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HomeMy WebLinkAboutSEP2019-00008 Belfair Water Line Extension Belfair Park n Ride Multiple Parcels - SEP Determinations - 7/8/2019 MASON COUNTY Planning Division of Community Development 615 W. Alder St. Bldg. 8, Shelton,WA 98584 360-427-9670 ext 352 DETERMINATION OF NONSIGNIFICANCE (WAC 197-11-340) SEP2019-00008 Description of Proposal: BELFAIR PARK AND RIDE WATERLINE EXTENSION-GRADING PROJECT Proponent: DAVID, OVERTON Location of Proposal: 25200 NE STATE ROUTE 3 Parcel Number: 123214-100000; -300130; -400000; and 123280003000 Legal Description: SEC E21;W22;and NE28 Twn 23 R 1 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 360-427-9670 x352 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 the Dept. of Community Development, 615 W Alder St, Shelton WA 98584 by 07/22/2019. Appeal of this determination must be filed with a 14-day period following this final determination date, per Mason County Code Chapter 15.11 Appeals. Authorized Local Government Official bate Printed by:Ron Buckholt on:07/082019 03:15 PM Page 1 of 1 MASON COUNTY DCD SEPA Contact List Sent SEPA 2-019-GDODS5 to (check all that apply) on V E] Skokomish Tribal Nation, Nat.Res.Dept. WA Department of Commlerce ATTN: Julian Sammons reviewteam@commerce.wa.gov N 541 Tribal Center Rd., Skokomish Nation,98584 jsammons@skokomish.org U.S.Army Corps of Engineers dsarff@skokomiosh.org SEPA Reviewer-Jason Sweeney Skokomish Tribal Historic Preservation Officer PO Box C-3755,Seattle,98124 ATTN: Kris Miller Jason.t.sweeney@usace.army.mil 80 N Tribal Center Rd,Skokomish Nation,98584 shlanay1@skokomish.org WA Dept.of Fish and Wildlife Quinault Indian Nation SEPAdesk@dfw.wa.gov ATTN: Mark Mobbs PO Box 189,Tahola,98587 WA Dept.of Fish and Wildlife mmobbs@quinault.org ""` ATTN: Chris Waldbillig Squaxin Tribal Nation,Natural Res.Dept. 450 Port Orchard Blvd,Suite 290 2952 SE Old Olympic HWY,Shelton 98584 Port Orchard,WA 98366 jdickison@squaxin.us Chris.waldbillig@dfw.wa.gov emarbet@squaxin.us szaniewski@squaxin.us WA Dept.of Fish and Wildlife rfoster@squaxin.us ATTN: Darrin Masters F1 The Confederated Tribe of the Chehalis 450 Port Orchard Blvd, Suite 290 ATTN: SEPA Reviewer-Glen Connelly Port Orchard,WA 98366 420 Howanut Rd., Oakville,98568 Darrin.Masters@dfw.wa.gov gconnelly@chehalistribe.org WA DNR,South Puget Sound Region WA Dept.of Fish and Wildlife 950 Farman Avenue N, Enumclaw,98022-9282 ATTN: Allison Cook southpuget.region@dnr.wa.gov (Habitat Biologist-S Puget Sound Watershed) WA DNR,Aquatic Resources 1111 Washington St SE,Olympia WA,98501 PO BOX 47027,Olympia, 98504-7027 allison.cook@dfw.wa.gov and@dnr.wa.gov WA DNR,SEPA Center WA Dept.of Transportation ATTN: External Coordinator ATTN: Dale Severson PO BOX 47015,Olympia,98504-7015 P.O. Box 47440,Olympia 98504-7440: sepacenter@dnr.wa.gov OR-SEPA-REVIEW@wsdot.wa.gov - Olympic Region Clean Air Agency ATTN: Lauren Whybrew City of Shelton 2940-B Limited Ln. NW,Olympia. 98502 ATTN:Jason Dose lauren.whybrew@orcaa.org 525 West Cota St.,Shelton 98584 Mason County Transit jasond@ci.shelton.wa.us ATTN: Danette Brannin 790 E Johns Prairie Rd,Shelton,98584 Port of Shelton dbrannin@masontransit.org ATTN: Brandon Palmer Mason County PUD#1 21 West Sanderson Way, Shelton 98584 ATTN: Darrin Hall BrandonP@portofshelton.com N 21971 Hwy 101,Shelton,98584 darrinh@mason-pud1.org Dep't of Archaeology&Historic Preservation Mason County PUD#3 P.O.Box 48343,Olympia,98504-8343 ATTN: Kristin French SEPA@dahp.wa.gov kristin.french@masonpud3.org WA Department of Ecology F--j Tacoma Public Utilities-Real Property Services Environmental Review Section ATTN: Dave Letterman PO BOX 47703, Olympia,98504-7703 3628 S 35th St,Tacoma, 98409-3192 separegister@ecy.wa.gov dletterm@cityoftacoma.org WA Department of Health Mason Cty P.W.ATTN:, ATTN:Joe Laxson joe.laxson@doh.wa.gov Q Mason Cty E.H.ATTN: Other: Q Mason Cty Bldg ATTN: Agent: R Li Q�U ®d Po erll 11)'2Y1�,'n Applicant: J 0 School District: MC DCD last updated on 2/28/19 I! � SEPA Environmental Checklist Mason County P tttjt Center uw. 3 SEP ?-01 q -0b00 e ❑ Single Family DNS: $600.00 Parcel Other DNS: 0 to 9.99 acres: $730 ( Date Rcvd: 10 to 20 acres: Over 20 acres: $1100 bm( 4,�P ❑ DS/EIS: $5000 + $90 per hour 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: 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 1. Name of proposed project, if applicable: Belfair Park and Ride Water Line Extension 2. Name of applicant: David Overton 3. Address and phone number of applicant and contact person: David Overton Apex Engineering attn:Scott Ruedy PO Box 1477 2601 South 351h,Suite 200 Tacoma,WA 98401 Tacoma,WA 98409 Phone: 360-277-0595 Phone 253-473-4494 SEPA Environmental checklist(WAC 197-12-960)(MC version-non project portion omitted): 2016 1 of 12 SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portion omitted): 2016 Page 1 of 11 4. Date checklist prepared: 12118118 revised 412612019 5. Agency requesting checklist: Mason County 6. Proposed timing or schedule (including phasing, if applicable): Construction has been completed. 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. None anticipated. Water line extension is likely to allow other development to proceed under separate permitting. 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. A forest practice permit FPA 2417997 was approved on the property. 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. None known at this time. 10. List any government approvals or permits that will be needed for your proposal, if known. None anticipated. 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.) The majority of the project has been completed. A 3,746-foot-long 60'wide area was cleared and graded to accommodate the installation of a water line extension. The total area cleared was 224,760 square feet. An additional phase is anticipated which is an additional 1,807lineal feet. This will bring the total area to 333,180 square feet of total area. 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. Parcel #(s): 123214300130, 12328000300, 123214100000, 123214400000 Address: Belfair, Washington Twp/Range/Section and/or GPS location: A portion of the E% Section 21, the W% Section 22 and the NE% Section 28, Township 23 North, Range 1 West W.M. SEPA Environmental checklist(WAC 197-12-960)(MC version-non project portion omitted): 2016 2 of 12 1 B. ENVIRONMENTAL ELEMENTS 1. Earth a. General description of the site (circle one): Flat, rolling, ill steep slopes, mountainous, other: b. What is the steepest slope on the site (approximate percent slope)? The steepest slope on the site is an isolated area of 15% slope. The steepest slope of water line installation is approximately 5%. 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. Per NRCS Web Soil Survey: Alderwood Gravelly Sandy Loam Everett Gravelly Loamy Sand d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. None known 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. Grading and erosion control for water line installation. Cut= 6,823 C Y+- Fill= 1,927 CY+- Net= 4,896 CY+- Cut f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. Minimal erosion could occur, but it is unlikely due to the soil classification, minimal slopes and conditions near the site. During the construction phases, erosion more likely to happen between the months of October and April. g. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? None at this time. h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: Temporary Erosion and Sediment Control(TESC) BMP's will be implemented during site construction as well as TESC measures carried over from clearing and grading. On site grading will be reviewed and permitted by Mason County prior to any earthwork. The TESC measures will remain in place from the clearing and grading activities until the site is stabilized and with Mason County approval. TESC BMP's will be used as necessary. 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. During Construction:Dust and exhaust from vehicles and construction machinery and equipment. SEPA Environmental checklist(WAC 197-12-960)(MC version-non project portion omitted): 2016 3 of 12 b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. None known or anticipated. c. Proposed measures to reduce or control emissions or other impacts to air, if any: All construction equipment will be in proper working order and within compliance of the State regulations regarding vehicle emissions. In accordance with Mason County standards, the site will be watered, and the streets will be cleaned, as necessary, to reduce dust emissions during construction. 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. Mason County GIS mapping which was based on a predictive modeling for streams, rather than field verification, incorrectly depicts Irene Creek as a two forked stream on the portions of the project area which then crossing SR-3 flowing to the west. However, Irene Creek is only located to the west of SR-3. While the locations shown on the GIS map are topographic low spots they are not actually a stream or stream habitat area. These low spots are also depicted on the forest practice permit for the site and shown as approved crossings due to this predictive modeling mapping, however, there is not a stream on site. 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. While work was adjacent to the above described areas, there was not actually surface water, so no work occurred over, in or adjacent to the a surface water source. 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. None 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. None required. 5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. The site is not within the 100-year floodplain. See FEMA panel 5301150135C. 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. None known. 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. No. SEPA Environmental checklist(WAC 197-12-960)(MC version-non project portion omitted): 2016 4 of 12 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. There is no system proposed. 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. Source: Stormwater Where: There are no impervious surfaces proposed with the completed waterline. Storm water ultimately flows westerly to the Union River and to the Puget Sound 2) Could waste materials enter ground or surface waters? If so, generally describe. As there are no pollution generating impervious surfaces proposed, it is not anticipated that waste materials could enter the ground or surface water from the water line. 3) Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site? If so, describe. No, the site is proposed to mimic existing drainage patterns. d. Proposed measures to reduce or control surface, ground, and runoff water, and drainage pattern impacts, if any: Temporary erosion and sediment control(TESC) measures will be used both for the clearing and grading. TESC measures will remain in place and TESC best management practiced(BMP's) will be applied as necessary through completion of the site work. All disturbed areas will be stabilized by land cover and trees will be replaced, where appropriate, in accordance with the forest practice permit. 4. Plants a. Check the types of vegetation found on the site: deciduous tree: alder, maple, aspen, other x 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? Evergreen trees and bushes and shrubs were removed. The area cleared was 224,760 square feet. SEPA Environmental checklist(WAC 197-12-960)(MC version-non project portion omitted): 2016 5 of 12 c. List threatened and endangered species known to be on or near the site. None known d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any: Except for the water line easement area, the areas cleared will be replanted per the forest practice permit. (2417997) 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. birds: hawk, heron, eagle, on it other: mammals: deer bear, elk, beaver, other: fish: bass, salmon, trout, herring, shellfish, other: b. List any threatened and endangered species known to be on or near the site. The project site has not been documented to provide critical habitats for federally listed Endangered, Threatened, or Sensitive species via review of the US Fish and Wildlife Service ECOS online mapper. c. Is the site part of a migration route? If so, explain. The Puget Sound is part of the Pacific Flyway, birds that inhabit the region vary seasonally. The State of Washington Priority Habitats and Species (PHS) Mapping was reviewed as part of this review. The mapping resource did not identify any priority habitats or priority species within or immediately adjacent to the area that was cleared. d. Proposed measures to preserve or enhance wildlife, if any: None proposed. 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. Not applicable. 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: None proposed or needed. SEPA Environmental checklist(WAC 197-12-960)(MC version-non project portion omitted): 2016 6 of 12 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? No If so, describe. 1) Describe any known or possible contamination at the site from present or past uses. None known 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 known. 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. None known 4) Describe special emergency services that might be required. No special emergency services are required. 5) Proposed measures to reduce or control environmental health hazards, if any: None proposed at this time. b. Noise 1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? No noise in the area will affect the project. 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. During construction, short-term noise emitted from the use of construction equipment and activities would be created during permitted hours of construction per Title 9.36. Long term noise is not anticipated with this project. 3) Proposed measures to reduce or control noise impacts, if any: All construction vehicles are required to be muffled per existing vehicle regulations. Construction will be limited to normal construction day time hours between approximately 7AM and 10 PM during the week and 9 AM to 10PM on the weekend. Noise is regulated by Mason County Code 9.36. 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. The site has been used as working forest lands and has a forest practice permit. Uses adjacent to the site includes a church, commercial/industrial buildings and a water tank. SEPA Environmental checklist(WAC 197-12-960)(MC version-non project portion omitted): 2016 7 of 12 b. Has the project site been used as working farmlands or working forest lands? If so, describe. The site has been used as working forest lands and has a forest practice permit. 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? None If resource lands have not been designated, how many acres in farmland or forest land tax status will be converted to nonfarm or non-forest use? None 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. There are no structures where it was cleared. d. Will any structures be demolished? If so, what? No e. What is the current zoning classification of the site? General Commercial& Multi-Family Residential f. What is the current comprehensive plan designation of the site? Resource-Designated Forest Land g. If applicable, what is the current shoreline master program designation of the site? Not applicable. h. Has any part of the site been classified as a critical area by the city or county? If so, specify. No i. Approximately how many people would reside or work in the completed project? None j. Approximately how many people would the completed project displace? None k. Proposed measures to avoid or reduce displacement impacts, if any: Not applicable. L. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: No proposed measures. m. Proposed measures to ensure the proposal is compatible with nearby agricultural and forest lands of long-term commercial significance, if any: Except for the water line easement area, the areas cleared will be replanted per the forest practice permit. (2417997) SEPA Environmental checklist(WAC 197-12-960)(MC version-non project portion omitted): 2016 8 of 12 9. Housing a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-income housing. No housing provided. b. Approximately how many units, if any, would be eliminated? Indicate whether high, middle, or low-income housing. No housing eliminated. c. Proposed measures to reduce or control housing impacts, if any: No impact to housing so no measures to reduce or control housing impacts are proposed. 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. b. What views in the immediate vicinity would be altered or obstructed? No protected views are altered or obstructed by the water line and associated clearing. c. Proposed measures to reduce or control aesthetic impacts, if any: While there is no aesthetic impact associated with the water line the cleared area will be replanted per the Forest Practice Permit requirements. 11. Light and glare a. What type of light or glare will the proposal produce? What time of day would it mainly occur? No light or glare would be produced. b. Could light or glare from the finished project be a safety hazard or interfere with views? No c. What existing off-site sources of light or glare may affect your proposal? No d. Proposed measures to reduce or control light and glare impacts, if any: None proposed. 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? No recreational opportunities are designated. 