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HomeMy WebLinkAboutSEP2003-00007 ATF Grade, Fill, Restoration, Addendum - SEP Determinations - 10/13/2004 ON STATE MASON COUNTY o A o N DEPARTMENT OF COMMUNITY DEVELOPMENT Y S N =N Planning Division °i y P O Box 279, Shelton, WA 98584 (360)427-9670 1864 MITIGATED DETERMINATION OF NONSIGNIFICANCE (WAC 197-11-350) SEP2003-00007 Description of Proposal: Review of after-the-fact, unpermitted grading, filling activities resulting in impacts to wetlands and creating artificially oversteepened slopes. Restoration is required by Mason County and restoration plan is part of this SEPA review. Proponent: RON GROTJAN Site Address (If Assigned): 5401 N JORSTAD CREEK RD HOODSPORT Directions to Site: Lake Cushman Road to right at Forest Service Rd. 24 to 3 miles north to orange blazed trees. Turn right and follow road to end. Parcel Number: 423027500110 Legal Description: TRS 11-25 OF S 8/98 PTN TENAS LK WIN SEC 2 Lead Agency: Mason County The Lead Agency for this proposal has determined that it does not have a probable significant adverser 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. MITIGATED MEASURES ARE ATTACHED. Please contact Rick Mraz at ext. 577 with any questions. This DNS is issued under 197-11-340(2), the Lead Agency will not act on this proposal for 14 days from the date below. Comments must be submitted to Rick Mraz, C/O Mason County DCD, Planning Division, PO Box 279, Shelton WA 98584 by 10/28/2004. '10/��/6-A WiAuth4onedocal Govern nt Official —� ate Ai Cars J``�'A CA-Ttt� PA c 0E Pkee\.ccn'r MITIGATED DETERMINATION OF NONSIGNIFICANCE (WAC 197-11-350) SEP2003-00007 CONDITIONS OF THIS DETERMINATION 1) The provisions of the restoration plan prepared by Agua Tiera (ATEC) and dated November 2003 shall be adhered to throughout this project. 2) All future development of the proposed site will be subject to the conditions that are listed. However, this does not exempt future proposals from further review through the SEPA process. 3) Water quality is not to be degraded to the detriment of the aquatic environment as a result of this project. JAJE- -t qW,0 WAC 197-11-960 Environmental checklist. ENVIRONMENTAL CHECKLIST Purpose ofchecklist: The State Environmental Policy Act (SEPA), chapter 43.21C RCW, requires all governmental agencies to consider the environmental impacts of a proposal before making decisions. An environmental impact statement(EIS) must be prepared for all proposals with probable significant adverse impacts on the quality of the environment. The purpose of this checklist is to provide information to help you and the agency identify impacts from your proposal(and to reduce or avoid impacts from the proposal, if it can be done)and to help the agency decide whether an EIS is required. Instructions for applicants: This environmental checklist asks you to describe some basic information about your proposal. Governmental agencies use this checklist to determine whether the environmental impacts of your proposal are significant, requiring preparation of an EIS. Answer the questions briefly,with the most precise information known,or give the best description you can. You must answer each question accurately and carefully,to the best of your knowledge. In most cases,you should be able to answer the questions from your own observations or project plans without the need to hire experts. If you really do not know the answer, or if a question does not apply to your proposal, write "do not know" or "does not apply." Complete answers to the questions now may avoid unnecessary delays later. Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations. Answer these questions if you can. If you have problems,the governmental agencies can assist you. 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. Use of checklist for nonproject proposals: Complete this checklist for nonproject proposals,even though questions may be answered "does not apply." IN ADDITION, complete the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS(part D). For nonproject actions,the references in the checklist to the words "project," "applicant," and "property or site" should be read as"proposal,""proposer,"and"affected geographic area,"respectively. A. BACKGROUND 1. Name of proposed project,if applicable: Grotjan Wetland Restoration 2. Name of applicant: Ron Grotjan 3. Address and phone number of applicant and contact person: 102 Pond Ln., Sequim,WA 98382 (360)683-6139 4. Date checklist prepared: Aug.25,2002,Dec.2,2003,Oct.6,2004 5. Agency requesting checklist: Mason County Dept.of Community Development 6. Proposed timing or schedule(including phasing,if applicable): After agency approval of restoration plan. 7. Do you have any plans for future additions,expansion,or further activity related to or connected with this proposal? If yes,explain. No. 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. Wetland Delineation Report(December 2002)and Wetland Restoration Plan(November 2003)prepared by Agua Tierra Environmental Consulting,Inc.(ATEC). 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. The Army Corps of Engineers(ACOE)reviewed this project and made a determination that they are not asserting jurisdiction. 10. List any government approvals or permits that will be needed for your proposal,if known. Hydraulic Permit Approval(HPA)submitted to Washington Department of Fish and Wildlife(WDFW) on Sept. 17,2004. Mason County Land Modification Permit to address un-permitted grading and restoration grading. 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.) Restoration activities as outlined in Wetland Restoration Plan dated November 2003 to correct un- permitted wetland impacts on approximately 40,492 square feet of emergent wetland and 39,350 square feet of associated buffer. 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. Take Cushman/Staircase Rd.from Hoodsport 9 miles to the end.Go right on Forest Service Road 24 and drive 3 miles to 2 orange marked trees on the right.Enter driveway and bear left.Vicinity,regional and assessor maps are included in the Wetland Restoration Plan. 2 B. ENVIRONMENTAL ELEMENTS 1. Earth a. General description of the site(circle one): Flat,rolling,hilly,steep slopes,mountainous, other...... Hilly. b. What is the steepest slope on the site(approximate percent slope)? Upland areas located near the wetland have maximum slopes approaching 50%. 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 prime farmland. Mapped soils: McMurray peat 0-2% slopes; Hoodsport gravelly sandy loam 5-15% slopes; Grove gravelly sandy loam 15-30%slopes. d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. No. e. Describe the purpose,type,and approximate quantities of any filling or grading proposed. Indicate source of fill. Excavation and grading will be used to restore wetland buffer slopes to 2H:1 V and upland slopes restored to 3H:IV. See Wetland Restoration Grading Plan Map. Restoration related to grading will not exceed 5000 cubic yards of material. f. Could erosion occur as a result of clearing,construction,or use? If so,generally describe. Following grading all slopes will be revegetated and seeded with an erosion control mixture. g. About what percent of the site will be covered with impervious surfaces after project construction(for example,asphalt or buildings)? Less than 0.0 1%. h. Proposed measures to reduce or control erosion,or other impacts to the earth,if any: Slopes will be revegetated with native vegetation and an erosion control seed mixture. 2.Air a. What types of emissions to the air would result from the proposal(i.e.,dust,automobile, odors,industrial wood smoke)during construction and when the project is completed? If any,generally describe and give approximate quantities if known. None. Emissions from the gasoline-powered generator now used would be greatly reduced or eliminated. b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. No. 3 c. Proposed measures to reduce or control emissions or other impacts to air,if any: NA 3. Water a. Surface: 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. Surface water: 1) Tenas Lake southeast of the project area; 2) associated Category II wetland within project area; 3) unnamed seasonal tributary of Lilliwaup creek enters property through northeast corner and flows into Tenas Lake adjacent to project area. 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. Grading and excavation of upland slopes adjacent to wetland. Removal of fill material within wetland. See attached Grading Plan Map and Wetland Restoration Plan. 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. Wetland fill material will be removed to the greatest extent practicable without disturbing the underlying peat soils(a thin veneer of fill less than 3 inches thick is expected to remain)within Impact Areas(see attached Grading Plan Map): I#2=approximately 4,117 sq.ft I#7=approximately 3,963 sq.ft 1#9=approximately 12,367 sq.ft I#10=approximately 11,169 sq.ft. 4)Will the proposal require surface water withdrawals or diversions? Give general description,purpose,and approximate quantities if known. Restoration work will NOT require surface water withdrawl or diversion. 