Full EAF
[[880,76,1721,133][12][B,I,][Times New Roman]]Full Environmental Assessment Form
[[993,133,1607,190][12][B,I,][Times New Roman]]Part 1 - Project and Setting
Instructions for Completing Part 1
Part 1 is to be completed by the applicant or project sponsor.
Responses become part of the application for approval or funding,
are subject to public review, and may be subject to further verification.
Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to
any item, please answer as thoroughly as possible based on current information; indicate whether missing information does not exist,
or is not reasonably available to the sponsor; and, when possible, generally describe work or studies which would be necessary to
update or fully develop that information.
Applicants/sponsors must complete all items in Sections A & B. In Sections C, D & E, most items contain an initial question that
must be answered either “Yes” or “No”. If the answer to the initial question is “Yes”, complete the sub-questions that follow. If the
answer to the initial question is “No”, proceed to the next question. Section F allows the project sponsor to identify and attach any
additional information. Section G requires the name and signature of the project sponsor to verify that the information contained in
Part 1is accurate and complete.
A. Project and Sponsor Information.
Name of Action or Project:
WestMountianSkiAreaSitePlanReviewfor"Overflow"ParkingLot,ZipLine,MountainBikeTrailSystemandrezoningof"overflow"parkinglotparcels
Project Location (describe, and attach a general location map):
43and57WestMountainRoad,Queensbury,NY12804foroverflowparkinglotand59WestMountainRoadforZipLineandMountainBikeTrailSystem
Brief Description of Proposed Action (include purpose or need):
Theprojectinvolvesthere-zoningoftwoparcelsofland(315.5-1-3.2and315.5-1-2)fromMDR(ModerateDensityResidential)toRC(Recreational
Commercial)toallowfortheexpansionoftheWestMountainSkiAreaparkinglottoaccommodate"overflow"parking.Additionally,siteplanapprovalis
alsorequestedfortheparkingexpansionaswellaszip-lineandexistingmountainbikevenueontheexistingWestMountainSkiAreaparceltax
no.307.-1-29.ExistingresidentialusesonlandstoberezonedwillcontinueandbeusedforWestMountainSkiareasupportpurposes..
Name of Applicant/Sponsor: Telephone:
518-745-9892
ApexCapital,LLC
E-Mail:
Address:
59WestMountainRoad
City/PO: State:ZipCode:
Queensbury
NewYork12804
Project Contact (if not same as sponsor; give name and title/role): Telephone:
same
E-Mail:
Address:
City/PO:State: ZipCode:
Property Owner (if not same as sponsor): Telephone:
E-Mail:
same
Address:
City/PO:State: ZipCode:
Page 1 of 13
B. Government Approvals
B.Government Approvals Funding, orSponsorship.
(“Funding” includesgrants, loans, taxrelief,and anyotherforms of financial
assistance.)
Government Entity If Yes: Identify Agency and Approval(s) Application Date
Required
(Actual or projected)
a.City Council, Town Board, Yes No
TownBoard-Re-Zoning
or Village Board of Trustees
b.City, Town or Village Yes No
PlanningBoard-SEQRDeclarationand
Planning Board or Commission
SitePlanReview
c.City Council, Town or Yes No
Village Zoning Board of Appeals
d.Other local agencies Yes No
e.County agencies Yes No
239-MReferral
f.Regional agencies Yes No
g. State agencies Yes No
h.Federal agencies Yes No
i.Coastal Resources.
[[195,1301,245,1349][10][,I,][Times New Roman]]i [[206,1301,1083,1349][10][,,][Times New Roman]].Is theprojectsite withinaCoastal Area, or the w [[1063,1301,1908,1349][10][,,][Times
New Roman]]aterfront area ofa DesignatedInland Waterway? [[2157,1301,2256,1349][10][,,][Times New Roman]]Yes [[2260,1301,2371,1349][10][,,][Times New Roman]] No
[[184,1397,246,1445][10][,I,][Times New Roman]]ii [[207,1397,1072,1445][10][,,][Times New Roman]].Is theproject site locatedin a community with [[1033,1397,1553,1445][10][,,][Times
New Roman]]anapproved LocalWaterfron [[1524,1397,1983,1445][10][,,][Times New Roman]]t Revitalization Program? [[2151,1397,2276,1445][10][,,][Times New Roman]] Yes [[2265,1397,2376,1445][10][,,][Ti
mes New Roman]] No
[[174,1445,247,1493][10][,I,][Times New Roman]]iii [[208,1445,1218,1493][10][,,][Times New Roman]].Is the project site within a Coastal Erosion Hazard Area? [[2151,1445,2276,1493][10][,,][Times
New Roman]] Yes [[2265,1445,2376,1493][10][,,][Times New Roman]] No
C. Planning and Zoning
C.1. Planning and zoning actions.
Will administrative or legislative adoption, or amendment of a plan, local law, ordinance, rule or regulation be the Yes No
only approval(s) which must be granted to enable the proposed action to proceed?
If Yes,
complete sections C, F and G.
If No,
proceed to question C.2 and complete all remaining sections and questions in Part 1
C.2. Adopted land use plans.
a.Do any municipally- adopted (city, town, village or county) comprehensive land use plan(s) include the site Yes No
where the proposed action would be located?
If Yes, does the comprehensive plan include specific recommendations for the site where the proposed action Yes No
would be located?
b.Is the site of the proposed action within any local or regional special planning district (for example: Greenway Yes No
Brownfield Opportunity Area (BOA); designated State or Federal heritage area; watershed management plan;
or other?)
If Yes, identify the plan(s):
_______________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
c.Is the proposed action located wholly or partially within an area listed in an adopted municipal open space plan, Yes No
or an adopted municipal farmland protection plan?
If Yes, identify the plan(s):
________________________________________________________________________________________________________
2003TownofQueensburyOpenSpaceVisionPlan
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Page 2 of 13
C.3. Zoning
a.Is the site of the proposed action located in a municipality with an adopted zoning law or ordinance. Yes No
If Yes, what is the zoning classification(s) including any applicable overlay district?
_________________________________________________________________________________________________________
TheskiareaiszonedRCRecreationCommerical.ThisisthelocationoftheproposedziplineandMountainBikevenue.Theexpandedparkingis
_________________________________________________________________________________________________________inanareacurrentlyzonedMDRMediumDensityResidentialandisproposedtoberezonedtoRC.
b.Is the use permitted or allowed by a special or conditional use permit? Yes No
c.Is a zoning change requested as part of the proposed action? Yes No
If Yes,
[[167,585,229,633][10][,I,][Times New Roman]]i. [[199,585,2420,633][10][,,][Times New Roman]]What is the proposed new zoning for the site? __________________________________________________________
_________
RC-RecreationalCommercial
C.4. Existing community services.
a.In what school district is the project site located? ________________________________________________________________
QueensburyUnionFreeSchoolDistrict
b.What police or other public protection forces serve the project site?
_________________________________________________________________________________________________________
WarrenCountySheriffandNewYorkStatePolice
c.Which fire protection and emergency medical services serve the project site?
__________________________________________________________________________________________________________
FireprotectionisprovidedbytheWestGlensFallsFireDepartment.EMSisprovidedbyWestGlensFallsEMS.
d.Whatparks serve the project site?
__________________________________________________________________________________________________________
AllTownofQueensburyParks
__________________________________________________________________________________________________________
D. Project Details
D.1. Proposed and Potential Development
a.What is the general nature of the proposed action (e.g., residential, industrial, commercial, recreational; if mixed, includeall
components)?
Theprojectincludesrezoningoftwoparcelsforexpandedparking,andsiteplanreviewfortheexpandedparking,newziplineand
approvalofexistingmountainbiketrails.
_________________________________________________________________________________________________________
b. a. Total acreage of the site of the proposed action? _____________ acres
382.34
b.Total acreage to be physically disturbed?_____________ acres
parkingexpansionand0.04acreszipline
2.07
c.Total acreage (project site and any contiguous properties) owned towers
or controlled by the applicant or project sponsor?_____________ acres
382.34
c.Is the proposed action an expansion of an existing project or use? Yes No
[[192,1914,254,1962][10][,I,][Times New Roman]]i. [[224,1914,1368,1962][10][,,][Times New Roman]]IfYes, what is the approximate percentage of the proposed expans [[1334,1914,1895,1962][10][,,][Times
New Roman]]ion and identify the units (e.g., [[1856,1914,2347,1962][10][,,][Times New Roman]]acres, miles, housing units,
square feet)? % ____________________ Units: ____________________
2.11acrestotalparkingexpansionandziplinetowers.