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: No impacts on recreation are anticipated so no measures to reduce or control impacts are proposed. SEPA Environmental checklist(WAC 197-12-960)(MC version-non project portion omitted): 2016 9 Of 12 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. According to the Washington Information System for Architectural and Archaeological Records Data (WISAARD) there are no listed places or objects on or adjacent to the site. No structure on site or adjacent to the site is listed on, any national or state preservation registers. National/State Eligibility: No structures on or near the site have been formally shown as eligible for the national/state register. However, it is possible that properties in the vicinity built more than 50 years ago could become eligible. 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. None known 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. The Department of Archaeology and Historic Preservation (DAHP) is Washington State's primary agency with knowledge and expertise in historic preservation. They provide an online search for registered and inventoried properties, known as WISAARD. WISAARD was reviewed for this checklist. Also, The National Register of Historic Places provided by the US Department of the interior was reviewed. 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. If ground disturbing activities encounter human skeletal remains during the course of construction, then all activity will cease that may cause further disturbance to those remains. The area of the find will be secured and protected from further disturbance. The finding of human skeletal remains will be reported to the county medical examiner/coroner and local law enforcement in the most expeditious manner possible. The remains will not be touched, moved, or further disturbed. The county medical examiner/coroner will assume jurisdiction over the human skeletal remains and make a determination of whether those remains are forensic or non-forensic. If the county medical examiner/coroner determines the remains are non-forensic, then they will report that finding to the Department of Archaeology and Historic Preservation (DAHP) who will then take jurisdiction over the remains. The DAHP will notify any appropriate cemeteries and all affected tribes of the find. The State Physical Anthropologist will make a determination of whether the remains are Indian or Non-Indian and report that finding to any appropriate cemeteries and the affected tribes. The DAHP will then handle all consultation with the affected parties as to the future preservation, excavation, and disposition of the remains. 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. The site is accessed from SR-3 and Logyard Road. SEPA Environmental checklist(WAC 197-12-960)(MC version-non project portion omitted): 2016 10 of 12 r r 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? The site is not served by public transit. The nearest transit stop is at the Roy Boad Road Park and Ride which is located approximately% mile to the south. c. How many additional parking spaces would the completed project or non-project proposal have? How many would the project or proposal eliminate? No parking needed or proposed. 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). No. e. Will the project or proposal use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe. 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 non-passenger vehicles). What data or transportation models were used to make these estimates? No vehicle trips are generated. 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: No transportation impacts. 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. No, in fact a water line extension will help support fire protection in the area. b. Proposed measures to reduce or control direct impacts on public services, if any. No impact is anticipated so no measures to reduce or control impacts are proposed. 16. Utilities a. Circle utilities currently available at the site: lectricit natural gas, refuse service, telephone, sanitary sewer, septic system, a e 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. As part of the clearing and trenching a water line extension was installed. SEPA Environmental checklist(WAC 197-12-960)(MC version-non project portion omitted): 2016 11 of 12 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 Signed: Print Name of Signee: 7 ��e 0 If applicable, Position and Agency/Organization: Date Submitted: Page SEPA Environmental checklist(WAC 197-12-960)(MC version-non project portion omitted): 2016 12 of 12 123217500040T'' 123212490080 T:. 123211300060 123217500020 123217500030 123211400020 1 123219999999 123211400040: 123211390051 123211390052 123211400030 1 j 123211390011 1232 1 0001 1 123211400001 ; � 123211390012 I � I w• � 1 k 123214200070 .?"'� 123214200060 123214290082 12.3213190070 123214296083 t 3213 1 0040 T23N 1 W 123214290081 I: 123214290084 123214100000 123219999999 fMF I � 123213102000 \ `I• _, 123214200090,' �. 1 I I � I '123213400010 123214300130 123214300000 M 23214300010 I 123214400000 1 ,123213400030 123214360100 i { Y �/. 's ''rr . E r i•i-aIG'lobe 'G`e ye, i-�-abed, USDA,�US�S, E� � �4 a•ping,Aero• 123214300110 GhS�Us^e�Comm nit, Patrick, I just talked with our manager Kell Rowen about the situation. The site is greater than the maximum required setback of 225' from the wetland that sits on the County line. The NHD overlay does show a non-fish stream within proximity of the MTA site, but based on my field inspection(see photo below), we do not believe that this feature rises to the level of a regulated stream in our Critical Area Ordinance. On that basis, we are comfortable not requiring a study or letter such as what Ron has requested. However, if this project were challenged, having a letter from a biologist confirming what appears to be obvious could come in handy. Your choice. Michael 77 Ste' i vva 1 d (s Planning a�ader-ArcRender Eire Edd yew Hook—k, jcols y(Wn Help t:.:: 0« 1.3,220 0 A /I:id—SPD(TEAIR) (-70 "-� 40494W •M .. r_ _______.__ e U Masm d:❑DRAFT FEMAFIeedplain `IF 0 Marine Wddtde Heritage L y-(1' &'❑primly Habitns 9t Specieslryers ! 1-�- ff C7 Resource Ordinance lryen , ff®County BoundaryLy- - F3®Centaur layers Bi 0 10h Contours Ro t i. 3... ) d:❑20 h C.M.—(Z... t 1' t 100h Centaurs(2 mto1.1C Rarceh B U ONR Taaed P-els ^ r 6 C7 we.Districts _`, $F GeologicH—dLayw &:[j WatenirM ResourceInventory An r. 9:G Shoret:,eEmnonmenol Designai ❑C,itical Aquder Recharge Areas 4:r' G Hydralogy Lryen ff❑Me—County Pht Course l "1 ff®Wnlands-Nation lWnlands 6®NHD Water Bodies ®®NHDWater Courses DNR W.-Bodies(Fish) . II{( E:!7 DNR We,,Courses(Fish) ff Cl Mp...d Water 305b Bst 2014 ;;Q0000 +xs+woaxo ip P Town ships and Sectons i FE❑Trbal Resavniens �'•; y.p Federal Lana fryers n.FFhu EIRM o.n.h-o-.n�.d 2aersr llse map IryW bya particular pe.cemage.Cheese/rom tlr fAnlypew apdce q-- 10719939579590091 Feel >>>Patrick Holm<patrick.holm@scjalliance.com> 12/21/2018 1:44 PM>>> Thanks for the response Ron. I had originally included an attachment to the Forest Practices Application that addressed the proximity of the wetland and streams. Michael had told me he visited the site and saw no stream/wetland issues over the phone. MTA has a limited grant funding so I wanted to make sure we weren't having them do something that didn't need to be done if it was resolved as part of the FPA. Based,on your correspondence, I want to confirm that Michael's site visit assessment is not official and we need to have a wetland biologist prepare the written confirmation mentioned above. Thanks! Page 1 of 1 Ronald Buckholt - SEP2019-00008 From: Ronald Buckholt Date: 3/12/2019 12:24 PM Subject: SEP2019-00008 Dear Applicant, I am Ron Buckholt, planner with Mason County, reviewing SEPA Checklist submittal (SEP2019-00008) for an after-the-fact project involving the clearing and grading for the installation of a water line extension. Unfortunately, the subject permits are being placed on HOLD, due to the following reason(s): 1. The SEPA Checklist submittal did not include a detailed site plan. Please provide a scaled site plan depicting the scope of work and the location of project area in relationship to the property boundaries, etc. Furthermore, the SEPA checklist indicates that the project encroached along two riverine habitat areas. Please provide the subject two riverine habitat areas on the site plan, as well, so that staff can evaluate potential impacts and determine whether or not any potential restoration will be required. Stream and wetland regulations can be found in MCC 8.52.110 and 170. 2. According to the submitted SEPA Checklist,the project exceeded 200 cu.yrds. of earthwork, therefore, a grading application is required to permit the after-the-fact work. Please provide. Please address these issues in order for the review process to proceed.Thank you in advance. about:blank 3/12/2019 Mason County WA GIS Page 1 of 1 Mason County WA GIS - _ _ec — �� .. - 10, nS �] � S __\, rig' I r •I [�.11N _' a� �t�i} �•aY l rr J v • 345 j https:Hgis.co.mason.wa.us/mason/?find=123280003000 3/12/2019 ri^ %C.;.ww.'.._.... ..�.�.:�+��..®::Y" _t.1'a-r...v .•4.. •+N..♦ .y�4RN�-� +-t:..�M».M� a F � • 444 s t � Y ol VIA- i ' Mason County WA GIS Page 1 of 1 Mason County WA GIS rc by Parcel or Addre S Fiber j V *' � Continetol wA3 { orW Greens '. r� 4 I _ t �' ff I r 7 _- 1 IA �. FZ � I J , I r1f 1 F 1 �° I wry- 1v 1 J� 0.2mi , -122.78047.473Deg https://gis.co.mason.wa.us/mason/?find=123280003000 3/12/2019 FPA/N#: c� f l 7 g 9 �► WASHINGTON STATE DEPARTMENTOF Step 1 Received Date: Natural Resources Step 1 Comments Due Date: Small Forest Landowner Step 1 Decision Due Date: Long-Term Forest Practice Application Step 2 Received Date: Office Review Checklist Step 2 Comments Due Date: WDFW Concurrence Due Date: WDFW Concurrence Review Complete: c7 Step 2 Decision Due Date: STEP 1: Region: S r y FP Forester:_3 9 7o Shut down zone:15q _ -5L" ki�3a p Pt No•^1 h M0-5c.7 L-P Landowner:rrcrt-s, racrtlj3 yf i Cv,;iterd.-WroJectName: aver t okt + �SQonir 7P5 s P WRIA: WAU- Legal Description: a )� �� , a J� _ �2� a 3 �i 3 - /L41 STEP 2: Term of Long Term Application(3 to 15 years): FPA Classification: [ ] III [ ] IVG [ ] IVS Resource Review—Step 1 Strategies&Prescriptions—Step 2 [ ] Saltwater Islands [ ] Alternate Plan:attach plan [ ] Rain-on-Snow and Outside Approved WA [ ] Watershed Analysis Prescriptions [ ] Unstable Features [ ] Columbia River Gorge National Scenic Area [ ]Soils Map(Highly Erodible&Very Unstable) [ ] Timber Harvesting acres SLPSTAB [ ] Within Unstable Land forms ( ] Landslide Hazard Zonation [ ] Within WMZ of [ ]A [ ]B [ ]Landslide Polygon [ ] Within [ ]A [ ]B [ ]Forested wetland Hydric Soils [ ] Wetland Mitigation Plan [)Q Wetland 0 Forested, N A,[ylB [ ] Within RMZ/ELZ of type [ ]S [ ]F [ ]N water [�Q Streams[ ]S, Oq F, rN N,[ ]CMZ,[ ]Pond [ ] Hardwood Conversion:attach form [ ] Sensitive sites [ ] Volume greater than 5 MBF per acre [ ] Bald Eagle nest or roost within 660 feet ( ] Even-aged Harvest greater than 120 acres [ I Water Verification [ ] Ground-based equipment on slopes>40% %' Road Assessment [ ] Road construction feet [ ] RMAP# [ ] on slopes>65% Stream Crossing(s) [ ] stream crossing(s) [ ] Hatchery(TRAX code FS) [ ] Road abandonment feet [ ] Group A or B Water Supply(TRAX code DM or MU) [ ] Cooperative Habitat Enhancement Agreement [ ] Bull Trout Overlay [ ] Landowner Option Plan for Northern Spotted Owl [ ] HCP Bull Trout Population [ ] SEPA Checklist/Documents [ ] Other: ASSOCIATED NON-SCANNED DOCUMENTS—On file with the FPA/N at the region office. ( ]SEPA Checklist/Documents [ ]Large Landowner Road Maintenance and Abandonment Plan ASSOCIATED SCANNED DOCUMENTS [ ] Hardwood Conversion Form [ ] Small Landowner RMAP Checklist [ ] Shoreline Permit [ ] Wetland Mitigation [ J Conversion Option Harvest Plan [ ] Shade Documentation [ ] Water Protocol Survey [ ] FPHP Plans&Specifications [ ] DFC Printout [ ] Modification Form# [ ] Natural Regeneration [ ] Qualified Expert Report Water Classification Worksheet (XJ Marbled Murrelet Form [ ] Watershed Analysis Worksheet [ J FPBM Appendix(s) WASHINGTON STATE DEPARTMENTOF Natural Resources For DNR Region Office Use Only r FPA#: 2 I�] Step 1 d Small Forest Landowner Region: spS Long-term Forest Practices Application Received Resource and Roads Assessment Date: PLEASE USE THE INSTRUCTIONS TO COMPLETE THIS FORM. TYPE OR PRINT IN INK. 1. Landowner and Contact Person Legal Name of LANDOWNER CONTACT PERSON Southwest Kitsap,L.P_ Casey Chamblin 00 Lusignan Forestry until approval then landowner Mailing Address: Mailing Address: P.O.Box 1007 P.O.Box 1007 City, State,Zip City, State,Zip Shelton,WA.98584 Shelton,WA.98584 Phone ( 360 ) 426-1140 Phone ( 360 ) 490-6333 jfrost@lfiforest.com cichamblin@gmail.com Email: Email: 2. Landownership Information:See instructions a. ❑ No 0 Yes Are you a small forest landowner per RCW 76.09.540? If yes, Go to b. b. ❑ No ®Yes Is your entire proposed harvest area on a single contiguous ownership consisting of one or more parcels? 3. What are the legal descriptions of the areas included in this assessment? Section Township Range ENV Tax Parcel Number County See Attached 5/9/2014 1 of 4 EASTERN AND WESTERN WASHINGTON STEP 1 aNWASHINGTON STATE DEPARTMENT OF ,__ Natural Resources For DNR Region Office Use Only Step 1 FPA#: _ Small Forest Landowner Region: Long-term Forest Practices Application Received Resource and Roads Assessment Date: PLEASE USE THE INSTRUCTIONS TO COMPLETE THIS FORM. TYPE OR PRINT IN INK. 1. Landowner and Contact Person Legal Name of LANDOWNER CONTACT PERSON North Mason,L.P. Casey Chamblin C\O Lusignan Forestry until approval then landowner Mailing Address: Mailing Address.- P.O.Box 1007 P.O.Box 1007 City, State,Zip City, State, Zip Shelton,WA.98584 Shelton,WA.98584 Phone ( 360 ) 426-1140 Phone ( 360 ) 490-6333 jtrost@lfiforest.com cichamblin@gmail.com Email: Email: 2. Landownership information: See instructions a. ❑ No ❑X Yes Are you a small forest landowner per RCW 76.09.540? If yes, Go to b. b. ❑ No ©Yes Is your entire proposed harvest area on a single contiguous ownership consisting of one or more parcels? 3. What are the legal descriptions of the areas included in this assessment? Section Township Range E/W Tax Parcel Number County See Attached 5/9/2014 1 of 4 EASTERN AND WESTERN WASHINGTON STEP 1 ark WASHINGTON STATE DEPARTMENTOF IMW Natural Resources For DNR Region Office Use Only r FPA#: Step 1 Small Forest Landowner Region: Long-term Forest Practices Application Received Resource and Roads Assessment Date: PLEASE USE THE INSTRUCTIONS TO COMPLETE THIS FORM. TYPE OR PRINT IN INK. 1. Landowner and Contact Person Legal Name of LANDOWNER CONTACT PERSON North Bay Properties,L.P. Casey Chamblin CIO Lusignan Forestry until approval then landowner Mailing Address: Mailing Address: P.O.Box 1007 P.O.Box 1007 City, State,Zip City, State,Zip Shelton,WA.98584 Shelton,WA.98584 Phone ( 360 ) 426-1140 Phone ( 360 ) 490-6333 jfrost@lfiforest.com cichamblin@gnail.com Email: Email: 2. Landownership information: See instructions a. ❑ No ❑x Yes Are you a small forest landowner per RCW 76.09.540? If yes. Go to b. b. ❑ No ©Yes Is your entire proposed harvest area on a single contiguous ownership consisting of one or more parcels? 3. What are the legal descriptions of the areas included in this assessment? Section Township Range FJW Tax Parcel Number County See Attached 519=14 1 of 4 EASTERN AND WESTERN WASHINGTON STEP 1 ra WASHINGTON STATE DEPARTMENTOF Natural Resources For DNR Region Office Use Only Step 'I FPA#: — Small Forest Landowner Region: Long-term Forest Practices Application Received Resource and Roads Assessment Date: PLEASE USE THE INSTRUCTIONS TO COMPLETE THIS FORM. TYPE OR PRINT IN INK. 1. Landowner and Contact Person Legal Name of LANDOWNER CONTACT PERSON Coulter Creek,L.P. Casey Chamblin C\O Lusignan Forestry until approval then landowner Mailing Address: Mailing Address: P.O.Box 1007 P.O.Box 1007 City, State, Zip City, State,Zip Shelton,WA.98584 Shelton,WA.98584 Phone ( 360 ) 426-1140 Phone ( 360 ) 490-6333 jfrost@lfiforest.com elchamblin@gmail.com Email: Email: 2. Landownership information: See instructions a. ❑ No nX Yes Are you a small forest landowner per RCW 76.09.540? If yes, Go to b. b. ❑ No ❑X Yes Is your entire proposed harvest area on a single contiguous ownership consisting of one or more parcels? 3. What are the legal descriptions of the areas included in this assessment? Section Township Range E/W Tax Parcel Number County See Attached 5/9/2014 1 of 4 EASTERN AND WESTERN WASHINGTON STEP 1 WASHINGTON STATE DEPARTMENT OF Natural Resources For DNR Region Office Use Only r FPA#: Step 1 Small Forest Landowner Region: Long-term Forest Practices Application Received Resource and Roads Assessment Date` PLEASE USE THE INSTRUCTIONS TO COMPLETE THIS FORM. TYPE OR PRINT IN INK. 1. Landowner and Contact Person Legal Name of LANDOWNER CONTACT PERSON Overton&Associates Casey Chamblin C\O Lusignan Forestry until approval then landowner Mailing Address: Mailing Address: P.O.Box 1007 P.O.Box 1007 City, State,Zip City, State,Zip Shelton,WA.98584 Shelton,WA.98584 Phone ( 360 ) 426-1140 Phone ( 360 ) 490-6333 jfrost@lfiforest.com cichamblin@gmail.com Email: Email: 2. Landownership information: See instructions a. ❑ No ❑X Yes Are you a small forest landowner per RCW 76.09.540? If yes, Go to b. b. ❑ No ©Yes Is your entire proposed harvest area on a single contiguous ownership consisting of one or more parcels? 