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CHECKLIST

A. GEOLOGIC FACTORS
1. Is the site subject to geologic hazards (seismic, landslide, mudflow, or tsunami)? Yes No
* If yes, specify which hazards, the extent, and the relative level of risk.
2. Will the proposed project create a geologic hazard or increase the intensity of such a hazard? Yes No
* If yes, specify which hazard, how it will increase the hazard, the extent of increase, and whether or not
the project can be redesigned to avoid or minimize the generated or intensified hazard.
3. Has the site been officially designated as having preservation value, either Natural (open space, unique biotic
habitat, mineral resource, etc.) or Cultural (prime agricultural land, archaeologic, paleontologic, historic,
etc.)? Yes No
* If yes, specify which value and whether or not the project can be redesigned to avid or minimize the
loss of the value involved.
Source of Information
B. SOIL FACTORS
4. Is the site subject to soil hazards (stump, soil creep, subsidence, expansiveness, erosion, stream siltation, etc.)
Yes No
* If yes, specify which hazard(s), the (ir), extent, and relative level of risk.
5. Will the project generate any soil hazard? Yes No
* If yes, specify which hazard(s), how it will increase the hazard, the extent of the increase the hazard, the
extent of the increase, and whether or not the project can be redesigned to avoid or minimize the
generated or intensified hazard.
Source of Information
C. BIOTIC COMMUNITY FACTORS
6. Is the site subject to fire hazard from flammable brush grass or tress? Yes

No

7. Will the project generate any of the above hazards? Yes No


* If yes, specify the type of hazard, how it will increase the hazard, the extent of the increase and what
measure can be incorporated into the project to avoid or minimize the generated or intensified hazard.
8. Are there any rare or endangered plant or animal species, historically important trees, or unique biotic habitat
(marshland etc.) on site? Yes No
* If yes, specify which of the above.
9. Will the project disturb any of the above environmental factors?Yes No
* If yes, specify which factor(s), the extent of the disturbance and whether or not the project can be
redesigned to avoid or minimize conflict with the above factors.
10. Is the site a nesting place for migrating fowl? Yes No
* If yes, specify the specie of fowl and extent of the nesting area.
11. Will the project involve disturbance of a nesting area for migrating fowl? Yes No
* If yes, specify the area disturbed, the extent of the disturbance and any redesign of the project that will
avoid or minimize the disturbance.

D. WATERSHED FACTORS
12. Is the site located in a floodplain area? Yes No
* If yes, specify the frequency and severity of flooding on the site, the area of the site subject to
inundation and relative level of risk.
13. Will the project be subject to damage from flooding? Yes No
* If yes, specify the extent of area of the project subject to inundation, anticipated amount of damage
from the frequency and severity of flooding known to the site and what preventive measures may be taken
to prevent flooding damage.
14. Is there a source of public or private water on site? Yes No
* If yes, specify the location of such a water supply source, its liter per minute volume flow and whether
it provides the present of secondary water supply on site.
15. Does the quality of water provided in the site meet the correct national water quality control standards? Yes
No
* If yes, specify to what extent the water supply fails to achieve attainment of such standards.
16. Will the project generate pollutants (human waste, toxic wastes, surface water runoff, etc.) that will seriously
affect any on-site sources of water? Yes No
* If yes, specify the type and source of pollutant, amount of discharge by volume and parts per million
and the relative level of risk of biotic and human communities.
17. Will the project seriously interfere with the present rate of soil and subsurface percolation? Yes No
* If yes, specify the extent that the percolation rate will be
Source of Information
E. AIRSHED FACTORS
18. Does the present on-site quality comply with applicable air quality control standards? Yes No
*If yes, to what extent quality fails to achieve attainment of such standards.
19. Will the project generate pollutants (hydrocarbon thermal, odor, dust, or smoke particulate, radiation, etc.) that
will seriously impact the air-present quality on-site of the surrounding area? Yes No
*If yes, specify the type and source pollutant , amount of peak discharge in parts per million per 24 hour
period and the relative level of risk to biotic and human communities.
20. Is the site located in a high wind hazard area? Yes No
*If yes, specify the range and peak velocity and direction of high winds and relative level risk to
structure, trees, overhead utility lines, and similar items.
21. Will any feature of the project(Structures, trees, overhead utility lines, etc.) be exposed to hazardous winds?
Yes No
*If yes, specify which feature, the extent of exposure and what mitigating measures are or can be
designated into the project to avoid or minimized such exposure(s).