0.55%
d.Is the proposed action a subdivision, or does it include a subdivision? Yes No
If Yes,
[[182,2125,244,2173][10][,I,][Times New Roman]]i. [[214,2125,792,2173][10][,,][Times New Roman]]Purpose or type of subdivision? [[752,2125,1259,2173][10][,,][Times New Roman]](e.g.,
residential, industrial, [[1219,2125,1868,2173][10][,,][Times New Roman]]commercial; if mixed, specify types)
________________________________________________________________________________________________________
[[171,2221,244,2269][10][,I,][Times New Roman]]ii. [[204,2221,947,2269][10][,,][Times New Roman]] Is a cluster/conservation layout proposed? [[2138,2221,2247,2269][10][,,][Times New
Roman]] Yes [[2252,2221,2363,2269][10][,,][Times New Roman]] No
[[161,2269,246,2317][10][,I,][Times New Roman]]iii. [[216,2269,888,2317][10][,,][Times New Roman]]Number of lots proposed? ________
[[171,2317,251,2365][10][,I,][Times New Roman]]iv. [[222,2317,1825,2365][10][,,][Times New Roman]]Minimum and maximum proposed lot sizes? Minimum __________ Maximum __________
e.Will proposed action be constructed in multiple phases? Yes No
[[171,2430,233,2478][10][,I,][Times New Roman]]i. [[214,2430,1824,2478][10][,,][Times New Roman]]If No, anticipated period of construction: _____ months
Spring2019toFall2019
3-4
[[161,2478,234,2526][10][,I,][Times New Roman]]ii. [[215,2478,368,2526][10][,,][Times New Roman]]If Yes:
Total number of phases anticipated_____
Anticipated commencement date of phase 1 (including demolition) _____ month _____ year
Anticipated completion date of final phase _____ month _____year
Generally describe connections or relationships among phases, including any contingencies where progress of one phase may
determine timing or duration of future phases: _______________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Page 3 of 13
f.Does the project include new residential uses? YesNo
If Yes, show numbers of units proposed.
One Family Two Family Three Family Multiple Family (four or more)
Initial Phase ___________ ___________ ____________ ________________________
At completion
of all phases ___________ ___________ ____________ ________________________
g.Does the proposed action include new non-residential construction (including expansions)? YesNo
(parkinglotandzipline)
If Yes,
[[181,532,231,580][10][,I,][Times New Roman]]i [[193,532,926,580][10][,,][Times New Roman]].Total number of structures ___________
none
[[171,580,244,628][10][,I,][Times New Roman]]ii. [[215,580,1105,628][10][,,][Times New Roman]]Dimensions (in feet) of largest proposed structure: [[1065,580,2023,628][10][,,][Times
New Roman]]________height; ________width; and _______ length
n/a
[[161,627,246,675][10][,I,][Times New Roman]]iii. [[216,627,1945,675][10][,,][Times New Roman]]Approximate extent of building space to be heated or cooled: ______________________ square
feet
n/a
h.Does the proposed action include construction or other activities that will result in the impoundment of any Yes No
liquids, such as creation of a water supply, reservoir, pond, lake, waste lagoon or other storage?
If Yes,
[[171,842,233,890][10][,I,][Times New Roman]]i. [[203,842,2414,890][10][,,][Times New Roman]]Purpose of the impoundment: _____________________________________________________________________________
___
[[160,890,233,938][10][,I,][Times New Roman]]ii. [[204,890,1435,938][10][,,][Times New Roman]]If a water impoundment, the principal source of the water: [[1423,890,1735,938][10][
,,][Times New Roman]] Ground water [[1722,890,2161,938][10][,,][Times New Roman]] Surface water streams [[2149,890,2435,938][10][,,][Times New Roman]] Other specify:
_________________________________________________________________________________________________________
[[150,986,235,1034][10][,I,][Times New Roman]]iii. [[205,986,903,1034][10][,,][Times New Roman]]Ifother than water, identify the type of [[864,986,1676,1034][10][,,][Times New Roman]]impounded/conta
ined liquids and their source.
_________________________________________________________________________________________________________
[[160,1082,240,1130][10][,I,][Times New Roman]]iv. [[211,1082,2440,1130][10][,,][Times New Roman]]Approximate size of the proposed impoundment. Volume: ____________ million gallons;
surface area: ____________ acres
[[171,1130,240,1178][10][,I,][Times New Roman]]v. [[210,1130,1852,1178][10][,,][Times New Roman]]Dimensions of the proposed dam or impounding structure: ________ height; _______
length
[[160,1177,240,1225][10][,I,][Times New Roman]]vi. [[211,1177,2197,1225][10][,,][Times New Roman]]Construction method/materials for the proposed dam or impounding structure (e.g., earth
fill, rock, wood, concrete):
________________________________________________________________________________________________________
D.2. Project Operations
a.Does the proposed action include any excavation, mining, or dredging, during construction, operations, or both? Yes No
(Not including general site preparation, grading or installation of utilities or foundations where all excavated
materials will remain onsite)
If Yes:
[[171,1595,243,1643][10][,I,][Times New Roman]]i . [[203,1595,2439,1643][10][,,][Times New Roman]]What is the purpose of the excavation or dredging? _________________________________________________
______________
gradesiteforparkinglotandfootersforziplinetowers
[[150,1646,223,1694][10][,I,][Times New Roman]]ii. [[194,1646,842,1694][10][,,][Times New Roman]]How much material (including rock, [[802,1646,1899,1694][10][,,][Times New Roman]] earth,
sediments, etc.) is proposed to be removed from the site?
Volume (specify tons or cubic yards): ____________________________________________
none
Over what duration of time? ____________________________________________________
n/a
[[150,1796,235,1844][10][,I,][Times New Roman]]iii. [[206,1796,2264,1844][10][,,][Times New Roman]]Describe nature and characteristics of materials to be excavated or dredged, and plans
to use, manage or dispose of them.
________________________________________________________________________________________________________
gradesiteforparkinglotandfootersforziplinetowers-nomaterialtoberemovedfromsite
________________________________________________________________________________________________________
i[[182,1940,251,1988][10][,I,][Times New Roman]]v. [[222,1940,1413,1988][10][,,][Times New Roman]]Will there be onsite dewatering or processing of excavated materials? [[2153,1940,2278,1988][10][,,][
Times New Roman]] Yes [[2267,1940,2378,1988][10][,,][Times New Roman]] No
If yes, describe. ___________________________________________________________________________________________
________________________________________________________________________________________________________
[[171,2095,240,2143][10][,I,][Times New Roman]]v. [[210,2095,1954,2143][10][,,][Times New Roman]]What is the total area to be dredged or excavated? _____________________________________acres
2.11
[[161,2143,241,2191][10][,I,][Times New Roman]]vi. [[211,2143,1960,2191][10][,,][Times New Roman]]What is the maximum area to be worked at any one time? _______________________________
acres
2.11
----
[[150,2195,242,2243][10][,I,][Times New Roman]]vii. [[212,2195,1933,2243][10][,,][Times New Roman]]What would be the maximum depth of excavation or dredging? __________________________
feet
1footexpandedparkingarea
[[150,2243,253,2291][10][,I,][Times New Roman]]viii. [[224,2243,871,2291][10][,,][Times New Roman]]Will the excavation require blasting? [[2143,2243,2269,2291][10][,,][Times New Roman]]
Yes [[2256,2243,2367,2291][10][,,][Times New Roman]] No
and4feetziplinefootings
[[150,2293,230,2341][10][,I,][Times New Roman]]ix. [[201,2293,2406,2341][10][,,][Times New Roman]]Summarize site reclamation goals and plan: __________________________________________________________
___________
________________________________________________________________________________________________________
Re-seedziplinebaseareas,re-seedparkingareaonparcelat43WestMountainRoadandgravelsurfaceparkingareaontheparcelat57West
________________________________________________________________________________________________________
MountainRoad.
b.Would the proposed action cause or result in alteration of, increase or decrease in size of, or encroachment Yes No
into any existing wetland, waterbody, shoreline, beach or adjacent area?
