Instructions for SDDOT Categorical Exclusion Checklist
and
Environmental Commitments Checklist
1. Utilize this checklist for all federally funded projects coordinated as
Categorical Exclusions (CE).
2. Reference the Programmatic Agreement Between the FHWA & the SDDOT
Regarding the Processing of Determining Categorical Exclusions on DOT
Projects to determine whether project qualifies as a Batched CE (CE 1),
Certified CE (CE 2), or an Approved CE (CE 3).
3. FHWA signature is required for projects utilizing the information beneath the
double line border on ANY of the NEPA Clearance Actions. More specifically,
for projects that qualify as an Approved CE (CE 3).
4. FHWA Approval may be requested for Certified CE projects when a Section
404 Nationwide permit is required. The purpose for the request will be stated
in Section C, Comments.
5. If FHWA signature is not required, then “N/A” will be entered on the FHWA
Approval line in Section D.
6. The assigned ‘Project Design Manager’ to include in the Environmental
Commitments Checklist can be located in the Approved Scope’s Executive
Summary tab.
7. Upon certification/approval of the SDDOT CE Checklist & Environmental
Commitments Checklist, distribute document to the Project Design Manager
indicated on Environmental Commitments Checklist and any other necessary
designees to ensure information proceeds to Section A – Estimate of
Quantities and Environmental Commitments and plan set incorporation.
8. Significant changes to the project scope, work limits, or plans after a
Categorical Exclusion has been certified or approved will require redetermination of CE validity.
9. Delete this entire page prior to certifying or approving document.
i
South Dakota Department of Transportation
Categorical Exclusion Checklist
Project:
County:
PCN:
Environmental Initiation Date: 03/17/2014
CE Action:
A. NEPA Clearance Actions
Federally Threatened, Endangered, and Protected Species
USFWS Concurrence that project will not adversely affect listed species received on:
.
Individual informal consultation conducted with USFWS and a biological assessment submitted.
USFWS Concurrence to individual informal consultation received:
Appended to Programmatic Biological Opinion on
.
Project determination of “May Affect, Is Likely to Adversely Affect” occurs to Federally listed species that are
not addressed in the Biological Opinion.
USFWS Concurrence received:
.
Section 4(f) and 6(f)
No
property will be affected.
23 CFR 774.13 Exc.
applies to the requirement for Section 4(f) approval. FHWA concurrence:
Section
properties have been noted and
documents were processed and approved by
on
.
Historic and Archaeological Preservation
A Finding of
was received on
SHPO/THPO has conditioned the finding. See attached documentation.
Cultural resources will be affected by the project and Section 106 procedures have been completed.
Memorandum of Agreement implemented on
.
Wetlands
No wetlands are located within the anticipated work limits.
Wetland impacts will be mitigated
; the Statewide Wetland Finding applies.
One or more acres of wetland impacts will be mitigated
FHWA approved a Wetland Finding on
;.
.
USACE Coordination on Dredge and Fill
A Section 404 Permit is not required.
SDDOT reasonably anticipates a Nationwide Permit will be received.
An Individual Permit will be applied for and imposed conditions will be complied with.
FEMA – Floodplain Impacts reviewed by
on
No designated floodplains exist within the project limits.
Project is within a floodplain but will have no floodplain impacts.
Project has an effect on the floodplains. See attached documentation.
(Note: If the improvement results in a longitudinal encroachment on the floodplain, it must be discussed in detail.)
Oct 2013
1
SDDOT - Categorical Exclusion Checklist
Right-of-Way
No right-of-way is required.
Minor amounts of right-of-way are required.
Type: Low Cost
; Strip Acquisition(s)
; Corner Acquisition(s)
More than minor amounts of right-of-way are required.
Displacement/Relocation is required
Substantial affects to property functions
DENR Coordination Completed:
GFP Coordination Completed:
Tribal Consultation
X
Tribal consultation was initiated with the Tribes checked below on 12/26/2012.
Bureau of Indian Affairs
X
Sisseton – Wahpeton Oyate
X
Cheyenne River Sioux Tribe
X
Standing Rock Sioux Tribe
X
X
Crow Creek Sioux Tribe
X
Flandreau Santee Sioux Tribe
Lower Brule Sioux Tribe
X
Oglala Sioux Tribe
Rosebud Sioux Tribe
Tribal comments were received. [letter(s) attached]
Yankton Sioux Tribe
Iowa Tribe of Oklahoma
Three Affiliated Tribes of ND
Ponca Tribe of Nebraska
Northern Arapaho Tribe
Tribal coordination requests FHWA involvement.
