Instructions for the SDDOT Categorical Exclusion Checklist and South Dakota Department of Transportation Office of Project Development Environmental Becker-Hansen Building 700 E. Broadway Ave. Pierre, SD 57501-2586 Questions? Call (605) 773-3268 http://www.sddot.com/business/environmental/default.aspx 1. Use this checklist for all federally funded projects coordinated as a Categorical Exclusion (CE) class of action. 2. Reference the Programmatic Agreement Between the FHWA and the SDDOT Regarding the DOT Projects Process for Determining Categorical Exclusions to determine if the project qualifies as a Batched CE (CE 1), Certified CE (CE 2) or an Approved CE (CE 3). To see the agreement, copy and paste this address in your Internet browser: http://www.sddot.com/business/environmental/docs/ PAgreementCategoricalExclusions.pdf 3. FHWA signature is required for projects using the information beneath the double line border on ANY of the NEPA Clearance Actions. More specifically, for projects that qualify as an Approved CE (CE 3). 4. FHWA approval may be requested for Certified CE projects when a Section 404 Nationwide permit is required. The purpose for the request will be stated in Section C,. 5. If FHWA signature is not required, then N/A will be entered on the FHWA approval line in Section D. 6. The assigned Project Design Manager to include in the can be located in the Approved Scope s Executive Summary tab in C2C. 7. Upon certification/approval of the SDDOT CE Checklist and, distribute the document to the Project Design Manager indicated on the and any other necessary designees. (Provide copy to Hydraulics when there is a 404 permit needed.) a. Environmental Project Coordinator (EPC) will include a project-specific Section A Estimate of Quantities and Environmental Commitments with this notification for incorporation into the final plan set. For a Section A form, copy and paste this address in an Internet browser: http://www.sddot. com/business/design/files/default.aspx and scroll down. 8. Delete this entire guidance page after certification/approval of the document. 9. Significant changes to the project scope, work limits or plans after a Categorical Exclusion has been certified or approved will require redetermination of CE validity. Instructions
South Dakota Department of Transportation Categorical Exclusion Checklist Project County PCN Enter C2C Location Desc here: Enter C2C Purpose and Need here: Environmental Initiation Date / / CE Action EPC A. NEPA Clearance Actions Federally Threatened, Endangered and Protected Species USFWS concurrence that project will not adversely affect listed species received on: / /. Individual informal consultation conducted with USFWS and a biological assessment submitted. USFWS concurrence to individual informal consultation received: / /. Appended to Programmatic Biological Opinion on: / /. Project determination of May Affect, Is Likely to Adversely Affect occurs to Federally listed species that are not addressed in the Biological Opinion. USFWS Concurrence received: / /. Section 4(f) and 6(f) No property will be affected. 23 CFR 774.13 Exc. applies to the requirement for Section 4(f) approval. FHWA concurrence: / /. Section properties have been noted. document(s) were processed and approved by on / /. Historic and Archaeological Preservation A Finding of was received on / /. SHPO/THPO has conditioned the finding. See attached documentation. Cultural Resources will be affected by the project, and Section 106 procedures have been completed. Memorandum of Agreement implemented on / /. Wetlands [Identification method: ] Wetlands within the project area will not be impacted because. wetland impacts will be mitigated ; the Statewide Wetland Finding applies. One or more acres of wetland impacts to will be mitigated. FHWA approved a Wetland Finding on / /. USACE Coordination on Dredge and Fill A Section 404 Permit is not required. SDDOT reasonably anticipates a Nationwide Permit will be received. An Individual Permit will be applied for, and imposed conditions will be complied with. FEMA - Floodplain Impacts reviewed by on / /. No designated floodplains exist within the project limits. Project is within a floodplain but will have no floodplain impacts. Project has an effect on the floodplains. See attached documentation. (Note: If the improvement results in a longitudinal encroachment on the floodplain, it must be discussed in detail.) Page 1 of 5