If Yes:
[[181,2656,243,2704][10][,I,][Times New Roman]]i. [[214,2656,1277,2704][10][,,][Times New Roman]]Identify the wetland or waterbody which would be affected (b [[1246,2656,2367,2704][10][,,][Times
New Roman]]y name, water index number, wetland map number or geographic
description): ______________________________________________________________________________________________
[[212,2752,2430,2800][10][,I,][Times New Roman]]_________________________________________________________________________________________________________
Page 4 of 13
[[171,80,244,128][10][,I,][Times New Roman]]ii. [[215,80,1353,128][10][,,][Times New Roman]]Describe how the proposed action would affect that waterbody or [[1316,80,2302,128][10][,,][Times
New Roman]] wetland, e.g. excavation, fill, placement of structures, or
alteration of channels, banks and shorelines. Indicate extent of activities, alterations and additions in square feet or acres:
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
[[160,367,245,415][10][,I,][Times New Roman]]iii. [[216,367,2166,415][10][,,][Times New Roman]]Will proposed action cause or result in disturbance to bottom sediments? [[2153,367,2278,415][10]
[,,][Times New Roman]] Yes [[2267,367,2357,415][10][,,][Times New Roman]] No
If Yes, describe: __________________________________________________________________________________________
[[171,463,251,511][10][,I,][Times New Roman]]iv. [[222,463,1725,511][10][,,][Times New Roman]]Will proposed action cause or result in the destruction or removal of aquatic vegetation?
[[2143,463,2279,511][10][,,][Times New Roman]] Yes [[2267,463,2378,511][10][,,][Times New Roman]] No
If Yes:
a ofvegetation proposedto be removed ___________________________________________________________
acreageof aquatic vegetation remaining after project completion________________________________________
purpose of proposed removal (e.g. beach clearing, invasive species control, boat access): ____________________________
____________________________________________________________________________________________________
proposed method of plant removal: ________________________________________________________________________
if chemical/herbicide treatment will be used, specify product(s): _________________________________________________
[[171,861,240,909][10][,I,][Times New Roman]]v. [[210,861,2429,909][10][,,][Times New Roman]]Describe any proposed reclamation/mitigation following disturbance: ______________________________________
___________
_________________________________________________________________________________________________________
c.Will the proposed action use, or create a new demand for water? Yes No
If Yes:
[[182,1075,244,1123][10][,I,][Times New Roman]]i. [[214,1075,1829,1123][10][,,][Times New Roman]]Total anticipated water usage/demand per day: __________________________ gallons/day
[[171,1123,244,1171][10][,I,][Times New Roman]]ii. [[215,1123,933,1171][10][,,][Times New Roman]]Will the proposed action obtain water fro [[903,1123,1516,1171][10][,,][Times New Roman]]m
an existing public water supply? [[2153,1123,2278,1171][10][,,][Times New Roman]] Yes [[2267,1123,2378,1171][10][,,][Times New Roman]] No
If Yes:
Name of district or service area: _________________________________________________________________________
Does the existing public water supply have capacity to serve the proposal? Yes No
Is the project site in the existing district? Yes No
Is expansion of the district needed? Yes No
Do existing lines serve the project site? Yes No
[[161,1495,246,1543][10][,I,][Times New Roman]]iii. [[216,1495,1593,1543][10][,,][Times New Roman]]Will line extension within an existing district be necessary to supply the project?
[[2153,1495,2278,1543][10][,,][Times New Roman]] Yes [[2267,1495,2378,1543][10][,,][Times New Roman]] No
If Yes:
Describe extensions or capacity expansions proposed to serve this project: ________________________________________
____________________________________________________________________________________________________
Source(s) of supply for the district: ________________________________________________________________________
[[171,1766,251,1814][10][,I,][Times New Roman]]iv. [[222,1766,1015,1814][10][,,][Times New Roman]]Is a new water supply district orservice area [[975,1766,1797,1814][10][,,][Times New
Roman]]proposed to be formed to serve the project site? [[2153,1766,2278,1814][10][,,][Times New Roman]] Yes [[2267,1766,2378,1814][10][,,][Times New Roman]] No
If, Yes:
Applicant/sponsor for new district: ________________________________________________________________________
Date application submitted or anticipated: __________________________________________________________________
Proposed source(s) of supply for new district: _______________________________________________________________
[[182,2027,251,2075][10][,I,][Times New Roman]]v. [[221,2027,1221,2075][10][,,][Times New Roman]]If a public water supply will not be used, describe plans to [[1192,2027,1664,2075][10][,,][Times
New Roman]] provide water supply for [[1624,2027,2019,2075][10][,,][Times New Roman]]the project: ________ [[1990,2027,2416,2075][10][,,][Times New Roman]]___________________
_________________________________________________________________________________________________________
[[161,2126,230,2174][10][,I,][Times New Roman]]vi [[191,2126,1110,2174][10][,,][Times New Roman]].If water supply will be from wells (public or private [[1078,2126,2066,2174][10][,,][Times
New Roman]]), maximum pumping capacity: _______ gallons/minute.
d. Will the proposed action generate liquid wastes? Yes No
If Yes:
[[171,2308,233,2356][10][,I,][Times New Roman]]i. [[214,2308,976,2356][10][,,][Times New Roman]]Total anticipated liquid waste generation pe [[944,2308,1320,2356][10][,,][Times New Roman]]r
day: ___________ [[1290,2308,1615,2356][10][,,][Times New Roman]]____ gallons/day
[[171,2356,244,2404][10][,I,][Times New Roman]]ii. [[215,2356,1230,2404][10][,,][Times New Roman]]Nature of liquid wastes to be generated (e.g., sanitary wast [[1191,2356,1755,2404][10][,,][Times
New Roman]]ewater, industrial; if combinatio [[1726,2356,2270,2404][10][,,][Times New Roman]]n, describe all components and
approximate volumes or proportions of each): __________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
[[150,2548,235,2596][10][,I,][Times New Roman]]iii. [[205,2548,1579,2596][10][,,][Times New Roman]]Will the proposed action use any existing public wastewater treatment facilities? [[2143,2548,2269,2
596][10][,,][Times New Roman]] Yes [[2257,2548,2368,2596][10][,,][Times New Roman]] No
If Yes:
Name of wastewater treatment plant to be used: _____________________________________________________________
Name of district: ______________________________________________________________________________________
Does the existing wastewater treatment plant have capacity to serve the project? Yes No
Is the project site in the existing district? Yes No
Is expansion of the district needed? Yes No
Page 5 of 13
Do existing sewer lines serve the project site? Yes No
Will line extension within an existing district be necessary to serve the project? Yes No
If Yes:
Describe extensions or capacity expansions proposed to serve this project: ____________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
[[150,392,230,440][10][,I,][Times New Roman]]iv. [[201,392,992,440][10][,,][Times New Roman]]Will a new wastewater (sewage) treatment di [[953,392,1664,440][10][,,][Times New Roman]]strict
be formed to serve the project site? [[2143,392,2269,440][10][,,][Times New Roman]] Yes [[2257,392,2368,440][10][,,][Times New Roman]] No
If Yes:
Applicant/sponsor for new district: ____________________________________________________________________
Date application submitted or anticipated: _______________________________________________________________
What is the receiving water for the wastewater discharge? __________________________________________________
[[150,641,219,689][10][,I,][Times New Roman]]v. [[200,641,930,689][10][,,][Times New Roman]]If public facilities will not be used, descri [[890,641,1625,689][10][,,][Times New Roman]]be
plans to provide wastewater treatment [[1586,641,2280,689][10][,,][Times New Roman]]for the project, including specifying pro [[2250,641,2376,689][10][,,][Times New Roman]]posed
receiving water (name and classification if surface discharge, or describe subsurface disposal plans):
________________________________________________________________________________________________________
________________________________________________________________________________________________________
[[150,832,230,880][10][,I,][Times New Roman]]vi. [[201,832,2403,880][10][,,][Times New Roman]]Describe any plans or designs to capture, recycle or reuse liquid waste: ________________________________
_______________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
e.Will the proposed action disturb more than one acre and create stormwater runoff, either from new point Yes No
sources (i.e. ditches, pipes, swales, curbs, gutters or other concentrated flows of stormwater) or non-point
source (i.e. sheet flow) during construction or post construction?
If Yes:
[[171,1209,233,1257][10][,I,][Times New Roman]]i. [[203,1209,1805,1257][10][,,][Times New Roman]]Howmuch impervious surface will the project create in relation to total size of project
parcel?