3. What are the legal descriptions of the areas included in this assessment? Section Township Range EAN Tax Parcel Number County See Attached 5/9/2014 1 of 4 EASTERN AND WESTERN WASHINGTON STEP 1 Owner section township range a\w tax parcel numbers county Overton&Associates 27 23 1 w 272301-3-019-1002 Kitsap Overton&Associates 27 23 1 w 272301-3-017-1004 Kitsap Overton&Associates 27 23 1 w 272301-3-026-1003 Kitsap Overton&Associates 27 23 1 w 272301-3-027-1002 Kitsap Overton&Associates 27 23 1 w 272301-3-023-1006 Kitsap Overton&Associates 27 23 1 w 272301-3-034-1003 Kitsap Overton&Associates 27 23 1 w 272301-3-033-1004 Kitsap Overton&Associates 27 23 1 w 272301-3-028-1001 Kitsap Overton&Associates 27 23 1 w 272301-3-032-1005 Kitsap Overton&Associates 27 23 1 w 272301-4-016-1003 Kitsap Overton&Associates 27 23 1 w 272301-4-015-1004 Kitsap Overton&Associates 27 23 1 w 272301-3-029-1000 Kitsap Overton&Associates 27 23 1 w 272301-3-030-1007 Kitsap Overton&Associates 27 23 1 w 272301-3-031-1006 Kitsap Overton&Associates 27 23 1 w 272301-4-019-1000 Kitsap Overton&Associates 27 23 1 w 272301-4-020-1007 Kitsap Overton&Associates 27 23 1 w 272301-4-021-1006 Kitsap Overton&Associates 27 23 1 w 272301-1-014-1001 Kitsap Overton&Associates 27 23 1 w 272301-1-015-1000 Kitsap Overton&Associates 27 23 1 w 272301-1-016-1009 Kitsap Overton&Associates 27 23 1 w 272301-1-017-1008 Kitsap Overton&Associates 27 23 1 w 272301-1-018-1007 Kitsap Overton&Associates 27 23 1 w 272301-1-019-1006 Kitsap Overton&Associates 27 23 1 w 272301-1-020-1003 Kitsap Overton&Associates 27 23 1 w 272301-1-021-1002 Kitsap Overton&Associates 27 23 1 w 272301-1-022-1001 Kitsap Overton&Associates 26,27 23 1 w 272301-1-036-1005 Kitsap Overton&Associates 26,27 23 1 w 272301-1-037-1004 Kitsap Overton&Associates 26,27 23 1 w 272301-1-038-1003 Kitsap Overton&Associates 26,27 23 1 w 262301-2-012-1002 Kitsap Overton&Associates 26,27 23 1 w 262301-2-013-1001 Kitsap Overton&Associates 26,27 23 1 w 262301-2-014-1000 Kitsap Overton&Associates 26 23 1 w 262301-2-015-1009 Kitsap Overton&Associates 26 23 1 w 262301-2-020-1002 Kitsap Overton&Associates 26 23 1 w 262301-2-019-1005 Kitsap Overton&Associates 26 23 1 w 262301-2-018-1006 Kitsap Overton&Associates 26 23 1 w 262301-2-017-1007 Kitsap Overton&Associates 23,26 23 1 w 262301-2-016-1008 Kitsap Overton&Associates 23,26 23 1 w 232301-3-022-1001 Kitsap Overton&Associates 23 23 1 w 232301-3-023-1000 Kitsap Overton&Associates 23 23 1 w 232301-3-029-1004 Kitsap Overton&Associates 23 23 1 w 232301-3-030-1001 Kitsap Overton&Associates 23 23 1 w 232301-3-021-1002 Kitsap Overton&Associates 23 23 1 w 232301-3-028-1005 Kitsap Overton&Associates 23 23 1 w 232301-3-033-1008 Kitsap Overton&Associates 23 23 1 w 232301-3-032-1009 Kitsap Overton&Associates 23 23 1 w 232301-3-031-1000 Kitsap Overton&Associates 23 23 1 w 262301-2-025-1007 Kitsap Overton&Associates 23 23 1 w 232301-3-035-1006 Kitsap Overton&Associates 23 23 1 w 232301-3-036-1005 Kitsap Owner section township range a\w tax parcel numbers county Overton&Associates 32 23 1 w 12332-44-00000 Mason Overton&Associates 32 23 1 w 12332414=10 Mason Overton&Associates 32 23 1 w 12332-14-MIO Mason Overton&Associates 33 23 1 w 12333-10-00000 Mason Overton&Associates 28 23 1 w 12328-34-00000 Mason Overton&Associates 28 23 1 w 12328-31-00000 Mason Overton&Associates 28 23 1 w 12328-24-00000 Mason Overton&Associates 28 23 1 w 12328-21-00000 Mason Overton&Associates 27 23 1 w 272301-2-009-1006 Kitsap Overton&Associates 27 23 1 w 272301-3-009-1004 Kitsap Overton&Associates 27 23 1 w 272301-3-015-1006 Kitsap Overton&Associates 28 23 1 w 12328-21-00000 Mason Overton&Associates 28 23 1 w 12328-00-03000 Mason Overton&Associates 21 23 1 w 12321-43-00130 Mason Overton&Associates 21 23 1 w 12321-41-00000 Mason Overton&Associates 21 23 1 w 12321-44-00000 Mason Overton&Associates 21 23 1 w 12321-14-00001 Mason Overton&Associates 15 23 1 w 152301-3-004-1003 Kitsap Overton&Associates 22 23 1 w 222301-2-020-1006 Kitsap Overton&Associates 22 23 1 w 222301-2-020-1105 Kitsap Overton&Associates 22 23 1 w 222301-3-011-1005 Kitsap Overton&Associates 22 23 1 w 222301-2-022-1004 Kitsap Overton&Associates 22 23 1 w 222301-1-024-1004 Kitsap Overton&Associates 22 23 1 w 222301-1-023-1005 Kitsap Overton&Associates 22 23 1 w 222301-1-011-1009 Kitsap Overton&Associates 22 23 1 w 222301-1-016-1004 Kitsap Overton&Associates 22 23 1 w 222301-1-013-1007 Kitsap Overton&Associates 22 23 1 w 222301-1-015-1005 Kitsap Overton&Associates 22 23 1 w 222301-1-019-1001 Kitsap Overton&Associates 22 23 1 w 222301-1-018-1002 Kitsap Overton&Associates 22 23 1 w 222301-1-014-1006 Kitsap Overton&Associates 22 23 1 w 222301-1-017-1003 Kitsap Overton&Associates 22 23 1 w 222301-1-012-1008 Kitsap Overton&Associates 27 23 1 w 272301-1-023-1000 Kitsap Overton&Associates 27 23 1 w 272301-2-033-1006 Kitsap Overton&Associates 27 23 1 w 272301-1-010-1005 Kitsap Overton&Associates 27 23 1 w 272301-1-035-1006 Kitsap Overton&Associates 27 23 1 w 272301-1-034-1007 Kitsap Overton&Associates 27 23 1 w 272301-1-033-1008 Kitsap Overton&Associates 27 23 1 w 272301-3-010-1001 Kitsap Overton&Associates 27 23 1 w 272301-2-023-1008 Kitsap Overton&Associates 27 23 1 w 272301-2-026-1005 Kitsap Overton&Associates 27 23 1 w 272301-2-025-1006 Kitsap Overton&Associates 27 23 1 w 272301-3-014-1007 Kitsap Overton&Associates 27 23 1 w 272301-3-013-1008 Kitsap Overton&Associates 27 23 1 w 272301-3-011-1000 Kitsap Overton&Associates 27 23 1 w 272301-3-012-1009 Kitsap Overton&Associates 27 23 1 w 272301-3-025-1004 Kitsap Overton&Associates 27 23 1 w 272301-3-018-1003 Kitsap Overton&Associates 27 23 1 w 272301-3-016-1005 Kitsap Owner section township range a\w tax parcel numbers county Southwest Kitsap,L.P. 33 23 1 w 12333-12-00010 Mason North Bay Properties,L.P. 33 23 1 w 12333-13-00030 Mason North Mason,L.P. 33 23 1 w 12333-13-00060 Mason North Mason,L.P. 33 23 1 w 12333-13-00050 Mason North Mason,L.P. 33 23 1 w 12333-13-00080 Mason Southwest Kitsap,L.P. 33 23 1 w 12333-24-00060 Mason Southwest Kitsap,L.P. 33 23 1 w 12333-24-00070 Mason North Bay Properties,L.P. 33 23 1 w 12333-32-00070 Mason North Bay Properties,L.P. 33 23 1 w 12333-32-00080 Mason North Bay Properties,L.P. 33 23 1 w 12333-21-00030 Mason North Mason,L.P. 33 23 1 w 12333-21-00060 Mason North Mason,L.P. 33 23 1 w 12333-21-00070 Mason North Mason,L.P. 28 23 1 w 12328-43-00070 Mason North Mason,L.P_ 28 23 1 w 12328-43-00060 Mason Southwest Kitsap, L.P. 28 23 1 w 12328-42-00030 Mason Southwest Kitsap,L.P. 28 23 1 w 12328-42-00020 Mason North Bay Properties,L.P. 28 23 1 w 12328-43-00030 Mason North Bay Properties,L.P. 28 23 1 w 12328-43-00020 Mason North Bay Properties,L.P. 28 23 1 w 12328-41-00010 Mason North Bay Properties,L.P. 28 23 1 w 12328-41-00040 Mason North Mason,L.P. 28 23 1 w 12328-41-00050 Mason Coulter Creek,L.P. 28 23 1 w 12328-44-00080 Mason Coulter Creek,L.P. 28 23 1 w 12328-14-00070 Mason Southwest Kitsap,L.P. 23 23 1 w 232301-4-013-1000 Kitsap 4.Are there potentially unstable slopes or landforms within the boundaries of your forest practices activity area? Z No ❑Yes—attach geotechnical report and"Slope Stability Informational Form."If applicable,attach the SEPA checklist, HCP or Watershed Analysis prescriptions. 5.Are there potentially unstable slopes or landforms adjacent to your forest practices activity area? OX No ❑Yes—complete and attach the"Slope Stability Informational Form." If applicable,attach geotechnical report, HCP or Watershed Analysis prescriptions. 6.Is the area included in this assessment:(Answer each question) a. 9 No ❑Yes Within 500 feet of a public park?Park name: b. (] No ❑Yes Using forest roads that are included in a Road Maintenance and Abandonment Plan (RMAP)? i. If yes, What is the RMAP number? ii. For any forest roads that aren't included in an RMAP complete number 10, Road Assessment. c. ❑ No n Yes Within 50 miles of saltwater and do you own more than 500 acres of forest land in Washington State?If Yes-include the "Marbled Murrelet Form"or attach/reference HCP prescriptions. d. OX No ❑Yes Including areas of critical wildlife habitat? If yes, document types of habitat and their locations on a separate Activity Map from the one(s)used for the rest of your assessment. e. OX No ❑ Yes In or directly adjacent to a potential Channel Migration Zone(CMZ)?If Yes—include the "CMZ Assessment Form."Attach/reference applicable HCP and/or Watershed Analysis prescriptions. 7. Streams, Lakes,and Ponds inventory. List each one separately. Show them,along with their Identifiers, on your Activity Map. Stream DNR Field Site Class, Is there a Segment, Mapped Verified Type S or F Stream Length CMZ? Lake,or Water T Water Type water,only Width Pond, Type (see (see (feet) (feet) N;see instructions) Identifier instructions) instructions) inuctions) L-1 F F III >10 800 N S-1 N F III >10 1800 N S-2 N F QI >10 660 N S-3 N F III >10 2000 N S-4 N Np 1 1500 N S-5 F F III 4 3400 N S-6 N F RA 5 1300 N S-7 F F III 6 300 N S-8 F F III 9 800 N S-9 F F III >10 1600 N S-10 N Non 1 660 N S-11 F F III 8 700 N 5/9/2014 2 of 4 EASTERN AND WESTERN WASHINGTON STEP t 7.Streams,Lakes,and Ponds inventory.(cont.) Stream Segment, DNR Field Site Class, Stream Length Is there a CMZ? Lake or Pond, Mapped Verified Type 5 or F Identifier Water Type Water Type water,only Width(feet) (feet) S-12 N F NI 3 300 N S-14 N i F III 4 300 N 5-15 U j Non - 1 2000 N S-16 LI F II 3 1300 N S-17 U F 111 2 800 N S-18 U Non 1 250 I N j-- i 1 I � - 8. Wetlands Inventory.List each wetland separately. Show the boundaries of each wetland,along with its Identifier, on your Activity Map.Include all type A and B wetlands that are within 200 feet of the area covered by Step 1. Don't include forested wetlands that are less than 3 acres in size. Wetland Total Wetland Wetland Type Total Wetland Identifier Wetland Type Wetland Area Identifier (A, B, or Forested) Area (acres) (A, B, or Forested) (acres) W-1 B 15 w-5 B 1.5 W-2 B 0.5 W-6 B 0.4 W-3 B 0.4 W-7 A 5.5 W-4 A 2 W-8 Forested 6 9. Sensitive Site Inventory for Type Np waters.List each site separately and show It,along with its Identifier, on your Activity Map. Site Type of Site Describe how you marked water type breaks and sensitive sites on the Identifier ground. NIA 10. Roads assessment. Show roads, water crossings, spoil areas,and rock pits,along with their identifiers, on an Activity Map. Road Date Road issue assessed(see Comments Identifier Assessed instructions for categories) R-1 5\2014 Road crosses typed water C-1 5\2014 Culvert in F water C-2 5\2014 Culvert in F water C-3 5\2014 Culvert in F water R-2 5\2014 Road crosses typed water C-4 5\2014 Culvert in F water R-3 5\2014 No Issues 5/9/2014 3 of 4 EASTERN AND WESTERN WASHINGTON STEP 1 10.Road assessment(Cont.) - r_ Road Date Assessed Road issue assessed(see instructions for Identifier catagories) Comments R-4 5\14 No Issues R-5 5\14 No Issues R-6 5\14 Road crosses typed water C-6 5\14 Culvert in F water R-7 5\14 No Issues R-8 5\14 No Issues R-9 5\14 No Issues R-10 5\14 No Issues R-11 5\14 No Issues R-12 5\14 No Issues R-14 5\14 No Issues R-15 5\14 No Issues S.Wetland Inventory(Cont.) Wetland Wetland Type (A, Total Wetland Wetland Wetland Type (A- Total Wetland Identifier B,or Forested) Area(acres) Identifier B,or Forested) Area(acres) W-9 B 3 W-10 B 0.4 W-11 B 2 W-12 B 5 W-14 A 25 i 10.Road assessment(Coot) Road Date Assessed Road issue assessed(see instructions for Identifier cats ories) Comments C-5 5\14 Culvert in Np water -..__._...__.__.__. . C-7 5\14 Culvert in non water,Storm drainage C-8 5\14 Culvert in F water E - 1 I I 11. How are the following marked on the ground?(Flagging,paint,road, fence, etc) F/N water type breaks: �OfN t, &j:1 Np/Ns water type breaks: (� N f, n 12. Have you reviewed the proposed activity area to determine if it may involve historic sites and/or Native American cultural resources? Read the instructions carefully before answering this question. ❑No %Yes 13. Additional Information: (This is optional. You may add extra pages if needed.) Sec �7x-�Cc- �r-<1 I affirm that the information contained herein is true. Landowner signature Print name: Date: �T "NOTE: if you are a "Perpetual Timber Rights Owner,"and are submitting this without the Landowner's Signature,provide written evidence the landowner has been notified. 5/9/2014 4 of 4 EASTERN AND WESTERN WASHINGTON STEP 1 Marbled Murrelet Form Western Washington Forest Practices Application/Notification Complete this form only if you are harvesting timber(including salvage) or constructing roads. Do not complete this form if you have an HCP for marbled murrelets. Answer every question. 1. X❑No [-]Yes For this FPA/N, has a protocol survey(s) been completed that includes: Harvest units(and within 300 ft on your ownership),or Salvage units(and within 300 ft on your ownership), or Any area of proposed road construction(and within 300 ft on your ownership)? If'Yes, fill out the table and check the appropriate findings below. Survey was Survey has been Survey is complete Survey was disapproved by submitted to but has not yet approved by WDFW and is WDFW and been submitted to Survey ID Township WDFW being survey approval is WDFW , (Name or Range,& (Attach approval resubmitted with unknown (Submit survey Unit# Section this FPA/N letter from WDFW) (Explain below) (Explain below) with FPA/N) ❑Occupancy ❑ Occupancy ❑Occupancy ❑Occupancy ❑Presence ❑ Presence ❑Presence ❑Presence ❑No Detections ❑ No Detections ❑No Detections ❑No Detections ❑Occupancy ❑Occupancy ❑Occupancy ❑Occupancy ❑Presence ❑Presence ❑Presence ❑Presence ❑No Detections ❑No Detections ❑No Detections ❑No Detections ❑Occupancy ❑Occupancy ❑Occupancy ❑Occupancy ❑Presence ❑Presence ❑Presence ❑Presence ❑No Detections ❑No Detections ❑No Detections ❑No Detections Explanation: 2. QX No ❑Yes ❑Unknown Will you harvest, salvage, or construct roads within 0.25 miles of an occupied site? 3. ❑X No ❑Yes ❑Unknown Will you fly helicopter(s)over or within 0.25 miles of an occupied site? 4. X❑ No ❑Yes Will you harvest live trees in a buffer of an occupied site? If Yes, describe the leave trees and buffer widths you will leave. NOTE: If you leave less than required in WAC 222-16-080(1) (h) (v)this is a Class IV-Special and an Environmental Checklist is required Description of managed buffers. Form QQ46(05-14-05) 1 of 2 5. No Yes Are there nesting platforms within any harvest unit (including salvage and road construction)that are within 300 feet that: • Are not located within a surveyed area, and; • Have a minimum of 2 platforms per acre, and; • Are located within 7 or more acres of contiguous habitat, and; • Have a least 40% (number not volume) of the dominant and co-dominant trees made up of Douglas-fir,western hemlock,western red cedar, or Sitka spruce? If"Yes", complete the table below for those areas. Name or#(as shown on map)of Number of Platform Assessment Method delineated stands Nesting trees 32 inches Field Sampling Method, Sample Plot of contiguous Delineated platforms dbh or greater Method, 100%Cruise Method, Inventory habitat stand acres per acre with platforms Model Method,or Other 6. nX No ❑Yes Are there areas within this forest practice or within 300 feet that: • Are not surveyed, and; • Are not listed in question 5, and; • Have trees that are at least 32 inches dbh If "Yes", list the forest practice unit numbers from your activity map. Provide brief description of current stand conditions. Such as tree species composition, stand age (if known), and maximum tree size(dbh). Harvest Unit#(s) F1 Within the Unit ❑Within 300 feet of the Unit Description: Harvest Unit#(s) [-]Within the Unit Within 300 feet of the Unit Description: Harvest Unit#(s) I-IWithin the Unit ❑Within 300 feet of the Unit Description: 7. If you answered yes to question 1, 4, or 5, include a map (separate from your map that shows your harvest units and/or road construction) See the instructions for the information required on each map. Form QQ46(05-14-05) 2 of 2 Western Washington Water Type Classification Worksheet StreamlSegment ID: S' I Stream/Segment ID: 5• Z. Stream/Segment ID: 5 3 Date Observed: S/Zory Date Observed: s/z0(-A Date Observed: -5/7Z0l-1 1. Do you have a protocol survey? (See the Board Manual Section 13) Or,does the stream have waiver characteristics? (See WAC 222-16-031(3)(b)(ii)) pq No. Continue. [ No. Continue. pQ No. Continue. [ ]Yes.Attach documentation or [ ]Yes.Attach documentation or [ ]Yes.Attach documentation or approved WTMF number: approved WTMF number: approved WTMF number: [ ] Fish found. Stop. [ ] Fish found. Stop. ( j Fish found. Stop. [ ] No fish found. Go to 6. [ ]No fish found.Go to 6. [ ] No fish found. Go to 6. 2. Were fish observed or are fish known to use the stream any time of the year? [ ]Yes.Type F water. Stop. [ ]Yes.Type F water. Stop. [ j Yes.Type F water. Stop. bQ No. Continue pQ No. Continue. No. Continue. 3. Is there an impoundment(ponded water)upstream of the assessed segment,that is greater than.5 acres? )?9 Yes. Type F water. Stop. Yes. Type F water. Stop. [ ]Yes.Type F water. Stop. [ ]No. Continue. ( ] No. Continue. No. Continue. 4. Are there segments within or above the assessed portion of the stream where the average BFW is two feet or greater? AND the average stream gradient is less than or equal to 16%? [ ]Yes.Type F water. Stop. [ )Yes.Type F water. Stop. ptJ Yes.Type F water. Stop. [ j No. Continue. [ ]No. Continue. [ ]No. Continue. 5. Are there segments within or above the assessed portion of the stream where the average BFW is two feet or greater? AND the average stream gradient is between 16%and 20%? AND,the contributing basin to the stream is greater than 50 acres? [ ]Yes. Type F water. Stop. [ ]Yes. Type F water. Stop. [ ]Yes. Type F water. Stop. [ ] No. Continue. [ ] No. Continue. [ ]No.Continue. 