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Site Specific Review Checklist <br /> This checklist is for categorically excluded activities as listed in the unspecified site strategy. <br /> Address of Site <br /> Signature of Person Who Inspected Site <br /> Final Signature <br /> Date of Completed Review <br /> If there are more than 4 new construction units together, this form cannot be used . Refer to 24 CFR <br /> Part 58 . 35 (a ) ( 4 ) . 'I <br /> i <br /> 1 . Floodplain Management : i <br /> Check the Flood Insurance Rate Map ( FIRM ) to determine if the site is in the Floodplain ( 500 year for critical <br /> actions, 100 year for all other activities) yes no <br /> If yes, and site involves new construction or major rehabilitation , the eight step decision making process is <br /> required as described at 24 CFR Part 55 . 20 . Also if yes is checked , Flood Insurance is required . Include proof <br /> of <br /> Flood Insurance and a copy of the flood insurance map showing location of site in flood plain . <br /> If no, attach a photocopy of the portion of the map that indicates your site is not in the Flood Plain . <br /> 2 . Wetland Protection : <br /> Is site is in a wetland or contain wetland ? yes no <br /> If yes, and site involves new construction or major rehabilitation , the eight step decision making process is <br /> required as described at 24 CFR Part 55 . 20 . <br /> 3 . Historic Preservation . <br /> Is the structure on the site or structure adjacent to the site more than 50 years old ? <br /> yes, no, OR <br /> What is the age of the structure on the site? <br /> What is the age of structures on adjacent sites? <br /> Is the site in a historic district? <br /> yes , no , OR <br /> If you are disturbing the soil , does your site have potential to contain archeological properties? <br /> yes, no, OR <br /> If yes to any of the above, then contact State Historic Preservation Office ( SHPO ) to determine if the property is <br /> eligible for the National Register of Historic Places . <br /> If no , proceed . <br /> 4 . Endangered Species . <br /> Contact Fish and Wildlife Service or National Marine Fisheries if the rehabilitation is major in scope ( increasing the <br /> building footprint) and endangered species are present; or if rehabilitation activities will be disturbing adjacent <br /> natural areas where endangered species are present . <br /> 5 . . Hazardous Operations <br /> a . Noise <br /> For rehabilitation , consideration of noise is all that is required . If the rehabilitation involves activities that would <br /> potentially reduce noise ( such as new windows or insulation ) , then consider modifying the activity to reduce <br /> noise . <br /> Page 9 of 10 <br />