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Sample Field Notes Checklist Project Number: Hue Program: Project Name: location: (street. city, county/state. & zip code) Project site is in a location described as: D Central city :::J Suburban D Infill urban development :::J In developing rural area o In undeveloped area Number cA Dwellin9 Units: C New constnJction C Rehabilitation Note to Reada': An Environmental Assessment (EA) is a concise public document that a Federal agency must prepare in order to comply with the National Environmental Policy Act (NEPA) and the related Federal environmenta1laws and authorities. The EA must support decision making process and provide a clear rationale, justification, and documentation for ratings assigned. IIlstnldioa. It is recommended that this checklist be used by HUD staff who prepare the Environmental Assessment (EA; form HUD-4128). It will constitute full documentation for many factors on the EA. and partial documentation for others. It will avoid narrative reports and expedite the environmental review process. This checklist., which is a slightly revised version of Appendix C of Handbook 1390.2, should be used pending revision of Handbook 1390.2. · Tbe number for each checksbeet topic is the number that appears on form HUD4128. Also, each checklist titleJbeading is followed by a reference to where the topic appears in the current Handbook 1390.2. Before the site visit. review the Phase I and all background information submitted with the application (if applicable). Dur- ing the site visit, the preparersofform HUD-4128 are to: (i) answer all relevant questiODS on this checklist; (ii) use the spaces provided for ccmments to include supplemental information as well as to record any recommended mitigation measures or requirements for project approval; (ill) key your answers to the relevant questions (using additional sheets of paper to provide more detailed infor- mation); and (iv) use the spaces provided for source documenta- tion to cite the information source used (e.g., title of a technical report, map, or special study; site inspection/field observation; name and location of the qualified data source(s) that provided the information, for example, the local planning agency, the local housing and/or community development agency. the State envi- ronmental protection agency. the State Historic Preservation Officer, or other qualified data source.) Preparers are to obtain and use, as appropriate, any environmental report (Federal. State. or local) that may bave already been prepared for the property or area in which the property is located. Several different types of maps will be useful in completing the review, such as the project plan or plot map. a location map showing major features and facilities in the vicinity, the USGS topographic map and FEMA flood map for the site area, and zoning/land use maps. Me"y olt/se CO"ditiolU c." ."d shDIIIll6e recoNhd directly 011 tIu project pl.", Distances to major features and facilities (e.g., schools and fire stations) and a description of the surrounding area are examples. The plan can then be refer- enced as "source documentation" on form HUD-4128. 9. Environmental Report List the Federal, State, or local agencies contacted to obtain their existing environmental reports and other data for the HUD environmental review for the proposed project: List the major reports obtained: (attach the report(s) or otherwise list the title, author. publication date) 10. PlaDRiDg Findings Is the project in compliance or conformance with the local zoning? L Yes I ~o 0 Not Applicable (If no or Dot applicable. explain) Is the project located within a coastal management zone (CZM)? C Y es ~ ~o 0 Not Applicable If your answer is YES. the State Coastal Zone Management (eZM) Agency must make a finding that the project is consistent with the approved State CZM program Is the State' s finding attached to this checksheet? C YesC No Is the project in compliance with the air quality State Implementation Plan (SIP)? eYes ~ No 0 Not Applicable 3 form HUD-4121 (10196) ref. Handbook 1390.2