6. Does the stream segment contain water at all times during a normal rainfall year? [ ]Yes. Type Np water.Go to 9. [ ]Yes.Type Np water. Go to 9. [ ]Yes. Type Np water. Go to 9. [ ] No. Continue. [ ]No. Continue. [ ] No. Continue. 7. Is the stream segment downstream of a perennial source of water? [ ]Yes.Type Np water. Go to 9. [ j Yes.Type Np water. Go to 9. [ ]Yes. Type Np water. Go to 9. [ ]No. Continue. [ ] No. Continue. [ ]No.Continue. 8. Is the stream physically connected by an above-ground channel to Type S, F,or Np water? ( ]Yes,Type Ns water. Stop. [ j Yes,Type Ns water. Stop. [ ]Yes,Type Ns water. Stop. [ )No,non-typed water. [ ] No, non-typed water. [ ]No, non-typed water. 9. Describe how you determined the uppermost point of perennial flow.Include a description of its location and show the point on a map(Use a separate piece of paper if necessary). Stream/Segment ID Description: Washington Department of Natural Resources • Water Classification Worksheet • August 15, 2013 Western Washington Water Type Classification Worksheet StreamlSegment ID: 5- `' Stream/Segment ID: 5 - 5 StreamlSegment ID: 5 -6 Date Observed: S/2o%`A Date Observed: S/zo 11 Date Observed: 5/z0 1'1 1. Do you have a protocol survey? (See the Board Manual Section 13) Or,does the stream have waiver characteristics? (See WAC 222-16-031(3)(b)(ii)) No. Continue. No. Continue. ,QQ No. Continue. [ ]Yes.Attach documentation or [ ]Yes.Attach documentation or [ ]Yes.Attach documentation or approved WTMF number: approved WTMF number: approved WTMF number: [ ] Fish found. Stop. [ ] Fish found. Stop. [ ] Fish found. Stop. [ ] No fish found. Go to 6. [ j No fish found. Go to 6. [ ] No fish found. Go to 6. 2. Were fish observed or are fish known to use the stream any time of the year? [ ]Yes. Type F water. Stop. [ ]Yes. Type F water.Stop. [ ]Yes.Type F water. Stop. No. Continue. M No. Continue. pCJ No. Continue. 3. Is there an impoundment(ponded water)upstream of the assessed segment,that is greater than.5 acres? [ ]Yes.Type F water. Stop. [ ]Yes.Type F water.Stop. [ ]Yes.Type F water. Stop. �Q No. Continue. pQ No. Continue. No. Continue. 4. Are there segments within or above the assessed portion of the stream where the average BFW is two feet or greater? AND the average stream gradient is less than or equal to 16%? [ ]Yes. Type F water. Stop. Yes.Type F water.Stop. Yes. Type F water. Stop. No. Continue. [ ] No. Continue. [ ] No. Continue. S. Are there segments within or above the assessed portion of the stream where the average BFW is two feet or greater? AND the average stream gradient is between 16%and 20%? AND,the contributing basin to the stream is greater than 50 acres? [ ]Yes. Type F water. Stop. [ ]Yes. Type F water.Stop. [ ]Yes. Type F water. Stop. [�Q No. Continue. [ J No. Continue. { ] No. Continue. 6. Does the stream segment contain water at all times during a normal rainfall year? [ ]Yes.Type Np water. Go to 9. [ ]Yes.Type Np water.Go to 9. [ ]Yes.Type Np water.Go to 9. No. Continue. [ ] No. Continue. [ ]No. Continue. 7. Is the stream segment downstream of a perennial source of water? [ ]Yes. Type Np water. Go to 9. [ ]Yes. Type Np water.Go to 9. [ ]Yes.Type Np water. Go to 9. No. Continue. [ ]No. Continue. [ J No. Continue. 8. Is the stream physically connected by an above-ground channel to Type S, F,or Np water? ]i4 Yes,Type Ns water. Stop. [ ]Yes,Type Ns water.Stop. { ]Yes, Type Ns water. Stop. [ ] No,non-typed water. [ ] No, non-typed water. [ ] No, non-typed water. 9. Describe how you determined the uppermost point of perennial flow. Include a description of its location and show the point on a map(Use a separate piece of paper if necessary). Stream/Segment ID Description: Washington Department of Natural Resources - Water Classification Worksheet - August 15, 2013 Western Washington Water Type Classification Worksheet Stream/Segment ID: S-7 Stream/Segment ID: 5 -S Stream/Segment ID: S-g Date Observed: 5/zo1'( Date Observed: 51zolq Date Observed: S/zo 14 1. Do you have a protocol survey? (See the Board Manual Section 13) Or,does the stream have waiver characteristics? (See WAC 222-16-031(3)(b)(ii)) (�c]No. Continue. bQ No.Continue. pq No. Continue. [ ]Yes.Attach documentation or j ]Yes.Attach documentation or [ ]Yes.Attach documentation or approved WTMF number: approved WTMF number. approved WTMF number. [ ] Fish found.Stop. [ ] Fish found.Stop. [ ]Fish found. Stop. [ ]No fish found. Go to 6. [ ]No fish found. Go to 6. [ ] No fish found. Go to 6. 2. Were fish observed or are fish known to use the stream any time of the year? [ ]Yes. Type F water. Stop. ( ]Yes.Type F water. Stop. [ ]Yes.Type F water. Stop. No. Continue. No. Continue. [DI No.Continue. 3. Is there an impoundment(ponded water)upstream of the assessed segment,that is greater than.5 acres? [ ]Yes. Type F water. Stop. [ ]Yes.Type F water. Stop. [ ]Yes.Type F water. Stop. bQ No. Continue. pq No. Continue. D9 No. Continue. 4. Are there segments within or above the assessed portion of the stream where the average BFW is two feet or greater? AND the average stream gradient is less than or equal to 16%? Yes. Type F water. Stop. Yes.Type F water. Stop. Yes. Type F water. Stop. [ J No.Continue. [ ]No. Continue. [ ] No. Continue. 5. Are there segments within or above the assessed portion of the stream where the average BFW is two feet or greater? AND the average stream gradient is between 16%and 20%? AND,the contributing basin to the stream is greater than 50 acres? [ ]Yes. Type F water. Stop. [ ]Yes. Type F water. Stop. [ ]Yes. Type F water. Stop. [ ]No. Continue. [ ] No. Continue. [ ] No. Continue. 6. Does the stream segment contain water at all times during a normal rainfall year? [ ]Yes.Type Np water. Go to 9. [ ]Yes.Type Np water. Go to 9. [ ]Yes.Type Np water. Go to 9. [ ] No. Continue. [ ] No. Continue. [ ]No. Continue. 7. Is the stream segment downstream of a perennial source of water? [ ]Yes. Type Np water. Go to 9. [ ]Yes.Type Np water. Go to 9 [ ]Yes. Type Np water. Go to 9. [ ] No. Continue. [ ] No. Continue. [ ]No. Continue. 8. Is the stream physically connected by an aboveground channel to Type S,F,or Np water? [ ]Yes, Type Ns water. Stop. ( ]Yes, Type Ns water. Stop. [ ]Yes, Type Ns water.Stop. [ ] No, non-typed water. [ ] No, non-typed water_ [ ] No, non-typed water. 9. Describe how you determined the uppermost point of perennial flow.Include a description of its location and show the point on a map(Use a separate piece of paper if necessary). Stream/Segment ID Description: Washington Department of Natural Resources • Water Classification Worksheet • August 15, 2013 Western Washington Water Type Classification Worksheet Stream/Segment ID: 5- k O Stream/Segment ID: 5 - t k Stream/Segment ID: 5 - t Z Date Observed: SV zo i y Date Observed: 5/zo I'i Date Observed: 51zo 1-f 1. Do you have a protocol survey? (See the Board Manual Section 13) Or,does the stream have waiver characteristics? (See WAC 222-16-031(3)(b)(ii)) M No. Continue. W No. Continue. pq No. Continue. [ ]Yes.Attach documentation or [ ]Yes.Attach documentation or [ ]Yes.Attach documentation or approved WTMF number: approved WTMF number: approved WTMF number. ( ] Fish found.Stop. [ ] Fish found.Stop. [ ] Fish found. Stop. [ ] No fish found. Go to 6. [ j No fish found. Go to 6. [ j No fish found. Go to 6. 2. Were fish observed or are fish known to use the stream any time of the year? [ ]Yes. Type F water. Stop. [ ]Yes.Type F water.Stop. [ ]Yes.Type F water. Stop. (�Q No. Continue. pq No. Continue. [X]No.Continue. 3. Is there an impoundment(ponded water)upstream of the assessed segment,that is greater than.5 acres? [ J Yes.Type F water. Stop. pQ Yes.Type F water.Stop. �j Yes. Type F water. Stop. aQ No. Continue. [ ] No. Continue. [ ] No. Continue. 4. Are there segments within or above the assessed portion of the stream where the average BFW is two feet or greater? AND the average stream gradient is less than or equal to 16%? [ ]Yes.Type F water. Stop. [ ]Yes.Type F water.Stop. [ ]Yes.Type F water.Stop. No. Continue. [ ] No. Continue. [ J No. Continue. 5. Are there segments within or above the assessed portion of the stream where the average BFW is two feet or greater? AND the average stream gradient is between 16%and 20%? AND,the contributing basin to j the stream is greater than 50 acres? [ ]Yes.Type F water. Stop. [ ]Yes.Type F water.Stop. [ ]Yes. Type F water. Stop. pQ No.Continue. [ ] No. Continue. [ ] No.Continue. 6. Does the stream segment contain water at all times during a normal rainfall year? [ ]Yes.Type Np water.Go to 9. [ ]Yes.Type Np water.Go to 9. [ ] Yes.Type Np water, Go to 9. M No. Continue. [ ]No. Continue. [ ]No. Continue. 7. Is the stream segment downstream of a perennial source of water? [ j Yes.Type Np water. Go to 9. [ ]Yes.Type Np water.Go to 9. [ ]Yes.Type Np water.Go to 9. jX] No. Continue. ( ] No. Continue. [ ] No. Continue. 8. Is the stream physically connected by an above-ground channel to Type S,F,or Np water? [ ]Yes,Type Ns water.Stop. [ ]Yes,Type Ns water.Stop. ( ]Yes,Type Ns water.Stop. No, non-typed water. [ ]No, non-typed water. [ ] No, non-typed water. 9. Describe how you determined the uppermost point of perennial flow.Include a description of its location and show the point on a map(Use a separate piece of paper if necessary). Stream/Segment ID Description: Washington Department of Natural Resources • Water Classification Worksheet - August 15, 2013 Western Washington Water Type Classification Worksheet Stream/Segment ID: S- 14 Stream/Segment ID: .5 -t5 Stream/Segment ID: 5- 16 Date Observed: 5/-o i,{ Date Observed: S/zo I`t Date Observed: 57 zo I`t 1. Do you have a protocol survey? (See the Board Manual Section 13) Or,does the stream have waiver characteristics? (See WAC 222-16-031(3)(b)(ii)) bQ No. Continue. K No. Continue. pq No.Continue. [ ]Yes.Attach documentation or [ ]Yes.Attach documentation or ( ]Yes.Attach documentation or approved WTMF number: approved WTMF number: approved WTMF number. [ ] Fish found.Stop_ [ ] Fish found. Stop. [ ]Fish found. Stop. [ ] No fish found. Go to 6. [ ] No fish found. Go to 6. [ ]No fish found. Go to 6. 2. Were fish observed or are fish known to use the stream any time of the year? [ ]Yes.Type F water. Stop. [ ]Yes.Type F water. Stop. [ ]Yes.Type F water.Stop. No. Continue. P4 No. Continue. [pC]No.Continue. 3. Is there an impoundment(ponded water)upstream of the assessed segment,that is greater than.5 acres? ( ]Yes.Type F water.Stop. [ ]Yes.Type F water. Stop. [ ]Yes.Type F water. Stop. No.Continue. No. Continue. ()g No.Continue. 4. Are there segments within or above the assessed portion of the stream where the average BFW is two feet or greater? AND the average stream gradient Is less than or equal to 16%7 pQ Yes.Type F water. Stop. [ J Yes.Type F water. Stop. [ ]Yes.Type F water.Stop. [ ] No. Continue. pQ No. Continue. 64 No.Continue. 5. Are there segments within or above the assessed portion of the stream where the average BFW is two feet or greater? AND the average stream gradient is between 16%and 20%? AND,the contributing basin to the stream is greater than 50 acres? [ ]Yes.Type F water. Stop. [ ]Yes.Type F water. Stop. Yes,Type F water.Stop. [ ] No. Continue. [jQ No. Continue. [ ] No.Continue. 6. Does the stream segment contain water at all times during a normal rainfall year? [ ]Yes.Type Np water.Go to 9. [ ]Yes.Type Np water. Go to 9. [ ]Yes.Type Np water.Go to 9. [ ] No. Continue. [j No. Continue. [ ] No.Continue. 7. Is the stream segment downstream of a perennial source of water? [ ]Yes.Type Np water. Go to 9. [ ]Yes.Type Np water.Go to 9. [ ]Yes. Type Np water. Go to 9. [ ]No. Continue. No.Continue. [ j No.Continue. 8. Is the stream physically connected by an aboveground channel to Type S,F,or Np water? [ ]Yes,Type Ns water.Stop. [ ]Yes,Type Ns water.Stop. [ ]Yes,Type Ns water.Stop. [ ] No,non-typed water. dq No, non-typed water. [ ] No, non-typed water. 9. Describe how you determined the uppermost point of perennial flow.Include a description of its location and show the point on a map(Use a separate piece of paper If necessary). Stream/Segment ID Description: Washington Department of Natural Resources • Water Classification Worksheet - August 15, 2013 Western Washington Water Type Classification Worksheet Stream/Segment ID: S - 17 Stream/Segment ID: 5 - le Stream/Segment ID: Date Observed: 5/zo t`4 Date Observed: S/z o I-i Date Observed: 1. Do you have a protocol survey? (See the Board Manual Section 13) Or,does the stream have waiver characteristics? (See WAC 222-16-031(3)(b)(ii)) dQ No. Continue. M No. Continue. [ ] No.Continue. [ ]Yes.Attach documentation or [ ]Yes.Attach documentation or [ J Yes.Attach documentation or approved WTMF number. approved WTMF number: approved WTMF number: [ ]Fish found.Stop. [ ]Fish found. Stop. ( ]Fish found. Stop. [ ]No fish found.Go to 6. [ ]No fish found. Go to 6. [ ]No fish found. Go to 6. 2. Were fish observed or are fish known to use the stream any time of the year? [ ]Yes. Type F water. Stop. [ J Yes.Type F water.Stop. [ ]Yes.Type F water. Stop. [k] No. Continue. No. Continue. [ ]No.Continue. 3. Is there an impoundment(ponded water)upstream of the assessed segment,that is greater than.5 acres? 69 Yes.Type F water.Stop. [ ]Yes.Type F water.Stop. [ ]Yes.Type F water. Stop. [ ] No. Continue. No. Continue. [ ] No. Continue. 4. Are there segments within or above the assessed portion of the stream where the average BFW is two feet or greater? AND the average stream gradient is less than or equal to 16%? [ ]Yes. Type F water. Stop. [ ]Yes.Type F water.Stop. [ ]Yes.Type F water.Stop. [ ]No. Continue. ]KJ No. Continue. [ ]No.Continue. 5. Are there segments within or above the assessed portion of the stream where the average BFW is two feet or greater? AND the average stream gradient is between 16%and 20%? AND,the contributing basin to the stream is greater than 50 acres? [ ]Yes.Type F water. Stop. ( ]Yes. Type F water.Stop. [ j Yes. Type F water. Stop. [ ]No. Continue. pq No. Continue. [ j No.Continue. 6. Does the stream segment contain water at all times during a normal rainfall year? [ ]Yes. Type Np water. Go to 9. [ ]Yes.Type Np water.Go to 9. [ ]Yes.Type Np water. Go to 9. [ ] No. Continue. QC]No. Continue. [ )No.Continue. 7. Is the stream segment downstream of a perennial source of water? [ ]Yes.Type Np water. Go to 9. [ ]Yes.Type Np water.Go to 9. [ ]Yes.Type Np water. Go to 9. [ ] No. Continue. No.Continue. [ ]No. Continue. 8. Is the stream physically connected by an above-ground channel to Type S,F,or Np water? ( ]Yes,Type Ns water. Stop. Yes,Type Ns water.Stop. [ ]Yes,Type Ns water. Stop. [ ]No, non-typed water. [ ]No, non-typed water. [ ] No, non-typed water. 9. Describe how you determined the uppermost point of perennial flow.Include a description of its location and show the point on a map(Use a separate piece of paper if necessary). Stream/Segment ID Description: Washington Department of Natural Resources •Water Classification Worksheet • August 15,2013 572=14 Map Output FOREST PRACTICE ACTIVITY MAP TOWNSHIP 23 NORTH HALF 0, RANGE 1 WEST(W.M.)HALF 0, SECTION 21 Application* 7 7 17 �� y y 5 +� 17o9$os +70 + 1709 1 N I oTKE R +7 8 7087 t82 t F 20 y1 22 W-9 i K 171�8$6$ 17 $$ 1708 $0 C,_8 1708+ io-CIA t{. 2 04- I F a 29 I08 4 1708740 t Please use the legend from the FPA Instruction or provide a list of symbols used. 5/2/2014 12:50:26 PM g G-i'9`'�toss•!9 tles�c�noT�o•� NAD83 w_ w�{�gr`) C�cstc��n���o Contour Interval:40 Feet 1l1 kff — — - 5/2MU Map Out FOREST PRACTICE ACTIVITY MAP TOWNSHIP 23 NORTH HALF 0, RANGE 1 WEST(W.M.)HALF 0, SECTION 22 Application* 04001 1 a S + 702 L� 1 0415 ./+17097 i4+ _t •!l Q*v •1 t t t • 17 786 1708782 +7 4 + 4 21 23 s `/p 1 r« p A rr.vrr..r..-. •I a 1 8762 1^ 7 784 782 J + n� - � S.1b �^r^'-�..� r�• •� �1. �� a 'rNN� 1 4 ,.vfe a...rn Ir..rrrr.rr•�vw�\+n.y O i R' 17087 27 + 8 1 28 �yi r 'X Please use the legend from the FPA Instruction or provide a list of symbols used. 51212014 12:54:46 PM MAD 83 Contour Interval:40 Feet 111 SM014 Map Output FOREST PRACTICE ACTIVITY MAP TOWNSHIP 23 NORTH HALF 0, RANGE 1 WEST(W.M.)HALF 0, SECTION 23 Application#: "m ( 7 q R 3 y i +709708 14 +709800 +70980 13 2 �I I I i + 8 8 1 80 t1709882) i I � F A r Z 3 i � t I 4 I � : 17 7 8 +7 �w/FV fIN AEI/iVif S vo P' f Q SIT N 4 17 748 _,�.�'• _ I 708 0 17 2 28 + 2 ' `- _ Please use the legend from the FPA Instruction or provide a list of symbols used. ^/��/`/// r NAI'JGS� �oN�OarJ\ .� >.I�O C�a.n•.�.� 5/2/2014 12:57:31 PM NAD 83 w-# = VJe��o �d c�eSig'�►� o Contour interval:40 Feet 5J2l2014 Map OuptA FOREST PRACTICE ACTIVITY MAP TOWNSHIP 23 NORTH HALF 0, RANGE 1 WEST(W.M.)HALF 0, SECTION 26 Application# o2W 1 -7 q 97 Y It 2 Z VI.T1 2 .9Y IF N 24 +7 748 .,�.� '_--.J 170 40 -—--4 7 2 • `�- � 2 C•1� I r� F K ia9lar Lai 17 7 J' 4 7 r a I ,�.-._ 4 I +Ji 4114--- 4 a Uo 17 T }T I,7 802 ` + t 1 4L I � 4 j „ 5 / 36 Please use the legend from the FPA Instruction or provide afli�stt of�symbols used.1 5f212014 12:53:24 PM 5-# $l�Gww� C,cbi��a?io•� R� =1Zoa� dcSir�ra' NAD63 ,�y S Contour Interval:40 Feet �i -# CC05s�n��Gbi4 roc. 1�0✓� `l ,l, &=014 M ap o*" FOREST PRACTICE ACTIVITY MAP TOWNSHIP 23 NORTH HALF 0, RANGE 1 WEST(W.M.) HALF 0, SECTION 27 Application#: A J 1 7 12 r 1 21 i Z2 R3 17 • t u_ -� N /fN// I/AI I/NiM/n NryNN R-7 + + Sao4<1 08744 a+ 1Ulr r /' 5'3 r +708 I 4708724 27 �� 26 J I �' jr wZ 11• C• fl S�ti •.•. /.10 7087 i1708706 17f 702 ! t1 4 i 93 IL Please use the legend from the FPA Instniction or provide a list of symbols used. J 5/2/2014 12:52:50 PM 5"# = 5+�eoM de5ic�.lci�fOr yj� �x•5���g I�ioad NAD83 `'J•#= W���a n� des tg..a� o. . / i Contour Interval:40 Feet � =W aL+br• C r".,s r�p 1n 512W14 Map Output FOREST PRACTICE ACTIVITY MAP TOWNSHIP 23 NORTH HALF 0, RANGE 1 WEST(W.M.) HALF 0, SECTION 32 Application#: 02`�17 Q 9 7 ,3L_t i^/ rwien�Rlr 2t708==- ..