_____
Square feetor _____ acres (impervious surface) 2.07
forparkingexpansion(nonewimperviousforzipline)
_____ Square feet or _____ acres (parcel size)
382.34
[[161,1352,234,1400][10][,I,][Times New Roman]]ii. [[204,1352,2409,1400][10][,,][Times New Roman]]Describe types of new point sources. _______________________________________________________________
___________
biofilterdischarge
_________________________________________________________________________________________________________
[[150,1448,235,1496][10][,I,][Times New Roman]]iii. [[205,1448,1246,1496][10][,,][Times New Roman]]Where will the stormwater runoff be directed (i.e. on-site st [[1208,1448,1822,1496][10][,,][Times
New Roman]]ormwater management facility/stru [[1793,1448,2279,1496][10][,,][Times New Roman]]ctures, adjacent properties,
groundwater, on-site surface water or off-site surface waters)?
________________________________________________________________________________________________________
On-sitebiofiltrationsystemwithoverflowtoexistingstormwaterpipe.
________________________________________________________________________________________________________
If to surface waters, identify receiving water bodies or wetlands: ________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Will stormwater runoff flow to adjacent properties? Yes No
[[150,1838,230,1886][10][,I,][Times New Roman]]iv. [[201,1838,2035,1886][10][,,][Times New Roman]]Doesproposed plan minimize impervious surfaces, use pervious materials or collect and
re-use stormwater? [[2147,1838,2273,1886][10][,,][Times New Roman]] Yes [[2260,1838,2371,1886][10][,,][Times New Roman]] No
f.Does the proposed action include, or will it use on-site, one or more sources of air emissions, including fuel Yes No
combustion, waste incineration, or other processes or operations?
If Yes, identify:
[[181,2042,231,2090][10][,I,][Times New Roman]]i [[193,2042,243,2090][10][,,][Times New Roman]]. [[214,2042,301,2090][10][,,][Times New Roman]]Mo [[270,2042,1033,2090][10][,,][Times
New Roman]]bile sources during project operations (e.g., [[994,2042,1774,2090][10][,,][Times New Roman]] heavy equipment, fleet or delivery vehicles)
_________________________________________________________________________________________________________
[[171,2138,244,2186][10][,I,][Times New Roman]]ii. [[215,2138,1438,2186][10][,,][Times New Roman]]Stationary sources during construction (e.g., power generation, structur [[1401,2138,1979,2186][10][,
,][Times New Roman]]al heating, batch plant, crushers)
________________________________________________________________________________________________________
[[160,2234,245,2282][10][,I,][Times New Roman]]iii. [[216,2234,1016,2282][10][,,][Times New Roman]]Stationary sources during operations (e.g., pro [[987,2234,1840,2282][10][,,][Times
New Roman]]cess emissions, large boilers, electric generation)
________________________________________________________________________________________________________
g.Will any air emission sources named in D.2.f (above), require a NY State Air Registration, Air Facility Permit, Yes No
or Federal Clean Air Act Title IV or Title V Permit?
If Yes:
[[150,2492,212,2540][10][,I,][Times New Roman]]i. [[193,2492,850,2540][10][,,][Times New Roman]]Is the project site located in an Air qu [[821,2492,2042,2540][10][,,][Times New Roman]]ality
non-attainment area? (Area routinely or periodically fails to meet [[2143,2492,2269,2540][10][,,][Times New Roman]] Yes [[2256,2492,2367,2540][10][,,][Times New Roman]] No
ambient air quality standards for all or some parts of the year)
[[150,2588,223,2636][10][,I,][Times New Roman]]ii. [[194,2588,1593,2636][10][,,][Times New Roman]]In addition to emissions as calculated in the application, the project will generate:
___________Tons/year ()of CarbonDioxide (CO)
2
___________Tons/year() of NitrousOxide (N)
2
___________Tons/year() of Perfluorocarbons (PFCs)
___________Tons/year() of Sulfur Hexafluoride (SF)
6
___________Tons/year ()of CarbonDioxide equivalent ofHydroflorocarbons (H)
___________Tons/year ()ofHazardous Air Pollutants (HAPs)
Page 6 of 13
h.Will the proposed action generate or emit methane (including, but not limited to, sewage treatment plants, Yes No
landfills, composting facilities)?
If Yes:
[[171,223,233,271][10][,I,][Times New Roman]]i. [[203,223,2422,271][10][,,][Times New Roman]]Estimate methane generation in tons/year (metric): _______________________________________________________
_________
[[161,271,223,319][10][,I,][Times New Roman]]ii [[184,271,2355,319][10][,,][Times New Roman]].Describe any methane capture, control or elimination measures included in project design
(e.g., combustion to generate heat or
electricity, flaring): ________________________________________________________________________________________
_________________________________________________________________________________________________________
i.Will the proposed action result in the release of air pollutants from open-air operations or processes, such as Yes No
quarry or landfill operations?
If Yes: Describe operations and nature of emissions (e.g., diesel exhaust, rock particulates/dust):
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
j.Will the proposed action result in a substantial increase in traffic above present levels or generate substantial Yes No
new demand for transportation facilities or services?
If Yes:
[[181,861,243,909][10][,I,][Times New Roman]]i. [[214,861,1208,909][10][,,][Times New Roman]]When is the peak traffic expected (Check all that apply): [[1252,861,1405,909][10][,,][Times
New Roman]] Morni [[1367,861,1438,909][10][,,][Times New Roman]]ng [[1552,861,1751,909][10][,,][Times New Roman]] Evening [[1852,861,2039,909][10][,,][Times New Roman]]Weekend
Randomly between hours of __________ to ________.
[[181,957,254,1005][10][,I,][Times New Roman]]ii. [[225,957,362,1005][10][,,][Times New Roman]]For co [[333,957,1259,1005][10][,,][Times New Roman]]mmercial activities only, projected
number of semi-tr [[1222,957,1598,1005][10][,,][Times New Roman]]ailer truck trips/day: [[1560,957,1808,1005][10][,,][Times New Roman]] __________ [[1779,957,2058,1005][10][,,][Times
New Roman]]____________ [[2029,957,2079,1005][10][,,][Times New Roman]]_
[[171,1005,256,1053][10][,I,][Times New Roman]]iii. [[226,1005,2332,1053][10][,,][Times New Roman]]Parking spaces: Existing _____________ Proposed ___________ Net increase/decrease
_____________
[[171,1052,251,1100][10][,I,][Times New Roman]]iv. [[222,1052,1221,1100][10][,,][Times New Roman]]Does the proposed action include any shared use parking? [[2143,1052,2269,1100][10][,,][Times
New Roman]] Yes [[2256,1052,2367,1100][10][,,][Times New Roman]] No
[[171,1100,240,1148][10][,I,][Times New Roman]]v. [[221,1100,2344,1148][10][,,][Times New Roman]]If the proposed action includes any modification of existing roads, creation of new roads
or change in existing access, describ [[2314,1100,2382,1148][10][,,][Times New Roman]]e:
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
[[150,1292,230,1340][10][,I,][Times New Roman]]vi. [[211,1292,1162,1340][10][,,][Times New Roman]]Arepublic/private transportation service(s) or facilities [[1129,1292,1509,1340][10][,,][Times
New Roman]] available within ½ m [[1491,1292,1921,1340][10][,,][Times New Roman]]ile of the proposed site? [[2143,1292,2269,1340][10][,,][Times New Roman]] Yes [[2257,1292,2368,1340][10][,,][Times
New Roman]] No
[[150,1340,230,1388][10][,I,][Times New Roman]]vii [[192,1340,2093,1388][10][,,][Times New Roman]] Will the proposed action include access to public transportation or accommodations
for use of hybrid, electric [[2143,1340,2269,1388][10][,,][Times New Roman]] Yes [[2257,1340,2368,1388][10][,,][Times New Roman]] No
or other alternative fueled vehicles?
[[150,1436,242,1484][10][,I,][Times New Roman]]viii [[203,1436,274,1484][10][,,][Times New Roman]].W [[264,1436,1916,1484][10][,,][Times New Roman]]ill the proposed action include plans
for pedestrian or bicycle accommodations for connections to [[1887,1436,2058,1484][10][,,][Times New Roman]] existing [[2143,1436,2269,1484][10][,,][Times New Roman]] Yes [[2257,1436,2347,1484][10]
[,,][Times New Roman]] No
pede
strian or bicycle routes?
k.Will the proposed action (for commercial or industrial projects only) generate new or additional demand Yes No
for energy?
Thereisnoadditionalenergydemandfortheziplineservice.Patronswillbetransporteduphillbyanexistingchairlift.
