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HomeMy WebLinkAboutSEP2017-00018 Cancelled New Cell Tower - SEP Determinations - 6/14/2017 yoN.srgTFo MASON COUNTY �P 0 Department of Community Services o s° �= Planning Division o T �? 6'15 W Alder St, Shelton, WA 98584 Y �,o~ (360)427-9670 1864 DETERMINATION OF NONSIGNIFICANCE (WAC 197-11-340) SEP2017-00018 Description of Proposal: NEW CELL TOWER PROPOSAL: "OL0719 NORTH BAY' Proponent: AT & T Location of Proposal: 480 E VICTOR RD BELFAIR Parcel Number: 122214200000 Legal Description: NW SE * Directions to Site: Lead Agency: Mason County The Lead Agency for this proposal has determined that it does not have a probable significant adverse impact on the environment. An Environmental Impact Statement (EIS) is not required under RCW 43.21 C.030(2)(c). This decision was made after review of a completed Environmental Checklist and other information on file with the Lead Agency. This information is available to the public upon request. Please contact Ron Buckholt at ext. 287 with any questions. This DNS is issued under WAC 197-11-340(2). The Lead Agency will not act on this proposal for 14 days from the date shown below, when the determination is final. Comments must be submitted to Dept. of Community Development, 615 W Alder St, Shelton .WA 98584 by 6/28/2017. Appeal of this determination must be filed within a 14-day period following this final determination date, per Mason County Code Chapter 15.11 Appeals. Authorized Local Government Official Date SEPA Environmental Checklist Mason County Permit center Use: ❑ Single Family DNS: $385 SEP S�FZOIY- Q618 Other DNS: 0 to 9.99 acres: $630 Parcel#: I Z 2 ZI- IL_ 0000 10 to 20 acres: $755 6 f t`V'tSFb� Date Rcvd: Over 20 acres: $945 ❑ DS/F,IS: $2,525+70 Per hr REVISED 6/5/17 Purpose of checklist: Governmental agencies use this checklist to help determine whether the environmental impacts of your proposal are significant. This information is also helpful to determine if available avoidance, minimization or compensatory mitigation measures will address the probable significant impacts or if an environmental impact statement will be prepared to further analyze the proposal. Instructions for applicants: hI elpl This environmental checklist asks you to describe some basic information about your proposal. Please answer each question accurately and carefully, to the best of your knowledge. You may need to consult with an agency specialist or private consultant for some questions. You may use"not applicable" or "does not apply" only when you can explain why it does not apply and not when the answer is unknown. You may also attach or incorporate by reference additional studies reports. Complete and accurate answers to these questions often avoid delays with the SEPA process as well as later in the decision- making process. The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of time or on different parcels of land. Attach any additional information that will help describe your proposal or its environmental effects. The agency to which you submit this checklist may ask you to explain your answers or provide additional information reasonably related to determining if there may be significant adverse impact. Instructions for Lead Agencies: Please adjust the format of this template as needed. Additional information may be necessary to evaluate the existing environment, all interrelated aspects of the proposal and an analysis of adverse impacts. The checklist is considered the first but not necessarily the only source of information needed to make an adequate threshold determination. Once a threshold determination is made, the lead agency is responsible for the completeness and accuracy of the checklist and other supporting documents. A. BACKGROUND hf ip-1 1. Name of proposed project, if applicable: jheip] OL0719 North Bay 2. Name of applicant: h[ m New Cingular Wireless PCS, LLC ("AT&7) 3. Address and phone number of applicant and contact person: hLelpl Joe Riddle, Project Manager--Centerline Solutions LLC 6623 NE 78th Ct. Ste. B1, Portland, OR 97218 360-904-5858 SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 1 of 11 4. Date checklist prepared: LLem 3/13/17 Revised 6/9/17 5. Agency requesting checklist: n� eM Mason County- 6. Proposed timing or schedule(including phasing, if applicable): h[ elp] Expect building permit filed <3/31, Construction start<7/1 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. jLem No 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. hI eipl Phase 1 study complete, NEPA/SHPO/TCNS in process, Wetland Delineation report submitted 9. Do you know whether applications are pending for governmental approvals of other proposals directly affecting the property covered by your proposal? If yes, explain. hI em No 10. List any government approvals or permits that will be needed for your proposal, if known. Jkm FAA/FCC Registration; Mason County Building Permit, NEPA/SHPO 11. Give brief, complete description of your proposal, including the proposed uses and the size of the project and site. There are several questions later in this checklist that ask you to describe certain aspects of your proposal. You do not need to repeat those answers on this page. (Lead agencies may modify this form to include additional specific information on project description.)1hem Construction of a 50'x50'fenced compound with approximately 115' long 12'wide access road from E Victor Rd to contain 90' monopole cell tower and associated ground equipment contained in an 11.5'x 20' prefabricated building. 30 KW emergency backup generator in sound enclosure and mounted on 5'x 10' concrete pad. Facilty will be unstaffed. 12. Location of the proposal. Give sufficient information for a person to understand the precise location of your proposed project, including a street address, if any, and section, township, and range, if known. If a proposal would occur over a range of area, provide the range or boundaries of the site(s). Provide a legal description, site plan, vicinity map, and topographic map, if reasonably available. While you should submit any plans required by the agency, you are not required to duplicate maps or detailed plans submitted with any permit applications related to this checklist. Lk!pj Parcel#(s): 12221-42-00000 Address: 480 E Victor Rd Belfair Legal Description: NW 1/4 SE 1/4 Sec 21, T22N, R1W, exc. S 330'thereof and exc. ROW for Victor Rd Twp/Range/Section and/or GPS location: 47 deg 22 min 53.0 sec N 122 deg 48 min 25.7 sec W SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 2 of 11 B. ENVIRONMENTAL ELEMENTS nI e�pl 1. Earth a. General description of the site 1tejpj (circle one): Flat, rolling, hilly, steep slopes, mountainous, other: b. What is the steepest slope on the site (approximate percent slope)?LhO No slope c. What general types of soils are found on the site(for example, clay, sand, gravel, peat, muck)? If you know the classification of agricultural soils, specify them and note any agricultural land of long-term commercial significance and whether the proposal results in removing any of these soils. hel I Geotech report describes hard sandy silt with gravel, dense silty sand with gravel, sandy gravel, loose silty fine sand, very dense sandy gravel, and dense sand with gravel,to max. depth of exploration, 30' d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. LtgM No history of unstable soils e. Describe the purpose, type, total area, and approximate quantities and total affected area of any filling, excavation, and grading proposed. Indicate source of fill. n[ eiPJ Grading of approximately 115'access road for firm graveled surface; grading and leveling of 50'x 50'site compound. Fill will be from site vicinity, little should be required f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. Lheip Site will be constructed so as to drain away from foundation; no erosion of road or site should occur g. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? hL eip] Approximately 25% of the 50'x 50'compound will be covered by building or tower foundation h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: Lelp] Grading and drainage plan to be provided with construction drawings for building permit 2. Air a. What types of emissions to the air would result from the proposal during construction, operation, and maintenance when the project is completed? If any, generally describe and give approximate quantities if known. hf elpl Diesel exhaust from licensed and regulated generator for testing approximately 20 min per week and during emergencies, otherwise no emissions will be generated b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. Lhelpj No c. Proposed measures to reduce or control emissions or other impacts to air, if any: Lkm Generator design is registered for WA state emissions compliance; no other emissions from site SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 3 of 11 3. Water a. Surface Water: k 1) Is there any surface water body on or in the immediate vicinity of the site(including year- round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe type and provide names. If appropriate, state what stream or river it flows into. h[ eIPJ A very small wetland area was noted on the Wetland Deliniation report, adjacent to the access road 2) Will the project require any work over, in, or adjacent to (within 200 feet)the described waters? If yes, please describe and attach available plans. nei Yes, site access road adjacent to but not intruding on wetland buffer zone. 3) Estimate the amount of fill and dredge material that would be placed in or removed from surface water or wetlands and indicate the area of the site that would be affected. Indicate the source of fill material. 1hei None 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. h[ el No 5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. hei ] No 6) Does the proposal involve any discharges of waste materials to surface waters? If so, describe the type of waste and anticipated volume of discharge. Lheip] No b. Ground Water: 1) Will groundwater be withdrawn from a well for drinking water or other purposes? If so, give a general description of the well, proposed uses and approximate quantities withdrawn from the well. Will water be discharged to groundwater? Give general description, purpose, and approximate quantities if known. hL el No 2) Describe waste material that will be discharged into the ground from septic tanks or other sources, if any(for example: Domestic sewage; industrial, containing the following chemicals. . . ; agricultural; etc.). Describe the general size of the system, the number of such systems, the number of houses to be served (if applicable), or the number of animals or humans the system(s) are expected to serve. [Leipj None c. Water runoff(including stormwater): 1) Describe the source of runoff(including storm water) and method of collection and disposal, if any(include quantities, if known). Where will this water flow? Will this water flow into other waters? If so, describe. hf elpl No runoff exceeding current levels will be produced, natural drainage in area, no other waters impacted SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 4 of 11 i 2) Could waste materials enter ground or surface waters? If so, generally describe. h[ e[p] No waste materials will be produced by site 3) Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site? If so, describe. No d. Proposed measures to reduce or control surface, ground, and runoff water, and drainage pattern impacts, if any: None, no significant drainage impacts will be produced by site 4. Plants Lnei a. Check the types of vegetation found on the site: of eipl T deciduous tree: alder, maple, aspen, other VT evergreen tree: fir, cedar, pine, other V shrubs J grass pasture crop or grain orchards, vineyards or other permanent crops wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other water plants: water lily, eelgrass, milfoil, other other types of vegetation b. What kind and amount of vegetation will be removed or altered? n[ elp] 50'x 50'compound and 12'x 115' road will be cleared, road will be routed around trees 12'inch or larger in diameter c. List threatened and endangered species known to be on or near the site. nC eip] None known d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any: n[ M Site will be landscaped per code if required due to extensive screening provided by natural forest e. List all noxious weeds and invasive species known to be on or near the site. None known 5. Animals a. List any birds and other animals which have been observed on or near the site or are known to be on or near the site. Examples include: n[ elpl birds: hawk, heron, eagle, songbirds, other: songbirds, occasional water birds and shore birds mammals: deer, bear, elk, beaver, other: none observed, but expect deer, rodents fish: bass, salmon, trout, herring, shellfish, other: None SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 5 of 11 b. List any threatened and endangered species known to be on or near the site. n[ elpl None c. Is the site part of a migration route? If so, explain. r,[ eipj Not known d. Proposed measures to preserve or enhance wildlife, if any: hf M None e. List an invasive animal species known to be on or near the site. Y None known 6. Energy and natural resources a. What kinds of energy(electric, natural gas, oil, wood stove, solar)will be used to meet the completed project's energy needs? Describe whether it will be used for heating, manufacturing, etc. hf e Electricity will be brought to site to power radio equipment b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally describe. n[ elp] No c. What kinds of energy conservation features are included in the plans of this proposal? List other proposed measures to reduce or control energy impacts, if any: h[ e None 7. Environmental health a. Are there any environmental health hazards, including exposure to toxic chemicals, risk of fire and explosion, spill, or hazardous waste, that could occur as a result of this proposal? If so, describe. h[ M None 1) Describe any known or possible contamination at the site from present or past uses. None determined to exist by Phase 1 study 2) Describe existing hazardous chemicals/conditions that might affect project development and design. This includes underground hazardous liquid and gas transmission pipelines located within the project area and in the vicinity. None exist 3) Describe any toxic or hazardous chemicals that might be stored, used, or produced during the project's development or construction, or at any time during the operating life of the project. Petroleum fuels during construction and for backup generator(diesel); backup batteries at site in hazmat protective enclosure 4) Describe special emergency services that might be required. None anticipated 5) Proposed measures to reduce or control environmental health hazards, if any: None required, no environmental hazards SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 6 of 11 b. Noise 1) What types of noise exist in the area which may affect your project(for example: traffic, equipment, operation, other)? n[ elpj None 2) What types and levels of noise would be created by or associated with the project on a short-term or a long-term basis (for example: traffic, construction, operation, other)? Indi- cate what hours noise would come from the site. r,( pi Some traffic impact possible for 3-4 weeks during construction; HVAC expected to be at ambient noise