SDDOT Categorical Exclusion Checklist A. NEPA Clearance Actions (continued) Right of Way. No right of way is required.. Minor amounts of right of way are required. Type: Low Cost Strip Acquisition(s) Corner Acquisition More than minor amounts of right of way are required. Displacement/relocation is required Substantial effects to property functions DENR Coordination Completed GFP Coordination Completed Tribal Consultation Tribal consultation was initiated with the Tribes checked below on. Bureau of Indian Affairs Sisseton-Wahpeton Oyate Cheyenne River Sioux Tribe Standing Rock Sioux Tribe Crow Creek Sioux Tribe Yankton Sioux Tribe Flandreau Santee Sioux Tribe Iowa Tribe of Oklahoma Lower Brule Sioux Tribe Three Affiliated Tribes of N.D. Oglala Sioux Tribe Ponca Tribe of Nebraska Rosebud Sioux Tribe Northern Arapaho Tribe Tribal comments were received. [Letter(s) attached.] Tribal coordination requests FHWA involvement. B. Other Unusual Circumstances Apply Noise Wild & scenic river Coast Guard permits Public controversy Traffic pattern changes Significant detour/traffic impacts Not applicable on usual circumstances: Air quality Other C. Describe any attachments or additional information necessary to support project s NEPA coordination efforts. D. Environmental Project Certification and Approval This review finds the proposed project does not individually or cumulatively have a significant impact on the environment as defined by NEPA, or involve unusual circumstances as defined in 23 CFR 771.117(b), such that it is excluded from the requirements to prepare an environmental assessment or environmental impact statement. Certification SDDOT Environmental Engineer Approval Date FHWA Environmental Engineer Date Page 2 of 5
Project # County PCN Environmental Class Code Responsible Manager The following conditions, concerns and issues described in this are based on the knowledge provided to secure the approved environmental classification date as exhibited on the Categorical Exclusion Checklist. If there are changes to the project scope, work limits or plans after approval of the Environmental Class Code, the Environmental Office must be contacted to evaluate potential for impacts. The following Commitments are to be included with the project action: Commitment A Wetlands Total Impacted Wetland Acreage Permanent Total Temporary and Summary of How Mitigation Will Be Accomplished Needed: Commitment B Federally Threatened, Endangered and Protected Species Commitment B1: Topeka Shiner Commitment B2: Whooping Crane Commitment B3: American Burying Beetle Commitment B4: Bald Eagle Commitment B5: (Other) Commitment C Water Source (Identify the watershed where the project is located.) Commitment D Water Quality Standards Commitment D1: Surface Water Quality Commitment D2: Surface Water Discharge (List each water body and its associated water quality standard.) Commitment E Storm Water (Identify any Major receiving body or bodies of water.) Page 3 of 5
(continued) Commitment F Seasonal Work Restriction (Identify stream name, classification and seasonal work restriction that applies.) Commitment H Waste Disposal Site Commitment I Historical Preservation Office Clearances Commitment J Construction Practices for Temporary Works in Waterways of the U.S. (Identify the Water(s) of the U.S. and associated OHWE.) Commitment K Rapid City Area Air Quality Control Zone Commitment L Contaminated Material (List name and location of known and/or suspected gas stations, underground storage tanks, etc.) Page 4 of 5
(continued) Commitment M Section 4(f)/6(f) Resources If yes (check appropriate) Section 4(f) public park Section 4(f) wildlife refuge Section 4(f) historic site Section 4(f) recreational lands Section 4(f) waterfowl refuge Section 6(f) property 4(f) Type of Use: Permanent Incorporation/Permanent Easement Temporary Occupancy Constructive De Minimus Impact Other Consideration 6(f) Type of Use: Temporary Nonconforming use 6(f) Use Conversion Approval Commitment N Section 404 Permit Commitment O Tribal Monitoring and Traditional Cultural Properties (Coordinate site avoidance with the designer.) Commitment P Coordination with State Archaelogical Research Center (Coordinate site avoidance with the designer.) Commitment Q Tree Replacement Commitment R Fire Prevention in the Black Hills Area Commitment S Migratory Birds Work Restriction Commitment T (other) Page 5 of 5