- 29 a Ar � x F !!I (1 I +707882 170 88 ( 1707 i j 2qv I � �TUGR � 32 33 L S Putt,1<ou nd f t P 1 864 1�, t 707888 • 1 r � s Pu'at libu ad t 0TN6R }Q Please use the legend from the FPA Instruction or provide a list of symbols used. t2'# 'ROo.d (itSig7_0.4�0h NAD83412:44:48PM Contour Interval:40 Feet 1/1 I I Y 5r"14 Map Odd FOREST PRACTICE ACTIVITY MAP i TOWNSHIP 23 NORTH HALF 0, RANGE 1 WEST(W.M.) HALF 0, SECTION 28 Application#. -7 9 q 7 i R-9 a'4d 20 �+� z F a -Jr"A u = t- - • I t R 1 �1Oa ,iiu 1708740 . -� + Z i :�. R•8 �r • I � � Z �,lc•M-• t � i Z --: vN iv . , v�.% 0872 r 17 2+ 82 27 • /-�. 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GIGs:c�noc4;o.. ��=1Zoad �Gs:gn4�id►� v1 - &=014 Map Output FOREST PRACTICE ACTIVITY MAP TOWNSHIP 23 NORTH HALF 0, RANGE 1 WEST(W.M.)HALF 0, SEC110N 15 Application#: P&-< 17 11—7 �fSSIB2 0 1709 4 t� c 170974 1709744 17097 + + + 709722 1,.->�• '--=: 09724 + 09728 _ N 4P f! Z F Lid4r La1ii f St 702 1709704 7097 7, 21 \0 2 23 Please use the legend from the FPA Instru ion or provide a list of symbols used. 5/2/2014 12:56:08 PM NAD83 -# �P.oc.d �.lc +o r�j Contour Interval:40 Feet 1/1 ay1 -7 T234N R14W RIt � T23-Oti RI-0N-51n y T210\R141\1 1 CotJRrryf}.rR�EA P2 d g_to F.p� - Y t; yt-ttg7S.fJ MAKECA NHW KIRK TT3-OM1 HI-0VP S20 p��i d UV Rt-0R��• �3 T' 1'3-41S RI'1\\V,i A'F MCKNIGHT A4 '?• �•t b. A Y FERN.. d < l C•1 � y � i �•S v, m 1.4KE �, w-■ � i � C ? Z •O O 0C � M ry f.341\RIUI\�T9 R$ C= S dELFA1R � o PEE :sue "1'23-IIV RiJI\l LT-3 ThinninglEvenage Permit Y` _ 4 0 DYERLY Wm � " -I �lT3 NUTal PoreAlne w1 .nn r�ryas fLi-O~ai\c ti3T T2J-ON 1 \'S33 T210ti RI-0H S3d Osaeonuro I ® M1r W4bmYiw n.nN Y..pYI w. ALDER T22-ON RI-0\1"S06 "!'22-0\Hi-0N'SOS I T22-0N RI-0\\"SOJ '1 -O'Z2S RI-0K"SOJ Revisions to FPA/N 2417997 DATE DOCUMENT DESCRIPTION 8/4/2015 ICN 18161 &associated pages Made all the changes required by ICN 18161 Forest Practices wASHfNGToN STATE DEPARTMENTOF Natural Resources Informal Conference Note ICN No. Legal Subdivision Section I TWP J RGE E/W Application I Not K ation# Class 18181 Multiple 23N 01 W 2417997 3 Landowner Timer Owner Operator Same as Landowner Same as Landowner Mailing Address Mailing Address Mailing Address PO Box 1007 City,state(Province),Zip(Postal Code) City,State(Province),Zip(Postal Code) City,State(Province),Zp(Postal Code) Shelton, WA. 98584 Meeting Location Telephone Date Time Region On-Site Conference[ ) 7114f2015 4:00 SPS Subjects Dlacussed: LTA Step 1 review of resources Decisions Made: STREAMS: 1)S-16 and S-17 are typed as"F"water,but does not exist.Sheet flows during heavy rain events;no evidence of scour, or connectivity. 2)W-9 is typed as a"B"wetland txrt is a forested wetland.W-7 needs to be added on the activity map as an"A"wetland. 3)Crossing C•4 and C-6 are fish barriers;during step 2t include how the fish barriers will are addressed. 4)C-5 crosses an Ns stream;currently a ford exists.Need to install a minimum 18"culvert. 5)All roads and stream crossings that fail under BPA powerfines by rule interpretation are considered non forestiand. Draw BPA right-of-way on activity maps and remove crossings that fall within this area from the LTA. Department of Ecology has water quality concerns If hauling on roads within BPA right-of-way. Also Gocaa.-. wPFv~1 PRINT Participants'Names -SIGNATURES of Participarrta Representing Mailed estti e. o� WlbI1 ( Position No. Dale work Pflone 3970 Forest Precbm Foreseer 7114=15 3WA9e8260 (Participant signal means Note Is correct ubjects discussed and decisions made at the rne"ng.) Did not atterrd—mail copies to, [ ]Timber Owner [N Landowner [ 1 Other Parties: ihUr� a u 0038 Gf P—.1104 WTlte--Repfon C wmr--Oparetor Pink—ONR RepresentWve I Wetlands inventory ;Clef each wvdand separately,& abe boutldaNes of ewch wetland,along w1*ks tdaertltif ,vwyour dcdVjty Map.lndtide al!type A andgiwoftn&tbat are wi tfn 200 feet of the anot co vw W**0W f. VOT nchWa lorimWed wstlands that are less Mw l acres 1n size. Wetland Total I a 1AIet(ond WetlaIrni Type Total Wetland Wetland Type ldentier Weiland 14tiBs identifier ( , B,or Forested Area (acres) {A,B,or Fcsested) (acres} will:fi b is w:s B vv 0.5 ► : . a .. o. %V-3 B 0.4 fi A 5S W-4 A 2 W-i3 Evre b Sensitive Site Inventory for TYpe:Np waters.List each site separately and show it,along with its IdertMer, on yourAcdvity 1lltapy: Site Describe howydu:tnarked WaW4pe brealF5aFa3aensitive,s Identifier Typeof Site.. 10. Roads assessmentsowma*wafer crossings,,spoil on an Activity Map. Roam Dte RoW issue assessed(see Coniments, Identifier Assessed instructions for categvrin!; !?A14 R yob Vjped watt I.-' ShOM Culvert in F water Fish Darric r jk-4 M614 I,b;Iawcs R S S1014 ]7o fsaue�. 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J7t1& 070872+F.' � 08 27 r 29 R•6 Z Yp r Ada , Y•� N 4�Te1s ute3> 1 tt +l�instruction or provido list of symbofsuae#; -' ..` +MfNn"af?''yzAlLr /C6+ oc..•�A!'. 1�,:.: 31�ttha•��4:': t 512/2014 12:52:50 PM NAD 83 Contour Interval:49 Feet 5ralzol4 Map output FOREST PRACTICE ACTIVITY MAP TOWNSHP 23 NORTH HALF 0, RANGE 1 WEST(W.M.)HALF 0, SECTION 33 Application# +179;TQi181' 0A 28 x 2 17 Or ,21 tI +��e� f i + S Please usO Oe legend from the FPA 1!04 Dan or provide a list of symbols used. 5t2/2014 12:47.01 P)4 tx►f ;~+ f i 5/Z=4 Map , FOREST PRACTICE ACTIVITY MAP TOWNSHIP 23 NORTH HALF 0. RANGE 1 WEST(W.M.)HALF'0,! a 32. Application#.• izoso 02ell I I I � h gg N 'L. w i 0 17 ' n a t please O&OWCpgend from the Fi+141rtlflRtmon or provWenRbadltt p, ..f�I.rrt`r` 3 �,t VC S� µ ►�0.r'�Y J 6►s2t2f�t4�.��B:1sA� MO �Dl�lt�f�l11181t 4�51�8j '. FPA No: 2417997 WASHINGTON STATE DEPARTMENT OF Decision Date: 08/04/2015 g'.4rarNaturalResources PeterGoldmark-CommissionerofPublicLands project Name: Small Forest Landowner Long-term Forest Practices Application Step 1 Resource and Roads Assessment Notice of Decision Decision M Validated Landowner has correctly identified resources and completed road assessment. [ ] Rejected This Forest Practices Application is rejected for the reason listed below. [ ] Closed Applicant has withdrawn Step 1 of the long-term FPA Reasons for Reiection NOTE:Validation of Step 1 is not an approved application for forest practices activities. You must obtain an approved Step 2 Resources Protection Strategies of the Long-term Application and submit a 5 Day Notice of Operation prior to starting any forest practices activity per WAC 222-20-016. Issued By: Jason Sharp Region: South Puget Sound Title: Resource Protction Forester Date: 08/04/2015 Copies to: M Landowner Issued in person: [ ] Landowner[ ]Timber Owner[ ]Operator By: Washington State Department of Natural Resources•LTA Step 1 Notice of Decision•Sept 20,2010 Page 1 of 2 Appeal Information You have thirty (30) days to appeal this Decision and any related State Environmental Policy Act determinations to the Pollution Control Hearings Board in writing at the following addresses: Physical address: 1111 Israel Rd.SW,Ste 301,Tumwater,WA 98501 Mailing address: P.O. BOX 40903, OLYMPIA,WA 98504-0903 Information regarding the Pollution Control Hearings Board can be found at: http://www.eho.wa.gov/ At the same time you file an appeal with the Pollution Control Hearings Board, also send a copy of the appeal to the Department of Natural Resources' region office and the Office of the Attorney General at the following addresses. Office of the Attorney General Department Of Natural Resources Natural Resources Division South Puget Sound Region 1125 Washington Street SE And 950 Farmen Ave E PO Box 40100 Olympia, WA 98504-0100 Enumclaw, WA 98022 Other Applicable Laws Operating as described in this application/notification does not ensure compliance with the Endangered Species Act, or other federal, state, or local laws_ Hydraulic Proiect Approval(HPA)(Chapter 77.55RCW and WAC 222-50-020(2)) The Department of Fish and Wildlife(WDFW), as the jurisdictional agency issuing HPAs, has final authority for approving water crossing structures in Type S and F waters. WDFW continues to have authority on Type N waters and may exercise that authority on some Type N waters. Notice: The HPA water crossing requirements supersede what is indicated on the FPA. Landowners are required by law to follow the provisions as directed on the HPA. Transfer of Forest Practices Application/Notification (WAC 222-20-0101 Use the"Notice of Transfer of Approved Forest Practices Application/Notification" form. This form is available at region offices and on the Forest Practices website: http://www.dnr.wa.gov/businesspermitstforestpractices. Notify DNR of new Operators within 48 hours. Continuing Forest Land Obligations(RCW 76.09.060, RCW 76.09.070, RCW 76.09.390,and WAC 222-20-055) Obligations include reforestation, road maintenance and abandonment plans, conversions of forest land to non- forestry use and/or harvest strategies on perennial non-fish habitat(Type Np)waters in Eastern Washington. Before the sale or transfer of land or perpetual timber rights subject to continuing forest land obligations, the seller must notify the buyer of such an obligation on a form titled"Notice of Continuing Forest Land Obligation"_ The seller and buyer must both sign the"Notice of Continuing Forest Land Obligation" form and send it to the DNR Region Office for retention. This form is available at DNR region offices. if the seller fails to notify the buyer about the continuing forest land obligation, the seller must pay the buyer's costs related to continuing forest land obligations, including all legal costs and reasonable attorneys'fees incurred by the buyer in enforcing the continuing forest land obligation against the seller. Failure by the seller to send the required notice to the DNR at the time of sale will be prima facie evidence in an action by the buyer against the seller for costs related to the continuing forest land obligation prior to sale. DNR affidavit of mailing: On this day 08/04/2015 , I placed in the United States mail at Enumclaw WA, (date mm/dd/yyyy) (post office location) postage paid, a true and accurate copy of this document. Notice of Decision FPA# 2417997 Charlotte Bass c (Printed name) (Signature) Washington State Department of Natural Resources•LTA Step 1 Notice of Decision•Sept 20,2010 Page 2 of 2 N#: If 17R`7 7 WASHINGTON STAB- -ZPARTMENTOF Step 1 Rece We: Natural Resources Step 1 Comments Due Date: Step 1 Decision Due Date: Small Forest Landowner Long-Term Forest Practice Application Step 2 Received Date: fZ�Z3I I� Office Review Checklist Step 2 Comments Due Date: ' 1/a WDFW Concurrence Due Date: WDFW Concurrence Review Complete: Step 2 Decision Due Date: STEP 1: Region: S S FP Forester: 3 q 70 T Shut down zone: lv� -5V ki-to ap LPG tie^7A Ma.5c,, J'-p Landowner: ,JU,- „ Cz eter C",-Wroject Name: averIckz d- 3-P WRIA: I< V5u0 WAU: Legal Description: STEP 2: Term of Long Term Application(3 to 15 years): ) 5 FPA Classification: [)]III [ ]IVG [ ]IVS Resource Review-Step 1 Strategies&Prescriptions-Step 2 [ ] Saltwater Islands [ ] Alternate Plan:attach plan [ ] Rain-on-Snow and Outside Approved WA [ ] Watershed Analysis Prescriptions [ ] Unstable Features [ ] Columbia River Gorge National Scenic Area [ ]Soils Map(Highly Erodible&Very Unstable) [ ] Timber Harvesting ]] Z_1 acres [A SLPSTAB [ J Within Unstable Land forms [ ] Landslide Hazard Zonation [f] Within WMZ of W A [ ]B [ ]Landslide Polygon [ ] Within [ ]A [ ]B [ ]Forested wetland b(] Hydric Soils [ ] Wetland Mitigation Plan 77 N Wetland 0Forested, [A A,['`]113 [ J Within RMZ/ELZ of type [ ]S [4 F [ ] N water (� Streams[ ]S,%F,In N, [ ]CMZ,[ ]Pond [ ] Hardwood Conversion:attach form [ ] Sensitive sites [ ] Volume greater than 5 MBF per acre [ ] Bald Eagle nest or roost within 660 feet Even-aged Harvest greater than 120 acres [ ] Water Verification [ ] Ground-based equipment on slopes>40% Road Assessment [ ] Road construction -5 feet [ ] RMAP# [ ] on slopes>65% Stream Crossing(s) [ ] stream crossing(s) [ ] Hatchery(TRAX code FS) [ ] Road abandonment feet [ ] Group A or B Water Supply(TRAX code DM or MU) [ J Cooperative Habitat Enhancement Agreement [ ] Bull Trout Overlay [ ] Landowner Option Plan for Northern Spotted Owl ( ] HCP Bull Trout Population [ ] SEPA Checklist/Documents [ ] Other. 3T"z.pu G' ASSOCIATED NON-SCANNED DOCUMENTS-On file with the FPA/N at the region office. [ ]SEPA Checklist/Documents [ ]Large Landowner Road Maintenance and Abandonment Plan ASSOCIATED SCANNED DOCUMENTS [ ] Hardwood Conversion Form [ ] Small Landowner RMAP Checklist [ ] Shoreline Permit [ ] Wetland Mitigation [ ] Conversion Option Harvest Plan [ ] Shade Documentation [ ] Water Protocol Survey [ ] FPHP Plans&Specifications [ ] DFC Printout [ ] Modification Form# [ ] Natural Regeneration [ ] Qualified Expert Report j7t] Water Classification Worksheet pq Marbled Murrelet Form [ ] Watershed Analysis Worksheet [ ] FPBM Appendix(s) WASHINGTON STATE DEPARTMENTOF Natural Resources r For DNR Region Office Use Only Step 2 Small Forest Landowner Region: Long-term Forest Practices Application Received Date: Resource Protection Strategies Western Washington PLEASE USE THE INSTRUCTIONS TO COMPLETE THIS APPLICATION. TYPE OR PRINT IN INK. 1. Landowner and Contact Person Legal Name of LANDOWNER CONTACT PERSON 2.Long-term FPA number: Casey Chamblin,until approval than 2417997 Overton&Associates,cAo Lusignan Forestry landowner Mailing Address: Mailing Address: This is the number DNR P.O.Box 1007 P.O.Box 1007 assigned to your Step 1, Resource and Roads Assessment. City, State,Zip City, State,Zip Shelton,WA.98584 Shelton,WA.98584 Phone (360 )426-1140 Phone (360 )490-6333 Email:lfrost@Ififorest.com Email: cichamblin@gmail.com 3. For how many years do you want this Long-term FPA to be valid?bears. Long-term FPAs are valid from 4 to 15 years. 4. Are you selling standing timber? eX Yes ❑No If Yes, record your Forest Tax Registration Account Number: _EQ0-0007- O For tax reporting information or to receive a tax number, call the Department of Revenue at 1-800-548-8829. 5. Is this forest practice application: (Answer each question) a. ❑No ❑X Yes Within the city limits or inside an urban growth area? If Yes, SEE INSTRUCTIONS FOR ADDITIONAL REQUIRED DOCUMENTS. b. x❑No ❑Yes Within a public park? If Yes, include SEPA Environmental Checklist or SEPA Determination, except for Harvestinglsalvaging less than 5,000 board feet within a developed public park. c. ❑X No ❑Yes Include an approved Conversion Option Harvest Plan (COHP)from the local government? If yes, include a copy. d. ©No ❑Yes Within 200'of the Ordinary High Water Mark(OHWM)or floodway of Type S water? If yes, check with the county or city to determine whether a substantial development permit is required under the local shorelines master plan. e. ❑X No ❑Yes Include an Alternate Plan? If yes, include a copy. 5/9/2014 1 of 6 WESTERN WASHINGTON STEP 2 Ah WASHINGTON STATE DEPARTMENTOF MIIW Natural Resources r For DNR Region Office Use Only Step 2 Small Forest Landowner Region: Long-term Forest Practices Application Resource Protection Strategies Received Date: Western Washington PLEASE USE THE INSTRUCTIONS TO COMPLETE THIS APPLICATION. TYPE OR PRINT IN INK. 1. Landowner and Contact Person Legal Name of LANDOWNER CONTACT PERSON 2.Long-term FPA number: Casey Chamblin,until approval than 2417997 Coulter Creek LP,c\o Lusignan Forestry landowner Mailing Address: Mailing Address: This is the number DNRassigned to your Step 1, P.O.Box 1007 P.O.Box 1007 Resource and Roads Assessment. City, State,Zip City,State,Zip Shelton,WA.98584 Shelton,WA.98584 Phone (360 )426-1140 Phone (360 )490-6333 Email:jfrost@ififorest.com Email: cichamblin@gmail.com 3. For how many years do you want this Long-term FPA to be valid? 1_years. Long-term FPAs are valid from 4 to 15 years. 4. Are you selling standing timber? ❑X Yes []No If Yes, record your Forest Tax Registration Account Number: $Oo -06 3 t7 O S For tax reporting information or to receive a tax number, call the Department of Revenue at 1-800-548-8829. 5. Is this forest practice application: (Answer each question) a. ❑No ❑x Yes Within the city limits or inside an urban growth area?If Yes, SEE INSTRUCTIONS FOR ADDITIONAL REQUIRED DOCUMENTS. b. ❑x No ❑Yes Within a public park? If Yes, include SEPA Environmental Checklist or SEPA Determination, except for Harvesting/salvaging less than 5,000 board feet within a developed public park. c. ❑X No []Yes Include an approved Conversion Option Harvest Plan(COHP)from the local government? If yes, include a copy. d. ❑x No ❑Yes Within 200'of the Ordinary High Water Mark(OHWM)or floodway of Type S water? If yes, check with the county or city to determine whether a substantial development permit is required under the local shorelines master plan. e. ❑X No ❑Yes Include an Alternate Plan? If yes, include a copy. 5/9/2014 1 of 6 WESTERN WASHINGTON STEP 2 AhWASHINGTON STATE DEPARTENTOF M Natural l Resources Stew For DNR Region Office Use Only Small Forest Landowner Region: Long-term Forest Practices Application Received Date: Resource Protection Strategies Western Washington PLEASE USE THE INSTRUCTIONS TO COMPLETE THIS APPLICATION. TYPE OR PRINT IN INK. 1. Landowner and Contact Person Legal Name of LANDOWNER CONTACT PERSON 2.Long-term FPA number: Casey Chamblin,until approval than 2417997 North Bay Properties,c\o Lusignan Forestry landowner Mailing Address: Mailing Address: This is the number DNR P.O.Box 1007 P.O.Box 1007 assigned to your Step 1,Resource and Roads Assessment. City, State,Zip City, State, Zip Shelton,WA.98584 Shelton,WA.98584 Phone (360 )426-1140 Phone (360 )490-6333 Email:jfrost@lfiforest.com Email: cichamblin@gmail.com 3. For how many years do you want this Long-term FPA to be valid?bears. Long-term FPAs are valid from 4 to 15 years. 