outside 1 00'from site;testing of emergency backup generator 20 min per week 3) Proposed measures to reduce or control noise impacts, if any: of M Generator is inside sound enclosure with muffled exhaust; baffled exhaust from HVAC 8. Land and shoreline use a. What is the current use of the site and adjacent properties?Will the proposal affect current land uses on nearby or adjacent properties? If so, describe. h[ elM Currently site if forested land zoned R-5 b. Has the project site been used as working farmlands or working forest lands? If so, describe. Parcel surrounding site id dedicated forest land; site parcel has been removed from forest designation. How much agricultural or forest land of long-term commercial significance will be converted to other uses as a result of the proposal, if any? Approximately 3,880 sf including site and access road will be removed from forest use If resource lands have not been designated, how many acres in farmland or forest land tax status will be converted to nonfarm or nonforest use? hf M Approximately 3,880 sf including site and access road will be removed from forest use 1) Will the proposal affect or be affected by surrounding working farm or forest land normal business operations, such as oversize equipment access, the application of pesticides, tilling, and harvesting? If so, how: No c. Describe any structures on the site. LnLeM 90' monopole cell tower and 11.5'x 20 shelter building with 5'x 10' generator pad with backup generator d. Will any structures be demolished? If so, what? n[ elpj No e. What is the current zoning classification of the site? hI em R-5 f. What is the current comprehensive plan designation of the site?Lhei j Unknown g. If applicable, what is the current shoreline master program designation of the site? h0 Unknown h. Has any part of the site been classified as a critical area by the city or county? If so, specify. [f1elp] No i SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 7 of 11 f i. Approximately how many people would reside or work in the completed project?LwpJ None. Site is unstaffed. j. Approximately how many people would the completed project displace?Lhel None k. Proposed measures to avoid or reduce displacement impacts, if any: Lhelg] None required L. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: Lhem None required m. Proposed measures to ensure the proposal is compatible with nearby agricultural and forest lands of long-term commercial significance, if any: None required 9. Housing a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low- income housing. h[ elp] None. Site is unmanned b. Approximately how many units, if any, would be eliminated? Indicate whether high, middle, or low-income housing. h[ el None. No structures will be removed c. Proposed measures to reduce or control housing impacts, if any: hL eM None required 10. Aesthetics a. What is the tallest height of any proposed structure(s), not including antennas; what is the principal exterior building material(s) proposed?1qeiPJ 90'. Galvanized steel b. What views in the immediate vicinity would be altered or obstructed? hj elpl Expect existing tree screening to largely obsure view of all but top 30'or so of tower, ground location will not be visible fr m surroun In parcgIs or road c. Proposed measures to reduce or corlgtro� aesthetic Impacts, if any: hf etM Siting chosen to provide very good screening of site by existing trees and brush 11. Light and glare a. What type of light or glare will the proposal produce? What time of day would it mainly occur?[he[p] None b. Could light or glare from the finished project be a safety hazard or interfere with views? h[ eM No c. What existing off-site sources of light or glare may affect your proposal?[hel No d. Proposed measures to reduce or control light and glare impacts, if any: [help] None needed SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 8 of 11 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity?Lp] None noted b. Would the proposed project displace any existing recreational uses? If so, describe. n� e� No c. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: LUgjpj None needed 13. Historic and cultural preservation a. Are there any buildings, structures, or sites, located on or near the site that are over 45 years old listed in or eligible for listing in national, state, or local preservation registers located on or near the site? If so, specifically describe. n[ elp] No b. Are there any landmarks, features, or other evidence of Indian or historic use or occupation? This may include human burials or old cemeteries. Are there any material evidence, artifacts, or areas of cultural importance on or near the site? Please list any professional studies conducted at the site to identify such resources. of m No c. Describe the methods used to assess the potential impacts to cultural and historic resources on or near the project site. Examples include consultation with tribes and the department of archeology and historic preservation, archaeological surveys, historic maps, GIS data, etc.ltpipj Archeology report as required, NEPA/SHPO/TCNS d. Proposed measures to avoid, minimize, or compensate for loss, changes to, and disturbance to resources. Please include plans for the above and any permits that may be required. None needed 14. Transportation a. Identify public streets and highways serving the site or affected geographic area and describe proposed access to the existing street system. Show on site plans, if any. nL M Graveled road to site from E Victor Road b. Is the site or affected geographic area currently served by public transit? If so, generally describe. If not, what is the approximate distance to the nearest transit stop? hI elpl No c. How many additional parking spaces would the completed project or non-project proposal have? How many would the project or proposal eliminate?LnLeM 1 parking space at site, no parking lost due to site SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 9 of 11 d. Will the proposal require any new or improvements to existing roads, streets, pedestrian, bicycle or state transportation facilities, not including driveways? If so, generally describe(indicate whether public or private). n[ elp� Only access road from E Victor Road e. Will the project or proposal use(or occur in the immediate vicinity of)water, rail, or air transportation? If so, generally describe. Lela No f. How many vehicular trips per day would be generated by the completed project or proposal? If known, indicate when peak volumes would occur and what percentage of the volume would be trucks (such as commercial and nonpassenger vehicles). What data or transportation models were used to make these estimates? of el Less than one trip per week to site, no peak volumes. After construction, access will be by passenger vehicle (1) g. Will the proposal interfere with, affect or be affected by the movement of agricultural and forest products on roads or streets in the area? If so, generally describe. No h. Proposed measures to reduce or control transportation impacts, if any: nLe None needed 15. Public services a. Would the project result in an increased need for public services (for example: fire protection, police protection, public transit, health care, schools, other)? If so, generally describe. hf M No b. Proposed measures to reduce or control direct impacts on public services, if any. hf m None needed 16. Utilities a. Circle utilities currently available at the site: hI M electricity, natural gas, water, refuse service, telephone, sanitary sewer, septic system, other b. Describe the utilities that are proposed for the project, the utility providing the service, and the general construction activities on the site or in the immediate vicinity which might be needed. of eipj Electricty and fiber will be brought to site from E Victor Road by local providers. Minor trenching will be required. SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 10 of 11 C. SIGNATURE hel The above answers are true and complete to the best of my knowledge. I understand that the lead agency is relying on them to make its decision. Signature: Date Signed: Print Name of Signee: Joe Riddle, Centerline Solutions If applicable, Position and Agency/Organization: -Project Manager, Agent for New Cingular Wireless PCS, LLC Date Submitted: i SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 11 of 11 NOTES: _ _______ AT&T PROJECT AREA ,, SITE PLAN DERIVED FROM:SURVEY,AERIAL -�ye.