5)Does the proposal lie within a 100-year floodplain? If so,note location on the site plan. 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. No. 4 b. Ground: 1) Will groundwater be withdrawn,or will water be discharged to groundwater? Give general description,purpose,and approximate quantities if known. 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. 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. NA 2)Could waste materials enter ground or surface waters? If so,generally describe. No. d. Proposed measures to reduce or control surface,ground,and runoff water impacts,if any: Upland slopes will be planted immediately following grading and excavation with native conifers and erosion control seed mixture(see Restoration Plan). 4. Plants a. Check or circle types of vegetation found on the site: deciduous tree: alder,maple,aspen,other evergreen tree: fir,cedar,pine,other shrubs grass pasture crop or grain wet soil plants: cattail,buttercup,bullrush,skunk cabbage,other water plants: water lily,eelgrass,milfoil,other other types of vegetation See attached list"Plants Encountered On-site"(ATEC Wetland Delineation Report,December 2002). b. What kind and amount of vegetation will be removed or altered? Clearing of native upland wand wetland species has occurred on-site. Site is to be revegetated with native species as recommended in Restoration Plan. c. List threatened or endangered species known to be on or near the site. None. d. Proposed landscaping,use of native plants,or other measures to preserve or enhance vegetation on the site,if any: Native plantings(see attached Restoration Plan Planting Zone Map). 5 5. Animals a. Circle any birds and animals which have been observed on or near the site or are known to be on or near the site: birds: hawk,heron,eagle,songbirds,other: mammals: deer,bear,elk,beaver,other: fish: bass,salmon,trout,herring,shellfish,other: Birds: Hawk,heron,eagle,songbirds,grouse,swallows,ducks. Mammals: Dee,bear,elk,cougar. Fish: Trout. b. List any threatened or endangered species known to be on or near the site. None. c. Is the site part of a migration route? If so,explain. Trumpeter swans sometimes visit in the winter. d. Proposed measures to preserve or enhance wildlife,if any: Leave things as undeveloped as possible. 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. NA b. Would your project affect the potential use of solar energy by adjacent properties? If so,generally describe. NA 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: NA 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. No. 1)Describe special emergency services that might be required. None. 2)Proposed measures to reduce or control environmental health hazards,if any: NA b. Noise 6 1)What types of noise exist in the area which may affect your project(for example: traffic,equipment,operation,other)? 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. Temporary noise from backhoe during excavation and grading work phase. 3)Proposed measures to reduce or control noise impacts,if any: None.Noise is short-term. 8. Land and shoreline use a. What is the current use of the site and adjacent properties? Forest land. • b. Has the site been used for agriculture? If so,describe. No. c. Describe any structures on the site. Mobile trailer and pole barn. d. Will any structures be demolished? If so,what? No. e. What is the current zoning classification of the site? Forest. f. What is the current comprehensive plan designation of the site? Forest,natural wetlands. g. If applicable,what is the current shoreline master program designation of the site? Tenas Lake. h. Has any part of the site been classified as an "environmentally sensitive"area? If so,specify. Category II wetland on-site. i. Approximately how many people would reside or work in the completed project? One man,Dave Woodall,age 63,lives in his small mobile home.I hope to work part time on the property. j. Approximately how many people would the completed project displace? None. k. Proposed measures to avoid or reduce displacement impacts,if any: NA 7 1. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans,if any: NA 9. Housing No structures are proposed. a. Approximately how many units would be provided,if any? Indicate whether high,mid- dle,or low-income housing. NA b. Approximately how many units,if any,would be eliminated?Indicate whether high, middle,or low-income housing. NA c. Proposed measures to reduce or control housing impacts,if any: NA 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? No structures are proposed. b. What views in the immediate vicinity would be altered or obstructed? NA c. Proposed measures to reduce or control aesthetic impacts,if any: NA 11. Light and glare a. What type of light or glare will the proposal produce? What time of day would it mainly occur? NA b. Could light or glare from the finished project be a safety hazard or interfere with views? NA c. What existing off-site sources of light or glare may affect your proposal? NA d. Proposed measures to reduce or control light and glare impacts,if any: NA 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? Fishing,hiking,nature-watching. 8 b. Would the proposed project displace any existing recreational uses? If so,describe. No. c. Proposed measures to reduce or control impacts on recreation,including recreation op- portunities to be provided by the project or applicant,if any: Keeping things as small,quiet and unobtrusive as possible. 13. Historic and cultural preservation a. Are there any places or objects listed on,or proposed for,national,state,or local preser- vation registers known to be on or next to the site? If so,generally describe. No. b. Generally describe any landmarks or evidence of historic,archaeological,scientific,or cultural importance known to be on or next to the site. None. c. Proposed measures to reduce or control impacts,if any: NA 14. Transportation a. Identify public streets and highways serving the site,and describe proposed access to the existing street system. Show on site plans,if any. Forest Service Road 24. Declaration of Intention enclosed. b. Is site currently served by public transit? If not,what is the approximate distance to the nearest transit stop? No. c. How many parking spaces would the completed project have? How many would the project eliminate? NA d. Will the proposal require any new roads or streets,or improvements to existing roads or streets,not including driveways? If so,generally describe(indicate whether public or private). No. e. Will the project use(or occur in the immediate vicinity of)water,rail,or air transporta- tion? If so,generally describe. No. f. How many vehicular trips per day would be generated by the completed project?If known,indicate when peak volumes would occur. None. g. Proposed measures to reduce or control transportation impacts,if any: NA 9 15. Public services All items within this section are not applicable to this proposed project. a. Would the project result in an increased need for public services(for example: fire pro- tection,police protection,health care,schools,other)? If so,generally describe. NA b. Proposed measures to reduce or control direct impacts on public services,if any. NA 16. Utilities All items within this section are not applicable to this proposed project. a. Circle utilities currently available at the site: electricity,natural gas,water,refuse serv- ice,telephone,sanitary sewer,septic system,other. NA 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. NA C. SIGNATURE 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: .................................................................................................................................................................... DateSubmitted: .......................................................................................................................................................... 10 15. Public services All items within this section are not applicable to this proposed project. a. Would the project result in an increased need for public services(for example: fire pro- tection,police protection,health care,schools,other)? If so,generally describe. NA b. Proposed measures to reduce or control direct impacts on public services,if any. NA 16. Utilities All items within this section are not applicable to this proposed project. a. Circle utilities currently available at the site: electricity,natural gas,water,refuse serv- ice,telephone,sanitary sewer,septic system,other. NA 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. NA C. SIGNATURE The above answers are true and complete to the best of my knowledge. I understand that the lead agency is relying onn th to ke its dreision. 1 ..., ...