4. Are you selling standing timber? ZXYes ❑No If Yes, record your Forest Tax Registration Account Number: c 00 070 " 30 For tax reporting information or to receive a tax number, call the Department of Revenue at 1-800-548-8829. 5. Is this forest practice application: (Answer each question) a. ❑No ❑x Yes Within the city limits or inside an urban growth area? If Yes, SEE INSTRUCTIONS FOR ADDITIONAL REQUIRED DOCUMENTS. b. ❑x No ❑Yes Within a public park? If Yes, include SEPA Environmental Checklist or SEPA Determination, except for Harvesting/salvaging less than 5,000 board feet within a developed public park. c. ONo ❑Yes Include an approved Conversion Option Harvest Plan(COHP)from the local government? /f yes, include a copy. d. ❑x No ❑Yes Within 200'of the Ordinary High Water Mark (OHWM)or floodway of Type S water? If yes, check with the county or city to determine whether a substantial development permit is required under the local shorelines master plan. e. ❑x No ❑Yes Include an Alternate Plan? If yes, include a copy. 5/9/2014 1 of 6 WESTERN WASHINGTON STEP 2 WASHINGTON STATE DEPARTMENTOF Natural Resources r For DNR Region Office Use Only Step 2 Small Forest Landowner Region: Long-term Forest Practices Application � Received Date: Resource Protection Strategies Western Washington PLEASE USE THE INSTRUCTIONS TO COMPLETE THIS APPLICATION. TYPE OR PRINT IN INK. 1. Landowner and Contact Person Legal Name of LANDOWNER CONTACT PERSON 2.Long-term FPA number: Casey Chamblin,until approval than 2417997 North Mason LP,c\o Lusignan Forestry landowner Mailing Address: Mailing Address: This is the number DNR assigned to your Step 1, P.O.Box 1007 P.O.Box 1007 Resource and Roads Assessment City,State,Zip City, State,Zip Shelton,WA.98584 Shelton,WA.98584 Phone (360 )426-1140 Phone (360 )490-6333 Email:jfrost@lfiforest.com Email: cichamblin@gmail.com 3. For how many years do you want this Long4erm FPA to be valid?bears. Long-term FPAs are valid from 4 to 15 years. 4. Are you selling standing timber? OX Yes []No If Yes, record your Forest Tax Registration Account Number: 80d- 4 70 - 300 For tax reporting information or to receive a tax number, call the Department of Revenue at 1-800-548-8829. 5. Is this forest practice application: (Answer each question) a. ❑No [Yes Within the city limits or inside an urban growth area?If Yes, SEE INSTRUCTIONS FOR ADDITIONAL REQUIRED DOCUMENTS. b. 2jNo 0Yes Within a public park? If Yes, include SEPA Environmental Checklist or SEPA Determination, except for Harvesting/salvaging less than 5,000 board feet within a developed public park. c. ZNo DYes Include an approved Conversion Option Harvest Plan(COHP)from the local government?If yes, include a copy. d. NNo E]Yes Within 200'of the Ordinary High Water Mark(OHWM)or floodway of Type S water? If yes, check with the county or city to determine whether a substantial development permit is required under the local shorelines master plan. e. NNo []Yes Include an Alternate Plan?If yes, include a copy. 5/9/2014 1 of 6 WESTERN WASHINGTON STEP 2 WASHINGTON STATE DEPARTMENTOF ` Natural Resources r For DNR Region Office Use Only Step 2 Small Forest Landowner Region: Long-term Forest Practices Application Received Date: Resource Protection Strategies Western Washington PLEASE USE THE INSTRUCTIONS TO COMPLETE THIS APPLICATION. TYPE OR PRINT IN INK. 1. Landowner and Contact Person Legal Name of LANDOWNER CONTACT PERSON 2.Long-term FPA number: Casey Chamblin,until approval than 2417997 Southwest Kitsap LP,c\o Lusignan Forestry landowner Mailing Address: Mailing Address: This is the number DNR P.O.Box 1007 P.O.Box 1007 assigned to your Step 1, Resource and Roads Assessment. City, State,Zip City, State,Zip Shelton,WA.98584 Shelton,WA.98584 Phone (360 )426-1140 Phone (360 )490-6333 Email:jfrost@lfiforest.com Email: cichamblin@gmaiI.com 3. For how many years do you want this Long-term FPA to be valid? 1_years. Long-term FPAs are valid from 4 to 15 years. 4_ Are you selling standing timber? OXYes [:]No If Yes, record your Forest Tax Registration Account Number: 800 070 - Z-ig For tax reporting information or to receive a tax number, call the Department of Revenue at 1-800-548-8829. 5. Is this forest practice application: (Answer each question) a. ❑No XZYes Within the city limits or inside an urban growth area? If Yes, SEE INSTRUCTIONS FOR ADDITIONAL REQUIRED DOCUMENTS. b. OX No ❑Yes Within a public park? If Yes, include SEPA Environmental Checklist or SEPA Determination, except for Harvesting/salvaging less than 5,000 board feet within a developed public park. c. [ENo ❑Yes Include an approved Conversion Option Harvest Plan (COHP)from the local government? If yes, include a copy. d. px No ❑Yes Within 200'of the Ordinary High Water Mark (OHWM)or floodway of Type S water? If yes, check with the county or city to determine whether a substantial development permit is required under the local shorelines master plan- e. F No []Yes Include an Alternate Plan? If yes, include a copy. 5/9/2014 1 of 6 WESTERN WASHINGTON STEP 2 6. Are you substituting prescriptions from an approved state or federal conservation agreement or watershed analysis? ❑x No ❑Yes Write "Using Prescriptions"in tables that apply- Attach or reference prescriptions/crosswalk on file. 7. Is the taxpayer eligible for the EARR Tax Credit? []No ❑x Yes not working in or over typed waters, skip to number 1 ********** Prior to answering number 8-11 in this section please refer to the Forest Practices Application Instructions and Forest Practices Board Manual Section 5(BM 5). 8. Are you proposing any of the following projects NOT permitted by current HPAs from WDFW? a. ❑ No ❑Yes Installing, replacing or repairing a culvert at or below the bankfull width of Type S or F Water(s) that exceeds a five percent gradient? b. ❑ No ❑ Yes Constructing, replacing, or repairing a bridge at or below the bankfull width of unconfined streams in Type S or F water(s)? c. ❑ No ❑ Yes Placing fill material within the 100-year flood level of unconfined streams in Type S or F water(s)? 9. Have you consulted with DNR and/or WDFW about the proposed hydraulic project(s) in or over Type S or F water? ❑ No []Yes 10. If installing, replacing, removing or maintaining structures in or over any typed water,complete the table below. Type S and F waters require detailed plan infonnation. Provide plan details in number 23 or attach plan to the FPA/N. Provide crossing locations and identifiers on your Activity Map. (A detailed plan with profiles may also be required for more complex hydraulic projects in Type N Waters per WAC 222-24-042(2)), m a� o E A v m �-� s `m .0 0 E °' v c 2 « wF z �°' � oo � E � (D cm 3 m « UaCN»C0 3>,a rnavm 2``a° � wo La m` m2 UC1 Con a 0�0 c .o Z 0 0 a. Xm m 60 m _ u� co c wa) - da C o 0 C 2 0.LL: Za y d C0 o f O LL O � }U W - C a C U? LL U) LL *Existing HPAs issued by WDFW will be complied and enforced by WDFW until expiration. Plan details are not required for hydraulic projects permitted with an existing HPA(see instructions). **Fords and equipment crossings on Type S and F Waters may result in an unauthorized incidental take of certain endangered or threatened fish species. For more information, see"Background for the state's Incidental Take Permits for certain endangered and threatened fish species"following number 16 of the Long-term FPA/N Instructions. 5/9I2014 2 of 6 WESTERN WASHINGTON STEP 2 Forest Practices WA.SFiINGTON STATE DEPARTMENTOr Natural Resources Informal Conference Note 1CN No, Legal Subdivision Section I TWP I RGE EM Application i Notification# I Class 18161 Muitipie 23N 01 W 2417997 3 Landowner Timber Owner operator �•-°°� �° •� °�-au.o.d•� Same as Landowner Same as Landowner Mailing Address Mailing Address Mailing Address PO Box 1007 City,State(P(ovince),Zip(Postal Code) City,State(Province),Zip(Postal Code) City,State(Provi—),Zip(Postal Code) Shelton, WA. 98584 Meeting Location Telephone Date Time Region On-Site Conference[ ] 7/14/2015 4:00 SPS Subjects Discussed: LTA Step 1 review of resources Decisions Made: STREAMS: 1)S-16 and S-17 are typed as"F"water,but does not exist.Sheet flows during heavy rain events;no evidence of scour or connectivity. 2)W-9 is typed as a'B'wetland but is a forested wetland.W-7 needs to be added on the activity map as an'A'wetland. 3)Crossing C-4 and C-6 are fish barriers;during step 2,include how the fish barriers will be addressed. 4)C-5 crosses an Ns stream;currently a ford exists.Need to install a minimum 18'culvert. 5)All roads and stream crossings that fall under BPA powerlines by rule interpretation are considered non forestland. Draw BPA right-of-way on activity maps and remove crossings that fail within this area from the LTA. Department of Ecology has water quality concerns if hauling on roads within BPA tight-of-way. 1tf jAfso pFhJ PRINT Participants'Names *SIGNATURES of Participants Representing copl- Maw CI^c�+'tQS foal L �cY [i o sL. 13,e, v A W •. Fct1 T&-Sov� LP--',5 Skoko•••s4 �*; t 1 Posidon No. Slgneh�re 8 Tdle of DNR Representative Date Work Phone 3970 roast Pracdee Forester 7/1Ut0�5 384�90-e28D '(Participant signature means Note Is correct ubjects discussed and decisions made at the meeting.) Did not attend-mail copies to: ( ]Timber Owner X Landowner [ ]Other Patties: — _-- (10b R—it/W VNrte--Ra4m Canary--Operas r Pink—DNR Representedve 11. If conducting any of the following activities in or over typed water,complete the table below. Some activities will require identifiers on your Activity map and/or more information in number 23,Additional Information. See instructions. *Activity Type S Water Type F Water Type Np Water Type Ns Water Equipment Crossing** Suspending Cables Cable Yarding LWD Placement/Removal Beaver Dam Removal Felling and Bucking Other(describe in number 31) *Existing HPAs issued by WDFW will be complied and enforced by WDFW until expiration. Plan details are not required for hydraulic projects permitted with an existing HPA(see instructions). **Fords and equipment crossings on Type S and F Waters may result in an unauthorized incidental take of certain endangered or threatened fish species. For more information, see"Background for the state's Incidental Take Permits for certain endangered and threatened fish species"following number 16 of the Long-term FPA/N Instructions. 12. If constructing or abandoning forest roads complete the table below. Show the road locations and I dentifiers on your Activity Map. Include abandonment plans for temporary roads and abandonment projects. Road Construction Road Abandonment Road Identifier(name, Steepest number) Length(feet) Side-slope Length(feet) Abandonment Date (%) P-1 2800 15 N\A NW P-2 800 15 NW NW 13. If depositing spoils and/or expanding or developing a rock pit for forestry use,complete the table below. Show their locations,along with their Identifiers,on your Activity Map. Amount of Spoils Rock Pit Identifier Acres of Existing Spoil Area Identifier Deposited (name,number,or Acres of New e Rock Pit (letter,number) cubic yards) letter Pit Developedd Expanded N\A NW 14. If operating in or within 200 feet of a wetland,complete the table below.Show the boundaries of each wetland, along with its Identifier,and WMZ on your Activity Map.See instructions for information. Wetland Wetland Planned Total How many How many Identifier Type Planned Activities Activities in Wetland acres are you acres are you (number, (A, B,or in Wetland Maximum Width Area(acres) draining? filling? letter) Forested) WMZ See Attached 5/9/2014 3 of 6 WESTERN WASHINGTON STEP 2 15.Complete the table below for timber harvest and/or salvage. Show all harvest areas,along with their Unit Numbers,on your Activi Ma . Harvest Method c m (Rubber Tired Skidder, `m Harvest Type Tracked Skidder, Dozer, E o o (Even-aged, x Shovel, Full Suspension .0 on 10 0 -0 g 0 -0 � Uneven-aged, Salvage, Cable, Lead-end Suspension o r' m �' m � & w r Z Right-of-Way) 10 Cable, Helicopter,Animal, a, m E 0 E m E E m m o Z Chipper-forwarder, Slash 42 A o R o 0 o to p3 m} Bundler) a x > x > x-- > x W x See Attached If not using the exempt 20 acre parcel RMZ rule, skip to number 19 16. If using the exempt 20-acre parcel RMZ rule on Type S,F,or Np Waters answer the following questions. Show all RMZs on your Activity Map. a. ❑No ❑Yes Was this parcel 20 acres or less before June 5, 2006? b. ❑No ❑Yes Have you owned less than 80 forested acres on or before June 4, 2006? 17. If harvesting within the Maximum RMZ widths of a Type S or F Water on a 20-acre exempt parcel, complete the table below. Show RMZs,along with their associated stream segment identifiers,on your Activity Map. (Include stream shade assessment methodology if you are harvesting within 75 feet, or the maximum RMZ, whichever is LESS. If using BM1 to evaluate shade, you may use the"Stream Shade Assessment Worksheet"). Are you Stream Segment Water Type Segment Length Bankfull Width Maximum RMZ harvesting within Identifier(letter) (S, F) (feet) (feet) Width (feet) the maximum RMZ? (Y or N) 18.Are you harvesting within 29 feet of a Type Np water on a 20 acre exempt parcel? ❑No Skip to number 21. []Yes See instructions and describe leave tree strategy in number 23. Then skip to number 21. 5/9/2014 4 of 6 WESTERN WASHINGTON STEP 2 19. If harvesting within 200 feet of any of Type S or F Waters,complete the table below. Include DFC for all inner zone harvest,unless you have an HCP prescription. Show RMZs and CMZs,along with their associated stream segment identifiers,on your Activity Map. (include stream shade assessment methodology if you are harvesting within 75 feet, or the maximum RMZ, whichever is LESS. If using BM1 to evaluate shade,you may use the"Stream Shade Assessment Worksheet"). Stream RMZ Segment Water Type Site Class Stream Is there a Harvest DFC Run Total width Identifier (S or F) (I-V) Width(feet) CMZ? Code(s) of RMZ Number (feet) (letter) (y,/N) (see instructions) See Attached 20. If harvesting within 50 feet of Type Np Water,complete the table below. Show RMZs,along with their associated stream se ment identifiers,on your Activity Map. Stream Total Stream Length of No-Harvest, Stream Total Stream Length of No-Harvest, Segment Length in 50-foot Buffers in Segment Length in 50-foot Buffers in Identifier Harvest Unit Harvest Unit Identifier Harvest Unit Harvest Unit (letter) (feet) (feet) (letter) (feet) (feet) NSA 21. How are the following marked on the ground?(Flagging,paint, road, fence, etc) Harvest Boundaries: Ribbon,Paint,Roads,Type change, Clumped Wildlife Reserve Trees/Green Recruitment Trees: Ribbon,Paint Right-of-way limits/road centerlines: Ribbon Stream Crossing Work: NSA Riparian Management Zone Boundaries and Leave/Take Trees: Ribbon,Paint Extents of unstable feature(s): NW Channel Migration Zone(s): NSA Wetland Management Zone Boundaries and Leave/Take Trees: Ribbon,Paint 22. Have you reviewed the proposed activity area to determine if it may involve historic sites and/or Native American cultural resources? Read the instructions carefully before answering this question. []No nx Yes 5/9/2014 5 of 6 WESTERN WASHINGTON STEP 2 23. Additional Information: (attach additional paper, if needed) • For hydraulic protects in or over F or S water(s) see instructions for additional required plan information 24. We acknowledge the following: • The information on this application is true. • We understand this proposed forest practice is subject to: o The Forest Practices Act and Rules o All other federal,state or local regulations • Compliance with the Forest Practices Act and Rules does not ensure compliance with the Endangered Species Act or other federal,state or local laws. • This isn't a conversion application to non-forestry use. The county or city may deny development permits on this parcel for the next 6 years. • The following may result in an unauthorized incidental take of certain endangered or threatened fish species o Conversion of land to non-forestry use o Harvesting within the maximum RMZ on a 20-acre exempt parcel that was acquired after June 5,2006 Signature of LANDOWNER* Print Name: Date: `NOTE: If you are a "Perpetual Timber Rights Owner,"and are submitting this without the Landowner's Signature,provide written evidence the landowner has been notified. 5/9I2014 6 of 6 WESTERN WASHINGTON STEP 2 A '.. 9 Cr W aaowma"q' aI oo $ T = r egg e3 D po 'n W r p a. ID d ID a 0- z z Z z z z z 7 z z z z z z A � i N I � v X c o. e=i z Z 2 z z d 2 z Z Z z z 3 s I g � N 7 D � v a N In N O W m W o f+ N f+O O ni A in A in A In Ln (p C a a � f 0 0 0 0 0 0 0 0 0 00 0 0-T- 9 � g o ol00000000000� 3 g 15.(Continued) — -- tv. _ _ -- -_Unit Number Biomassume to be Volume to be Steepest Volume t0 Acres to be harvested slope n Harvest Ty pe Harvest Harvest Method harvested be harvested (Y\N) harvested (biomass % Harvest H-31 Even a (mbn tonne e) ( ) Unit(% ged N Rubber tired skidder,shovel 191 200 N\A 100 30 H-32 Even-aged N Rubber tired skidder,shovel 20S 220 N\A 100 20 H-33 Even-aged N Rubber tired skidder,shovel 107 12S N\A 100 20 _H-34 Even-aged N Rubber tired skidder,shovel 239 2S0 N\A 100 30 H-35 Even-aged N Rubber tired skidder,shovel so 100 N\A 100 25 H-36 Even-aged N Rubber tired skidder,shovel 227 135 N\A 100 2S H-37 Even-aged N Rubber tired skidder,shovel 122 130 N\A 100 30 H 38 Even-aged N Rubber tired skidder,shovel 57 7S N\A 100 30 N � I cL O in 3 7 iA N r 0 I I � oo ryC N I p a I L � T i T T T T T T T T T T T T T T T T T II f � IO O O�O O O AIW oo O ;D cn Ln A 0 0 0 0 3 3 N N .