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STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 650.050-12 <br /> TYPE 1 CATEGORICAL EXCLUSION ENVIRONMENTAL MANAGEMENT <br /> CHECKLIST 10/15 <br /> YES NO <br /> 10. Will the action result in a determination other than(1) no involvement, (2) "no effect,"or ❑ l <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 0 <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? 0 LI <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: 5'16.F7 <br /> Name: Andy Sobc_ <br /> Company: IRC <br /> Address: 1801 27th Stre t Vero Beach, FL 32960 11, <br /> LAP Administrator: irc ." ) �G � Date: 7/1x117 <br /> Christine Fasiska 0,...c~,"—t-Amft411/M <br /> FDOT Concurrence: Date: if 2 <br /> 42 <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 /> • Preliminary Environmental Site Assessment <br /> • SHPO Concurrence Letter <br />