Matthew H. Mead
Governor
William T. Panos
Interim Director
DATE
Mr. Joseph Dailey
Wyoming Division Administrator
Federal Highway Administration
2617 E. Lincolnway, Suite D
Cheyenne, WY 82001-5662
Project No: INSERT PROJECT NUMBER
INSERT PROJECT NAME
ROAD NAME/LOCATION
INSERT COUNTY
TYPE OF WORK
Dear Mr. Dailey:
Pursuant to the requirements of the National Environmental Policy Act, APPLICANT submits
this Categorical Exclusion (CE) for the above referenced project. Justification for the
determination of minimal and temporary impacts is presented in the following sections.
PROJECT LOCATION AND DESCRIPTION
The proposed project is located at LOCATION in TOWN, COUNTY Wyoming. More
specifically the proposed project is located in Section ##, Township##N, Range##W (Figure 1).
The project will consist of (Brief description of the project).
PURPOSE AND NEED
The primary purpose of this project is to (describe the project in detail).
The need for this project is (describe why the project is needed)
Alternatives
The “No Action” alternative is (what would happen if the project were not built)
The preferred alternative is to (briefly describe the project and why it is preferred)
AFFECTED ENVIRONMENT / IMPACTS
Wyoming Department of Transportation Form 100, attached, summarizes potential
environmental impacts associated with this project. There is a potential for minimal and
temporary impacts, associated with construction. These impacts, and other pertinent issues, are
discussed in more detail below.
SOCIAL IMPACTS
Land Use Changes
What is the current and future land uses surrounding the project area?
Revised: 06/04/13
Project No: INSERT PROJECT NUMBER
INSERT PROJECT NAME
Page 2 of 7
What is the current and future land uses associated with any ROW taken by the project?
Relocation Potential
Will any families have to be relocated due to the proposed project?
Churches and Schools
Are any churches or schools located in or adjacent to the project area?
If so, explain possible impacts associated with the project.
Controversy Potential
Is the proposed project controversial in the community or with adjacent neighbors?
Energy
What effects will the project have on energy resources (oil, gas, coal, uranium, etc) in the area?
Utilities
What utilities are located in or near the project?
Will the utilities have to be moved?
Designated Emergency Routes
Will there be an effect on any designated emergency routes during the project construction and how will
those impacts be addressed?
Environmental Justice
What is the socio-economic setting around the project?
Are there any low-income families, housing, or neighborhoods in the area?
Will there be a disproportional effect to these areas?
Public Transportation
Will the project affect public transportation or public transportation routes?
Right-of-Way
Describe ownership, acres and impacts of any taken right-of-way.
Is any public land being taken or used for easements?
Construction Permits
Is there construction permits required? Construction permits are defined as using land not owned by the
agency on a temporary basis to complete the construction project.
Pedestrian and Bicycle
What affects will the project have on pedestrians and bicycles?
ARCHAEOLOGICAL AND HISTORICAL IMPACTS
Are there any archaeological or historic sites in the project area?
Consult with the State Historic Preservation Office for a determination of National Register of Historic
Places eligibility and project effects (Attach letter to SHPO and SHPO reply).
Consultation with The State Historic Preservation Office (SHPO) was initiated on DATE. SHPO
concurred in a determination of (no historic properties affected or no historic properties
Project No: INSERT PROJECT NUMBER
INSERT PROJECT NAME
Page 3 of 7
adversely affected – Choose only one this determination is located on the SHPO reply letter) on
DATE and recommends the undertaking proceed in accordance with state and federal laws
subject to the following stipulation:
If any cultural materials are discovered during construction, work in the area shall
halt immediately, the appropriate State and Federal agency shall be contacted, and
the materials evaluated by an archaeologist or historian meeting the Secretary of
Interior’s Professional Qualification Standards (48 FR22716, Sept. 1983).
SECTION 4(f)
Recreational Areas
Are any of the following located on or adjacent to the project: fairgrounds, public open spaces, parks,
state game lands, or other recreation facilities fully open to the public?
Will there be any impacts to these facilities? If so describe.
Will there be any impacts to these facilities? If so describe.
-
If a pathway does not go through a park, delete this text and the text below.
If a pathway goes through a park, use the language below and acquire a signed letter from the park
owner confirming all possible planning to minimize harm has been accomplished in the location and
design of the bikeway or walkway facility.
FHWA’s May 23, 1977 Section 4(f) Programmatic Determination for Bikeway or Walkway
Construction Projects determined that pathways will not have a significant effect upon the
quality of the human environment and will be beneficial to the recreational potential of parks. It
is also determined that (1) there is no feasible and prudent alternative to the use of Section 4(f)
lands, and (2) the conditions for approval will insure that the pathway will be planned to
minimize impact. Written approval of the official having jurisdiction over the Section 4(f)
property will confirm that the location and design of the pathway has been planned to minimize
impact.
Historic Properties
Are there any archaeological sites, buildings or structures in or adjacent to the project that is eligible or
listed on the National Register of Historic Places?
NATURAL ENVIRONMENT
Waters of the U.S. and Wetlands
Are there any Waters of the U.S. on the project?
Are there any ditches or valleys that have a definable bed and bank?
Will there be any work in the ditches or valleys? If yes explain the impacts.
Are there any wetlands on the project?
Will these wetlands be impacted?
Is avoidance possible and have alternative routes been investigated?
Are there any practical measures to minimize impacts?
Project No: INSERT PROJECT NUMBER
INSERT PROJECT NAME
Page 4 of 7
What is the total acres disturbed to wetlands?
What are the total acres of disturbance to Waters of the U.S.?
Is wetland mitigation required?
Are there any potential mitigation sites?