If Yes:
Any lightingwillbelowenergyuseLEDfixtures.Anyadditionalenergyusewillbeminimal.
[[171,1761,233,1809][10][,I,][Times New Roman]]i. [[203,1761,872,1809][10][,,][Times New Roman]]Estimate annual electricity demand du [[843,1761,1457,1809][10][,,][Times New Roman]]ring
operation of the proposed acti [[1417,1761,1760,1809][10][,,][Times New Roman]]on: ____________ [[1731,1761,2427,1809][10][,,][Times New Roman]]________________________________
_________________________________________________________________________________________________________
Minimal
[[160,1857,233,1905][10][,I,][Times New Roman]]ii. [[204,1857,254,1905][10][,,][Times New Roman]]A [[234,1857,1648,1905][10][,,][Times New Roman]]nticipated sources/suppliers of electricity
for the project (e.g., on-site combustion, [[1609,1857,2273,1905][10][,,][Times New Roman]]on-site renewable, via grid/local utilit [[2234,1857,2348,1905][10][,,][Times New Roman]]y,
or
other):
________________________________________________________________________________________________________
NationalGrid/localutility
[[150,2000,235,2048][10][,I,][Times New Roman]]iii. [[205,2000,959,2048][10][,,][Times New Roman]]Will the proposed action require a new, or [[919,2000,1578,2048][10][,,][Times New
Roman]]an upgrade to, an existing substation? [[2143,2000,2269,2048][10][,,][Times New Roman]] Yes [[2256,2000,2367,2048][10][,,][Times New Roman]] No
No
l.Hours of operation. Answer all items which apply.
[[181,2152,243,2200][10][,I,][Times New Roman]]i. [[214,2152,608,2200][10][,,][Times New Roman]]During Construction: [[1215,2152,1288,2200][10][,I,][Times New Roman]]ii. [[1269,2152,1631,2200][10][,,
][Times New Roman]]During Operations:
Monday - Friday: _________________________Monday - Friday: ____________________________
9:00am-10:00pm-wintermonths
8:00am-4:00pm
Saturday: ________________________________Saturday: ___________________________________
9:00am-10:00pm-wintermonths
8:00am-4:00pm
Sunday: _________________________________Sunday: ____________________________________9:00am-10:00pm-wintermonths
None
Holidays: ________________________________Holidays: ___________________________________9:00am-10:00pm-wintermonths
None
Page 7 of 13
m.Will the proposed action produce noise that will exceed existing ambient noise levels during construction, Yes No
operation, or both?
If yes:
[[150,223,212,271][10][,I,][Times New Roman]]i. [[193,223,1226,271][10][,,][Times New Roman]]Provide details including sources, time of day and duration:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
[[150,366,212,414][10][,I,][Times New Roman]]ii [[173,366,1836,414][10][,,][Times New Roman]].Will proposed action remove existing natural barriers that could act as a noise barrier
or screen? [[2143,366,2269,414][10][,,][Times New Roman]] Yes [[2257,366,2368,414][10][,,][Times New Roman]] No
Describe: _________________________________________________________________________________________________
_________________________________________________________________________________________________________
n.[[181,529,231,577][10][,I,][Times New Roman]]. [[192,529,1051,577][10][,,][Times New Roman]] Will the proposed action have outdoor lighting? [[2143,529,2269,577][10][,,][Times New
Roman]] Yes [[2256,529,2377,577][10][,,][Times New Roman]] No
If yes:
Describe source(s), location(s), height of fixture(s), direction/aim, and proximity to nearest occupied structures:
[[165,625,227,673][10][,I,][Times New Roman]]i.
_________________________________________________________________________________________________________
Theziplinewillnotbeilluminatedtohighlightthetowers.VerylowlevelLEDstandswillbeaddedalongtheridecables.Focusedlightingwillbe
_________________________________________________________________________________________________________ addedwithintheziplinetowersbelowtheroofs.Fixtureswillbe"DarkSky"compliant.
[[150,768,212,816][10][,I,][Times New Roman]]ii [[173,768,223,816][10][,,][Times New Roman]]. [[204,768,1146,816][10][,,][Times New Roman]]Will proposed action remove existing natural
barriers [[1106,768,1824,816][10][,,][Times New Roman]]that could act as a light barrier or screen? [[2143,768,2269,816][10][,,][Times New Roman]] Yes [[2256,768,2367,816][10][,,][Times
New Roman]] No
Describe: _________________________________________________________________________________________________
_________________________________________________________________________________________________________
o[[171,945,221,993][10][,I,][Times New Roman]]. [[192,945,1059,993][10][,,][Times New Roman]]Does the proposed action have the potential to pro [[1030,945,1790,993][10][,,][Times New
Roman]]duce odors for more than one hour per day? [[2143,945,2269,993][10][,,][Times New Roman]] Yes [[2257,945,2368,993][10][,,][Times New Roman]] No
If Yes, describe possible sources, potential frequency and duration of odor emissions, and proximity to nearest
occupied structures: ______________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
p.Will theproposed action include any bulkstorageof petroleum (over1,100gallons) Yes No
or chemical products?
If Yes:
[[171,1366,233,1414][10][,I,][Times New Roman]]i. [[203,1366,2413,1414][10][,,][Times New Roman]]Product(s) to be stored ______________________________________________________________________________
________
[[160,1414,233,1462][10][,I,][Times New Roman]]ii. [[204,1414,1397,1462][10][,,][Times New Roman]]Volume(s) ______ per unit time ___________ (e.g., month, year)
[[150,1462,235,1510][10][,I,][Times New Roman]]iii. [[208,1462,1001,1510][10][,,][Times New Roman]]Generally describeproposed storagefacilities [[978,1462,2420,1510][10][,,][Times New
Roman]] ___________________________________________________________________
________________________________________________________________________________________________________
q.Will the proposed action (commercial, industrial and recreational projects only) use pesticides (i.e., herbicides, Yes No
insecticides) during construction or operation?
If Yes:
Describe proposed treatment(s):
[[192,1723,254,1771][10][,I,][Times New Roman]]i.
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
[[180,1962,253,2010][10][,I,][Times New Roman]]ii. [[224,1962,1399,2010][10][,,][Times New Roman]]Will the proposed action use Integrated Pest Management Practices? [[2143,1962,2289,2010][10][,,][Tim
es New Roman]] Yes [[2277,1962,2388,2010][10][,,][Times New Roman]] No
r.Will the proposed action (commercial or industrial projects only) involve or require the management or disposal Yes No
of solid waste (excluding hazardous materials)?
If Yes:
[[181,2157,243,2205][10][,I,][Times New Roman]]i. [[214,2157,746,2205][10][,,][Times New Roman]]Describe any solid waste(s) to [[716,2157,1054,2205][10][,,][Times New Roman]] be generated
duri [[1016,2157,1369,2205][10][,,][Times New Roman]]ng construction or [[1329,2157,1771,2205][10][,,][Times New Roman]]operation of the facility:
Construction: ____________________ tons per ________________ (unit of time)
Operation : ____________________ tons per ________________ (unit of time)
[[171,2307,244,2355][10][,I,][Times New Roman]]ii. [[215,2307,1276,2355][10][,,][Times New Roman]]Describe any proposals for on-site minimization, recycling or [[1240,2307,1711,2355][10][,,][Times
New Roman]] reuse of materials to avoi [[1671,2307,2131,2355][10][,,][Times New Roman]]d disposal as solid waste:
Construction: ________________________________________________________________________________________
____________________________________________________________________________________________________
Operation: __________________________________________________________________________________________
____________________________________________________________________________________________________
[[150,2553,235,2601][10][,I,][Times New Roman]]iii. [[206,2553,1417,2601][10][,,][Times New Roman]]Proposed disposal methods/facilities for solid waste generated on-site:
Construction: ________________________________________________________________________________________
____________________________________________________________________________________________________
Operation: __________________________________________________________________________________________
____________________________________________________________________________________________________
Page 8 of 13
s.Does the proposed action include construction or modification of a solid waste management facility? Yes No
If Yes:
Type of management or handling of waste proposed for the site (e.g., recycling or transfer station, composting, landfill, or
[[181,175,243,223][10][,I,][Times New Roman]]i.
other disposal activities): ___________________________________________________________________________________
[[171,271,244,319][10][,I,][Times New Roman]]ii. [[225,271,619,319][10][,,][Times New Roman]]Anticipated rate of di [[580,271,924,319][10][,,][Times New Roman]]sposal/processing:
________ Tons/month, if transfer or other non-combustion/thermal treatment, or
________ Tons/hour, if combustion or thermal treatment
[[171,420,256,468][10][,I,][Times New Roman]]iii. [[226,420,815,468][10][,,][Times New Roman]]If landfill, anticipated site life: __ [[786,420,1148,468][10][,,][Times New Roman]]________________
[[1120,420,1544,468][10][,,][Times New Roman]]______________ years
t.Will proposed action at the site involve the commercial generation, treatment, storage, or disposal of hazardous Yes No
waste?