�, a}&} — NE VICTOR ROAD IMAGES.AS-GUILTS AND SITE PHOTOS. ` ` 2. GENERAL CONTRACTOR TO MAINTAIN POSITIVE MEASU DRAINAGE SITE EROSION CONTROL MEASURES PER JURISDICTIONAL REQUIREMENTS AT ALL (E)BUILDING(TYP) ; � 1 ' O TIMES OF CONSTRUCTION. 1 o O AC SS TO TELECOM FACILrrY AND ACCESSIBLE ONLY TO AU IS RESTRICTEDCENTERLINE OPERSONNEL SOLUTIONS jQ¢ > L(E)FORESTED 7 APN:1272,-42-00000 ARE / (E)SUBJECT PROPERTY LINE AREA:S2826 ACRES ADJACENT ZONING (E)ADJACENT PROPERTY LINE 1,-SINGLE FAMILY RESIDENTIAL I p C3o scALE:t••4avau,x,� v 28a aoo eoo SO4O$W 1 OVERALL PARCEL PLAN SCALE:t'•20a-0'F12)(34) A.; Q. Qa7 yP � 2 0O1 (N)INGRESS/EGRESS POTENTIAL POWER SOURCE is 1SKVA POTENTIAL POV4FR SOURCE 2: FROM NE VICTOR PAD.MCUNTED TRANSFORMER OH 1 SKVA TRANSFORMER q Q/ P P P P 'f'Q R�yy�EO 1 ME ACTOR ROAD — ---- 0 /09/2 / --' ——————_ I CP PROJECT NO.: ATT-I5-WA2-20 )TREES TO BE I E F F F F PRELIMINARY F F EMOVD(TYP) f F 0. DATE D/C DESCRIPTION R \ I I \ / 0 W WIG— UE CDREMIEW 1 03-0]-1]JGICI CLIENT COMMENT LINE OF 1,a \ § \ \ I I (E)WAVE BROADBAND \�J 2 03-1]-1]ICI CLIENT COMMENT WETLAND BUFFER FIBER CONDUIT PATH I (FIBER SOURCE) UC TA 0 DATE SOBM L SCRIPTION BMIIJAL 05-017 JGGWTLAND B— R (E)FORESTED AREA SIIE NAME 1 NORTH BAY APN:17J2,�2-00000 (I AREA:t7➢2BACRES \ J 1 1 i SUBJECT (tt 2T4 58B S F) �� ; / I PROPERTY LINE (E)BUILDING(TYP) SITE ADDRESS r 1 IBO EAST VICTOR ROAD (N)9a MONOPOLE BELFAIR,WA 98528 r I SHEET TITLE \ C � AT&T PROJECT AREA 1 NOTE: I 9/ OVERALL�NEW POWERRELCO/FIBER ROUTES,SOURCE, SITE PLAN �Irc EASEMENTS.RUN LENGTHS.CONDUIT SIZES, TN MN ETC.ARE PRELIMINARY PENDING RECEIPTOF I UTILITY COORDINATION REPORT(TYP) ( I I W E S A-1 .0 L'111%,7) a 80Y 8a t2a 2 OVERALL SITE/TREE REMOVAL PLAN SCALE:,'-BOSCALE:,••JO-0'QD(34) ORAWNGABBREVATIOMI STRUCTURAL CONCRETE NOTES SPECIAL INSPECTION NOTES AFF ABOVE FINISH FLOOR U(S) -NOS)1. ALL CONCRETE WDRKSHALLBEINACCORDANCE WITHTHE ACI318-11 AND THE SPECIRCAT10NMR 1. CONTRACTOR SHALL PROVIDE REQUIRED SPECIAL INSPECTIONS PERFORMED BY AN INDEPENDENT AGL ABD✓EDRADELEVEL I LINEAR FEET �/� at&t CAST4WPLACE CONCRETE. INSPECTOR,APPROVED BY AT&T AND THE LOCAL JURMDICTION,AS REQUIRED BY IBC SECTION IMI AND 1705 FOR THE FOLLOWING: AM AMERICAN WIRE GAUGE MAX MAX,.- 2. ALL CONCRETE FOR SUBS ON GRADE,SHELTER FOUNDATION,AND PIER FOUNDATIONS FOR FENCES, ICE BRIDGE,AND H47tAME SHALL HAVE A MINIMUM COMPRESSIVE STR ENGTH k'=J,000 PSI AT 26 DAYS A. STRUCTURALSTEEL AC WROONDTDNNG MECH MECHANICAL UNLESS NOTED OTHERWISE.SPECIAL INSPECTION REQUIRED AS NOTED. L ALL HIGH STRENGTH SOLT INSTALLATIONS;BOLTING INSPECTION TASKS SHALL BE IN Ap,) ADJL6TAME MFR MANUFACTURER ACCORDANCE WITH TABLES NS.B•1,N5.6..AND N5.6-3 PER AISC3 10. 3. REINFORCING STEEL SHALL CONFORM TO ASTM A 615,GRADE W,DEFOR MED UNLESS NOTED IL FIELOWELOINO(IFUTILIZED). APpROX APPROXIATELY MGR MANAGER OTHERWISE.WELDED WIRE FABRIC SHALL CONFORM TO ASTM A 185 WELDED STEEL WIRE FABRIC *CENTERLINE UNLESS NOTED OTHERWISE.SPLICES CLASS'W AND ALL HOOKS SHALL BE STANDARD UNLESS NOTED B. BOLTS AND ANCHORS IN CONCRETE: AZ AZIMUTH MN MINMUM SOLUTIONS OTHERWISE. L RETROFIT ANCHORS IN CONCRETE(ASHESIVE/EPDXY,EXPANSION,WEDGE,OR SCREW TYPE ANCHORS):INSPECT SIZE.LENGTH,CLEANLINESS,AND INSTALLATION PER MANUFACTURER'S BLDG SULDB1G MSC MISCELLANEOUS 4. THEFOLLOINGWNIMUMCONCRETE COVER SWILL BE PROVIDED FOR REINFORCING STEEL UNLESS RECOMMENDATIONS. SHOWN OTHERWISE ON DRAWINGS: CM CDNS7RUCTONIAMA MR METAL C. CONCRETE CONSTRUCTION: CONICRETECAST AGAINST EARTH...........3 IN. I. VERIFICATIONAND INSPECTION OFCONCRETE CONSTRUCTION SHALL BE IN ACCORDANCENTTH GAB GANNET M1Z1 METALIZE(D) MSC SECTION iT05,TABLE ln" CONCRETE EXPOSED TO EARTH OR WEATHER: CL CENTERUNE MW MCROMWVE N8AND LARGER.............2 IN. 2. PROVIDE SPECIAL INSPECTIONS FOR OTHER?EMS NOTED ON DRAWINGS TO CONFIRM COMPLIANCE A5ANDSMALLER&VAVF-......_--112IN. WITH CONTRACT DOCUMENTS. CLG CENNG NEC NATIONAL FLEL'INpAL CODE CONCRETE NOT EXPOSED TO EARTH OR WEATHER OR NOT CAST AGAINST THE GROUND: 3. "ESPECIAL INSPECTOR SHALL PROVIDER COFYOFTHEREPORTTOTHEOLMJER,ARCHITECT, CLR CLEAR lN6 NEW SUB AND WALL.............V4 IN. STRUCTURAL ENGINEER,CONTRACTOR,AND BUILDING OFFICIAL Cp COPPER NC NOTNCONIMCT BEAMS AND COIUMNS._.._..._...1 12 IN. 4. CONTINUOUS THIRD PARTY SPECIAL INSPECTION REQUIRED FOR ALL BELZONA Ill 1MOUNTED CONC CONCRETE HIS NOTTGSCALE 5. ANe CHAMFERSHALLBEPROVIDEDATALL EXPOSED EDGES OFCONCRETE U.N.O.IN ACCORDANCE PLATES AND HARDWARE. WITH ACI 301,LATEST EDITION,SECTION 4. CON) CONDUIT WA NDTAPPl1CABLE 6, HOLES TO RECEIVE EXPANSIONWVEDGE ANCHORS SHALL BE I/B"LARGER IN DIAMETER THAN THE CONST CONSTRUCTION OU ONCENTER ANCHOR BOLT,DOWEL OR ROD AND SWILL CON FORM TO MANUFACTURERS RECOMMENDATION FOR EMBEDMENT DEPTH OR AS SHOWN ON THE DRAWINGS.LOCATE AND AVOID CUTTING EXISTING REBAR CONT CONTINUOUS OD OUTSIDE DW.ETER WHEN DRILLING HOLES IN ELEVATED CONCRETE SLABS. OM CAICWA Lit OP OVERHEAD POWER ]. USE AND INSTALLATION W ITTEN RTE ADHESIVE AND EXPANSIONMIEDGE ANCHORS SHALL BE PER wAS/YV CPS IOCB MANUFACTURERS WRITTEN RECOMMENDED PROCEDURES. G'C DRAFIER2TECIQR OT WERNNFADFIBER 8. FOUNDATIONDESIGN LS BASED ON PRESUMPTIVE SOIL PARAMETERS.R IS STRONGLY RECOMMENDED mm DEMOLISH OPp OPPOSITE RyyY H Z 0W THATINDEPENDENT SOILS TESTING BE PERFORMED BYAUCENSEDGEOTECHNKC LENGINEER TO OIA OIUETER M. PROPERLY LINE VERIFY SOIL BEARING CAPACITY,SLOPE STABILITY,AND ALL OTHER RELATED SOIL PARAMETERS. DM DIMENSION PLYW) PLYWOOD q / STRUCTURAL STEEL NOTES ON DOWN ISM PRo,EDTMAW,GER Fp k Eo 1. ALLSTEELWOR SHALL BE IN ACCORDANCE WITH THE LATEST EDITION OF THE AISC MANUAL OF STEEL DR DETAIL — —p0Rx CONSTRUCTION.STEEL SECTIONS SHALL BE IN ACCORDANCE,RTH"W AS INDICATED BELOW: DWO pAWNG PT PRESSURE TREATED 0 09/2 WJ3HAPE5:ASTM A992,50 KSI ANGLES,BARS CHANNELS:ASTM A36,36 KSI EA HSS SECTIONS:ASTM 500,a KSI EACH RO CP PROJECT NO.: A'15-0 2-20 PIPE SECTIONS:ASTM A53.E,35 MI ELECT ELECII I ROW RIONTOF WAY PRELIINARY 2. ALL EXTERIOR EXPOSEDSTEELAND HARDWARE SHALL BE HOT DIPPED GALVANIZED. ELEV ELEVATION RRIYRRH RBIOIE RAgO UNIT 0. DATE D/C DESCRIPTION 3. ALL WELDING SHALL BE PERFORMED USING E70XX ELECTRODES AND WELDING SHALL CONFORM TO EO EOIYLL REO REQUIRED 0 02-f 0.17 JGICL 50%CD REVIEW AISC.WHERE FILLETWELD SIZES ARE NOT SHOWN,PROVIDE THE MINIMUM SIZE PER TABLE n.4 IN THE _ I 1 0 7-17 JG/JG CLIENTCOMMENT AISG'MANUAL OF STEEL CONSTRUCTION'.PAINTED SURFACES SHALL BE TOUCHED UP.ALL MELDING EQUR' EQUIPMENT SBTC SOUDSARETINN:DCOPPER 2 03-17-17 CVCL CLIENTCOMMENT SHALL BE PERFORMED IN AN APPROVED SHOP. (O EXISTING SF SQUARE FEET SUBMITTAL THAN SO d. BOLTS FOR STEELTO STEEL CONNECTIONS TO BE PER ASTM A325.HOLES TO BE I/18'DA URGER O. DATE D/C DESCRIPTION THAN BOLT,U.N.D. FM EXTERIOR SM SHEET 0 00.2417 Cl/CL BP SUBMITTAL 5. NON-STRICTURALCONNECTIONS FOR STEEL GRATING MAY USE 54MASTM A 337 BOLTS UNLESS FIN FINISH SPEC SPEDFIGITION 06-0617—G WETLANDBUFFER NOTED OTHERWASE. FLR FLOOR SO SDLMRE 6. FIELD MODIFICATIONS ARE TO BE COATED WITH 73NC ENRICHED PAINT. I FOOT,FEET SS STMNESS STEL SITE NAME 7. HOLESTORECEMEEXPANSOWWEDGEANCHORSSHALLCONFORMTOMANUFACTURER'S GA GMIOF SR STEEL RECOMMENDATION