Appendix D - Sample Letters & Forms

Appendix Contents

Sample Letter Notifying Another Agency That They Are Lead Agency
Sample Responses to a "Request for Early Notice"
Sample EIS Fact Sheet
Sample DNS/Adoption Notice
Sample DS/Adoption Notice

 

Appendix D of the SEPA Handbook contains sample letters and forms for use by SEPA lead agencies. These forms and letters are in addition to the forms found in Part 11 of the SEPA Rules, Chapter 197-11 WAC. If the form you are looking for is not listed in this appendix, check the SEPA forms webpage.


Notifying Another Agency That They Are Lead Agency

SEPA Coordinator
Agency
(Address)

Dear :

The (agency name) recently received an application for (permit) and/or and environmental checklist from (applicant name) for (project description). The (agency name) has determined under WAC 197-11-924 that (agency name) is the SEPA lead agency for this proposal, because a (permit) is required from you. Accordingly, I am enclosing the completed environmental checklist and a copy of the permit application. Please keep us informed of your progress in reaching a threshold determination.

If you have any questions, or if we can be of any assistance, please contact (name) at (phone).

Sincerely,

 

Enclosures

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Sample Responses to a "Request For Early Notice"

1.  You Are Lead Agency: DNS Likely

(name and address)

Dear :

This is the (agency name) response to your "request for early notice" on (name or describe project) under WAC 197-11-350.   (Agency name) currently considers a determination of nonsignificance (DNS) likely for your proposal. However, our formal threshold determination has not been completed and this letter is not a DNS.

If you have any questions, call (name) at (phone).

Sincerely,

2.  You Are Lead Agency: DS Likely - General or Specific Areas of Concern

(name and address)

Dear :

(Agency name) currently considers a determination of significance (DS) likely for your proposal. We are concerned about probable significant adverse impacts in the following area(s): (list general or specific areas of concern).

You may change or clarify your proposal to mitigate these impacts. Either submit a changed or clarified environmental checklist (and/or permit application), or prepare a written attachment to your existing environmental checklist. If you submit attachments, the proposal, as changed or clarified, must be easily understood when one reads the checklist and attachment(s).

We are suspending the threshold determination on your proposal until you respond in writing. You may either change or clarify your proposal or ask that we base the threshold determination on your original checklist and permit application.

If you change or clarify your proposal, we will begin the threshold determination process based on the changes or clarifications. Changes to or clarifications of your proposal to mitigate significant adverse impacts do not guarantee issues of a determination of nonsignificance (DNS).

If you have any questions, call (name) at (phone).

Sincerely,

3.  You Are Lead Agency: DS Likely - Mitigation Measures Specified

(name and address)

Dear :

(Agency name) currently considers a determination of significance (DS) likely for your proposal. If you incorporate the following mitigation measures to your proposal, probable significant adverse environmental impacts will be eliminated and the (agency name) will issue a determination of nonsignificance (DNS).

(Describe the mitigation measures. Remember, if the proponent agrees to change the project to include these measures, you must issue a DNS.) You may change or clarify your proposal to include these mitigation measures. Either submit a changed or clarified environmental checklist (and/or permit application), or prepare a written attachment to your existing environmental checklist. If submit an attachment, the proposal, as changed or clarified, must be easily understood when one reads the checklist and attachment(s).

We are suspending the threshold determination on your proposal until you respond in writing. You may either change or clarify your proposal or ask that we base the threshold determination on your original checklist and permit application.

If you changed or clarify your proposal to include the mitigation measures listed above, we will issue a DNS for a fourteen-day comment period. (Describe public notice your agency must perform.) The information gained during the comment period will determine of the DNS will then be retained, modified, or withdrawn.

If you have any questions, call (name) at (phone).

Sincerely,

4.  You are not Lead Agency.

(name and address)

Dear :

We have determined that (agency name) is the SEPA lead agency for this proposal and have forwarded your completed environmental checklist and/or a copy of your permit to them.
If you want to pursue a mitigated determination of nonsignificance (DNS), contact (agency name or person at the agency) to determine their procedures for a "request for early notice."