+ �zzlzzzz xizzzzzzzzzzz 3 JJ z 1 Cm o -t b Immm .J.P, mwoomwaowwa+ eowmofD =I n� (o I 3333�33 333 �`3333333 � zzzzzz zzzzzzzz sssssssssssssss O O O r r ►A+ O r r yr Ar Ar �p Ar Ar ar pr r c i0 o O O O at o O O O O a SEPA Environmental Checklist Mason County Permit Center Use: SEP �� 1 - ❑ Single Family DNS: $600.00 Parcel #: XOther DNS: 0 to 9.99 acres: $730 10 to 20 acres: $880 Date Rcvd RECEIVED Over 20 acres: $1100 ❑ DS/EIS: $5000 + $90 per hour FEB 2 7 2019 615 W. Alder Street 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: 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 1. Name of proposed project, if applicable: Belfair Park and Ride Water Line Extension 2. Name of applicant: David Overton 3. Address and phone number of applicant and contact person: David Overton Apex Engineering attn: Scott Ruedv PO Boxe459, 1,1144 2601 South 35" Suite 200 7 TAtPAU ik W'40 Tacoma,WA 98409 Phone: 233 Z17-"61 Phone 253-277-0595 � r .. .�.,. �„ -ttd.'..e..` ..�. SEPA Environmental checklist(WAC 197-11-960)(MC version-non project portiorfomitted): 2016 Page 1 of 11 4. Date checklist prepared: 12118118 5. Agency requesting checklist: Mason County 6. Proposed timing or schedule (including phasing, if applicable): Construction has been completed. 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. None anticipated 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. A forest practice permit FPA 2417997 was approved on the property. 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. None known at this time. 10. List any government approvals or permits that will be needed for your proposal, if known. None anticipated. 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.) The project has been completed. A 3,746-foot-long 60'wide area was cleared and graded to accommodate the installation of a water line extension. The total area cleared was 224,760 square feet. 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. Parcel #(s): 123214300130, 12328000300, 123214100000, 123214400000 Address: Belfair, Washington Twp/Range/Section and/or GPS location: A portion of the E% Section 21, the W% Section 22 and the NE% Section 28, Township 23 North, Range .1 West W.M. B. ENVIRONMENTAL ELEMENTS 1. Earth a. General description of the site (circle one): Flat, rolling, ill steep slopes, mountainous, other: b. What is the steepest slope on the site (approximate percent slope)? The steepest slope on the site is 20% 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. Per NRCS Web Soil Survey: Alderwood Gravelly Sandy Loam Everett Gravelly Loamy Sand d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. None known 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. Grading and erosion control for water line installation. Cut= 1,907 CY+- Fill= 1,530 CY+- Net= 377 CY+- Cut f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. Minimal erosion could occur, but it is unlikely due to the soil classification, minimal slopes and conditions near the site. During the construction phases, erosion more likely to happen between the months of October and April. g. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? None at this time. h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: Temporary Erosion and Sediment Control(TESC) BMP's will be implemented during site construction as well as TESC measures carried over from clearing and grading. On site grading will be reviewed and permitted by Mason County prior to any earthwork. The TESC measures will remain in place from the clearing and grading activities until the site is stabilized and with Mason County approval. TESC BMP's will be used as necessary. 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. During Construction:Dust and exhaust from vehicles and construction machinery and equipment. b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. None known or anticipated. c. Proposed measures to reduce or control emissions or other impacts to air, if any: All construction equipment will be in proper working order and within compliance of the State regulations regarding vehicle emissions. In accordance with Mason County standards, the site will be watered, and the streets will be cleaned, as necessary, to reduce dust emissions during construction. 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. According to the National Wetlands Inventory there is a Freshwater Forested/Shrub Wetland habitat that is classified as a PSSC(Palustrine, Scrub-Shrub, Seasonal Flooded) south of the site. Also, there is a Riverine habitat classified as a R4SBC (Riverine, Intermitten, Streambed, Seasonally Flooded)runs through the site. 2) Will the project reg6ire any work over, in, or adjacent to (within 200 feet) the described waters? If yes, please describe and attach available plans. Yes, clearing took place across two areas along the Riverine Habitat 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. There is no fill or dredge materials that will be placed within surface water or wetlands. 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. None required. 5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. The site is not within the 100-year floodplain. 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. None known. 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. 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. There is no system proposed. c. Water runoff(including stormwater): I) 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. The storm water will be collected in roadside ditches and dispersed onto the applicants property where it will infiltrate over time. 2) Could waste materials enter ground or surface waters? If so, generally describe. no waste material will enter ground or surface waters 3) Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site? If so, describe. No, the site is proposed to mimic existing drainage patterns. d. Proposed measures to reduce or control surface, ground, and runoff water, and drainage pattern impacts, if any: Temporary erosion and sediment control(TESC) measures will be used both for the clearing and grading. TESC measures will remain in place and TESC best management practiced(BMP's) will be applied as necessary through completion of the site work. All disturbed areas will be stabilized by land cover and trees will be replaced in accordance with the forest practice permit. 4. Plants a. Check the types of vegetation found on the site: deciduous tree: alder, maple, aspen, other x 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? Evergreen trees and bushes and shrubs were removed. The area cleared was 224,760 square feet. c. List threatened and endangered species known to be on or near the site. None known d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any: Except for the water line easement area, the areas cleared will be replanted per the forest practice permit. (2417997) 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. birds: hawk, heron, eagle, on it other: mammals: deer ear elk, beaver, other: fish: bass, salmon, trout, herring, shellfish, other: b. List any threatened and endangered species known to be on or near the site. The project site has not been documented to provide critical habitats for federally listed Endangered, Threatened, or Sensitive species via review of the US Fish and Wildlife Service ECOS online mapper. c. Is the site part of a migration route? If so, explain. The Puget Sound is part of the Pacific Flyway, birds that inhabit the region vary seasonally. The State of Washington Priority Habitats and Species (PHS) Mapping was reviewed as part of this review. The mapping resource did not identify any priority habitats or priority species within or immediately adjacent to the area that was cleared. d. Proposed measures to preserve or enhance wildlife, if any: None proposed. 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. Not applicable. 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: None proposed or needed. 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? No If so, describe. 1) Describe any known or possible contamination at the site from present or past uses. None known 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 known. 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. None known 4) Describe special emergency services that might be required. No special emergency services are required. 5) Proposed measures to reduce or control environmental health hazards, if any: None proposed at this time. b. Noise 1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? No noise in the area will affect the project. 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. During construction, short-term noise emitted from the use of construction equipment and activities would be created during permitted hours of construction per Title 9.36. Long term noise is not anticipated with this project. 3) Proposed measures to reduce or control noise impacts, if any: All construction vehicles are required to be muffled per existing vehicle regulations. Construction will be limited to normal construction day time hours between approximately 7AM and 10 PM during the week and 9 AM to 10PM on the weekend. Noise is regulated by Mason County Code 9.36. 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. The site has been used as working forest lands and has a forest practice permit. Uses adjacent to the site includes a church, commercial/industrial buildings and a water tank. b. Has the project site been used as working farmlands or working forest lands? If so, describe. The site has been used as working forest lands and has a forest practice permit. 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? None If resource lands have not been designated, how many acres in farmland or forest land tax status will be converted to nonfarm or non-forest use? None 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. There are no structures where it was cleared. d. Will any structures be demolished? If so, what? No e. What is the current zoning classification of the site? General Commercial& Multi-Family Residential f. What is the current comprehensive plan designation of the site? Resource-Designated Forest Land g. If applicable, what is the current shoreline master program designation of the site? Not applicable. h. Has any part of the site been classified as a critical area by the city or county? If so, specify. No i. Approximately how many people would reside or work in the completed project? None j. Approximately how many people would the completed project displace? None k. Proposed measures to avoid or reduce displacement impacts, if any: Not applicable. L. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: No proposed measures. m. Proposed measures to ensure the proposal is compatible with nearby agricultural and forest lands of long-term commercial significance, if any: Except for the water line easement area, the areas cleared will be replanted per the forest practice permit. (2417997) 9. Housing a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-income housing. No housing provided. b. Approximately how many units, if any, would be eliminated? Indicate whether high, middle, or low-income housing. No housing eliminated. c. Proposed measures to reduce or control housing impacts, if any: No housing provided. 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. b. What views in the immediate vicinity would be altered or obstructed? No c. Proposed measures to reduce or control aesthetic impacts, if any: No structures. 11. Light and glare a. What type of light or glare will the proposal produce? What time of day would it mainly occur? No light or glare would be produced. b. Could light or glare from the finished project be a safety hazard or interfere with views? No c. What existing off-site sources of light or glare may affect your proposal? No d. Proposed measures to reduce or control light and glare impacts, if any: None proposed. 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? No recreational opportunities are designated. 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: No impacts on recreation. 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. According to the Washington Information System for Architectural and Archaeological Records Data (WISAARD) there are no listed places or objects on or adjacent to the site. No structure on site or adjacent to the site is listed on, any national or state preservation registers. National/State Eligibility: No structures on or near the site have been formally shown as eligible for the national/state register. However, it is possible that properties in the vicinity built more than 50 years ago could become eligible. 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. None known 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. The Department of Archaeology and Historic Preservation (DAHP) is Washington State's primary agency with knowledge and expertise in historic preservation. They provide an online search for registered and inventoried properties, known as WISAARD. WISAARD was reviewed for this checklist. Also, The National Register of Historic Places provided by the US Department of the interior was reviewed. 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. If ground disturbing activities encounter human skeletal remains during the course of construction, then all activity will cease that may cause further disturbance to those remains. The area of the find will be secured and protected from further disturbance. The finding of human skeletal remains will be reported to the county medical examiner/coroner and local law enforcement in the most expeditious manner possible. The remains will not be touched, moved, or further disturbed. The county medical examiner/coroner will assume jurisdiction over the human skeletal remains and make a determination of whether those remains are forensic or non-forensic. If the county medical examiner/coroner determines the remains are non-forensic, then they will report that finding to the Department of Archaeology and Historic Preservation (DAHP) who will then take jurisdiction over the remains. The DAHP will notify any appropriate cemeteries and all affected tribes of the find. The State Physical Anthropologist will make a determination of whether the remains are Indian or Non-Indian and report that finding to any appropriate cemeteries and the affected tribes. The DAHP will then handle all consultation with the affected parties as to the future preservation, excavation, and disposition of the remains. 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. The site is on the 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? The site is not served by public transit. The nearest transit stop is at the Roy Boad Road Park and Ride which is located approximately% mile to the south. c. How many additional parking spaces would the completed project or non-project proposal have? How many would the project or proposal eliminate? No parking needed or proposed. 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). No. e. Will the project or proposal use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe. 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 non-passenger vehicles). What data or transportation models were used to make these estimates? No vehicle trips are generated. 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: No transportation impacts. 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. No b. Proposed measures to reduce or control direct impacts on public services, if any. No 16. Utilities a. Circle utilities currently available at the site: lectricit natural gas, < � refuse service, telephone, sanitary sewer, septic system, a e Page 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. As part of the clearing and trenching a water line extension was installed. 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 Signed: Print Name of Signee: If applicable, Position and Agency/Organization: S.lio,ee�'/`!