EXHIBIT IV-I

ENVIRONMENTAL ASSESSMENT CHECKLIST

Requires Modification

Needs Mitigation

Potentially Adverse – Requires More Study

Potentially Beneficial

No Impact Anticipated

IMPACT CATEGORIES

Potentially Adverse – Requires Documentation

Project Name & Identification No.:

SOURCE OF DOCUMENTATION (Note date of contact or page reference). Additional material may be attached.

Land Development Conformance with Comprehensive Plans & Zoning Compatibility & Urban Impact Slope Erosion Soil Suitability Hazards & Nuisances, Including Site Safety (See Exhibit IV-J-2) Energy Consumption

Noise Effects of Ambient Noise on Project & Contribution to Community Noise Levels (See Exhibit IV-J-3)

IV-I-1 (Revised 4/01)

EXHIBIT IV-I, Cont. ENVIRONMENTAL ASSESSMENT CHECKLIST

Requires Modification

Needs Mitigation

Potentially Adverse – Requires More Study

Potentially Beneficial

No Impact Anticipated

IMPACT CATEGORIES

Potentially Adverse – Requires Documentation

Project Name & Identification No.:

SOURCE OF DOCUMENTATION (Note date of contact or page reference). Additional material may be attached.

Air Quality Effects of Ambient Air Quality on Project & Contribution to Community Pollution (See Exhibit IV-C-5) Environmental Design & Historic Values Visual QualityCoherence, Diversity, Compatible Use, & Scale Historical, Cultural, & Archaeological Resources (See Exhibit IV-C-1) Socioeconomic Demographic / Character Changes Displacement Employment & Income Patterns Community Facilities & Services Educational Facilities Commercial Facilities Health Care Social Services

IV-I-2 (Revised 4/01)

EXHIBIT IV-I, Cont. ENVIRONMENTAL ASSESSMENT CHECKLIST

Requires Modification

Needs Mitigation

Potentially Adverse – Requires More Study

Potentially Beneficial

No Impact Anticipated

IMPACT CATEGORIES

Potentially Adverse – Requires Documentation

Project Name & Identification No.:

SOURCE OF DOCUMENTATION (Note date of contact or page reference). Additional material may be attached.

Community Facilities & Services (Continued) Solid Waste Waste Water Storm Water Water Supply Public Safety - Police

Public Safety - Fire Public Safety Emergency Medical Open Space Recreation Cultural Facilities Transportation

IV-I-3 (Revised 4/01)

EXHIBIT IV-I, Cont. ENVIRONMENTAL ASSESSMENT CHECKLIST

Requires Modification

Needs Mitigation

Potentially Adverse – Requires More Study

Potentially Beneficial

No Impact Anticipated

IMPACT CATEGORIES

Potentially Adverse – Requires Documentation

Project Name & Identification No.:

SOURCE OF DOCUMENTATION (Note date of contact or page reference). Additional material may be attached.

Natural Resources Water Resources Surface Water Floodplain (See Exhibit IV-C-2) Wetlands (See Exhibit IV-C-2) Unique Natural Features & Agricultural Lands (Exhibit IV-C-6) Vegetation & Wildlife (See Exhibit IV-C-4) Environmental Justice

IV-I-4 (Revised 4/01)

EXHIBIT IV-I, Cont. ENVIRONMENTAL ASSESSMENT CHECKLIST Continued - Page 5

Summary of Findings and Conclusions:

Summary of Environmental Conditions:

Project Modifications and Alternatives Considered:

IV-I-5 (Revised 4/01)

EXHIBIT IV-I, Cont. ENVIRONMENTAL ASSESSMENT CHECKLIST Continued - Page 6

Additional Studies Performed (Attach Study or Summary):

Mitigation Measures Needed:

1.

Is the project in compliance with applicable laws and regulations?

2.

A Finding of No Significant Impact can be made. Project will not significantly affect the quality of the human environment. Yes No

3.

Is an EIS required?

Yes

Yes

No

No

________________________________________ Prepared by

_________________________________________________ Certifying Official: (Include Title)

_______________________ Date

IV-I-6 (Revised 4/01)