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STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 65"50-12 <br /> TYPE 1 CATEGORICAL EXCLUSION ENVIRONMENTAL MANAGEMENT <br /> CHECKLIST ions <br /> YES NO <br /> 10. Will the action result in a determination other than (1) no involvement, (2)"no effect,"or ❑ <br /> (3) "no adverse effect" regarding properties protected under Section 106 of the National <br /> Historic Preservation Act? <br /> 11. Does the action have known contamination sites which would have more than a minimal ❑ <br /> impact to design, and right-of-way or construction activities once assessed as described <br /> in Part 2, Chapter 22, Contamination Impacts of the PD&E Manual, and can't be <br /> avoided or remediated? <br /> 12. Will the action have substantial controversy on environmental grounds? ❑ <br /> IMPORTANT: If all answers are No, the project is a Type 1 Categorical Exclusion and this checklist will <br /> be the NEPA document. If the answer to any of these questions is Yes, follow the Minor Categorical <br /> Exclusion Determination Key and coordinate with FHWA as appropriate. <br /> This project has been evaluated and has been determined to meet the conditions as set forth in Florida's <br /> Programmatic Agreement for Categorical Exclusions effective October 2015, as a Type 1 Categorical <br /> Exclusion. <br /> LAP Reviewer: Date.- <br /> Name: <br /> ate:Name:Andy Sob&dk <br /> Company: IRC <br /> Address: 1801 27`h Street Vero Beach, FL 32960 <br /> LAP Administrator: Date: 41281 <br /> r� <br /> Christine Fasiska <br /> 0/11L� t� <br /> FDOT Concurrence: Date: 7 D-7 <br /> " <br /> Ann Broadwell, District 4 Environmental Administrator <br /> The following is a list of any supporting activities(e.g field reviews, as appropriate, etc.), reports, or <br /> technical studies that were prepared and are included in the project file that were necessary to support <br /> the conclusions reached on the checklist. <br /> • Field Review 9/17/14 <br /> • Cultural Resources Assessment Survey(CRAS) 11/2015- FHWA and SHPO concurrence <br /> received 12/16/15 and 12/18/15. respectively <br /> • ETDM EST Screening <br /> I <br /> I <br /> i <br />