If Yes:
[[181,635,243,683][10][,I,][Times New Roman]]i. [[214,635,2416,683][10][,,][Times New Roman]]Name(s) of all hazardous wastes or constituents to be generated, handled or managed at facility:
___________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
[[171,779,244,827][10][,I,][Times New Roman]]ii. [[215,779,1193,827][10][,,][Times New Roman]]Generally describe processes or activities involving haza [[1161,779,1691,827][10][,,][Times
New Roman]]rdous wastes or constituents: [[1651,779,1930,827][10][,,][Times New Roman]]____________ [[1901,779,2180,827][10][,,][Times New Roman]]____________ [[2152,779,2410,827][10][,,][Times
New Roman]]___________
_________________________________________________________________________________________________________
________________________________________________________________________________________________________
[[171,923,244,971][10][,I,][Times New Roman]]iii [[205,923,1293,971][10][,,][Times New Roman]].Specify amount to be handled or generated _____ tons/month
[[171,971,251,1019][10][,I,][Times New Roman]]iv. [[222,971,1283,1019][10][,,][Times New Roman]]Describe any proposals for on-site minimization, recycling or [[1247,971,1741,1019][10][,,][Times
New Roman]] reuse of hazardous constitu [[1712,971,2080,1019][10][,,][Times New Roman]]ents: ____________ [[2051,971,2414,1019][10][,,][Times New Roman]]________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
[[181,1114,250,1162][10][,I,][Times New Roman]]v. [[220,1114,1684,1162][10][,,][Times New Roman]]Will any hazardous wastes be disposed at an existing offsite hazardous waste facility?
[[2143,1114,2269,1162][10][,,][Times New Roman]] Yes [[2256,1114,2377,1162][10][,,][Times New Roman]] No
If Yes: provide name and location of facility: _______________________________________________________________________
________________________________________________________________________________________________________
If No: describe proposed management of any hazardous wastes which will not be sent to a hazardous waste facility:
________________________________________________________________________________________________________
Nohazardouswasteswillbegeneratedbytheproposedproject.
________________________________________________________________________________________________________
E. Site and Setting of Proposed Action
E.1. Land uses on and surrounding the project site
a.Existing land uses.
[[198,1664,260,1712][10][,I,][Times New Roman]]i. [[231,1664,1337,1712][10][,,][Times New Roman]]Check all uses that occur on, adjoining and near the project site.
Urban Industrial Commercial Residential (suburban) Rural (non-farm)
Forest Agriculture Aquatic Other (specify): ____________________________________
[[177,1808,250,1856][10][,I,][Times New Roman]]ii. [[232,1808,838,1856][10][,,][Times New Roman]]If mix of uses, generally describe:
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
b.Land uses and covertypes on the project site.
Land use orCurrent Acreage After Change
Covertype Acreage Project Completion (Acres +/-)
Roads, buildings, and other paved or impervious
7.68+/-9.75+/-
2.07+/-
surfaces
Forested
241.74+/-241.23+/-0.51+/-
Meadows, grasslands or brushlands (non-
132.17+/-
130.61+/-1.56+/-
agricultural, including abandoned agricultural)
Agricultural
000
(includes active orchards, field, greenhouse etc.)
Surface water features
0.75+/-0.75+/-0
(lakes, ponds, streams, rivers, etc.)
Wetlands (freshwater or tidal)
0
00
Non-vegetated (bare rock, earth or fill)
000
Other
Describe: _______________________________
________________________________________
Page 9 of 13
c.Is the project site presently used by members of the community for public recreation? Yes No
[[188,129,250,177][10][,I,][Times New Roman]]i. [[220,129,2405,177][10][,,][Times New Roman]]If Yes: explain: ________________________________________________________________________________________
__
d.Are there any facilities serving children, the elderly, people with disabilities (e.g., schools, hospitals, licensed Yes No
day care centers, or group homes) within 1500 feet of the project site?
If Yes,
[[188,337,250,385][10][,I,][Times New Roman]]i. [[220,337,565,385][10][,,][Times New Roman]]Identify Facilities:
________________________________________________________________________________________________________
________________________________________________________________________________________________________
e.Does the project site contain an existing dam? Yes No
If Yes:
[[188,608,250,656][10][,I,][Times New Roman]]i. [[220,608,970,656][10][,,][Times New Roman]]Dimensions of the dam and impoundment:
Dam height: _________________________________ feet
Dam length: _________________________________ feet
Surface area: _________________________________ acres
Volume impounded: _______________________________ gallons OR acre-feet
[[177,872,250,920][10][,I,][Times New Roman]]ii. [[221,872,320,920][10][,,][Times New Roman]]Dam [[312,872,2405,920][10][,,][Times New Roman]]s existing hazard classification: ______________________
___________________________________________________
ã
[[177,920,262,968][10][,I,][Times New Roman]]iii. [[233,920,781,968][10][,,][Times New Roman]]Provide date and summarize re [[749,920,1171,968][10][,,][Times New Roman]]sults of last
inspection:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
f.Has the project site ever been used as a municipal, commercial or industrial solid waste management facility, Yes No
or does the project site adjoin property which is now, or was at one time, used as a solid waste management facility?
If Yes:
[[188,1237,250,1285][10][,I,][Times New Roman]]i. [[210,1237,884,1285][10][,,][Times New Roman]] Has the facility been formally closed? [[2149,1237,2275,1285][10][,,][Times New Roman]]
Yes [[2263,1237,2384,1285][10][,,][Times New Roman]] No
If yes, cite sources/documentation: _______________________________________________________________________
[[177,1348,250,1396][10][,I,][Times New Roman]]ii. [[221,1348,1166,1396][10][,,][Times New Roman]]Describe the location of the project site relative to the [[1125,1348,2014,1396][10][,,][Times
New Roman]]boundaries of the solid waste management facility:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
[[167,1492,252,1540][10][,I,][Times New Roman]]iii. [[222,1492,891,1540][10][,,][Times New Roman]]Describe any development constraints [[857,1492,1265,1540][10][,,][Times New Roman]]
due to the prior solid [[1225,1492,1740,1540][10][,,][Times New Roman]]waste activities: __________ [[1711,1492,2408,1540][10][,,][Times New Roman]]________________________________
_______________________________________________________________________________________________________
g.Have hazardous wastes been generated, treated and/or disposed of at the site, or does the project site adjoin Yes No
property which is now or was at one time used to commercially treat, store and/or dispose of hazardous waste?
If Yes:
[[177,1765,239,1813][10][,I,][Times New Roman]]i. [[209,1765,1258,1813][10][,,][Times New Roman]]Describe waste(s) handled and waste management activities, [[1219,1765,2159,1813][10][,,][Times
New Roman]] including approximate time when activities occurred:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
h.Potential contamination history. Has there been a reported spill at the proposed project site, or have any Yes No
remedial actions been conducted at or adjacent to the proposed site?
If Yes:
[[188,2081,250,2129][10][,I,][Times New Roman]]i. [[220,2081,1850,2129][10][,,][Times New Roman]]Is any portion of the site listed on the NYSDEC Spills Incidents database or Environmental
Site [[2149,2081,2275,2129][10][,,][Times New Roman]] Yes [[2263,2081,2374,2129][10][,,][Times New Roman]] No
Remediation database? Check all that apply:
1206507
Yes – Spills Incidents database Provide DEC ID number(s): ________________________________
Yes – Environmental Site Remediation database Provide DEC ID number(s): ________________________________
Neither database
[[156,2346,229,2394][10][,I,][Times New Roman]]ii. [[200,2346,1213,2394][10][,,][Times New Roman]]If site has been subject of RCRA corrective activities, desc [[1181,2346,1622,2394][10][,,][Times
New Roman]]ribe control measures:__ [[1593,2346,2018,2394][10][,,][Times New Roman]]___________________ [[1990,2346,2395,2394][10][,,][Times New Roman]]__________________
________________________________________________________________________________________________________
N/A-NoinformationonRCRAdatabase.