FOR EMBEDMENT DEPTH AND DIAMETER.LOCATE AND AVOID CUTTING EXISTING O L0719 REBAR OR TENDONS WHEN DRIVINGS WAL NNQ HOLES IN ELEVATED CONCRETE ASS OR CONCRETE MILLS. GAL, GALVAED 81RUCT Sl1IlCR1RE BTRUCTUUAL 8. USE AND INSTALIATIONOF CONCRETE EXPANSIOWNEDGE ANCHOR,SHALLBE PER ICC& 0C GENERAL WRtAC1OR TOO TOPOFQDNDRETE NORTH BAY MANUFACTURER'S WRITTEN RECOMMENDED PROCEDURES.THIRD PARTY SPECAL INSPECTION IS REQUIRED FOR CONCRETE EXPANSION ANCHORS(I.E.SIMPSON STRONGBOLT 2 WEDGE ANCHORS PER WA9 GYP&LMVALLBCNRD TOM TOPOFMASONRY ESR3WTL INSTALLATION OF WEDGE ANCHORS IN MASONRY IS NOT PERMITTED. w GRADE THRU TnnoUGH SITE ADDRESS 480 EAST VICTOR ROAD GRID GROUND TN/D T►YED BELFAIR,WA 8W528 NIG WAG HEATING.VEN &WR U3 IJ!! D CONOlMX4l HORR HORIZONTAL UND UN,ESSNOTEDOTIIERWSE SHEETTITLE HT HEIGHT UP UNDERGROUND MMER GENERAL IBC INTERNATIONAL BNUMID CODE UP LADEROROUND MS. NOTES D INSIDE DMMETER WF VERIFY INFIELD IN INCH VERT VERTICAL INSUL INSULATION WW T W TERPRODF SHEET NO. w INTERIOR W WITH GN-2 DNBar wo JBOX JUNCT WITHOUT 00'N T4TOP OF MONOPOLE TOP OF MONOPOLE s WT&T PANEL ANTENNA TIP HEIGHT (N)AT&T PANEL ANTENNA TIP HEIGHTI. n(BNOIdAT&T PANEL ANTENNA CENTERLINE / V��AT&T PANEL ANTENNA CENTERLINE lrrCENTERLINE soLurloNa (M SQUID(Ow) (N)SOLID(OVP) (TVP OF 3,1 NEW&2 FUTURE) (TYP OF 3,1 NEW&2 FUTURE) S.RRH(TYP OF 6).MOUNTED &RRH(TYP OF 6).MOUNTED (N)RRH(TYP OF 12.S NEW&6 FUTURE) BEHIND ANTENNAS (N)RRH(TYP OF 12,B NEW&B FUTURE) BEHIND ANTENNAS (N)AT&T PANEL ANTENNAS,TYP.OF 3 (N)AT&T PANEL ANTENNAS,TYP.OF 3 PER SECTOR,9 TOTAL IS NEW&3 PER SECTOR,9 TOTAL IS NEW&3 FUTURE),MOUNTED TO LOW PROFILE FUTURE),MOUNTED TO LOW PROFILE PLATFORM(VALMONT PARTN RMOP-496 PLATFORM(VALMONT PARTP RMOP496 W HANDRAIL KIT OR APPROVED W HANDRAIL KIT OR APPROVED EOUIV.);SUITABILITY OF PLATFORM EOl11VJ;SUITABILITY OF PLATFORM FOR FINAL LOADING CONFIGURATION FOR FINAL LOADING CONFIGURATION i TO BE ANALYZED BY OTHERS TO BE ANALYZED BY OTHERS (N)W-0-MONOPOLE:CAPACITY OF (N)9a4-MONOPOLE;CAPACITY OF MONOPOLE AND FOUNDATIN TO SUPPORT MON OOPOLE AND FOUNDATION TO SUPPORT g$R JqA_1 THE PROPOSED LOADING CONFIGURATION THE PROPOSED LOADING CONFIGURATION O4 WA$ TO BE ANALYZED BY OTHERS TO BE ANALYZED BY OTHERS y't �Oti H,�,O fI N (N)11'S x 27 AT&T (N)AT&T 210 GAL SWW DIESEL a EQUIP.SHELTER GENERATOR W WEATHER/SOUND ENCLOSURE ON(N)5'%9'CONC.PAD Q - 51 (H)SHELTER ACCESS 'Y �l'A1s+:/.,_7Jt1•`� DOOR W SIGNAGE �QNAT' 0 /09/2 CP PROJECT NO.: ATT-15-W42-20 (N)AT&T GPS ANTENNA MOUNTED TO(N)ICE BRIDGE PRELIMNARY (N)B HIGH CHAIN-LINK FENCEW O. DATE D/C DESCRIPTION (3)STRANDS OF BARBED WRE 0 02-10.1] JGIGL 9p%CD REVIEW (MATCH EXISTING FENCE) I 1 W 7-17 JGIJG CLIENTCOMMENT (N)AT&T ICE BRIDGE:ROUTE 2 03-17-17 1 CUCL CLIENT COMMENT CABLE FROM(N)SHELTER TO (N)MONOPOLE ENTRY PORT SUBMITTAL O. DATE 0/C DESCRIPTION 0 03-2&17 CVCL SP SUBMITTAL (N)124T ACCESS %6 8-17 JG/JG WETLANDBUFFER GATE W/SIGNAGE SITE NAME (N)V HIGH CHAIN LINK FENCE W (3)STRANDS OF BARBED WRE (MATCH EXISTING FENCE) OL0719 NORTH BAY SITE ADDRESS \ 480 EASTVICTOR ROAD BELFAIR,WA 98a20 ✓; ii c \f SHEET TITLE ELEVATIONS a-0'AGL ITT �(E)ORADE ad'AGL .. (212.1'AMSL) \ \ A SCALE:Y37-1.4T(11X17) a 1a Zd sCAlE:3/37•f'4T(11x17) O 1a '-'0' `'3•0 1 NORTH ELEVATION-FINAL ----- ---'-----3q 2 WEST ELEVATION-FINAL SCALE:3N&'•1'-0'(22X34) rSCALEI 6 OF 3/4 MINUS CRUSHED ROCK +aa at&t TOP(AVER,OVER WEED BARRIER, MAX.BETWEEN POSTS COMPACTED TO 95%IN 24'WIDE X 10 LONG ACCORDANCE W ASTd 0898 GRIP-STRUT S MIL WEED BARRIER NC E N T E R L I N E SOLUTIONS 2'OF 1 AW MINUS VALMONT'ICE UNDER LAYER BRIDGE'KIT ANGLE (E)GRADE OR APPROVED BRACKET EQUAL;PART TRAPEZE KIT W/ NIB24D-218A2 ALL HARDWARE S . . �// (TOTAL PER 10'SECTION) ID� EDGE OF CRUSHED n• \\ 8-12'00(TYP) IrexB•a URFACE U ROCK S UNDISTURBED CONC.PIER FTG. SOIL NATIVE SUBSOIL "/�/k/� HALL BE Y-T COMPACT TO 95%IN �• FINISHED OR 6'BELOW ACCORDANCE W/ GRADE FROST DEPTH, ASTM O155] NMICHEVER IS NOES: GREATER CONTRACTOR SHALL STRIP SUPERFICIAL SOFT,WET,ORGANIC OR DELETERIOUS SOILS TO EXPOSE FIRM AND UNYIELDING SOIL y .' IF STRIPPING IS REQUIRED DEEPER THAN 6,CONTRACTOR SHALL' CONTACT THE SITE CONSTRUCTION MANAGER TO DETERMINE THE APPROPRIATE TIME STRIPPING DEPTH AT THE ME OF A CONSTRUCTION. �$x, LO of WAS N�j ICE BRIDGE ELEVATION y�TO O y SCALE:NTS(11X17) SCALE:NTS(11X17) SCALE.W (11X17) �t�� 5-y'f1 1 COMPOUND FINISH SCALE.NTS(=34) 2 NOT IN USE SCALE NTS(22X34) 3 ICE BRIDGE SCALE NTS 2D34) roNAL o /09/2 CPPRWECTNO.'. ATT-15-0042-20 PRELIMINARY O. DATE DIC DESCRIPTION 2.125-0.00 OD KATHREIN GPS/E911 0 02-10.1]JG/CL 90%CD REVIEW MOUNTING COMBINED ANTENNAMODEL i 03-07-1] JG/JG ICLIENT COMMENT PIPE MAST pG.8BryI92NGPS-A OR 2 03-17-1]CULL—L.—TCMMENT CABLE MOUNTED TO REQUIRED TO APPROVED EOUN. ICE BRIDGE WN ACCOMMODATE SUBMITTAL VA MONITOR MOUNTING APPROVED EQUAL HARDWARE C. DATE 0/C OESCR IPTION BLOCKS:PART 03-241] CUCL BP SUBMITTAL J9 I ICXB78C OR#CXBISS .-0 17 JG/JG WETLANOBUFFER VALMONT-ICE 3-1/2"0 SCH 40 BRIDGE'KIT OR MTZL.PIPE W/ APPROVED EQUAL; CAP SITE NAME i PART#1824b216A2 VALMONT PIPE TO PIPE CLAMP SET $ OR APPROVED EQUIV.OYP OF 2); m 31?OD MP) PART 6 SCP10K OL0719 CONCRETE PIER NORTH BAY FOOTING PER ICE BRIDGE ELEVATION DETAIL,THIS SHEET CABLE FOR ANTENNA(TYP OF 2) SITE ADDRESS 480 EAST VICTOR ROAD BELFAIR,WA 98528 NOES: SHEET TILE I. LOCATION OF EXCEEDING MUST HAVE CLEAR VIEW OF SOUTHERN SKY:NO BLOCKAGES DIN OF SURFACE AREA OF HEMISPHERE AROUND ANTENNA ALLOWED. CONSTRUCTION 2 ALL DIPS A LEAR SIGNALS FR MNAMN OF(4)SAELLI SATELLITES ANA LOCATIONS MUST BE ABLE TO RE TO BE VECEIVE ERIFIED WT DETAILS SECTION A HANDHELD GPS UNIT BEFORE FINAL LOCATION IS SELECTED. SHEET NO. SCALE:NTS(11X17) SCALE:NTS(1/X17) SCALE:NTS(11%17) "A'-4.O 4 ICE BRIDGE SCALE;rns t2zx'4) 5 GPS ANTENNA SCALE:W.(22%34) 6 NOT IN USE SCALE:NTS(2934) MASON COUNTY DCD SEPA Contact List .�,,- /� Sent SEPA 20 I'"'I — (oc�1 � to (check all that apply) on '4 I 1 :E � -�` 'GV 0 Skokomish Tribal Nation, Nat. Res. Dept. WA Department of Ecology ATTN: Randy Lumper Environmental Review Section N 541 Tribal Center Rd., Skokomish Nation, 98584 PO BOX 47703, Olympia, 98504-7703 rlumper@skokomish.org separegister@ecy.wa.gov Skokomish Tribal Historic Preservation Officer WA Department of Commerce ATTN: Kris Miller reviewteam@commerce.wa.gov 80 N Tribal Center Rd, Skokomish Nation, 98584 shlanay1 @skokomish.org U.S.Army Corps of Engineers SEPA Reviewer-Jason Sweeney Quinault Indian Nation PO Box C-3755, Seattle, 98124 ATTN: Mark Mobbs Jason.t.sweeney@usace.army.mil PO Box 189,Tahola, 98587 mmobbs@quinault.org WA Dept. of Fish and Wildlife SEPAdesk@dfw.wa.gov Squaxin Tribal Nation, Natural Res. Dept. 2952 SE Old Olympic HWY, Shelton 98584 WA Dept,of Fish and Wildlife jdickison@squaxin.us ATTN: Joshua Benton(360)602-0364 emarbet@squaxin.us (Habitat Biologist-Hood Canal Watershed) szaniewski@squaxin.us 450 Port Orchard Blvd, Suite 290 sneil@squaxin.us Port Orchard,WA 98366 Joshua.Benton@dfw.wa.gov The Confederated Tribe of the Chehalis ATTN: SEPA Reviewer-Glen Connelly 420 Howanut Rd., Oakville, 98568 WA Dept.of Fish and Wildlife gconnelly@chehalistribe.org ATTN: Margie Bigelow (Habitat Biologist-S Puget Sound Watershed) WA DNR,South Puget Sound Region 2391 W Deegan Rd., Shelton, 98574 950 Farman Avenue N, Enumclaw, 98022-9282 margaret.bigelow@dfw.wa.gov southpuget.region@dnr.wa.gov WA Dept. of Transportation WA DNR,Aquatic Resources ATTN: Dale Severson PO BOX 47027, Olympia, 98504-7027 P.O. Box 47440, Olympia 98504-7440 and@dnr.wa.gov OR-SEPA-REVIEW@wsdot.wa.gov WA DNR,SEPA Center City of Shelton ATTN: External Coordinator ATTN:Jason Dose PO BOX 47015, Olympia, 98504-7015 525 West Cota St., Shelton 98584 sepacenter@dnr.wa.gov jasond@ci.shelton.wa.us Olympic Region Clean Air Agency Port of Shelton ATTN:Aaron Manley ATTN: Brandon Palmer 2940-B Limited Ln. NW, Olympia. 