�c eX 45pe!3"Pr e el.:1S J J;G G C Date Submitted: Page r, R�6 sT�re oA s 0 `dgy�ease�yr STATE OF WASHINGTON DEPARTMENT OF ECOLOGY PO Box 47775 -Olympia, Washington 98504-7775 •(360)407-6300 711 for Washington Relay Service •Persons with a speech disability can call 877-833-6341 July 22,2019 Ron Buckholt, Planner Mason County Department of Community Services Planning Division PO Box 279 Shelton, WA 98584 Dear Ron Buckholt: Thank you for the opportunity to comment on the determination of nonsignificance for the Belfair Park and Ride Water Line Extension Project(SEP2019-00008) located at 25200 Northeast State Route 3 as proposed by Apex Engineering for David Overton. The Department of Ecology(Ecology)reviewed the environmental checklist and has the following comment(s): HAZARDOUS WASTE&TOXICS REDUCTION: Tara Davis(360) 407-6275 New construction: Construction waste is usually left over from construction work sites.New construction creates dangerous waste from treated wood, paint, solvents, glue, roofing tars, and other materials.These must be designated and disposed of properly under the Dangerous Waste Regulations. Choose less hazardous materials and find safer alternatives, when possible. Recycling or reusing dangerous materials: If dangerous materials are to be thrown out,then you are required to designate and handle them according to the laws for that type of waste. However, recycled or reused dangerous materials are not regulated the same way. For example,a door painted with lead-based paint can be reused as it is without designation. If that door is to be discarded,then it must be designated and handled as dangerous waste. SOLID WASTE MANAGEMENT: Derek Rockett(360) 407-6287 All grading and filling of land must utilize only clean fill. All other materials may be considered solid waste and permit approval may be required from your local jurisdictional health department prior to filling. All removed debris resulting from this project must be Ron Buckholt July 22,2019 Page 2 disposed of at an approved site. Contact the local jurisdictional health department for proper management of these materials. WATER QUALITY/WATERSHED RESOURCES UNIT: Chris Montague-Breakwell(360)407-6364 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 stormdrains that lead to waters of the state. Sand, silt, clay particles, and soil will damage aquatic habitat and are considered to be pollutants. Any discharge of sediment-laden runoff or other pollutants to waters of the state is in violation of Chapter 90.48 RCW, Water Pollution Control,and WAC 173-201A, Water Quality Standards for Surface Waters of the State of Washington, and is subject to enforcement action. Construction Stormwater General Permit: The following construction activities require coverage under the Construction Stormwater General Permit: 1. Clearing, grading and/or excavation that results in the disturbance of one or more acres and discharges stormwater to surface waters of the State; and 2. Clearing, grading and/or excavation on sites smaller than one acre that are part of a larger common plan of development or sale, if the common plan of development or sale will ultimately disturb one acre or more and discharge stormwater to surface waters of the State. a) This includes forest practices(including, but not limited to, class IV conversions) that are part of a construction activity that will result in the disturbance of one or more acres,and discharge to surface waters of the State;and 3. Any size construction activity discharging stormwater to waters of the State that Ecology: a) Determines to be a significant contributor of pollutants to waters of the State of Washington. b) Reasonably expects to cause a violation of any water quality standard. If there are known soil/ground water contaminants present on-site, additional information (including, but not limited to:temporary erosion and sediment control plans; stormwater pollution prevention plan; list of known contaminants with concentrations and depths found; a site map depicting the sample location(s); and additional studies/reports regarding contaminant(s))will be required to be submitted. You may apply online or obtain an application from Ecology's website at: http://www.ecy.wa.gov/programs/wg/stonnwater/construction/-Application. Construction site operators must apply for a permit at least 60 days prior to discharging stormwater from construction activities and must submit it on or before the date of the first public notice. r r Ron Buckholt July 22, 2019 Page 3 Ecology's comments are based upon information provided by the lead agency. As such,they may not constitute an exhaustive list of the various authorizations that must be obtained or legal requirements that must be fulfilled in order to carry out the proposed action. 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 (MLD:201903874) cc: Tara Davis,HWTR Derek Rockett, SWM Chris Montague-Breakwell, WQ Apex Engineering, Scott Ruedy(Agent/Contact) Page 1 of 1 Ronald Buckholt - SEP2019-00008 From: Ronald Buckholt PLANNING Date: 3/12/201912:24 PM Subject: SEP2019-00008 Dear Applicant, I am Ron Buckholt, planner with Mason County, reviewing SEPA Checklist submittal (SEP2019-00008)for an after-the-fact project involving the clearing and grading for the installation of a water line extension. Unfortunately,the subject permits are being placed on HOLD, due to the following reason(s): 1. The SEPA Checklist submittal did not include a detailed site plan. Please provide a scaled site plan depicting the scope of work and the location of project area in relationship to the property boundaries,etc. Furthermore, the SEPA checklist indicates that the project encroached along two riverine habitat areas. Please provide the subject two riverine habitat areas on the site plan, as well, so that staff can evaluate potential impacts and determine whether or not any potential restoration will be required. Stream and wetland regulations can be found in MCC 8.52.110 and 170. 2. According to the submitted SEPA Checklist,the project exceeded 200 cu.yrds.of earthwork,therefore,a grading application is required to permit the after-the-fact work. Please provide. Please address these issues in order for the review process to proceed.Thank you in advance. about:blank 3/12/2019 vp'e May 6,2019 Mason County Community Services-Planning Attn: Ronald Buckholt 615 W Alder Street Shelton,WA 98584 Reference: SEPA Review: Application SEP2019-00008 Mr. Buckholt, We have addressed the following comments from the memo dated 3/12/2019 for the extension of a water line. 1. The SEPA Checklist submittal did not include a detailed site plan. Please provide a scaled site plan depicting the scope of work and the location of project area in relationship to the property boundaries, etc. Furthermore,.the SEPA checklist indicates that the project encroached along two riverine habitat areas. Please provide the subject two riverine habitat areas on the site plan,as well, so that staff can evaluate potential impacts and determine whether or not any potential restoration will be required. Stream and wetland regulations can be found in MCC 8.52.110 and 170. A detailed site plan has been provided as requested for your review. After further review, there are mot riverine habitat area on the site. Mason County GIS mapping which was based on a predictive modeling for streams, rather than field verification, incorrectly depicts Irene Creek as a two forked stream on the portions of the project area which then crossing SR-3 flowing to the west.However, Irene Creek is only located to the west of SR-3. While the locations shown on the GIS map are topographic low spots they are not actually a stream or stream habitat area. These low spots are also depicted on the forest practice permit for the site and shown as approved crossings due to this predictive modeling mapping,however, there is not a stream on site. 2. According to the submitted SEPA Checklist,the project exceeded 200 cu. yards. of earthwork, therefore,a grading application is required to permit the after-the-fact work.Please provide. We have provided a completed grading application as requested. Please let me know if you need additional information or if you have questions or concerns. I can assist in anyway. Thank you. KOO Scott Ruedy,AICP 2601 South 35th St.9200 ' Tacoma.WA 98409 1 apexengineering.net 1 (253)473.4494 ® ® rQ c SCJ ALLIANCE CONSULTING SERVICES TECHNICAL MEMORANDUM (Update) TO: Danette Brannin Mason Transit Authority 790 E.Johns Prairie Road Shelton,WA 98584 FROM: Lisa Palazzi,CPSS, PWS SCJ Alliance DATE: January 23,2019 PROJECT#: 738.05 SUBJECT: Results of onsite assessment of potential stream conditions 1. PROJECT DESCRIPTION SCJ Alliance was asked to assess potential stream conditions on the future Mason Transit Authority Park and Ride site, located inside of Tax Parcel number 12321-41-00000 nearthe intersection of Highway 3 and Log Yard Road,about a mile northeast of Belfair,WA(Figure 1). Mason County GIS maps indicate a potential stream crossing through the MTA development site, however, no streams were clearly documented in the past. To answer the question,SCJ Alliance staff—Patrick Holm, P.E. and Lisa Palazzi, CPSS, PWS—visited the site on January 16,2019 to evaluate culvert crossings and look for evidence of continuous surface flow pathways. No regulated streams were found on the Project Site. Figure 1. Mason Transit Park and Ride Project Site Area. 8730 Tallon Lane NE,Suite 200 • Lacey,WA 98516 • Office 360.352.1465 • Fax 360.352.1509 • www.scialliance.com (Y1 i✓1 r&14 1 y-- )l S�;,P16 1 h -S ) ex+ 6 q I /L}- e MTA Park&Ride Site Stream Assessment January 23,2019 -��`► Page 2 of 4 2. RESULTS AND DISCUSSION SCJ Staff visited the site on January 161h,2019 to assess potential stream conditions. The weather was 45 degrees and clear, but antecedent rainfall conditions were within normal range. the range of normal. The definition of a regulated stream per Mason County Code is the same as the state definition—WAC 222-16-030: "Streams: Those areas where surface waters flow sufficiently to produce a defined channel or bed. A defined channel or bed is an area which demonstrates clear evidence of the passage of water and includes, but is not limited to,bedrock channels, gravel beds,sand and silt beds and defined channel swales. The channel or bed need not contain water year round. This definition is not meant to include irrigation ditches, canals,storm or surface water runoff devices or other entirely artificial watercourses, unless they are used by salmon or used to convey streams naturally occurring prior to construction. " For purposes of this project,We focus on the definition of a Type Ns Stream (non-fish,seasonal): "Type Ns Streams"are all segments of natural waters within the bankfull width of the defined channels that are not Type S, F, or Np Waters. These are seasonal,nonfish habitat streams in which surface flow is not present for at least some portion of a year of normal rainfall and are not located downstream from any stream reach that is a Type Np Water. Ns Waters must be physically connected by an above-ground channel system to Type S, F,or Np Waters." Therefore,for a seasonal flow channel to be regulated as a stream,the surface flow pathway must surface flow into other streams or wetland systems. To make this determination,we walked the existing logging road that crosses through the project site and marked (with handheld GPS waypoints) locations of two culverts and associated flow pathways in the road in the vicinity of the mapped stream channel (Figure 2). The presence of culverts suggests that there was some surface flow in the past. We assessed surface flow pathways upstream and downstream at each culvert crossing. There was no flow or even evidence of past flow through the culverts on the day of the field visit. The areas upstream and downstream at each culvert crossing were dry with no scour marks or evidence of ponded water. Upstream from each culvert,there was no visible Figure 2.Showing locations of culvert crossing and handheld flow channel within 15 feet of the road. GPS waypoints. Downstream of both culverts,there was what appeared to be an old excavated channel for about 20-30feet, but neither channel showed evidence of flow or ponding,and both were vegetated with mostly upland plants—including Scotch broom,salal, sword fern, bracken fern and Oregon gr2pe. Photos in tables below provide visual evidence of lack of regulated stream conditions--no continuous surface drainage course downstream. Epp I - 5' ;� G Z/t MTA Park&Ride Site Stream Assessment January 23, 2019 Page 3 of 4 Table 1. Northern Culvert Waypoint Description 063 At northern culvert crossing. Photo looking at upstream inflow(culvert inlet is buried with gravel; no flow or evidence of flow). Second photo looking across the road at downstream outflow(culvert outlet open,no flow) 064 Downstream of northern culvert crossing, no flow; minimal evidence of water 065 Farther downstream of northern culvert crossing, no flow; minimal evidence of water 3-# ,ti.s`• s` tilY�� .r��,"r � k ,.v '/jam.� �,... vim...� ��" � Jj .#.ig � [�Jj !` "� • F � •s l r , T Figure 3.Top left:Northern Culvert(##1)inflow is blocked, but no evidence that water ponds for long periods of is time. •+ , " Top right:Outflow not blocked,still no evidence of flow orp x ?� Asti�� J Bottom left,farther downstream in cleared channel,but r t��� •. � �}�hE��h. ��, no flow or evidence of flow. Not a regulated stream ,y�,� •a t.�'ta { T l h' A f�cl MTA Park&Ride Site Stream Assessment January 23, 2019 Page 4 of 4 Table 2. Southern Culvert Waypoint Description 066 Southern culvert crossing,upstream end 067 Downstream from Southern culvert crossing,stops at wall of Scotch broom in old road and no channel _! r � r '' � f t M Tile `+� +�• �.- Figure 4.Top left:Southern culvert(N2)inflow is blocked, but no evidence that water ponds for long periods of time. i4nA1 Top right:Looking farther upstream—no evidence of scour channel or surface flow channel. �..=5 ,,,; a:Z .� �_ ? Left,downstream end of culvert,open,but no evidence of ;" flow or ponding. Not a regulated stream system. Bottom left and bottom right,looking farther downstream r ^;w from southern culvert. No evidence of surface flow,and ��,s�tr v�♦ t �t�+ �h` Irk a F'r topography does not allow for a continuous surface flow pathway. Not regulated stream system. � ,..r ,� '� ,�'; 3��.A4,.+�:.M i• ��'t if aaK, ���. �� ex"�' yr+S.�. �{ /FL ��a� "-s t r �•c� ri •� ti"-.. 0.0 J ♦ ` ltc 4,. xlk STATg O� 04 ; w z oy I STATE OF WASHINGTON DEPARTMENT OF ECOLOGY PO Box 47775 •Olympia, Washington 98504-7775•(360)407-6300 711 for Washington Relay Service •Persons with a speech disability can call 877-833-6341 April 26, 2019 Michael MacSems, SEPA Responsible Official Mason County Department of Community Services Planning Division PO Box 279 Shelton, WA 98584 Dear Michael MacSems: Thank you for the opportunity to comment on the mitigate etermination of nonsignificance for the Mason Transit Authority(MTA)Park and Ride ProjecEP2018-00097)proposed by . Mason Transit Authority. The Department of Ecology(Ecology)reviewed the environmental checklist and has the following comment(s): SOLID WASTE MANAGEMENT: Derek Rockett(360)407-6287 All grading and filling of land must utilize only clean fill. All other materials may be considered solid waste and permit approval may be required from your local jurisdictional health department prior to filling. All removed debris resulting from this project must be disposed of at an approved site. Contact the local jurisdictional health department for proper management of these materials. WATER QUALITY)WATERSHED RESOURCES UNIT: Chris Montague-Breakwell(360)407-6364 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 stormdrains that lead to waters of the state. Sand, silt,clay particles,and soil will damage aquatic habitat and are considered to be pollutants. Any discharge of sediment-laden runoff or other pollutants to waters of the state is in violation of Chapter 90.48 RCW,Water Pollution Control, and WAC 173-201A, Water Quality Standards for Surface Waters-of the State of Washington, and is subject to enforcement action. Michael MacSems,SEPA Responsible Official April 26,2019 Page 2 Construction Stormwater General Permit: The following construction activities require coverage under the Construction Stormwater General Permit: 1. Clearing,grading and/or excavation that results in the disturbance of one or more acres and discharges stormwater to surface waters of the State; and 2. Clearing, grading and/or excavation on sites smaller than one acre that are part of a larger common plan of development or sale,if the common plan of development or sale will ultimately disturb one acre or more and discharge stormwater to surface waters of the State. a) This includes forest practices(including,but not limited to,class IV conversions) that are part of a construction activity that will result in the disturbance of one or more acres,and discharge to surface waters of the State;and 3. Any size construction activity discharging stormwater to waters of the State that .Ecology: a) Determines to be a significant contributor of pollutants to waters of the State of Washington. b) Reasonably expects to cause a violation of any water quality standard. If there are known soil/ground water contaminants present on-site,additional information (including,but not limited to:temporary erosion and sediment control plans;stormwater pollution prevention plan; list of known contaminants with concentrations and depths found; a site map depicting the sample location(s);and additional studies/reports regarding contaminant(s))will be required to be submitted. You may apply online or obtain an application from Ecology's website at: http://www.egy.wa.goy/prograinL/wg/storinwater/construction/-Application. Construction site operators must apply for a permit at least 60 days prior to discharging stormwater from construction activities and must submit it on_or before the date of the first public notice. Ecology's comments are based upon information provided by the lead agency. As such,they may not constitute an exhaustive list of the various authorizations that must be obtained or legal requirements that must be fulfilled in order to carry out the proposed action.. 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 (MID:201901983) cc: Derek Rockett, SWM Chris Montague-Breakwell,WQ Danette Brannin,Mason Transit Authority(Proponent) BELFAIR PARK AND RIDE COVER SHEET A PORTION OF THE E 1/2 SECTION 2t THE W 1/2 SECTION 22 AND THE NE 1/4 SECTION 28,TOWNSFIIP 23 NORT BELFAIR,MASON AND KrrSAP COUNTIES, WASHINGTON / \ NMNG�N-\ -- - - - -- - - ---- - `123 MK \ WE ;T / / �LL SETBACKS ARE MEN SURED " FROM THE FURTHEST, g4' / I!FEET ROJECTION OF THE BUILD)NG { r I\ / I / THE 9 THE PT.38+35.86 / Ij/ FEET )THE / i / \ / )FEETN.MASON /I \`\ / \'�•/ A \ , METHODIST THE < I / Ntsc) .PC: 35+21.47 WER I `\ PT.32+21.25 ST OF 1CH ' \ Mk `\ STATE BP:;ry PT. 30+14.36 NT'A; , `� ` THE 9 FEET , I `\ NOMEI a u5A`♦ / \\ (Arras) \\ /ORE ^°E \ \ ASlIE LLL \ \ (cam.) / I NWFORO Aga:uc \ \ (Q ASTERN / ——————————— ` SW.V r� 2D SSa'SSDI 1 i SDIffi13'W .�t 1N�4�6�38T "3YE J 57.4W y6 / b-m-K 19 / I bdtse'Ss �' Q G1\ \ \ CU Fa SKVI NE 264.76•\ `\ \ W 5pse'S61Y su v B / PR 1, `` PR