________________________________________________________________________________________________________
[[167,2493,252,2541][10][,I,][Times New Roman]]iii. [[222,2493,680,2541][10][,,][Times New Roman]]Is the project within 2000 [[651,2493,1102,2541][10][,,][Times New Roman]] feet of any
site in the NY [[1083,2493,1950,2541][10][,,][Times New Roman]]SDEC Environmental Site Remediation database? [[2149,2493,2275,2541][10][,,][Times New Roman]] Yes [[2263,2493,2374,2541][10][,,][Time
s New Roman]] No
If yes, provide DEC ID number(s): ______________________________________________________________________________
[[167,2606,247,2654][10][,I,][Times New Roman]]iv. [[218,2606,1305,2654][10][,,][Times New Roman]]If yes to (i), (ii) or (iii) above, describe current status of site(s):
_______________________________________________________________________________________________________
Spillsincidentdatabaseindicatesthespillcasewasclosedon01.17.2013becausethenecessarycleanupandremovalactionshavebeencompleted
_______________________________________________________________________________________________________
andnofurtherremedialactivitiesarenecessaryand/orduetoadministrativereasons.(Seeattached'SpillIncidentsDatabaseDetails)
Page 10 of 13
[[177,80,246,128][10][,I,][Times New Roman]]v. [[216,80,816,128][10][,,][Times New Roman]]Is the project site subject to an ins [[782,80,1487,128][10][,,][Times New Roman]]titutional
control limiting property uses? [[2149,80,2275,128][10][,,][Times New Roman]] Yes [[2263,80,2384,128][10][,,][Times New Roman]] No
If yes, DEC site ID number: ____________________________________________________________________________
Describe the type of institutional control (e.g., deed restriction or easement): ____________________________________
Describe any use limitations: ___________________________________________________________________________
Describe any engineering controls: _______________________________________________________________________
Will the project affect the institutional or engineering controls in place? Yes No
Explain: ____________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
E.2. Natural Resources On or Near Project Site
a.What is the average depth to bedrock on the project site? ________________ feet
over6.5'
b. Are there bedrock outcroppings on the project site? Yes No
If Yes, what proportion of the site is comprised of bedrock outcroppings? __________________%
c.Predominant soil type(s) present on project site: ___________________________ __________%
100
Hinckleycobblysandyloam
___________________________ __________%
____________________________ __________%
d.What is the average depth to the water table on the project site? Average: _________ feet
over6.5
e.Drainage status of project site soils: Well Drained:_____%ofite
100
Moderately Well Drained: _____% of site
Poorly Drained _____%ofite
f.Approximate proportion of proposed action site with slopes: 0-10%:_____% of site
95
10-15%: _____% of site
15% or greater: _____% of site
5
(atzipline)
g.Are there any unique geologic features on the project site? Yes No
If Yes, describe: _____________________________________________________________________________________________
________________________________________________________________________________________________________
h.Surface water features.
[[177,1697,239,1745][10][,I,][Times New Roman]]i. [[209,1697,1927,1745][10][,,][Times New Roman]]Does any portion of the project site contain wetlands or other waterbodies (including
streams, rivers, [[2149,1697,2275,1745][10][,,][Times New Roman]] Yes [[2263,1697,2374,1745][10][,,][Times New Roman]] No
ponds or lakes)?
[[167,1793,240,1841][10][,I,][Times New Roman]]ii. [[211,1793,1264,1841][10][,,][Times New Roman]]Do any wetlands or other waterbodies adjoin the project site? [[2149,1793,2275,1841][10][,,][Times
New Roman]] Yes [[2263,1793,2374,1841][10][,,][Times New Roman]] No
If Yes to either [[418,1849,468,1897][10][,I,][Times New Roman]]i [[429,1849,524,1897][10][,,][Times New Roman]] or [[485,1849,547,1897][10][,I,][Times New Roman]]ii [[508,1849,1076,1897][10][,,][Ti
mes New Roman]], continue. If No, skip to E.2.i.
[[156,1905,241,1953][10][,I,][Times New Roman]]iii. [[222,1905,1089,1953][10][,,][Times New Roman]]Are any of the wetlands or waterbodies within or [[1050,1905,1513,1953][10][,,][Times
New Roman]]adjoining the project site [[1473,1905,1927,1953][10][,,][Times New Roman]]regulated by any federal, [[2149,1905,2275,1953][10][,,][Times New Roman]] Yes [[2263,1905,2374,1953][10][,,][
Times New Roman]] No
state or local agency?
[[167,2005,247,2053][10][,I,][Times New Roman]]iv. [[218,2005,562,2053][10][,,][Times New Roman]]For each identified [[708,2005,2024,2053][10][,,][Times New Roman]]wetland and waterbody
on theproject site, providethefollowing information
Streams:Name ____________________________________________Classification _______________________ 941-397on307.-1-29
C(T)
Snowmakingpondon307.-1-29
Lakesor Ponds:Name ____________________________________________Classification_______________________
Wetlands:Name ____________________________________________Approximate Size ___________________
Federalwaters
Wetland No. (if regulatedbyDEC) _____________________________
[[156,2256,225,2304][10][,I,][Times New Roman]]v. [[206,2256,761,2304][10][,,][Times New Roman]]Are any of the above water bod [[731,2256,1954,2304][10][,,][Times New Roman]]ies listed
in the most recent compilation of NYS water quality-impaired [[2149,2256,2275,2304][10][,,][Times New Roman]] Yes [[2263,2256,2374,2304][10][,,][Times New Roman]] No
waterbodies?
If yes, name of impaired water body/bodies and basis for listing as impaired: _____________________________________________
___________________________________________________________________________________________________________
i.Is the project site in a designated Floodway? Yes No
j.Is the project site in the 100 year Floodplain? Yes No
k.Is the project site in the 500 year Floodplain? Yes No
l.Is the project site located over, or immediately adjoining, a primary, principal or sole source aquifer? Yes No
If Yes:
Principal Aquifer
[[188,2806,250,2854][10][,I,][Times New Roman]]i. [[220,2806,2409,2854][10][,,][Times New Roman]]Name of aquifer: ____________________________________________________________________________________
_____
Page 11 of 13
m.Identify the predominant wildlife species that occupy or use the project site: ______________________________
______________________________ _____________________________________________________________
Urban-SuburbanWildlife
______________________________ _____________________________________________________________
n.Does the project site contain a designated significant natural community? Yes No
If Yes:
[[188,371,250,419][10][,I,][Times New Roman]]i. [[220,371,2417,419][10][,,][Times New Roman]]Describe the habitat/community (composition, function, and basis for designation): _______________________
______________
Pitch Pine-Scrub Oak BarrensandHemlock-NorthernHardwoodForest
________________________________________________________________________________________________________
[[177,467,250,515][10][,I,][Times New Roman]]ii. [[221,467,2412,515][10][,,][Times New Roman]]Source(s) of description or evaluation: ________________________________________________________________
________
[[167,515,252,563][10][,I,][Times New Roman]]iii. [[222,515,297,563][10][,,][Times New Roman]]Ex [[269,515,751,563][10][,,][Times New Roman]]tent of community/habitat:
700.0
Currently: ______________________ acres
and5,232acres
Following completion of project as proposed: _____________________ acres
Gain or loss (indicate + or -): ______________________ acres
o.Does project site contain any species of plant or animal that is listed by the federal government or NYS as Yes No
endangered or threatened, or does it contain any areas identified as habitat for an endangered or threatened species?
p.Does the project site contain any species of plant or animal that is listed by NYS as rare, or as a species of Yes No
special concern?
q.Is the project site or adjoining area currently used for hunting, trapping, fishing or shell fishing? Yes No
If yes, give a brief description of how the proposed action may affect that use: ___________________________________________
________________________________________________________________________________________________________
E.3. Designated Public Resources On or Near Project Site
a.Is the project site, or any portion of it, located in a designated agricultural district certified pursuant to Yes No
Agriculture and Markets Law, Article 25-AA, Section 303 and 304?