If you have any questions, contact me at (your phone and/or address).

Sincerely,

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Sample EIS Fact Sheet

Project Title and Description: include a brief description of the proposal and its location, include description and location of the alternatives if different

Name and Address of Proponent (with proposed date for implementation):

Name and Address of Lead Agency Responsible Officials:

Contact Persons for Lead Agencies:

List of Permits and Approvals: should be as complete as possible, note any which may be tentative or potential, include federal, state and local jurisdiction permits

e.g.: The following Okanogan County permits

  1. Shoreline Substantial Development Permit

  2. Conditional Use Permit/Zoning Requirements

  3. Etc.

Authors and Principal Contributors:

e.g.: The following are Agency individuals who were either reviewers or principal contributors to the preparation of the EIS:

Washington Department of Natural Resources

  1. David Hogan - Reclamation Geologist

  2. Etc.

The following are Contract individuals who were either reviewers or principal contributors to the preparation of the EIS:

Earth Resources Associates

  1. Ann Davis – Vegetation and Wetlands, Streams and Fisheries

  2. Etc.

Date of Issue of the Draft EIS:

Date DEIS Comments are due: generally this will be 30 days after the date of issue

Public Meetings: Identify public meetings, field trips, hearings – date, time location, and whether activity is to present information, answer questions, hear comment, etc.

Projected Date of Issue of Final EIS:

Agency Action and projected date for action: identify the lead agency decisions (permits, approvals, licenses) that need to be made for the proposal and identify the projected timing for those decision. If the projected timing is unknown, the agency can simply state no decisions can be made until at least 7 days after issuance of the FEIS. Often other agencies are also making decisions. If information about the timing for their decisions is available, it can be mentioned here also.

Subsequent Environmental Review: identify whether the lead agency knows if any subsequent environmental review is expected. For example if the EIS is for a comprehensive plan, the lead agency should explain whether additional environmental review is anticipated for site specific projects.

EIS Availability: identify how copies of the EIS can be acquired and their cost, if applicable.

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Determination of Nonsignificance and Adoption of Existing Environmental Document

Description of current proposal

Proponent

Location of current proposal

Title of document being adopted

Date adopted document was prepared

Description of document (or portion) being adopted

If the document being adopted has been challenged (WAC 197-11-630), please describe:

The document is available to be read at (place/time)

The lead agency for this proposal has determined that it does not have a probable significant adverse impact on the environment. An environmental impact statement (EIS) is not required under RCW 43.21C.030(2)(c). This decision was made after review of a completed environmental checklist and other information on file with the lead agency. This information is available to the public on request.

  • There is no comment period for this DNS.
  • This DNS is issued under WAC 197-11-340(2); the lead agency will not act on the proposal for 14 days from the date below. Comments must be submitted by

We have identified and adopted this document as being appropriate for this proposal after independent review. The document meets our environmental review needs for the current proposal and will accompany the proposal to the decision-maker.

Name of agency adopting document

Contact person, if other than responsible official

Phone

Responsible official

Position/title Phone

Address

Date Signature

ECY 050-46(b) (Rev. 4/98)

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Determination of Significance and Adoption of Existing Environmental Document

Description of current proposal

Proponent

Location of current proposal

Title of document being adopted

Agency that prepared document being adopted

Date adopted document was prepared

Description of document (or portion) being adopted

If the document being adopted has been challenged (WAC 197-11-630), please describe:

The document is available to be read at (place/time)

EIS REQUIRED. The lead agency has determined this proposal is likely to have a significant adverse impact on the environment. To meet the requirements of RCW 43.21C.030(2)(c), the lead agency is adopting the document described above. Under WAC 197-11-630, there will be no scoping process for this EIS.

We have identified and adopted this document as being appropriate for this proposal after independent review. The document meets our environmental review needs for the current proposal and will accompany the proposal to the decision maker.

Name of agency adopting document

Contact person, if other than responsible official

Phone

Responsible official

Position/title Phone

Address

Date Signature

ECY 050-46(a) (Rev. 4/98)

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