98502 21 West Sanderson Way, Shelton 98584 aaron.manley@orcaa.org BrandonP@portofsheiton.com Mason County Transit Office of Archaeology&Historic Preservation ATTN: Mike Oliver ATTN: Lance Wollwage PO Box 1880, Shelton, 98584 P.O. Box 48343, Olympia, 98504-8343 moliver@masontransit.org Lance.Wollwage@dahp.wa.gov Mason County PUD#1 Tacoma Public Utilities-Real Property Services ATTN: Steve Taylor ATTN: Dave Letterman N 21971 Hwy 101, Shelton, 98584 3628 S 35th St,Tacoma, 98409-3192 sntaylor@mason-pud1.org dletterm@cityoftacoma.org Mason Cty P.W.ATTN: 4 e'r Mason Cry E.H.ATTN: Other: School District: 1 r/�C/� ��?n�er/inCSo�N/IOnS.C�m Mason Cty Bldg ATTN: /. Agent: U MC DCD last updated on 11/8/2016 Applicant: SEPA Environmental Checklist Mason County Permit ��Cllenter Use: ❑ Single Family DNS: $385 SEP d�I - fJ oil Other DNS: 0 to 9.99 acre : 630 Parcel#: 1222' #a?—&kV0 10 to 20 acres: Date Rcvd: Over 20 acres: $945 IVED ❑ DS/EIS: $2,525+70 Per hr RECE MAR 17 2017 j 615 W. Alder Stre#,t Purpose of checklist: Governmental agencies use this checklist to help determine whether the environmental impacts of your proposal are significant. This information is also helpful to determine if available avoidance, minimization or compensatory mitigation measures will address the probable significant impacts or if an environmental impact statement will be prepared to further analyze the proposal. Instructions for applicants: hel This environmental checklist asks you to describe some basic information about your proposal. Please answer each question accurately and carefully, to the best of your knowledge. You may need to consult with an agency specialist or private consultant for some questions. You may use"not applicable"or "does not apply"only when you can explain why it does not apply and not when the answer is unknown. You may also attach or incorporate by reference additional studies reports. Complete and accurate answers to these questions often avoid delays with the SEPA process as well as later in the decision- making process. The checklist questions apply to all of your proposal, even if you plan to do them over a period of time or on different parcels of land. Attach any additional information that will help describe your proposal or its environmental effects. The agency to which you submit this checklist may ask you to explain your answers or provide additional information reasonably related to determining if there may be significant adverse impact. Instructions for Lead Agencies: Please adjust the format of this template as needed. Additional information may be necessary to evaluate the existing environment, all interrelated aspects of the proposal and an analysis of adverse impacts. The checklist is considered the first but not necessarily the only source of information needed to make an adequate threshold determination. Once a threshold determination is made, the lead agency is responsible for the completeness and accuracy of the checklist and other supporting documents. A. BACKGROUND itgi2i 1. Name of proposed project, if applicable: mom; OL0719 North Bay 2. Name of applicant: In� New Cingular Wireless PCS, LLC("AT&T") 3. Address and phone number of applicant and contact person: � Joe Riddle, Project Manager--Centerline Solutions LLC 6623 NE 78th Ct. Ste. B1, Portland, OR 97218 360-904-5858 SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 1 of 11 1 4. Date checklist prepared:Lhpipli 3/13/17 5. Agency requesting checklist: met Mason County 6. Proposed timing or schedule (including phasing, if applicable): ttt.l, Expect building permit filed<3/31, Construction start<6/1 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. fteap No 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. ILLeM Phase 1 study complete, NEPA/SHPO/TCNS in process 9. Do you know whether applications are pending for governmental approvals of other proposals directly affecting the property covered by your proposal? If yes, explain. Leal? No 10. List any government approvals or permits that will be needed for your proposal, if known. "e� FAA/FCC Registration; Mason County Building Permit 11. Give brief, complete description of your proposal, including the proposed uses and the size of the project and site. There are several questions later in this checklist that ask you to describe certain aspects of your proposal. You do not need to repeat those answers on this page. (Lead agencies may modify this form to include additional specific information on project description.)Itg1pi Construction of a 50'x50'fenced compound with approximately 115'long 12'wide access road from E Victor Rd to contain 90'monopole cell tower and associated ground equipment contained in an 11.5'x 20'prefabricated building. 30 KW emergency backup generator in sound enclosure and mounted on 5'x 10'concrete pad. Facilty will be unstaffed. 12. Location of the proposal. Give sufficient information for a person to understand the precise location of your proposed project, including a street address, if any, and section, township, and range, if known. If a proposal would occur over a range of area, provide the range or boundaries of the site(s). Provide a legal description, site plan, vicinity map, and topographic map, if reasonably available. While you should submit any plans required by the agency, you are not required to duplicate maps or detailed plans submitted with any permit applications related to this checklist. hei Parcel#(s): 12221-42-00000 Address: 480 E Victor Rd Belfair Legal Description: NW 1/4 SE 1/4 Sec 21, T22N, R1W, exc. S 330'thereof and exc. ROW for Victor Rd Twp/Range/Section and/or GPS location: 47 deg 22 min 53.0 sec N 122 deg 48 min 25.7 sec W SEPA Environmental checklist(WAC 197.11.960)(MC version-non project portion omitted): 2016 Page 2 of 11 B. ENVIRONMENTAL ELEMENTS ;hei;)' 1. Earth a. General description of the site `,ei) (circle one): Flat, rolling, hilly, steep slopes, mountainous, other: b. What is the steepest slope on the site(approximate percent slope)? hero No slope c. What general types of soils are found on the site (for example, clay, sand, gravel, peat, muck)? If you know the classification of agricultural soils, specify them and note any agricultural land of long-term commercial significance and whether the proposal results in removing any of these soils. heel Geotech report describes hard sandy silt with gravel, dense silty sand with gravel, sandy gravel, loose silty fine sand,very dense sandy gravel,and dense sand with gravel,to max. depth of exploration,30' d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe.Jhei No history of unstable soils e. Describe the purpose, a total area and approximate quantities and total affected area of an P P type, PP filling, excavation, and grading proposed. Indicate source of fill.JtPjPJ Grading of approximately 115'access road for firm graveled surface; grading and leveling of 50'x 50'site compound. Fill will be from site vicinity, little should be required f. Could erosion occur as a result of clearing, construction, or use. If so,generally describe. the . , Site will be constructed so as to drain away from foundation; no erosion of road or site should occur g. About what percent of the site will be covered with impervious surfaces after project construction(for example, asphalt or buildings)?It2ipj Approximately 25% of the 50'x 50'compound will be covered by building or tower foundation h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: ;fe Grading and drainage plan to be provided with construction drawings for building permit 2. Air a. What types of emissions to the air would result from the proposal during construction, operation, and maintenance when the project is completed? If any, generally describe and give approximate quantities