F. LAND USE FACTORS


22. Have local noise standards been established? Yes No
* If yes, cite the enabling legislation for these standards.
23. Is the site subject to an usually high noise level? Yes No
* If yes, specify the sources of the noise, the minimum-maximum decibel levels, both day and night.
24. Will the project generate unusually high noise level? Yes No

* If yes, specify the source of the noise, the range of noise levels and what measures can be or have been
designated into the project to minimize exposure to, or generation of, high noise levels.
25. Does the site have officially designed into the project to minimize exposure to, or generation of, high noise
levels? Yes No
* If yes, specify which item of importance and its location on site.
26. Will the project disturb any items of historic, archaeologic, or paleontologic importance? Yes No
* If yes, specify which item, the extent of the disturbance and what measures have been or can be
incorporated into the design of the project to avoid or minimize the disturbance.
27. Has the site been officially designated as a scenic vista-point, or being located in a scenic corridor, along a
scenic highway or having unique aesthetic value? Yes No
* If yes, cite the document officially establishing the designation.
28. Will the project conflict with any officially adopted scenic/aesthetic values? Yes No
* If yes, specify the type of conflict, its extent and any mitigating measures that have been or could be
incorporated into the project design that will avoid or minimize such a conflict.
29. Are there existing on-site any disadvantaged persons or businesses (aged, handicapped, low-income, etc.)?
Yes No
* If yes, specify who these person or businesses are, their total number, what measure are available to
assist their relocation, and whether or not suitable, comparable facilities exist to which these persons or
business may relocate.
30. Will the construction of the project cause relocation of any disadvantage persons or business? Yes No
* If yes, specify what persons or businesses will be dislocated, what measures will be employed to
relocate them, to what co-emperable facilities. Additionally state whether or not the site design can be
modified to avoid this conflict, including use of an alternative location.
Source of Information
G. LOCAL PLAN FACTORS
31. Does the proposed use of the site conform to the adopted or proposed local development plan or any of its
mandated elements (land use, housing, circulation, open space, conservation, noise, seismic safety, scenic
highways, and safety)? Yes No
* If yes, specify its con-conformance features, the extent of the non-conformity and how the design of the
project might be modified to minimize the non-conforming features.

32. Does the project conform with the established character of the surrounding area, set a precedent for similar
character with the surrounding area or exceed projected growth rates for the area. Yes No
* If yes, specify which of the above, the extent of the problem and what might be done to resolve the
conflict.
33. Is the project part of a larger project involving a series of cumulative sections? Yes No
* If yes, briefly describe the overall project, what phase of the overall project this project constitutes and
state whether or not a Programmatic Compliance for the overall project has been prepared.
34. Does the project reduce an already insufficient supply of low income housing? Yes No
* If yes, state the existing amount of available low income housing, the extent that the project decreases
that supply, (in number and present), and what measures might be incorporated into the plan, if any that
will mitigate this loss.
Source of Information

H. ECONOMIC FACTORS
35. Does the present use of the site require an expenditure of public money larger than the revenues it generates?
Yes No
* If yes, state the difference.
36. Will the project require expenditure of public funds in excess of public revenues generated by the project?
Yes No
* If yes, state the amount of difference.
Source of Information
I. SERVICE SYSTEM FACTORS
37. Are any of the public facilities (streets, highways, freeways, public transit, schools, parks, police, fire, and
hospitals) or public utilities (electrical, water, and gas supply, sewage, and storm drain discharge lines,
sanitary landfills) serving the site at or over capacity? Yes No
* If yes, specify which of the above, its capacity, whether it is at or over capacity (and by how much) and
what public plans, if any, are being proposed to overcome the capacity (and by what date).
38. Will the project generate any demands that will cause a public facility or utility to reach or exceed its
capacity? Yes No
* If yes, specify which of the above, its capacity, the extent of the projected impact and what measures
have been or can be incorporated into the project design.
Source of Information
J. COMMUNITY CONDITIONS

39. Is or has the site been subjected of any public controversy resulting from environmental concerns as set forth
in the foregoing factors? Yes No
K.
* If yes, specify which factors, the nature and extent of the controversy and present state of the
controversy.
L.
40. Will the project or can the project be expected to generate any public controversy over environmental
concerns? Yes No
M.
* If yes, cite the type and source of the controversy, its extent and what attempts have been, or are
being made by the sponsor or elected officials, public officials or agencies involved to resolve the
conflict.
N.
O.
P.

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