B. Other Unusual Circumstances Apply
List: (noise, wild & scenic river, Coast Guard permits, air quality, public controversy, changes in traffic patterns,
significant detour/traffic impacts, other). When it doesn't apply overwrite this field as "N/A".
C. Comments
List: (describe any attachments or additional information necessary to support project's NEPA coordination efforts)
D. Environmental Project Certification and Approval
This review finds the proposed project does not individually or cumulatively have a significant impact on the
environment as defined by NEPA, or involve unusual circumstances as defined in 23 CFR 771.117(b), such that it is
excluded from the requirements to prepare an environmental assessment or environmental impact statement.
Certification:
SDDOT Environmental Engineer
03/17/2014
Date
Approval:
FHWA Environmental Engineer
Oct 2013
Date
2
ENVIRONMENTAL COMMITMENTS CHECKLIST
PROJECT #
ENVIRONMENTAL CLASS CODE
COUNTY
PCN
PROJECT DESIGN MANAGER
The following conditions, concerns, and issues described in this Environmental Commitment Checklist are based on the
knowledge provided to secure the approved environmental classification date as exhibited on the Categorical Exclusion
Checklist. Note to Project Design Manager: Changes to the project scope, work limits, or plans after approval of the
Environmental Class Code that affect the environment or mitigation actions must be approved by the Environmental
Office.
Commitment A – Wetlands
Yes
Total Impacted Wetland Acreage:
No
n/a
Total Compensatory Wetlands Needed:
Comments:
Commitment B – Federally Threatened, Endangered, & Protected Species
Commitment B1: Topeka Shiner
Yes
No
Commitment B2: Whooping Crane
Yes
No
Commitment B3: American Burying Beetle
Yes
No
Commitment B4: Bald Eagle
Yes
No
Commitment B5: {other}
Yes
No
Comments:
Commitment C – Water Source
Comments:
n/a
n/a
n/a
n/a
n/a
Yes
No
n/a
Yes
Yes
No
No
n/a
n/a
Commitment E – Storm Water
Yes
Comments: {Identifty any Major receiving body of water(s):}
No
n/a
Commitment F – Seasonal Work Restriction
Comments:
Yes
No
n/a
Commitment H – Waste Disposal Site
Comments:
Yes
No
n/a
Yes
No
n/a
No
n/a
No
n/a
Commitment D – Water Quality Standards
Commitment D1: Surface Water Quality
Commitment D2: Surface Water Discharge
Comments:
Commitment I – Historical Preservation Office
Clearances
Comments:
Commitment J – Construction Practices for Temporary
Yes
Works in Waterways of the U.S.
Comments:
Commitment K –Rapid City Area Air Quality Control
Zone
Comments:
1
Yes
Oct 2013
ENVIRONMENTAL COMMITMENTS CHECKLIST
Commitment L – Contaminated Material
Comments:
Yes
No
n/a
Commitment M – Section 4(f)/6(f) Resources
Yes
No
n/a
If yes (check appropriate):
Section 4(f) public park
Section 4(f) wildlife refuge
Section 4(f) historic site
Section 4(f) recreational lands
Section 4(f) waterfowl refuge
Section 6(f) property
4(f) Type of
Fee Simple
Permanent Easement
Temporary Easement
Constructive
Use:
6(f) Type of
Temporary Non-conforming Use
6(f) Use – Conversion approval
Use:
Comments: {Include: property name, location, etc.} {Discuss if 4(f) impact requires 1 of the 5 programmatic evaluations, a De
Minimis, or an individual determination}
Commitment N – Section 404 Permit
Comments:
Commitment O – Tribal Monitoring and Traditional
Cultural Properties
Comments:
Yes
Yes
Commitment P – Coordination with State Archaeological
Research Center
Comments:
Commitment Q – Tree Replacement
Comments:
Commitment R – Fire Prevention in the Black Hills Area
Comments:
X
No
n/a
No
n/a
Yes
Yes
No
No
Yes
X
n/a
n/a
No
n/a
Commitment S – Migratory Birds Work Restriction
Comments:
Yes
No
n/a
Commitment T – {other}
Comments:
Yes
No
n/a
2
Oct 2013