if known. Ltej2j, Diesel exhaust from licensed and regulated generator for testing approximately 20 min per week and during emergencies, otherwise no emissions will be generated b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. ne No c. Proposed measures to reduce or control emissions or other impacts to air, if any: )"ems Generator design is registered for WA state emissions compliance; no other emissions from site SEPA Environmental checklist(WAC 197.11-960)(MC version-non prgect portion omitted): 2016 Page 3 of 11 3. Water a. Surface Water: 1) Is there any surface water body on or in the immediate vicinity of the site (including year- round and seasonal streams, saltwater, lakes, ponds,wetlands)? If yes, describe type and provide names. If appropriate, state what stream or river it flows into. heb, No 2) Will the project require any work over, in, or adjacent to (within 200 feet)the described waters? If yes, please describe and attach available plans.1Halo No 3) Estimate the amount of fill and dredge material that would be placed in or removed from surface water or wetlands and indicate the area of the site that would be affected. Indicate the source of fill material. nei None 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. j, elot No 5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. IttlJ21 No 6) Does the proposal involve any discharges of waste materials to surface waters? If so, describe the type of waste and anticipated volume of discharge.JtLei No b. Ground Water: 1) Will groundwater be withdrawn from a well for drinking water or other purposes? If so, give a general description of the well, proposed uses and approximate quantities withdrawn from the well.Will water be discharged to groundwater? Give general description, purpose, and approximate quantities if known. ne� No 2) Describe waste material that will be discharged into the ground from septic tanks or other sources, if any(for example: Domestic sewage; industrial, containing the following chemicals. . . ; agricultural; etc.). Describe the general size of the system, the number of such systems, the number of houses to be served (if applicable), or the number of animals or humans the system(s) are expected to serve. ih,ey None c. Water runoff(including stormwater : ( 9 ) 1) Describe the source of runoff(including storm water)and method of collection and disposal, if any(include quantities, if known). Where will this water flow? Will this water flow into other waters? If so, describe. lneiti No runoff exceeding current levels will be produced, natural drainage in area, no other waters impacted SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 4 of 11 2) Could waste materials enter ground or surface waters? If so, generally describe. Ljeju No waste materials will be produced by site 3) Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site? If so, describe. No d. Proposed measures to reduce or control surface, ground, and runoff water, and drainage pattern impacts, if any: None, no significant drainage impacts will be produced by site 4. Plants he! a. Check the types of vegetation found on the site: Lhei j T deciduous tree: alder, maple, aspen, other V evergreen tree: fir,cedar, pine, other shrubs grass pasture crop or grain orchards, vineyards or other permanent crops wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other water plants: water lily, eelgrass, milfoil, other other types of vegetation b. What kind and amount of vegetation will be removed or altered? nL e 50'x 50'compound and 12'x 115'road will be cleared, road will be routed around trees 12'inch or larger in diameter c. List threatened and endangered species known to be on or near the site. Lel?1 None known d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any: t! i i Site will be landscaped per code if required due to extensive screening provided by natural forest and invasive e. List all noxious weeds a species known to be on or near the site. None known 5. Animals a. List any birds and other animals which have been observed on or near the site or are known to be on or near the site. Examples include: «.�j� birds: hawk, heron, eagle, songbirds, other: songbirds,occasional water birds and shore birds mammals: deer, bear, elk, beaver, other: none observed, but expect deer, rodents fish: bass, salmon, trout, herring, shellfish, other: None SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 5 of 11 b. List any threatened and endangered species known to be on or near the site.. ei> None c. Is the site part of a migration route? If so, explain. tein" Not known d. Proposed measures to preserve or enhance wildlife, if any:1pipi None e. List any invasive animal species known to be on or near the site. None known 6. Energy and natural resources a. What kinds of energy(electric, natural gas, oil, wood stove, solar)will be used to meet the completed project's energy needs? Describe whether it will be used for heating, manufacturing, etc.lt2MElectricity will be brought to site to power radio equipment b. Would your project affect the potential use of solar energy by adjacent properties? If so,generally describe.; No c. What kinds of energy conservation features are included in the plans of this proposal? List other proposed measures to reduce or control energy impacts, if any: 1nei None 7. Environmental health a. Are there any environmental health hazards, including exposure to toxic chemicals, risk of fire and explosion, spill, or hazardous waste, that could occur as a result of this proposal? If so, describe.it2!pj None 1) Describe any known or possible contamination at the site from present or past uses. None determined to exist by Phase 1 study 2) Describe existing hazardous chemicals/conditions that might affect project development and design. This includes underground hazardous liquid and gas transmission pipelines located within the project area and in the vicinity. None exist 3) Describe any toxic or hazardous chemicals that might be stored, used, or produced during the project's development or construction, or at any time during the operating life of the project. Petroleum fuels during construction and for backup generator(diesel); backup batteries at site in hazmat protective enclosure 4) Describe special emergency services that might be required. None anticipated 5) Proposed measures to reduce or control environmental health hazards, if any: None required, no environmental hazards SEPA Environmental checklist(WAC 197-11-960)(MC version-non prgect portion omitted): 2016 Page 6 of 11 b. Noise 1) What types of noise exist in the area which may affect your project(for example: traffic, equipment, operation, other)?bfU None 2) What types and levels of noise would be created by or associated with the project on a short-term or a long-term basis (for example: traffic, construction, operation, other)? Indi- cate what hours noise would come from the site. Lem Some traffic impact possible for 3-4 weeks during construction; HVAC expected to be at ambient noise outside 1 00'from site;testing of emergency backup generator 20 min per week 3) Proposed measures to reduce or control noise impacts, if any: ne! Generator is inside sound enclosure with muffled exhaust; baffled exhaust from HVAC 8. Land and shoreline use a. What is the current use of the site and adjacent properties?Will the proposal affect current land uses on nearby or adjacent properties? If so, describe. nt elhl Currently site if forested land zoned R-5 b. Has the project site been used as working farmlands or working forest lands? If so, describe. Parcel surrounding site id dedicated forest land; site parcel has been removed from forest designation. How much agricultural or forest land of long-term commercial significance will be converted to other uses as a result of the proposal, if any? Approximately 3,880 sf including site and access road will be removed from forest use If resource lands have not been designated, how many acres in farmland or forest land tax status will be converted to nonfarm or nonforest use?ltei Approximately 3,880 sf including site and access road will be removed from forest use 1) Will the proposal affect or be affected by surrounding working farm or forest land normal business operations, such as oversize equipment access, the application of pesticides, tilling, and harvesting? If so, how: No c. Describe any structures on the site. nF!M 90'monopole cell tower and 11.5'x 20 shelter building with 5'x 10' generator pad with backup generator d. Will any structures be demolished? If so, what? r� No e. What is the current zoning classification of the site? meial R-5 f. What is the current comprehensive plan designation of the site?