Consult with the Army Corps of Engineers (attach correspondences).
Water Quality
Are there any potential surface or ground water impacts?
Identify if any WYDEQ Class I, Class II or impaired waters are located on or near the project area.
What water quality permits will be required? (WYPDES, Discharge Permits, impaired waters, etc.)
Wild and Scenic Rivers
Are any designated or proposed Wild and Scenic Rivers in or adjacent to the project area?
What affects will the project have on the bed, banks, or free flowing condition of the Wild and Scenic River?
Floodplains
Is the project located in a floodplain? If yes how will the natural flow of the floodplain be affected.
What alternatives to location in the floodplain have been evaluated?
Farmlands
Is any farmland being taken by this project?
Have you consulted with the Natural Resource Conservation Service to determine if the farmland being
taken is classified as prime or unique farmland?
Wildlife and Habitat
Is there big game crucial habitat in the project area?
Is the project located in sage grouse core area?
Does a Density Disturbance Calculation Tool (DDCT) for sage grouse need to be completed?
Does the project warrant a biological assessment, due to the location, type or quantity of habitat?
Is there any cutting of trees? If yes how many and what type?
Consult with the Wyoming Game and Fish Department (attach correspondences).
Threatened and Endangered Species
Has a wildlife consultant field reviewed the project, if so attach report?
Are there any prairie dog towns, rock cliffs, large old trees, wetlands, and water or food supplies on the
project?
Are there any ditches, streams or waterways?
Is there riparian areas nest to the ditch, stream or waterway?
Consult with the U.S. Fish and Wildlife Service and attach correspondences?
Vegetation
Describe current vegetation in the project area.
Describe how the disturbed areas will be re-vegetated.
Ecosystem
Consider the effects of the project on the community of living and non-living things that work together.
Project No: INSERT PROJECT NUMBER
INSERT PROJECT NAME
Page 5 of 7
Effects should be considered at the local level of the project and at a regional level, at a minimum.
Will there be any permanent or significant impacts to these communities of living and non-living
organisms that are working together?
PHYSICAL IMPACTS
Noise
Are there any noise receptors (residences, schools, etc) within the project area?
Will there be a long-term increase in background noise level due to the project?
Is a noise study required?
Air
How will this project affect air quality?
Will there be any adverse impacts to air quality?
Is the project in a non-attainment area?
Hazardous Waste Sites / Contamination
Are there any fueling stations, lube shops, mechanic, industrial or refineries in the area of the project?
Are there any buried storage tanks or pipelines in the area?
Are there any waste sites along the project?
Visual
What can be seen from the project area?
Are there any breathtaking scenic views?
Will the project have any adverse affects on visual qualities?
Is an in-depth analysis needed?
PUBLIC PARTICIPATION
Has there been any public meetings or are any planned.
MITIGATION SUMMARY
Describe what measures will be taken to mitigate the impacts to the environment including any additional
mitigation measures obtained from correspondences with other agencies.
If any unanticipated impacts are discovered during project work, the appropriate personnel will
be notified immediately to evaluate the impacts and determine the proper measures to be taken to
prevent further impacts and mitigate any impacts that require mitigation.
PREPARER
Name, Title, Organization
DETERMINATION
Project No: INSERT PROJECT NUMBER
INSERT PROJECT NAME
Page 6 of 7
I determine that Project Name is a categorical exclusion. The following Form 100 describes the
impact evaluation and findings.
____________________________________
Applicant’s Signature (type name here)
Date
Applicants Organization (re-type your organization name)
Wyoming Department of Transportation Concurrence
____________________________________
Timothy L. Stark, P.E.
Date
Environmental Services Engineer
WYDOT Environmental Service use only
FHWA signature [ ] required
[ ] not required
____________________________________
This project is a Categorical Exclusion per FHWA approval
____________________________________
Joseph Dailey
Date
Federal Highway Administration
Attachments: Form 100 - Environmental Impact Evaluation
Figure 1: Site Location
Figure 2: Proposed Improvements
Letter to the State Historic Preservation Office dated XXX
State Historic Preservation Office Concurrence Letter dated XXX
Attach all additional agency correspondences (scoping letter and response letter) – At
a minimum, we need the following letters: SHPO, Army Corps, Wyoming Game and
Fish, U.S. Fish and Wildlife. Also, include letter from the official having jurisdiction ove
the Section 4(f) property.
Attach additional studies that were completed (Wetland Delineations, Biological Reports,
Historical Reports, etc).
Wyoming Department of Transportation
Form 100 - Environmental Impact Evaluation
INSERT PROJECT NAME
INSERT COUNTY
Project Number: INSERT PROJECT NUMBER
ROAD NAME/LOCATION
None Present
No Impacts
Minimal
SEVERITY OF IMPACTS
SOCIAL IMPACTS
Land Use Changes
Community Cohesion
Relocation Potential
Churches and Schools
Controversy Potential
Energy
Utilities
Designated Emergency Routes
Environmental Justice
Public Transportation
Right-of-Way
Construction Permits
Pedestrian & Bicycle
ARCHAEOLOGICAL AND HISTORICAL IMPACTS
Historic Sites / Districts
Archaeological Sites
SECTION 4 (f)
Recreational Areas
Historic Properties
NATURAL ENVIRONMENT IMPACTS
Waters of the U.S. and Wetlands
Water Quality
Wild and Scenic Rivers
Floodplains
Farmlands
Wildlife and Habitat
Threatened and Endagered Species
Vegetation
Ecosystem
PHYSICAL IMPACTS
Noise
Air Quality
Temporary Impacts
Contamination
Hazardous Waste Sites
Visual
PERMITS REQUIRED
WATERS OF THE U.S. FINDINGS
REMARKS