecialemergencyservicesthatmightberequired.NotApplicable,Non-projectaction.2)Proposedmeasurestoreduceorcontrolenvironmentalhealthhazards,ifany:NotApplicable,Non-projectaction.b.Noise1)Whattypesofnoiseexistintheareawhichmayaffectyourproject(forexample:traffic,equipment,operation,other)?NotApplicable,Non-projectaction.2)Whattypesandlevelsofnoisewouldbecreatedbyorassociatedwiththeprojectonashort-termoralong-termbasis(forexample:traffic,construction,operation,other)?Indicatewhathoursnoisewouldcomefromthesite.NotApplicable,Non-projectaction.3)Proposedmeasurestoreduceorcontrolnoiseimpacts,ifany:NotApplicable,Non-projectaction.8.LANDANDSHORELINEUSEa.Whatisthecurrentuseofthesiteandadjacentproperties?NotApplicable,Non-projectaction.b.Hasthesitebeenusedforagriculture?Ifso,describe.NotApplicable,Non-projectaction.c.Describeanystructuresonthesite.NotApplicable,Non-projectaction.d.Willanystructuresbedemolished?Ifso,what?NotApplicable,Non-projectaction.-7- e.Whatisthecurrentzoningclassificationofthesite?NotApplicable,Non-projectaction.f.Whatisthecurrentcomprehensiveplandesignationofthesite?NotApplicable,Non-projectaction.g.Ifapplicable,whatisthecurrentshorelinemasterprogramdesignationofthesite?NotApplicable,Non-projectaction.h.Hasanypartofthesitebeenclassifiedasan“environmentallysensitive”area?Ifso,specify.NotApplicable,Non-projectaction.Approximatelyhowmanypeoplewouldresideorworkinthecompletedproject?NotApplicable,Non-projectaction.j.Approximatelyhowmanypeoplewouldthecompletedprojectdisplace?NotApplicable,Non-projectaction.k.Proposedmeasurestoavoidorreducedisplacementimpacts,ifany:NotApplicable,Non-projectaction.Proposedmeasurestoensuretheproposaliscompatiblewithexistingandprojectedlandusesandplans,ifany:NotApplicable,Non-projectaction.9.HOUSINGa.Approximatelyhowmanyunitswouldbeprovided,ifany?Indicatewhetherhigh,middle,orlow-incomehousing.NotApplicable,Non-projectaction.b.Approximatelyhowmanyunits,ifany,wouldbeeliminated?Indicatewhetherhigh,middle,orlow-incomehousing.NotApplicable,Non-projectaction.c.Proposedmeasurestoreduceorcontrolhousingimpacts,ifany:NotApplicable,Non-projectaction.10.AESTHETICS-8- a.Whatisthetallestheightofanyproposedstructure(s),notincludingantennas;whatistheprincipalexteriorbuildingmaterial(s)proposed.NotApplicable,Non-projectaction.b.Whatviewsintheimmediatevicinitywouldbealteredorobstructed?NotApplicable,Non-projectaction.c.Proposedmeasurestoreduceorcontrolaestheticimpacts,ifany:NotApplicable,Non-projectaction.11.LIGHTANDGLAREa.Whattypeoflightorglarewilltheproposalproduce?Whattimeofdaywoulditmainlyoccur?NotApplicable,Non-projectaction.b.Couldlightorglarefromthefinishedprojectbeasafetyhazardorinterferewithviews?NotApplicable,Non-projectaction.c.Whatexistingoff-sitesourcesoflightorglaremayaffectyourproposal?NotApplicable,Non-projectaction.d.Proposedmeasurestoreduceorcontrollightandglareimpacts,ifany:NotApplicable,Non-projectaction.12.RECREATIONa.Whatdesignatedandinformalrecreationalopportunitiesareintheimmediatevicinity?NotApplicable,Non-projectaction.b.Wouldtheproposedprojectdisplaceanyexistingrecreationaluses?Ifso,describe.NotApplicable,Non-projectaction.c.Proposedmeasurestoreduceorcontrolimpactsonrecreation,includingrecreationopportunitiestobeprovidedbytheprojectorapplicant,ifany:NotApplicable,Non-projectaction.13.HISTORICANDCULTURALPRESERVATIONa.Arethereanyplacesorobjectslistedon,orproposedfor,nationalstate,orlocalpreservationregistersknowntobeonornexttothesite?Ifso,generallydescribe.