�n�1z..,ld.f.................................................................................................................. 10 o sTATF 0� DECEIVED, � x y sae ao 1:a 1 0 12004 STATE OF WASHINGTON LMCpp _ p�gNNING DEPARTMENT OF ECOLOGY PO Box 47775 • Olympia, Washington 98504-7775 • (360)407-6300 October 28, 2004 Mr. RickMraz � seinrthedress Mason County - Community Development Department � ,� Planning Division watershed PO Box 279 Shelton,WA 98584 Dear Mr.Mraz: Thank you for the opportunity to comment on the mitigated determination of nonsignificance for the Grot an Wetland Restoration project(SEP2003-00007)located at 5401 North Jorstad Creek Road in Hoodsport as proposed by Ron Grot an. We reviewed the environmental checklist and have the following comments: WATER QUALITY: Betsy Dickes(360)407-6294 Any discharge of sediment-laden runoff or other pollutants to waters of the state is in violation of Chapter 90.48,Water Pollution Control,and WAC 173-201A,Water Quality Standards for Surface Waters of the State of Washington,and is subject to enforcement action. Erosion control measures must be in place prior to any clearing, grading, or construction. These control measures must be effective to prevent stormwater runoff from carrying soil and other pollutants into surface water or storm drains that lead to waters of the state. Sand, silt, clay particles, and soil will damage aquatic habitat and are considered to be pollutants. Erosion and sediment control is a key to preserving habitat and preventing denudation of a developing area. The following practices are recommended: Clearing limits and/or any easements or required buffers should be identified and marked in the field,prior to the start of any clearing, grading, or construction. Some suggested methods are staking and flagging or high visibility fencing. Soil in stockpiles should be stabilized or protected with sediment-trapping measures to prevent soil loss. All exposed areas of final grade or areas that are not scheduled for work,whether at final grade or otherwise, shall not remain exposed and un-worked for more than two days, between October 1 and April 30. Between May 1 and September 30,no soils shall remain exposed and un-worked for more than 7 days. Source control best management practices such as plastic covering,mulch,temporary seeding, and phased clearing(for example)should be used to control erosion during construction. More examples of effective source control Best Management Practices can be found in Washington Department of October 28, 2004 Page 2 Ecology's two stormwater management manuals,Stormivater Management Manual for Puget Sound(1992) and Stormwater Management Manual for Western Washington (2001). Provision should be made to minimize the tracking of sediment by construction vehicles onto paved public roads. If sediment is deposited,it should be cleaned every day by shoveling or sweeping. Water cleaning should only be done after the area has been shoveled out or swept. During construction,all releases of oils,hydraulic fluids, fuels, other petroleum products,paints, solvents,and other deleterious materials must be contained and removed in a manner that will prevent their discharge to waters and soils of the state. The cleanup of spills should take precedence over other work on the site. If you have any questions or would like to respond to these comments please contact the appropriate reviewing staff listed above. Department of Ecology Southwest Regional Office (AW: 04-7293) cc: Betsy Dickes,WQ Ron Grot an(Applicant) A AGUA TIERRA ENVIRONMENTAL CONSULTING, INC. TEC Design • Restore • Construct February 3, 2004 R � E 4"' F-' 0 'f 2004 ScottLonganecker mcci.'J - :-LANNING Mason County Planning Department PO Box 279 Shelton, WA 98584 Re: Grotjan Restoration Plan& SEPA Addendum Scott: Please find enclosed copies of the Wetland Restoration Plan and the Mason County Environmental Checklist (SEPA) Addendum. Both reports have been prepared to correct unpermitted wetland impacts for Mr. Ron Grotjan's property located off of U.S. Forest Service Road 24. Please let me know if you have any questions. I have also enclosed for your reference copies of plant species and quantities for each impact area. A master plant materials list has been included as Appendix D in the Wetland Restoration Plan. However I felt you may find it useful to have the information broken down farther for monitoring. Sincerely, Stacey Godin Restoration Specialist Enclosures RIVERS FISH HABITAT WETLANDS WATERSHEDS MARINE SHORELINES AGUA TIERRA ENVIRONMENTAL CONSULTING, INC. 506 Edison Street SE•Suite 100• Olympia,Washington 98501 T.(360)754-3755• F: (360)754-3431 • E-Mail:atec@aguatierra.net www.aguatierra.net MEP ADDENDUM FUR GROTJAN WE7L4ND RESTORATION WORK Prepared By Agua Tima Environmental Consulting,Inc. D.--,- 7m� MASON COUNTY ENVIRONMENTAL CHECKLIST(SEPA) ADDENDUM To: Mason County Community Development Department Planners: Kristen French and Scott Longanecker Date: December 3, 2003 Project: Grotjan Wetland Violation Restoration Project Reference #: Tax Parcel # 42302-75-00110 Applicant: Mr. Ronald Grotjan This Addendum has been prepared by Agua Tierra Environmental Consulting, Inc. (ATEC)to reflect changes to the "After the Fact"SEPA that was submitted on 9/06/02 by Mr.Grotjan. The SEPA submitted on 9/06/02 along with this Addendum accompany the"After the Fact"Land Modification Permit to address wetland restoration work necessary to correct un-permitted wetland activities. Answers stated within this Addendum only reflect changes to SEPA dated September 6, 2002. Other responses remain the same. A. BACKGROUND 1. Grotjan Wetland Restoration 2. same 3. same 4. December 2, 2003 5. same 6. After agency approval of restoration plan 7. No 8. Wetland Delineation Report (December 2002) and Wetland Restoration Plan(November 2003)by Agua Tierra Environmental Consulting, Inc. (ATEC) 9. US Army Corps of Engineers Seattle Division approval of Restoration Plan(submitted to Thomas Mueller, Seattle District Chief Regulator, on December 2, 2003). 10. Mason County Land Modification Permit to address un-permitted grading and restoration grading. 11. Restoration activities as outlined in Wetland Restoration Plan dated November 2003 to correct un-permitted wetland impacts on approximately 40,492 square feet of emergent wetland and 39,350 square feet of associated buffer. 12. same—vicinity, regional, and assessor maps are included in Wetland Restoration Plan. B. ENVIRONMENTAL ELEMENTS 1. EARTH a. hilly b. upland areas located near the wetland have maximum slopes approaching 50% c. Mapped soils: McMurray Peat 0-2%slopes; Hoodsport Gravelly Sandy Loam 5-15% slopes;Grove Gravelly Sandy Loam 15-30%slopes. d. same - 1 - MEP ADDENDUM FOR GROVAN WE7ZAND RESTORATION WORK Prepared By Agua Tierra Environmental Consulting,Inc. DecP* 1- 3 200z e. Excavation and grading will be used to restore wetland buffer slopes to 2H:1 V and upland slopes restored to 3H:1 V. See Wetland Restoration Grading Plan Map. Restoration related to grading will not exceed 5000 cubic yards of material. f Following grading all slopes will be revegetated and seeded with an erosion control mixture. g. same h. slopes will be revegetated with native vegetation and erosion control seed mixture. 2. AIR a. same b. same c. same 3. WATER a. 1. Surface water: 1)Tenas Lake southeast of the project area; 2)associated Category H wetland within project area; 3)unnamed seasonal tributary of Lilliwaup creek enters property through northeast comer and flows into Tenas Lake adjacent to project area. 2. Grading and excavation of upland slopes adjacent to wetland. Removal of fill material within wetland. See attached Grading Plan Map and Wetland Restoration Plan. 3. Wetland fill material will be removed to the greatest extent practicable without disturbing the underlying peat soils(a thin veneer of fill less than 3 inches thick is expected to remain)within Impact Areas (see attached Grading Plan Map): I#2=approximately 4,117 sq.ft I#7=approximately 3,963 sq.ft 1#9=approximately 12,367 sq.ft I#IO=approximately 11,169 sq.ft. 4. Restoration work will NOT require surface water withdrawal or diversion. 5. Same. 6. Same. b. I. same. 2. same c. 1. n/a 2. no. d. Upland slopes will be planted immediately following grading and excavation with native conifers and erosion control seed mixture(see Restoration Plan). 4. PLANTS a. See attached list"Plants Encountered On-site"(ATEC Wetland Delineation Report, December 2002). b. Clearing of native upland and wetland species has occurred on-site. Site is to be revegetated with native species as recommended in Restoration Plan. c. same d. Native plantings. See attached Restoration Plan Planting Zone Map. 5. ANIMALS a. same b. same C. same - 2 - MEP ADDENDUMFOR GROTJAN WETLAND RESTORATION WORK Prepared By Agua Tierra Environmental Consulting,Inc. December� �nn� d. same 6. ENERGY AND NATURAL RESOURCES a. n/a b. n/a c. n/a 7. ENVIRONMETNAL HEALTH a. no 1. no 2. n/a b. same 2. Temporary noise from backhoe during excavation and grading work phase. 