If Yes, provide county plus district name/number: _________________________________________________________________
b.Are agricultural lands consisting of highly productive soils present? Yes No
[[198,1924,260,1972][10][,I,][Times New Roman]]i. [[231,1924,2404,1972][10][,,][Times New Roman]]If Yes: acreage(s) on project site? _________________________________________________________________
__________
[[188,1972,261,2020][10][,I,][Times New Roman]]ii. [[232,1972,2408,2020][10][,,][Times New Roman]]Source(s) of soil rating(s): _______________________________________________________________________
__________
c.Does the project site contain all or part of, or is it substantially contiguous to, a registered National Yes No
Natural Landmark?
If Yes:
[[188,2192,250,2240][10][,I,][Times New Roman]]i. [[231,2192,911,2240][10][,,][Times New Roman]]Nature of the natural landmark: [[898,2192,1478,2240][10][,,][Times New Roman]]
Biological Community [[1465,2192,1846,2240][10][,,][Times New Roman]] Geological Feature
[[188,2240,261,2288][10][,I,][Times New Roman]]ii. [[232,2240,2406,2288][10][,,][Times New Roman]]Provide brief description of landmark, including values behind designation and approximate
size/extent: ___________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
d.Is the project site located in or does it adjoin a state listed Critical Environmental Area? Yes No
If Yes:
[[198,2519,260,2567][10][,I,][Times New Roman]]i. [[230,2519,2403,2567][10][,,][Times New Roman]]CEA name: ____________________________________________________________________________________________
_
[[188,2567,261,2615][10][,I,][Times New Roman]]ii. [[232,2567,2405,2615][10][,,][Times New Roman]]Basis for designation: ______________________________________________________________________________
_______
[[177,2615,262,2663][10][,I,][Times New Roman]]iii. [[233,2615,2400,2663][10][,,][Times New Roman]]Designating agency and date: ______________________________________________________________________
________
Page 12 of 13
e.Does the project site contain, or is it substantially contiguous to, a building, archaeological site, or district Yes No
which is listed on, or has been nominated by the NYS Board of Historic Preservation for inclusion on, the
State or National Register of Historic Places?
If Yes:
[[188,272,250,320][10][,I,][Times New Roman]]i. [[220,272,627,320][10][,,][Times New Roman]]Nature of historic/arch [[598,272,1003,320][10][,,][Times New Roman]]aeological resource:
[[991,272,1464,320][10][,,][Times New Roman]] Archaeological Site [[1453,272,2027,320][10][,,][Times New Roman]] Historic Building or District
[[177,320,250,368][10][,I,][Times New Roman]]ii. [[221,320,2403,368][10][,,][Times New Roman]]Name: _________________________________________________________________________________________________
[[156,368,241,416][10][,I,][Times New Roman]]iii. [[212,368,1177,416][10][,,][Times New Roman]]Brief description of attributes on which listing is based:
_______________________________________________________________________________________________________
f.Is the project site, or any portion of it, located in or adjacent to an area designated as sensitive for Yes No
archaeological sites on the NY State Historic Preservation Office (SHPO) archaeological site inventory?
g.Have additional archaeological or historic site(s) or resources been identified on the project site? Yes No
If Yes:
[[188,720,238,768][10][,I,][Times New Roman]]i [[199,720,2418,768][10][,,][Times New Roman]].Describe possible resource(s): __________________________________________________________________________
_____
[[177,768,250,816][10][,I,][Times New Roman]]ii. [[221,768,2404,816][10][,,][Times New Roman]]Basis for identification: _____________________________________________________________________________
______
h.theproject siteanyofficially designated and publicly accessible federal, state,or local Yes No
scenicor aesthetic resource?
If Yes:
[[188,993,250,1041][10][,I,][Times New Roman]]i. [[220,993,2409,1041][10][,,][Times New Roman]]Identify resource: _____________________________________________________________________________________
____
[[177,1041,250,1089][10][,I,][Times New Roman]]ii. [[221,1041,1295,1089][10][,,][Times New Roman]]Nature of, or basis for, designation (e.g., established highway [[1255,1041,1809,1089][10][,,][Times
New Roman]]overlook, state or local park, st [[1771,1041,2253,1089][10][,,][Times New Roman]]ate historic trail or scenic b [[2222,1041,2363,1089][10][,,][Times New Roman]]yway,
etc.): ___________________________________________________________________________________________________
[[156,1137,241,1185][10][,I,][Times New Roman]]iii. [[212,1137,1466,1185][10][,,][Times New Roman]]Distance between project and resource: _____________________ miles.
i.Is the project site located within a designated river corridor under the Wild, Scenic and Recreational Rivers Yes No
Program 6 NYCRR 666?
If Yes:
[[188,1346,250,1394][10][,I,][Times New Roman]]i. [[220,1346,412,1394][10][,,][Times New Roman]]Identify t [[374,1346,2418,1394][10][,,][Times New Roman]]he name of the river and its
designation: ________________________________________________________________
[[177,1397,250,1445][10][,I,][Times New Roman]]ii. [[221,1397,985,1445][10][,,][Times New Roman]]Is the activity consistent with development [[946,1397,1721,1445][10][,,][Times New
Roman]]restrictions contained in 6NYCRR Part 666? [[2149,1397,2275,1445][10][,,][Times New Roman]] Yes [[2263,1397,2374,1445][10][,,][Times New Roman]] No
F. Additional Information
Attach any additional information which may be needed to clarify your project.
If you have identified any adverse impacts which could be associated with your proposal, please describe those impacts plus any
measures which you propose to avoid or minimize them.
G. Verification
I certify that the information provided is true to the best of my knowledge.
Applicant/Sponsor Name ___________________________________ Date_______________________________________
Signature________________________________________________ Title_______________________________________
PRINTFORM
Page 13 of 13
ÛßÚ Ó¿°°»® Í«³³¿®§ λ°±®¬
Monday, December 03, 2018 8:55 AM
Disclaimer:
The EAF Mapper is a screening tool intended to assist
project sponsors and reviewing agencies in preparing an environmental
assessment form (EAF). Not all questions asked in the EAF are
answered by the EAF Mapper. Additional information on any EAF
question can be obtained by consulting the EAF Workbooks. Although
the EAF Mapper provides the most up-to-date digital data available to
DEC, you may also need to contact local or other data sources in order
to obtain data not provided by the Mapper. Digital data is not a
substitute for agency determinations.
B.i.i [Coastal or Waterfront Area]No
B.i.ii [Local Waterfront Revitalization Area]No
C.2.b. [Special Planning District]Digital mapping data are not available or are incomplete. Refer to EAF
Workbook.
E.1.h [DEC Spills or Remediation Site - Digital mapping data are not available or are incomplete. Refer to EAF
Potential Contamination History]Workbook.
E.1.h.i [DEC Spills or Remediation Site - Digital mapping data are not available or are incomplete. Refer to EAF
Listed]Workbook.
E.1.h.i [DEC Spills or Remediation Site - Digital mapping data are not available or are incomplete. Refer to EAF
Environmental Site Remediation Database]Workbook.
E.1.h.iii [Within 2,000' of DEC Remediation No
Site]
E.2.g [Unique Geologic Features]No
E.2.h.i [Surface Water Features]No
E.2.h.ii [Surface Water Features]No
E.2.h.iii [Surface Water Features]No
E.2.h.v [Impaired Water Bodies]No
E.2.i. [Floodway]Digital mapping data are not available or are incomplete. Refer to EAF
Workbook.
E.2.j. [100 Year Floodplain]Digital mapping data are not available or are incomplete. Refer to EAF
Workbook.
E.2.k. [500 Year Floodplain]Digital mapping data are not available or are incomplete. Refer to EAF
Workbook.
E.2.l. [Aquifers]Yes
E.2.l. [Aquifer Names]Principal Aquifer
E.2.n. [Natural Communities]Yes
Full Environmental Assessment Form - EAF Mapper Summary Report
[[2414,3217,2464,3255][8][B,I,][Times New Roman]]1
E.2.n.i [Natural Communities - Name]Pitch Pine-Scrub Oak Barrens
E.2.n.i [Natural Communities - Acres]700.0
E.2.o. [Endangered or Threatened Species]No
E.2.p. [Rare Plants or Animals]No
E.3.a. [Agricultural District]No
E.3.c. [National Natural Landmark]No
E.3.d [Critical Environmental Area]No
E.3.e. [National Register of Historic Places]Digital mapping data are not available or are incomplete. Refer to EAF
Workbook.
E.3.f. [Archeological Sites]No
E.3.i. [Designated River Corridor]No
Full Environmental Assessment Form - EAF Mapper Summary Report
[[2414,3217,2464,3255][8][B,I,][Times New Roman]]2
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