-9- NotApplicable,Non-projectaction.b.Generallydescribeanylandmarksorevidenceofhistoric,archaeological,scientific,orculturalimportanceknowntobeonornexttothesite.NotApplicable,Non-projectaction.c.Proposedmeasurestoreduceorcontrolimpacts,ifany:NotApplicable,Non-projectaction.14.TRANSPORTATIONa.Identifypublicstreetsandhighwaysservingthesite,anddescribeproposedaccesstotheexistingstreetsystem.Showonsiteplans,ifany.NotApplicable,Non-projectaction.b.Issitecurrentlyservedbypublictransit?Ifnot,whatistheapproximatedistancetothenearesttransitstop?NotApplicable,Non-projectaction.c.Howmanyparkingspaceswouldthecompletedprojecthave?Howmanywouldtheprojecteliminate?NotApplicable,Non-projectaction.d.Willtheproposalrequireanynewroadsorstreets,orimprovementstoexistingroadsorstreets,notincludingdriveways?Ifso,generallydescribe(indicatewhetherpublicorprivate?NotApplicable,Non-projectaction.e.Willtheprojectuse(oroccurintheimmediatevicinityof)water,rail,orairtransportation?Ifso,generallydescribe.NotApplicable,Non-projectaction.1.Howmanyvehiculartripsperdaywouldbegeneratedbythecompletedproject?Ifknown,indicatewhenpeakvolumeswouldoccur.NotApplicable,Non-projectaction.g.Proposedmeasurestoreduceorcontroltransportationimpacts,ifany:NotApplicable,Non-projectaction.15.PUBLICSERVICESa.Wouldtheprojectresultinanincreasedneedforpublicservices(forexample:fireprotection,policeprotection,healthcare,schools,other)?Ifso,generallydescribe.NotApplicable,Non-projectaction.-10- b.Proposedmeasurestoreduceorcontroldirectimpactsonpublicservices,ifany.NotApplicable,Non-projectaction.16.UTILITIESa.Circleutilitiescurrentlyavailableatthesite:electricity,naturalgas,water,refuseservice,telephone,sanitarysewer,septicsystem,other.NotApplicable,Non-projectaction.b.Describetheutilitiesthatareproposedfortheproject,theutilityprovidingtheservice,andthegeneralconstructionactivitiesonthesiteorintheimmediatevicinitywhichmightbeneeded.NotApplicable,Non-projectaction.C.SIGNATUREI,theundersigned,declareunderpenaltyofperjuryunderthelawsoftheStateofWashingtonthattothebestofmyknowledgetheaboveinformationistrue,correct,andcomplete.Itisunderstoodthattheleadagencymaywithdrawanydeclarationofnon-significancethatitmightissueinrelianceuponthischecklistshouldtherebeanywillfulmisrepresentationorwillfullackoffulldisclosureonmypart.ProponentSignature:NamePrinted:cZHE.Date:I-11- D.SUPPLEMENTALSHEETSFORNONPROJECTACTIONS(Thesesheetsshouldonlybeusedforactionsinvolvingdecisionsonpolicies,plansandprograms.Youdonotneedtofilloutthesesheetsforprojectactions.)Becausethesequestionsareverygeneral,itmaybehelpfultoreadtheminconjunctionwiththelistoftheelementsoftheenvironment.Whenansweringthesequestions,beawareoftheextenttheproposal,orthetypesofactivitieslikelytoresultfromtheproposal,wouldaffecttheitematagreaterintensityoratafasterratethaniftheproposalwerenotimplemented.Respondbrieflyandingeneralterms.1.Howwouldtheproposalbelikelytoincreasedischargetowater;emissionstoair;production,storage,orreleaseoftoxicorhazardoussubstances;orproductionofnoise?Theproposedamendmentstoclarifyprohibited,allowable,andconditionallyallowabledischarges;updatedefinitionsforillicitconnection,illicitdischarge,andstormwater;andtoprovideexamplesofillicitdischargeswouldnotincreasedischargetowater,emissiontoair,toxicsubstances,ornoise.Theymayworktodecreasedischargestowater.Proposedmeasurestoavoidorreducesuchincreasesare:NotApplicable,Non-projectaction.2.Howwouldtheproposalbelikelytoaffectplants,animals,fish,ormarinelife?Theproposedamendmentstoclarifyprohibited,allowable,andconditionallyallowabledischarges;updatedefinitionsforillicitconnection,illicitdischarge,andstormwater;andtoprovideexamplesofillicitdischargeswouldnotaffectplants,animals,fish,ormarinelife.IfillicitdischargesareminimizedbecauseoftheproposedCodeamendments,itmayworktohelpimprovetheenvironmentforanimals,fish,ormarinelife.Proposedmeasurestoprotectorconserveplants,animals,fish,ormarinelifeare:NotApplicable,Non-projectaction.3.Howwouldtheproposalbelikelytodepleteenergyornaturalresources?Theproposedamendmentstoclarifyprohibited,allowable,andconditionallyallowabledischarges;updatedefinitionsforillicitconnection,illicitdischarge,andstormwater;andtoprovideexamplesofillicitdischargeswouldnotdepleteenergyornaturalresources.Proposedmeasurestoprotectorconserveenergyandnaturalresourcesare:NotApplicable,Non-projectaction.-12- 4.Howwouldtheproposalbelikelytouseoraffectenvironmentallysensitiveareasorareasdesignated(oreligibleorunderstudy)forgovernmentalprotection;suchasparks,wilderness,wildandscenicrivers,threatenedorendangeredspecieshabitat,historicorculturalsites,wetlands,floodplains,orprimefarmlands?Theproposedamendmentstoclarifyprohibited,allowable,andconditionallyallowabledischarges;updatedefinitionsforillicitconnection,illicitdischarge,andstormwater;andtoprovideexamplesofillicitdischargeswouldnotaffectenvironmentallysensitiveareasorareasdesignated(oreligibleorunderstudy)forgovernmentalprotection;suchasparks,wilderness,wildandscenicrivers,threatenedorendangeredspecieshabitat,historicorculturalsites,wetlands,floodplains,orprimefarmlands.IfillicitdischargesareminimizedbecauseoftheproposedCodeamendments,itmayworktofurtherprotectenvironmentallysensitiveareas.Proposedmeasurestoprotectsuchresourcesortoavoidorreduceimpactsare:NotApplicable,Non-projectaction.5.Howwouldtheproposalbelikelytoaffectlandandshorelineuse,includingwhetheritwouldalloworencouragelandorshorelineusesincompatiblewithexistingplans?Theproposedamendmentstoclarifyprohibited,allowable,andconditionallyallowabledischarges;updatedefinitionsforillicitconnection,illicitdischarge,andstormwater;andtoprovideexamplesofillicitdischargesarenotlikelytoaffectlandandshorelineuse.Proposedmeasurestoavoidorreduceshorelineandlanduseimpactsare:NotApplicable,Non-projectaction.6.Howwouldtheproposalbelikelytoincreasedemandsontransportationorpublicservicesandutilities?Theproposedamendmentstoclarifyprohibited,allowable,andconditionallyallowabledischarges;updatedefinitionsforillicitconnection,illicitdischarge,andstormwater;andtoprovideexamplesofillicitdischargesarenotlikelytoaffecttransportationorpublicservices.Proposedmeasurestoreduceorrespondtosuchdemand(s)are:NotApplicable,Non-projectaction.7.Identify,ifpossible,whethertheproposalmayconflictwithlocal,state,orfederallawsorrequirementsfortheprotectionoftheenvironment.Theproposedamendmentstoclarifyprohibited,allowable,andconditionallyallowabledischarges;updatedefinitionsforillicitconnection,illicitdischarge,andstormwater;andtoprovideexamplesofillicitdischargesdonotconflictwithlocal,state,orfederallawsorrequirementsfortheprotectionoftheenvironment.Infact,theproposedcodeamendmentsareincompliancewithstaterequirementsfortheprotectionoftheenvironment.-13- SIGNATUREI,theundersigned,declareunderpenaltyofperjuryunderthelawsoftheStateofWashingtonthattothebestofmyknowledgetheaboveinformationistrue,correct,andcomplete.Itisunderstoodthattheleadagencymaywithdrawanydeclarationofnon-significancethatitmightissueinrelianceuponthischecklistshouldtherebeanywillfulmisrepresentationorwillfullackoffulldisclosureonmypart.c+ProponentSignature:NamePrinted:Date:-14-