3. None. Noise is short-term. 8. LAND AND SHORELINE USE: a. same b. same c. mobile trailer and pole barn d. same e. same f. same g. Tenas Lake h. Category lI wetland on-site i. same j. same k. same 1. n/a 9. HOUSING No structures are proposed. 10. AESTHETICS a. No structures are proposed. b. n/a c. n/a 11. LIGHT AND GLARE a. n/a b. n/a c. n/a d. n/a 12. RECREATION a. same b. same c. same - 3 - MEP ADDENDUM FOR GROVAN WEM4ND RESTORA77ON WORK Prepared By Agua Tiara Environmental Consuttin&Inc. 13. HISTORICAL AND CULTURAL PRESERVATION a. same b. same c. same 14. TRANSPORTATION a. same b. same c. n/a d. same e. same f same g. same 15. PUBLIC SERVICES and 16. UTILITIES All items within these sections are not applicable to this proposed project. - 4 - ATTACHMENTS: • Restoration Plan Planting Zone Map • Restoration Plan Grading Plan Map • List of Plants Encountered On-Site • Copy of SEPA checklist dated 9/06/02 NAME: C:\ATEC-CAD\Atec Pro cts WET LANDS GROTJAN GRADING PLAN.dw DATE: NOV 3 2003 TIME: 5:47 PM NOTES: 1) DELINEATED WETLAND BOUNDARY SURVEYED BY ATEC INC. 2) ALL PROPERTY LINE/MARKER REFERENCES ARE BASED ON MARKERS FOUND IN FIELD OR REPORTED BY PROPERTY OWNER/ MANAGER. 3) PROJECT AREA OVERLAPS MASON COUNTY TAX PARCEL NUMBER: 4230275-00110 4) LARGE WOODY DEBRIS (LWD) SHALL BE PRESERVED THROUGH OUT SITE AND OPPORTUNISTICALLY PLACED AS HABITAT FEATURES ® DIRECTION OF RESTORATION SPECIALIST. I - 13 PROPERTY CORNER I-2 - I -3 APPROXIMATE OFFSITE EXTENTION OF WETLAND BOUNDARY I -4 I -5 I -6 WETLAND A I - 10 I- 7 SP PERTY CORNER CULVERTS TO BE REMOVED LAKE LARGE FIR TREES �_9 TEN AS -VR f - .:..:..•.3 Oyu,;g;•• 'ti ..._ t'`\' ti`h.,� I - REMOVE FILL FROM BUFFER. REGRADE TO MATCH SURROUNDING 1-2 :REMOVE FILL. RESHAPE EXCAVATED HOLE AS DESCRIBED FOR I-6 1-3 :REMOVE FILL. SMOOTH GRADE TO MATCH ADJACENT BUFFER AREA GRADE 1 -4 :NO MODIFICATIONS TO GRADE REQUIRED WETLAND BOUNDARY INFO. WETLAND BOUNDARY 1-5 :NO MODIFICATIONS TO GRADE REQUIRED 85 FOOT WETLAND BUFFER 1 -6 ;TOL4HREMAINS. AND PEAT SIDE CUTSLOPES MATERIAL TO BE INSTALLED HOLES PEAT AS FILL N DEEPEST PARTEOF SHAPED HOLE. IMPACT AREAS TO WETLAND I-� • AND/OR BUFFER 1- 7 :REMOVE FILL. ROAD PRE-EXISTING 1 -8 :RESTORE SHORELINE SLOPES TO 3H : IV 1-9 ;REMOVE WETLAND FILL. AVOID DISTURBING UNDERLYING PEAT SOILS. RESIDUAL FILL (2-3 INCH LAYER MAX) ALLOWED TO REMAIN AS NEEDED TO AVOID DISTURBING PEAT LAYER. I_ 10:REMOVE WETLAND FILL. AVOID DISTURBING UNDERLYING PEAT SOILS. RESIDUAL FILL (2-3 INCH LAYER MAX) ALLOWED TO REMAIN AS NEEDED TO AVOID DISTURBING PEAT LAYER. I - :EXISTING SAND AND GRAVEL SLOPE® REPOSE. (SIDE SLOPE 1H : IV) STABILIZE MAGNETIC NORTH W/ DOUGLAS FIR AND EROSION CONTROL SEED MIX. 0' 100' 200' I - 12:NO GRADING CHANGES I I I I- 13:N0 GRADING CHANGES 1"=100'T 23N R 4W S 2 SM mm"5T.SE-5'''°° GROTJAN WETLAND DESIGNED x r_DATE"w+'WA.°�°' APPROVED SHEET cW"5"55 nnE RESTORATION PLAN DRAM )H• un��, T E C GRADING PLAN MAP DIGITIZED CHECKED C.F. 71/15/03 0F; AGUA TIERRA ENVIRONMENTAL CONSULTING, INC. REVISED x Ca, t NAME: C:\ATEC-CAD\Atec Pro cts WET LANDS GROTJAN GROTJAN.dw DATE: NOV 3 2003 TIME: 5:47 PM NOTES: 1) DELINEATED WETLAND BOUNDARY SURVEYED BY ATEC INC. 2) ALL PROPERTY LINE/MARKER REFERENCES ARE BASED ON MARKERS FOUND IN FIELD OR REPORTED BY PROPERTY OWNER/ MANAGER. 3) PROJECT AREA OVERLAPS MASON COUNTY TAX PARCEL NUMBER: 4230275-00110 4) LARGE WOODY DEBRIS (LWD) SHALL BE PRESERVED THROUGH OUT SITE AND OPPORTUNISTICALLY PLACED AS HABITAT FEATURES A DIRECTION OF RESTORATION SPECIALIST. �-g1N PHOTO MONITORING POINT ow '`TT'"`'' ' ~ PROPERTY CORNER I- 17 3 '" _ � ..... � � � •� �. +_ �- w\ APPROXIMATE OFFSITE a 3's=' :` { EXTENTION OF WETLAND BOUNDARY �.Z- PHOTO MONITORING POINT PERTY CORNER Ts I `•.:% t. �(A� XIMATE) r � r r r r r LAKE LARGE FIR TREES r r r r TE N A S I- 11 r r ,•-- r r J.. I- 12 APPROXIMATE OFFSITE r ;w' EXTENTION OF X WETLAND BOUNDARY PLANTING ZONES WETLAND BOUNDARY INFO. ® TYPE 1 PLANTING ZONE —VL WETLAND BOUNDARY PALUSTRINE EMERGENT WETLAND • : : s s SCRUB/ SHRUB WETLAND —KB— 85 FOOT WETLAND BUFFER TYPE 2 PLANTING ZONE SCRUB/ SHRUB WETLAND I _# : IMPACT AREAS TO WETLAND ROAD PRE-EXISTING AND/OR BUFFER TYPE 3 PLANTING ZONE Pruxtro M o"i toc' Pol A t(&I) UPLAND WETLAND BUFFER + _ PALUSTRINE EMERGENT WETLAND TYPE 4 PLANTING ZONE UPLAND SLOPE r OPEN WATER WETLAND MAGNETIC NORTH 0' 100, 200' I I I 1"=100' T23NR4WS2 5°°m'a��Mm GROTJAN WETLAND DESIGNED x X DAZE A,PROVED SHEET 754-3m RESTORATION PLAN DRAWN J.H. 11/03/03 nu A T PLANTING ZONE MAP DIGITIZED E C CHECKED S.G. 11/03/03 OF: AGUA TIERRA ENVIRONMENTAL CONSULTING, INC. REVISED X DON i Grotjan Wetland Delineation and Category Determination Prepared by: Agua Tierra Environmental Consulting, Inc. (ATEC) WETLAND INDICATOR STATUS OF PLANTS ENCOUNTERED NI=not an indicator NL=not listed Scientific Name Common Name Indicator Status ** Stratum:HERBS Carex obnupta SEDGE, SLOUGH OBL Cirsium arvense THISTLE, CANADIAN FACU+ Epilobium angustifolium FIREWEED FACU- Equisetum arvense HORSETAIL,COMMON FAC Hippuris vulgaris MARESTAIL OBL Gaultheria shallon SALAL FACU Geum macrophyllum AVENS,LARGELEAF FACW+ Juncus ensifolius RUSH,DAGGER LEAF FACW Limosella aquatica MUDWORT OBL Ludwigia palustris WATER-PURSLANE OBL Mentha arvensis MINT,FIELD MINT FAC Nuphar polysepalum POND-LILY,YELLOW OBL Oenanthe sarmentosa WATER PARSLEY OBL Polystichum munitum FERN, SWORD FACU Pteridium aquilinium FERN,BRACKEN FACU Rubus ursmus BLACKBERRY,TRAILING FACU Sparganium emersum BUR-REED,NARROW LEAF OBL Typha latifolia CATTAIL OBL Veronica catenata SPEEDWELL,PINK WATER OBL Veronica scutellata SPEEDWELL,MASRSH OBL ** Stratum: SHRUBS Acer circinatum MAPLE, VINE FACU+ Corpus stolonifera RED-OSIER DOGWOOD FACW Physocarpus capitatus PACIFIC NINE-BARK FAC+ Rosa nutkana NOOTKA ROSE FAC Salix ssp. WILLOW FAC Spiraea Douglasii DOUGLAS SPIRAEA FACW ** Stratum:TREES Acer macrophyllum MAPLE,BIG-LEAF FACU Alnus rubra ALDER RED FAC Pseudotsuga mcnziesii FIR,DOUGLAS FACU Thuja plicata CEDAR, WESTERN RED FAC Tsuga heteroph_ylla HEMLOCK, WESTERN FACU- FILE:ATEC/PROIECIS/LMSCO/SWOFFARD/WLDELIN.DOC 1 ;lot 41JIUM ivg,wi]t bP6 f ter'�-, J-)It, il,j f I If P'V.'f 80 !j YJ1 1-CIVOci ma)"', "'Vi u1jq)j,-/ J"'!C) OX,L;4A.A Y YA :A XJAJ8 J80 J11,TTA') iAq/J i A P Li 'I IqAtA ),/I,,j,jq p 4! f,,,q 'fir A4 f 3 -ill i'l)t,.Iq A OOV, 1:.")34 -33M W"!J-Oki .3111AR U.A.-4 AJUJA JOU Al VIA /Nal�13111 5uil(MI.) V5131?Tli >7)0A1A311 MASON CO. ENVIRONMENTAL CHECKLIST Page 1 A. BACKGROUND 1. Name of proposed project, if applicable: 2. Name of applicant: 1 on G1-o7JGl�J 3. Address and phone number of applicant and contact person: l0 2 pono� I-h Sbl o 673 051 l%a_ 973,32 4. Date checklist prepared: 5. Agency re nesting checklist: �IuSo�'1 �OGf/� �e of Col1lpUh1�f� 4�-e o 6. Proposed timing of sched�le (including phasing, if applicable): 10A . 7. Do you have any plans for future expansion, or further activity related to or connected with this proposal? If yes explain. � 1 SJ�r �i�yle ih 7G1�v1/-� 8. List any environmental information you know about that has been �prepared, or will bepepared, directly related to this proposal. 9. Do you know whether applications are pending for governments approvals of other proposals directly affecting the property covered by your proposal? If yes, explain. 1yo h e 10. List any government approvals or permits that will be needed for your proposal, if known. Aggotl Co ; ��0 D&Ic'1 o �is� d Ca�c�� flu o f r(S-el-5 E R A MASON CO. ENVIRONMENTAL CHECKLIST Page 2 > > Give a 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) �� � q S,yl�ll hyd�-v�l�'crric ehr:'f�i1of- �h�rrely vn fog usc� o/► /� >q, iVf d qm v►- wi e j/ G1 pPrvX. g �� °wl�e� ,G/ 7,v117' s C?s a h,Y c!;IcIlli-ems 6 y Toms Z k, near where t Nilters T/�e iy�f wQu%� ,hc ac:css rho s.�ul� sc so P��crty c?/7c/41,s be G�iG�er-tc�d through uhcuT l�scc� ' et" V -: > L . heolk Ten6,s k. The crisc�,ur9c-ol e lid yeliej-4110, person to understand the precise location of your propo 12. What is the location of the proposal. Give sufficient infop, and range, if sed project, rmation for a including a street address, if any, and section, townshi 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. Take / 6/1,L'ifiSC' ���t 1'/-PA17 B. ENVIRONMENTAL ELEMENTS: 1 EARTH: a. General description of the site (circle one): Flat rolling hilly, steep slopes, mountainous, other b. What is the steepest slope on the site a ( pproximate percent slope)? l,(/17eY(f lohvJcc� l5 ro asC C. What general types of soils are found on the site (for example cla sand J gray , peat, muck)? If you know the classification of agricultural soils, specify them and note any prime farmland. MASON CO. ENVIRONMENTAL CHECKLIST Page 3 d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. ho e. Describe the purpose, type, and approximate quantities of any filling or grading proposed. Indicate source of fill. S pctS oi'1 to e p rp pej-ty f0 . ;t"' IlC� L?CC&$S 6j/7Gl 'tof' C'1;t0tA P;Pc� IQy;ily J pravic e a phccf -oOk Nc q6,11ai-vilt*' f Could erosion occur as a result of clearing, construction, or use? If so generally describe. No' Sep% hci s �'XC�IINn� ct!rccihq i s p/a,017C- . y i?Q�, ve Sic