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ADECA FINDING OF CATEGORICAL EXCLUSION FORM 24 CFR § 58.35(a)

SUBJECT TO § 58.5

Grant Recipient: Grant Number:

Address: City: State: Zip Code: County:

Funding Source: CDBG ESG HOPWA Other:

ADECA Funds: Matching Funds: Total Funds:

Project Description and Location(s) (Include all actions which are either geographically or functionally related) [§58.32]:

LEVEL OF ENVIRONMENTAL REVIEW DETERMINATION:

Categorically Excluded per 24 CFR 58.35(a), and subject to laws and authorities at §58.5:

(Check the applicable box)

§58.35(a)(1) / §58.35(a)(3)(iii)(B)
§58.35(a)(2) / §58.35(a)(4)(i)
§58.35(a)(3)(i) / §58.35(a)(4)(ii)
§58.35(a)(3)(ii)(A) / §58.35(a)(4)(iii)
§58.35(a)(3)(ii)(B) / §58.35(a)(5)
§58.35(a)(3)(ii)(C) / §58.35(a)(6)
§58.35(a)(3)(iii)(A)

COMPLIANCE WITH 24 CFR 58.5 LAWS AND AUTHORITIES:

DIRECTIONS - Record below the compliance or conformance determinations for each statute, executive order, or regulation. Provide credible, traceable, and supportive source documentation for each authority. Where applicable, complete the necessary reviews or consultations and obtain or note applicable permits of approvals. Document clearly and completely citations, dates/names/titles of contacts, and page references. Attach additional documentation as appropriate. Consult the guidance provided by the web site listed below and ADECA Form ENV-SCW. Any compliance documentation should also be attached to the Checklist and included in the ERR.

Compliance Factors: (for guidance visit https://www.onecpd.info/environmental-review/federal-related-laws-and-authorities)

Statutes, Executive Orders, and
Regulations listed at 24 CFR §58.5 / Are formal compliance steps or mitigation required? / Compliance Documentation/Determinations
Yes / No
1. Historic Preservation
[36 CFR Part 800]
2. Tribal Historic Preservation
[HUD Notice CPD-12-006 (Issued 6/15/12)]
3. Floodplain Management
[Executive Order 11988; 24 CFR Part 55]
4. Floodplain Insurance
[Section 202 of the Flood Disaster Protection Act of 1973]
5. Wetland Protection
[Executive Order 11990; 3 CFR §§ 2, 5]
6. Coastal Zone Management
[16 USC 1451, §§ 307(c), (d)]
7. Sole Source Aquifers
[40 CFR Part 149]
Statutes, Executive Orders, and
Regulations listed at 24 CFR §58.5 / Are formal compliance steps or mitigation required? / Compliance Documentation/Determinations
Yes / No
8. Endangered Species Act
[50 CFR Part 402]
9. Wild and Scenic Rivers Act
[16 USC 1271, §§ 7(b), (c)]
10. Clean Air Act
[40 CFR Parts 6, 51, 93]
11. Farmland Protection Policy Act
[7 CFR Part 658]
12. Noise Abatement and Control
[24 CFR Part 58, §5(i)(2)]
13. Explosive and Flammable Operations
[24 CFR Part 51, Subpart C]
14. Airport Clear Zones and Accident Potential Zones
[24 CFR Part 51, Subpart D]
15. Site Contamination
[24 CFR 58.5(i)(2)]
16. Environmental Justice
[Executive Order 12898]

FIELD INSPECTION:

Performed by: Date:

Summary of Findings and Conclusions:

MITIGATION MEASURES AND CONDITIONS [40 CFR 1505.2(c)]:

Summarize below all mitigation measures adopted by the Responsible Entity to reduce, avoid, or eliminate adverse environmental impacts and to avoid non-compliance or non-conformance with the above-listed authorities and factors. These measures/conditions must be incorporated into project contracts, development agreements, and other relevant documents. The staff responsible for implementing and monitoring mitigation measures should be clearly identified in the mitigation plan.

LAW, AUTHORITY OR FACTOR / MITIGATION MEASURE

DETERMINATION:

This categorically excluded activity/project converts to EXEMPT per Section 58.34(a)(12), because it does not require any mitigation for compliance with any listed statutes or authorities, nor requires any formal permit or license; Funds may be committed and drawn down after certification of this part for this (now) EXEMPT project; OR

This categorically excluded activity/project cannot convert to Exempt status because one or more statutes or authorities listed at Section 58.5 requires formal consultation or mitigation. Complete consultation/mitigation protocol requirements, publish NOI/RROF and obtain ADECA’s “Notice of Removal of Grant Conditions” per Section 58.70 and 58.71 before committing or drawing down any funds; OR

This project is not categorically excluded OR, if originally categorically excluded, is now subject to a full Environmental Assessment (EA) according to Part 58 Subpart E due to extraordinary circumstances (Section 58.35(c)).

CERTIFICATION:

Preparer’s Name/Title/Organization

______

Preparer’s Signature Date

Name and Title of Certifying Officer

______

Signature of Certifying Officer Date

This original, signed document and related supporting material must be retained on file by the Responsible Entity in an Environmental Review Record (ERR) for the activity/project (ref: 24 CFR Part 58.38) and in accordance with recordkeeping requirements for the HUD program(s).

Revised 10/14

ADECA Form ENV-CEST