[rs :! Unknown g. If applicable, what is the current shoreline master program designation of the site?t.:t Unknown h. Has any part of the site been classified as a critical area by the city or county? If so, specify. help No SEPA Environmental checklist(WAC 19741-960)(MC version-non prgec(portion omitted): 2016 Page 7 of 11 i. Approximately how many people would reside or work in the completed project? inel,, None. Site is unstaffed. j. Approximately how many people would the completed project displace? eiO None k. Proposed measures to avoid or reduce displacement impacts, if any: t None required L. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any:Enelp, None required m. Proposed measures to ensure the proposal is compatible with nearby agricultural and forest lands of long-term commercial significance, if any: None required 9. Housing a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low- income housing. net^ None. Site is unmanned b. Approximately how many units, if any,would be eliminated? Indicate whether high, middle, or low-income housing.Lnei None. No structures will be removed c. Proposed measures to reduce or control housing impacts, if any:Lheio1 None required 10. Aesthetics a. What is the tallest height of any proposed structure(s), not including antennas;what is the principal exterior building material(s) proposed?1nei 90'. Galvanized steel b. What views in the immediate vicinity would be altered or obstructed? n1 2i Expect existing tree screening to largely obsure view of all but top 30'or so of tower, ground location will not be visible fr m surroun in arc Is pr road c. Proposed measures to reduce or corl rnA ges es is Impacts, if any: Lheipo Siting chosen to provide very good screening of site by existing trees and brush 11. Light and glare a. What type of light or glare will the proposal produce? What time of day would it mainly occur? 12 None b. Could light or glare from the finished project be a safety hazard or interfere with views? t No c. What existing off-site sources of light or glare may affect your proposal? tojol No d. Proposed measures to reduce or control light and glare impacts, if any: ;help; None needed SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 8 of 11 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? =help; None noted b. Would the proposed project displace any existing recreational uses? If so, describe. Lr ,� No c. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: helo None needed 13. Historic and cultural preservation a. Are there any buildings, structures, or sites, located on or near the site that are over 45 years old listed in or eligible for listing in national, state, or local preservation registers located on or near the site? If so, specifically describe. c-_i±L!pj No b. Are there any landmarks,features, or other evidence of Indian or historic use or occupation? This may include human burials or old cemeteries. Are there any material evidence, artifacts, or areas of cultural importance on or near the site? Please list any professional studies conducted at the site to identify such resources. ihe= No c. Describe the methods used to assess the potential impacts to cultural and historic resources on or near the project site. Examples include consultation with tribes and the department of archeology and historic preservation, archaeological surveys, historic maps, GIS data, etc.Itpipi Archeology report as required, NEPA/SHPO/TCNS d. Proposed measures to avoid, minimize, or compensate for loss, changes to, and disturbance to resources. Please include plans for the above and any permits that may be required. None needed 14. Transportation a. Identify public streets and highways serving the site or affected geographic area and describe proposed access to the existing street system. Show on site plans, if any.JtLei Graveled road to site from E Victor Road b. Is the site or affected geographic area currently served by public transit? If so, generally describe. If not, what is the approximate distance to the nearest transit stop? theio No c. How many additional parking spaces would the completed project or non-project proposal have? How many would the project or proposal eliminate? :helm 1 parking space at site, no parking lost due to site SEPA Environmental checklist(WAC 197-11.960)(MC version-non pr4ect portion omitted): 2016 Page 9 of 11 d. Will the proposal require any new or improvements to existing roads, streets, pedestrian, bicycle or state transportation facilities, not including driveways? If so, generally describe(indicate whether public or private).Lneia Only access road from E Victor Road e. Will the project or proposal use(or occur in the immediate vicinity of)water, rail, or air transportation? If so, generally describe. Jheb No f. How many vehicular trips per day would be generated by the completed project or proposal? If known, indicate when peak volumes would occur and what percentage of the volume would be trucks (such as commercial and nonpassenger vehicles).What data or transportation models were used to make these estimates? 'r ei Less than one trip per week to site, no peak volumes. After construction, access will be by passenger vehicle(1) g. Will the proposal interfere with, affect or be affected by the movement of agricultural and forest products on roads or streets in the area? If so, generally describe. No h. Proposed measures to reduce or control transportation impacts, if any:Jn ip.1 None needed 15. Public services a. Would the project result in an increased need for public services(for example: fire protection, police protection, public transit, health care, schools, other)? If so, generally describe. irei >I No b. Proposed measures to reduce or control direct impacts on public services, if any,JL21pj None needed 16. Utilities a. Circle utilities currently available at the site: Leipl, electricity, natural gas, water, refuse service, telephone, sanitary sewer, septic system, other b. Describe the utilities that are proposed for the project,the utility providing the service, and the general construction activities on the site or in the immediate vicinity which might be needed. ne!21 Electricty and fiber will be brought to site from E Victor Road by local providers. Minor trenching will be required. SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 10 of 11 C. SIGNATURE Lelj The above answers are true and complete to the best of my knowledge. I understand that the lead agency is relying on them to make its decision. Signature: Date Signed: 3 Print Name of Signee: Joe Riddle, Centerline Solutions If applicable, Position and Agency/Organization: -Project Manager,Agent for New Cingular Wireless PCS, LLC Date Submitted: i i i I I fi I I i i I i i i I i I SEPA Environmental checklist(WAC 197.11.990)(MC version-non project portion omdteo: 2016 Page 11 of 11