cis s 9- About what percent of the site will be covered with impervious surfaces after project constructions (for example, asphalt or buildings)? L&SS 74cr17 p v/ h. Proposed measures to reduce or control erosion. or other impacts to the earth, if any: Xe p/uH�,n�, whehE W;schcitVed 4�-q�cF i s f e lc�c�sec>/ f ��s; f I�olh� 'i-e45- 2. AIR: a. What types of emissions to the air would result from the proposal (i.e. dust, automobile, odors, industrial wood smoke) during construction and when the project is completed? If any, generally describe and give approximate quantities, if known. #ci1C, Ehii s�jvh5 � 7`�iC� �R Sc �l�9 e- Po,.vere� �ljc�Qyo� h�� y � � MASON CO. ENVIRONMENTAL CHECKLIST Page 4 b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. f7b C. Proposed measures to reduce or control emissions or other impacts to air, if any: 3. WATER: a. Surface: 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 a what stream or river it flows into. ppropriate, state 2) Will the project require any work over, in, or adjacent to within 200 feet) the described waters? If yes, please desU a and attach available plans. p, G , , 05SS;1.2% ous& ( g X 3) Estimate the amount of fill and dredge material that would be place 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. So�NE �ar�! hus- alp-eoc�y '4eel, .,novc--� klifl7i,9 76C.' o-FP More is PlgnAed. 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. FM9570 Sep Dee/qJr��ioh *h�) 5;0`yj e - �o A l(e r � MASON CO. ENVIRONMENTAL CHECKLIST Page 5 5) Does the proposal lie within a 100-year floodplain? If so, note locati on the site plan. no on 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. i7 0 b. Ground: 1) Will ground water be withdrawn, or will water be discharged to ground water? Give general description, purpose, and approximate quantities, if known. 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. hone C. Water Runoff (including storm water): 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? oc u If so describe. C �� �'Ho h? ��aur� 5uf G ce. �uh o (6"X�y '9 (p4 ��we��oOs(f (�'Xi `1 k-%)/ 90 info c ac�n f 2) Could waste materials enter ground or surface waters? If so, generally describe. e rJ0 • F Page 6N CO. ENVIRONMENTAL CHECKLIST d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: NNIMMl scd �l inaye is good. Rep%a�77I* ,y k1hc_"-e e'lf-7A s iAr-hed, h cr 6ec� 4. PLANTS: a. Check or circle types of vegetation found on the site: Zdeciduous tree:jftmaple spen, other evergreen tree: ar, pine other shrubs grass _ pasture — crop or grain _ wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other — water plants: water lily, eelgrass, milfoil, other _ other types of vegetation '�O�✓ uCeh� ;h fake b. What kind and amount of vegetation will be removed or altered? Sv C. List threatened or endangered species known to be on or near the site. l2G/7 e d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any: �,'7 where se l ova s ihQvec�. stC( 9 �sio c,cc//y ul�%rs Z Plac l,�i 9 d,4_i�YWOQo l 571u117ps etc a/ohq eon cs 9 q MASON CO. ENVIRONMENTAL CHECKLIST Page 7 5. ANIMALS a. Circle any birds and animals which have been observed on or near the site or are known to be on or near the site: birds: hawk, heron, ea le, songbirds other . sonic//��us1 A(u�,�S mammals: deer, bear, elk beaver, other . fish: bass, salmon, trou herring, shellfish, other r, . . . b. List any threatened or endangered species known to be on or near site. ha�E r the C. Is the site part of a migration route? If so, explain. �timlvclef d. Proposed measures to preserved or enhance wildlife, if any: fti N l�i�J he u e R ve /e 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. W4�e� 0'V9ertNral o�. Side PK�joosC E/eC'JIici V b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally describe. /7G C. What kinds of energy conservation features are included in the plans of this proposal? List other proposed measures to reduce or control impacts, if any: energy MASON CO. ENVIRONMENTAL CHECKLIST Page 8 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. Pe 1) Describe special emergency services that might be required. h e�N 2) Proposed measures to reduce or control environmental health hazards, if any: this 57ysfe,01�1 b. Noise. HUB, `7eq,�, but �i�ne fo �✓� rhi�i�i zG�� 6 � y cles:.Fyn 1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? . 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)? Indicate what hours noise would come from the site /S�eml C�CIGl�j�/J�Gn� ` alp-&eay e-lawd 3) Proposed measures to reduce or control noise impacts, if any: /10%'6? OXe l 716. 8. LAND AND SHORELINE USE: a. What is the current use of the site and adjacent properties? MASON CO. ENVIRONMENTAL CHECKLIST Page 9 b. Has the site been used for agriculture? If so, describe. yl D C. Describe any structures on the site. Sly o P d. Will any structures be demolished? If so, what? I7�j e. What is the current zoning classification of the site? For�s� f. What is the current comprehensive plan designation of the site? o Cale90 Y /o►rn1s 9. If applicable, what is the current shoreline master program designation of the site? h. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify. von �� �'holrJ i Approximately how many people would reside or work in the completed project? dn& rnah, 176Z1/C le'ocdgll, ale 63. /,vNs in his si t// �I'Me 04 Me prcFt?i-t y j. Approximately how many people would the completed project displace? n ohe k. Proposed measures to avoid or reduce displacement impacts, if any: MASON CO. ENVIRONMENTAL CHECKLIST Page 10 1. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: 9. HOUSING: a. Approximately how many units would be provi whether high, middle, or low-income housi , if any? Indicate b. Approximately how many u ' s, if any, would be eliminated? Indicate whether high, middle, o ow-income housing. C. P posed measures to reduce or control housing impacts, if any: 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? `'� h?4sohry 0 - rock b. What views in the immediate vicinity would be altered or obstructed? /70176) C. Proposed measures to reduce or control aesthetic impacts, if any: kc) LA s siru//, �ci'ie?� �rus;ve as pos5i;�/e � f MASON CO. ENVIRONMENTAL CHECKLIST Page 11 11. LIGHT AND GLARE a. What type of light or glare will the proposal produce? What time of day would it mainly occur? b. Could light or glare from the finished project be a safety hazard or interfere with views? ho C. What existing off-site sources of light or glare may affect your proposal: rope d. Proposed measures to reduce or control light and glare impacts, if any: 12. RECREATION: a. What designated and informal recreational opportunities are in the immediate vicinity? �'�y� A1l na�u _N✓0� y b. Would the proposed project displace any existing recreational uses? If so, describe. no C. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: MASON CO. ENVIRONMENTAL CHECKLIST Page 12 13. HISTORIC AND CULTURAL PRESERVATION: a. Are there any places or objects listed on, or proposed for, national, state, or local preservation registers known to be on or next to the site? If so, generally describe, ry b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. `JOne C. Proposed measures to reduce or control impacts, if any: 14. TRANSPORTATION: A. Identify public streets and highways serving the site and describe proposed access to the existing street system. Show on site plans, if any. fed. �q �ec /0� c ��a,, �� > �11 Ac.h�> oi� C 'oCIUSC-ey b. Is site currently served by public transit? If not what is the a distance to the existing street system. Show on site plans, if anpproy. �O C. How many parking spaces would the completed project have? How many would the project eliminate? d Will the proposal require any new roads or streets, or improvements to existing roads or streets, not including driveways? If so, generally describe (indicate whether public or private). NO r � MASON CO. ENVIRONMENTAL CHECKLIST Page 13 e. Will the project use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe. h0 f How many vehicular trips per day would be generated by the completed project? If known, indicate when peak volumes would occur. Y7vi'7L g Proposed measures to reduce or control transportation impacts, if any: �'✓�4 15. PUBLIC SERVICES: a. Would the project result in an increased need for public service (for example: fire protection, police protection, health care, schools, other)? If so, generally describe: hD b. Proposed measures to reduce or control direct impacts on public services, if any: IY4 16. UTILITIES: MASON CO. ENVIRONMENTAL CHECKLIST Page 14 a. Circle utilities currently available at the site: electricity, natural gas, /water, refuse service, telephone, sanitary sewer, septic syste ath (yusc��ihe Pc��c'J-e 9�n E' tof 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 �/y C(I-o e /ec t�-i C. P v cv e t- c Signature: 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 Submitted: 6 O� ESA LISTED SALMONIDS CHECKLIST Applic A' / at information Project Information Name AlOn (� OIJLIt P Name yro� u"� P� e c t �F� hone -3 6 0 6133 4,1-3 l tt� o� Cl Location„ %eh��s l k /n�?5on Coc(h7y Description This worksheet was designed to help project proponents and government agencies identify when a project needs further analysis regarding adverse effects on ESA (Endangered Species Act) listed salmonids . Salmonids are salmon, trout and chars, e.g. bull trout . For our purposes, "ESA listed salmonids " is defined as fish species listed as endangered, threatened or being considered for listing_ If ESA listed species are present or ever were present in the watershed where your project Will be Iocated, your project has the potential for affecting the m, and you need with the ESA. The questions in this section will help determine if the ESA listings comp ly impact your project. The Fish Program Manager at the appropriate Department of Fish and Wildlif ( regional office can provide information for the following two Questions e DFW} 1 . Are ESA listed salmonids currently present in the watershed in which your project will be located? Yes No c-**' Please describe. 2 . Has there ever been an ESA listed salmonid stock present in this watershed? Yes No Please describe . Uncertain If You answered "yes" to either of the above Questions, you should complete the remainder of this checklist. September 1999 - 1 • thePROJECT projectgpECIFICgs an�q Pic�t4uestions in this sedtion are specific to y. 1 • Name of watershed: 0001 CG(/1o1� 2 • Name of nearest waterbody: T� 3 • What is the distance water? from this project to the nearest body of Often a buffer b��bet 11 ween O qtV Te oIs �� negative i Project and a stream -.,l impact to fish. can reduce the chance of a /J (k: e !o 6ve1`/a/-ls 6-0 -S L' 4 • What is the current land use between Potentially affected water body the project and the �pfesf Y (Parking Lots, farmland, etc) 5. Is the project above a : ' natural permanent barrier 1�j1 r ' (waterfall) Yes No L.lGf/�u� natural tem porary barrier (beaver ' man-made barrier (culvert, Pond) Yes No � dam) other (explain) ; jam o� s-� Yes No f0!li�f��iCUSr; Q� /a(riCh �`j�/ /�e� ski ant(i o �';sh,� �v;/1�e 6• If Yes, are there any resident salmonid populations above the blockage? yes No r/ Don I t know 7• What percent of the (including protect will be impervious surface 5 pavement & roof area) ? Tofa/ %��rrv�oas s�rf�'�c� (hoo� afc�o,J wil/ be czzwd /55 5 . f l September 1999 2 PTBH MIGRATION: The following Questions will help determine if this Protect could interfere with migration of adult and Juvenile fish. Moth increases and decreases in grater floxs caa affect fish miQzatioa. 1 • Does the project require the withdrawal of: i • Surface water? Yesil Amount 10 No Q d oU DD Name of surface water body �D ii .. Ground water? Yes No 4--" Amount From where Depth of well 2- Will any water be rerouted? Yes No If yes, will this require a channel chap e? P�P� �o Tehas�^i �rr`jN�e i preseh�/ g o'� uU'1l�y 3 • Will there be retention or detention '�t ° � ponds? YYes � No If yes, will this be an infiltration pond or a surface 'GesS 174� !Wo Cla, discharge to either a municipal storm water system or a surface water body? JA DiSchcr a'hyviRy. �� /Ge �`0 7��zjs 4 5 If to a surface water discharge, plea waterbody. se give the name of the 4 . Will this project require the building of new roads? YeS No y Increased road jea reaching a streamge may affect the timing of water and may impact fish habitat• 5. Are culverts proposed as part of this project? yes No y 6. Will topography changes affect the duration/direction o runoff flows? yeS No � f If yes, describe the changes . 7 . Will the project involve any reduction of the floodway or floodplain by filling or other partial blockage of flows? Yes No c/ If yes, how will the loss of flood storage be mitigated by Your project? September 1999 3 QUALITY: The following Questions this Project could adversel will help determine if can cause problems for listeed�act water Quality• such impacts Hater Quality can be wade •rorse b species. y runoff from teerature, discharging contaminants, etc. '"r-ious surfaces, altering water 1 Do You know of an streams within thispwattershed?thYeSter 4ualit in any of the �' If yes, describe . No, 2 . Will your project either reduce or over a waterbod Y• Yes increase shade along or No z R�O�'a1 ° / f shading vegetation or the building of structures such as docks or floats often result in a change in shade. 3 . Will the project increase nutrient loading or have the Potential to increase nutrient loading or contaminants (fertilizers, other waste discharges, or runoff) waterbody? Yes Noy/ to the 4 • Will turbidity be increased because of construction of project or during operation of the project? Yes the en In-water or near water work will oftNo increase turbidity. 5 • Will your project require long term cleaning, maintenance, i . e. bridge highway salting, chemical sprays for vegetation management, clearing of parking lots? Yes No If Yes, please describe. September 1999 4 VEQB'TATION s f f The following Questions if the Project will affect ri are designed to determine adversely imPactin Pariah ve g salmon. getation, thereby, 1 • Will the project involve the r the stream banks? removal Yes No of any vegetation from �/ es�c -PT' -for 0 5mA111 �ortpe? Chaphel If Yes, please describe o amount and t the existing conditions, and he i���ke house type of vegetation to be removed. 2 ' If any vegetation is removed, do Yes ,/ � No If yes, what you plan to will plant? SU . p� types Of. plants will ,r you use? /� l/e y �'/� ��dyj �'�?s %- -,ro% r� Scptcmber 1999 5 RESOURCES Washington Department of Fish wnt'w.wa n�/�,d ,/ and Wildlife Website This site has useful information on fish habitat . Washington Department of Ecology Website www.wa gov/ecolo v/ Click on the Water Quality button on the left side of t National Marine Fisheries Services his Page . Evolutionarily Significant Website www.nwr.noaa nv Unit (ESU) maps can be found at Go to this site and then click on the ESA Salmon button. NOTE; Most applicants should have the info answer most of the Questions in this checklist. AdditionalY to information will need to be if it appears that the if by local and state agencies species. Project is likely to affect ESA listed ScPtembcr 1999 _ 6 MASON COUNTY f ENVIRONMENTAL CHECKLIST y Purpose of Checklist: MCGr yb _ au The State Environmental Policy Act (SEPA), chapter 43.21 C RCW, requires all governmental agencies to consider the environmental impacts of a proposal before making decisions. An environmental impact statement (EIS) must be prepared for all proposals with probable significant adverse impacts on the quality of the environment. The purpose of this checklist is to provide information to help you and the agency identify impacts from your proposal (and to reduce or avoid impacts from the proposal, if it can be done) and to help the agency decide whether an EIS is required. Instructions for Applicants: This environmental checklist asks you to describe some basic information about your proposal. Governmental agencies use this checklist to determine whether the environmental impacts of your proposal are significant, requiring preparation of an EIS. Answer the questions briefly, with the most precise information known, or give the best description you can. You must answer each question accurately and carefully, to the best of your knowledge. In most cases, you should be able to answer the questions from your own observations or project plans without the need to hire experts. If you really do not know the answer, or if a question does not apply to your proposal, write "do not know" or "does not apply". Complete answers to the questions now may avoid unnecessary delays later. Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations. Answer these questions if you can. If you have problems, the governmental agencies can assist you. 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. Use of Checklist for Non-project Proposals: Complete this checklist for non-project proposals, even though questions may be answered "does not apply". IN ADDITION, complete the SUPPLEMENTAL ACTIONS (part D). There is a $200.00 fee required for the processing of the checklist. Please make your check payable to "Mason County Treasurer." For non-project actions, the references in the checklist to the works "project", "applicant", and "property or site" should be read as "proposal", "proposer", and "affected geographic area", respectively. MASON CO. ENVIRONMENTAL CHECKLIST Page 1 A. BACKGROUND 1. Name of proposed project, if applicable: GFoljan Hya°Foelectr i c 2. Name of applicant: �o n GJ-o�JGh 3. Address and phone number_ of applicant and contact person: lD2 h 36a 6S3 /�GT 4. Date checklist prepared: :�GfGf o2 S�.240Z 5. Agency requesting checklist.- A'Iason �OGfri� /�e�o/ of Coyropl"f�l 6. Proposed timing o schedule (including phasing, if applicable): CA 7. Do you have any plans for future expansion; or further activity related to or connected with this proposal? If yes explain. A'9_ .boss�G i1�y W Ala jv CAhm 4si�a/j��r1`ad% 0�eo c s lelml/l 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. 9. Do you know whether applications are pending for governmental ' ATP Z'D&%0 approvals of other proposals directly affecting the property covered by,/�Tr 0A5okv your proposal? If yes, explain. �pe,,�,,f�,.�e�(4,- .�o lit G • ,„,��- rts�•����' 10. List any government approvals or permits that will be needed for your tM,4 /l-4 e7r4 proposal, if known. Mason Co ; !Wa De'o7 07 ris/ 'J Game/ Ala of Eli9lheeks l I" ERC MASON CO. ENVIRONMENTAL CHECKLIST Page 2 11. Give a 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. p&I#ih9 in 5#1a11 hy4velecJrlc 9ehemlof- �h�►rely vn fay usc� on /aW075 a oaihegl ,Gym s'eff d Ch ld -erg 6 Terns L k. A dgrr► ov wle,-� nprro)e. 8 �j�� would he ,�u/# ackoss 7hc- small s�sohal s/jmh, n�ar where 1t enters 7hep�,petty (),Mps enc/0Sea). !'aht ��'7�{e -�/our b erfed throuyA ctboN-t /soy cf 8 ''P/pe n&Olk Tenas L k. The c�iscAakged wmtt� , waild 9° lo.7c'nrs L k 12. What is the 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. Ta/C� C�rShry►�n�Sgircasc� �� �'f o`yj f�oojoorf 9r. 'ro 6hd. 6'z2 ht or1 FS. ;Zq 3 ter. to arahy� f'naf- e� tI-�es o� �7: ,-17yeh dt;veea y Of R4GJ,Tz3�l oZ ,N��F4 e�eICT&-s-L4 4 B. ENVIRONMENTAL ELEMENTS: 1. EARTH: a. General description of the site (circle one): Flat rolling, hilly, steep slopes, mountainous, other b. WI-hat is the steepest slope on the site (approximate percent slope)? where Ye l-v Jec` � a/�o 5�l 5 r �Ji /fiq y,6 e ,?07 �Mx C. What general types of soils are found on the site (for example, cl� sad, grav , peat, muck)? If you know the classification of agricultural soils, specify them and note any prime farmland. MASON CO. ENVIRONMENTAL CHECKLIST Page 3 d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. e. Describe the purpose, type, and approximate quantities of any filling or grading proposed. Indicate source of fill. Lowerjhy Some high Pots 611, tAe propel-ty l�o i/OpI-oi/e c?CCess 0/7d Io 1Q Ci 11-tAte P►P'e la y,1,y J pro vice a PACC 1ok tie genes-do,, 411 A,/1 �s From lAe a rea 6ejnq kvo,4&d - f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. No. Soi% has' excelled dl-Pl'nq je) 0 pep��hr�n c� h���ve Species g. About what percent of the site will be covered with impervious surfaces after project constructions (for example, asphalt or buildings)? L&s 7A- o4 o vi h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: /P�'P/a�I ; p1tcili9 �/�-� f /ohs Q /vh9 whehe cl15CAQged kva?cl- is 1-e1e415C701 2. AIR: a. What types of emissions to the air would result from the proposal (i.e. dust, automobile, odors, industrial wood smoke) during construction and when the project is completed? If any, generally describe and give approximate quantities, if known. �anC, Frpls�ions trioin 7`! 9aso lit?e paoveted 901C'"ayo,- her/ GiSe� �tro�Ic� 6e. q��a1/y �e��tceq� or �/i�ning7`�! MASON CO. ENVIRONMENTAL CHECKLIST Page 4 b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. ()o C. Proposed measures to reduce or control emissions or other impacts to air, if any: 4/41 3. WATER.- a. Surface: 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. 7'ena5 L k Un n(rm(f4' sea song I s�-� �a�, Lf 2) Will the project require any work over, in, or adjacent to (within 200 feet) the described waters? If yes, please descn a an attach available plans. �A e Ro wehl vase 3) Estimates the amount of fill and dredge material that would be place in i �j or removed from surface water or wetlands and indicate the area of the site that would be affected. Indicate the source of fill material. Sortie earl, has already �eeh move4f witAin ;;?w' o-P tv��,l�r,�s. No more i5 101qhAed. Yfel i�PGc�asressr►� �p���x 1�c✓e �� e� 4) Will the proposal require surface water withdrawals or diversions? I�✓c Cu��✓ i 71P Give general description, purpose, and approximate quantities if known. Fleas-0 see "Peclott-" t ion of I nkht)'on Yes S'ohi� watev wouY e ofi'�10 tc' -{'ram 57 �o I�`i'e MASON CO. ENVIRONMENTAL CHECKLIST Page 5 5) Does the proposal lie within a 100-year floodplain? If so, note location ems' on the site plan. 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. ro b. Ground 1) Will ground water be withdrawn, or will water be discharged to ground water? Give general description, purpose, and approximate quantities, if known. 90 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. hop e C. Water Runoff (including storm water): 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. No � 141416ff will occur JIo in y`ound 5of fG ce. GnC4 poweNhOG1Sc (g'xiI/� k,;�j 9a into ac/Jaceitf 2) Could waste materials enter ground or surface waters? If so, generally describe. nD MASON CO. ENVIRONMENTAL CHECKLIST Page 6 d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: 1Va1100 sc'! dru/na�� �s 9aorl, �e�1a�j�`;,,y kvhe"e hc4s iee,� rl i sIu,1-, ed, 4. PLANTS: a. Check or circle types of vegetation found on the site: Z eciduous tree: &1de , ple, spen, other evergreen tree: pine other shrubs grass _ pasture — crop or grain —wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other —water plants: water lily, eelgrass, milfoil, other .�fo/✓'q��h f �h ��k6 _ other types of vegetation b. What kind and amount of vegetation will be removed or altered? S'6#2e C. List threatened or endangered species known to be on or near the site. d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any: wkere so l W� s Qv�c . s?`a��jsl/-n 9 Y�r�u�� �iveFsc� 9 how t�. 571uep5 etc a/ohj ec��� MASON CO. ENVIRONMENTAL CHECKLIST Page 7 5. ANIMALS a. Circle any birds and animals which have been observed on or near the site or are known to be on or near the site: birds: hawk, heron, ea le, songbirds other . Srp/a/foays, cfuCkS mammals: deer, bear, elk beaver, other . .Co. ,wqq t-. . . fish: bass, salmon, trou herring, shellfish, other . . . . . . b. List any threatened or endangered species known to be on or near the 5 , /P�u site. hv/�C cj -�qe ""I 4S.S2Ql.4�/F.�t�✓' S'��e �1� C. Is the site part of a migration route? If so, explain. �iOMpefeY S'aMP5 97ojX,0-ryn65� it Jh W)'14 Y d. Proposed measures to preserved or enhance wildlife, if any: Zea ve 7`h e A/i, ha u a s with devefopeol a s p,)ss%6/e 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. WOE e)- �"41,we�; Jok general On- Site Parr-,Posed' �/ecfYi�i7�y b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally describe. 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: Reds C po5si l -Pu e l 4 �i Ye w, ovW co h su/n pp on MASON CO. ENVIRONMENTAL CHECKLIST Page 8 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,9 1) Describe special emergency services that might be required. 2) Proposed measures to reduce or control environmental health hazards, if any: PL411inq in this 5y5re`n b. Noise. YmM rJeQr twh ine, to he ml'nhiri zed 6y deg' grr 1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? yIG1J(-' 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)? Indicate what hours noise would come) from the site h 5 eavy C�q�iPrllerl 9a e (hlug� G ll-&qC(y G'o/I�r 3) Proposed measures to reduce or control noise impacts, if any: Np"j& 0'JrCg1 7.6, 8. LAND AND SHORELINE USE: a. What is the current use of the site and adjacent properties? �v�eS7' A17a MASON CO. ENVIRONMENTAL CHECKLIST Page 9 b. Has the site been used for agriculture? If so, describe. 1'I D C. Describe any structures on the site. SIi D P d. Will any structures be demolished? If so, what? 170 e. What is the current zoning classification of the site? Foke: f. What is the current comprehensive plan designation of the site? lt-of"ect h q�m+ .m J tvel1c r a16 O cc(16�0 -Y I we-1101hd( , g. If applicable, what is the current shoreline master program designation of �(f�j� the site? mil" h. Has any part of the site been classified as an "environmentally sensitive"-A4-4Q�&, 5d4ge-&-/ area? If so, specify. UDn '� �hoir/ G;vc i. Approximately how many people would reside or work in the completed project? On& jnah� GUoadgl/, age 6�, l%vas ih hrs small y�o,�„/� hoiric�. hope to W04 paF/ tl',Oe on The p&F&i- -y. j. Approximately how many people would the completed project displace? h©he k. Proposed measures to avoid or reduce displacement impacts, if any: MASON CO. ENVIRONMENTAL CHECKLIST Page 10 I. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: 9. HOUSING: a. Approximately how many units would be provi , if any? Indicate whether high, middle, or low-income housi �J b. Approximately how many u ' s, if any, would be eliminated? Indicate whether high, middle, o ow-income housing. C. P posed measures to reduce or control housing impacts, if any: 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? `� h?Qsahry Of- rcck b. What views in the immediate vicinity would be altered or obstructed? /70116) C. Proposed measures to reduce or control aesthetic impacts, if any: a s srrul/, pl'c� MASON CO. ENVIRONMENTAL CHECKLIST Page 11 11. LIGHT AND GLARE a. What type of light or glare will the proposal produce? What time of day would it mainly occur? h&)n6 b. Could light or glare from the finished project be a safety hazard or interfere with views? h© C. What existing off-site sources of light or glare may affect your proposal: hoNE d. Proposed measures to reduce or control light and glare impacts, if any: haii2 12. RECREATION: a. What designated and informal recreational opportunities are in the immediate vicinity? b. Would the proposed project displace any existing recreational uses? If so, describe. no C. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: MASON CO. ENVIRONMENTAL CHECKLIST Page 12 13. HISTORIC AND CULTURAL PRESERVATION: a. Are there any places or objects listed on, or proposed for, national, state, or local preservation registers known to be on or next to the site? If so, generally describe. PO b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. /)0he C. Proposed measures to reduce or control impacts, if any: /l'f1 14. TRANSPORTATION: A. Identify public streets and highways serving the site and describe proposed access to the existing street system. Show on site plans, if any. rarest R. ;24 Aee /0'-4 Z"ltehh*,Ph chC/-0 b. Is site currently served by public transit? If not, what is the approximate distance to the existing street system. Show on site plans, if any. h� C. How many parking spaces would the completed project have? How many would the project eliminate? ✓14 d. Will the proposal require any new roads or streets, or improvements to existing roads or streets, not including driveways? If so, generally describe (indicate whether public or private). P, MASON CO. ENVIRONMENTAL CHECKLIST Page 13 e. Will the project use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe. P10 f. How many vehicular trips per day would be generated by the completed project? If known, indicate when peak volumes would occur. h1)nL g. Proposed measures to reduce or control transportation impacts, if any: /✓A 15. PUBLIC SERVICES: a. Would the project result in an increased need for public service (for example: fire protection, police protection, health care, schools, other)? If so, generally describe: hU b. Proposed measures to reduce or control direct impacts on public services, if any: IY4 16. UTILITIES: MASON CO. ENVIRONMENTAL CHECKLIST Page 14 a. Circle utilities currently available at the site: electricity, natural gas, water, refuse service, telephone, sanitary sewer, septic system: ousolihe 'Powei-ed 9en ergfor 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: Hy at-o e lec iL p0c)eJ- c. Signature: 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: /C�01 Date Submitted: 9/,t/;, O� ESA LISTED SALMONIDS CHECKLIST Applicant Information Project Information Name Iqo h Gko-L Name G r of a� N� � e � c � ,IGt/D � tti /-1-ojec't Phone '360 6'?3 0501 Location testers 1 k, /,1�a5 Cockh7y Description This worksheet was designed to help project proponents and government agencies identify when a project needs further analysis regarding adverse effects on ESA (Endangered Species Act) listed salmonids . Salmonids are salmon, trout and chars, e.g. bull trout. For our purposes, "ESA listed salmonids" is defined as fish species listed as endangered, threatened or being considered for listing. If ESA listed species are present or ever were present in the watershed where your project will be located,your project has the potential for affecting them, and you need to comply with the ESA. The questions in this section will help determine if the ESA listings will impact your project. The Fish Program Manager at the appropriate Department of Fish and Wildlife (DFW) regional office can provide information for the following two questions 1 . Are ESA listed salmonids currently present in the watershed in which your project will be located? Yes No c/ Please describe. 2 . Has there ever been an ESA listed salmonid stock present in this watershed? Yes No r/ Uncertain Please describe. If you answered "yes" to either of the above questions, you should complete the remainder of this checklist. September 1999 1 PROJECT SPECIFICS: The Questions in this section are specific to the project and vicinity. 1. Name of watershed: N004 Canoe l 2 . Name of nearest waterbody: �S L k 3 . What is the distance from this project to the nearest body of water? ITIViv will �a i,��o �enot5 41 Ideal )v g�iah �oh gehera?`�is c%se-to Often a buffer between the project and a stream can reduce the chance of a negative impact to fish. �/e�lGIS(go go'� 4 . What is the current land use between the project and the potentially affected water body (parking lots, farmland, etc) ? �oPc's� 5. Is the project above a:• natural permanent barrier (waterfall) Yes !// No L.l 1 bWAIV • natural temporary barrier (beaver pond) Yes No z/ • man-made barrier (culvert, dam) Yest/ No • other (explain) : 2>am or) ScRSoi'!a) 9�1 act /7o ! /h) AolvetAoage at lower �hol ' Pike wi// be ad(� swill 6. If yes, are there any resident salmonid populations above the blockage? Yes No 4-"' Don It know 7 . What percent of the project will be impervious surface (including pavement & roof area) ? 7'ofa f'-4ce (hoof ak&A) wi aiDal P65r5�, September 1999 2 FISH MIGRATION: The following Questions will help determine if this Project could interfere with migration of adult and Juvenile fish. Both iecreases and decreases in water fiow's can affect fish migration. 1. Does the project require the withdrawal of : i . Surface water? Yes i--' No Amount 7o C[boi 00 Name of surface water body ii .. Ground water? Yes No 4,"' Amount From where Depth of well 2 . Will any water be rerouted? Yes No If yes, will this require a channel change? W fed w;11 o 7hro� h Pipe, -to 'rehas 1k where itpyesen f ly goes. /4'lQf"af-ity o�`_'/ow W%1/ nod" 6I 3 . Will there be retention or detention ponds? Yes 4--" No 1-6P5s7lg17 !Wo gals. If yes, will this be an infiltration pond or a surface discharge to either a municipal storm water system or a surface water body? j�ip P/schgjc� wild fe fo T� If to a surface water dis charge,waterbody. please give the name of the 4 . Will this project require the building of new roads? YeS No c-1 Increased road mileage may affect the timing of water reaching a stream and may impact fish habitat. 5. Are culverts proposed as part of this project? Yes Noo/ 6. Will topography changes affect the duration/direction of runoff flows? Yes No '--� If yes, describe the changes . 7 . Will the project involve any reduction of the floodway or floodplain by filling or other partial blockage of flows? Yes No [/ If yes, how will the loss of flood storage be mitigated by your project? September 1999 - 3 WATER QUALITY: The following questions will help determine if this project could adversely impact water quality. Such impacts can cause problems for listed species. Water Quality can be made worse by runoff from impervious surfaces, altering water temperature, discharging contaminants, etc. 1. Do you know of any problems with water quality in any of the streams within this watershed? Yes Now_ If yes, describe. 2 . Will your project either reduce or increase shade along or over a waterbody? Yes No z/ Removal of shading vegetation or the building of structures such as docks or floats often result in a change in shade. 3 . Will the project increase nutrient loading or have the potential to increase nutrient loading or contaminants (fertilizers, other waste discharges, or runoff) to the waterbody? Yes No 4. Will turbidity be increased because of construction of the project or during operation of the project? Yes No 1--' In-water or near water work will often increase turbidity. 5. Will your project require long term maintenance, i.e. bridge cleaning, highway salting, chemical sprays for vegetation management, clearing of parking lots? Yes No 4-**- If yes, please describe. September 1999 4 VEGETATION: The following Questions are designed if the project will affect riparian vegetation thereby, adversely impacting salmon. I . Will the project involve the removal of any vegetation from the stream banks? Yes No ey(Cepj J o l- s�alj, dot-#)ed� ChOpnel to -If yes, please describe the existing conditions, and he �htake house amount and type of vegetation to be removed. 2 . If any vegetation is removed, do you plan to re-plant? Yes -*"' No If yes, what types of. plants will you use? W ee Sol& Ule eel �idn ti'Gj s 90/- 11ie -to rip/a h f ih�� 9ehous s�eci�s . September 1999 - S RESOURCES Washington Department of Fish and Wildlife Website www.wa.g )v/wdfw/ This site has useful information on fish habitat . Washington Department of Ecology Website www.wa.gov/ecology/ Click on the Water Quality button on the left side of this page . National Marine Fisheries Services Website Evolutionarily Significant Unit (ESU) maps can be found at www.nwr.noaa.gov Go to this site and then click on the ESA Salmon button. NOTE: Most applicants should have the information necessary to answer most of the questions in this checklist. Additional information will need to be obtained by local and state agencies if it appears that the project is likely to affect ESA listed species. September 1999 6