**U.S. DEPARTMENT OF ENERGY**

**ENVIRONMENTAL QUESTIONNAIRE**

**I. [BACKGROUND]{.underline}**

The Department of Energy (DOE) National Environmental Policy Act (NEPA)
Implementing Procedures (10 CFR 1021) require careful consideration of
the potential environmental consequences of all proposed actions during
the early planning stages of a project or activity. DOE policy directs
at the earliest possible stage in a project whether such actions will
require preparation of an Environmental Assessment, an Environmental
Impact Statement, or a Categorical Exclusion. To comply with these
requirements, an Environmental Questionnaire (NETL Form F 451.1-1/3)
must be completed for each proposed action to provide DOE with the
information necessary to determine the appropriate level of NEPA review
and documentation. If the proposed project qualifies for Categorical
Exclusion designation, a Categorical Exclusion Designation Form *(Click
Twice to Link)* will also be completed in addition to the Environmental
Questionnaire.

**II. [INSTRUCTIONS]{.underline}**

Separate copies of the Environmental Questionnaire and Categorical
Exclusion Designation Form (if required) should be completed by the
principal proposer and principal subcontractor(s). In addition, if the
proposed project includes activities at different locations, an
independent questionnaire should be prepared for each location.
Supporting information can be provided as attachments.

In completing this Questionnaire, the proposer is requested to provide
specific information and quantities, when applicable, regarding air
emissions, wastewater discharges, solid wastes, etc., to facilitate the
necessary review. The proposer should identify the location of the
project and specifically describe the activities that would occur at
that location. In addition, the proposer will be required to submit an
official copy of the project's statement of work (SOW) or statement of
project objective (SOPO) that will be used in the contract/agreement
between the proposer and DOE.

**III. [QUESTIONNAIRE]{.underline}**

**A. PROJECT SUMMARY**

1\. Solicitation/Project Number: [     ]{.underline}

2\. Proposer and Subcontractors: [     ]{.underline}

3\. Principal Investigator: [     ]{.underline}

> Telephone Number: [     ]{.underline}

4\. Project Title: [     ]{.underline}

5\. Duration: [     ]{.underline}

6\. Location(s) of Performance (City/Township, County, State):
[     ]{.underline}

> [     ]{.underline}
>
> [     ]{.underline}

7\. Identify and select checkbox with the predominant project work
activities under Group A-7a, A-7b, or A-7c.      

> **Group A-7a**
>
> Categorical Exclusion CX-A: Routine administrative, procurement,
> training, and personnel actions. Contract activities/awards for
> management support, financial assistance, and technical services in
> support of agency business, programs, projects, and goals. Literature
> searches and information gathering, material inventories, property
> surveys; data analysis, computer modeling, analytical reviews,
> technical summary, conceptual design, feasibility studies, document
> preparation, data dissemination, and paper studies. Technical
> assistance including financial planning, assistance, classroom
> training, public meetings, management training, survey participation,
> academic contribution, technical consultation, stakeholders surveys.
> Workshop and conference planning, preparation, and implementation
> which may involve promoting energy efficiency, renewable energy, and
> energy conservation.

**Group A-7b**

Categorical Exclusion CX-B: Laboratory Scale Research, Bench Scale
Research, Pilot Scale Research, Proof-of-Concept Scale Research, or
Field Test Research. Work [DOES NOT]{.underline} involve new
building/facilities construction and site excavation/groundbreaking
activities. This work typically involves routine operation of
[existing]{.underline} laboratories, commercial buildings/properties,
offices and homes, project test facilities, factories/power plants,
vehicles test stands and components, refueling facilities, utility
systems, or other existing structures/facilities. Work will NOT involve
major change in facilities missions and operations, land use planning,
new/modified regulatory/operating permit requirements. Includes work
specific to routine DOE Site operations and Lab research work
activities, but NOT building construction and site preparation. DOE work
typically involves laboratory facilities and lab equipment operations,
buildings and grounds management activities; and buildings and
facilities maintenance, repairs, reconfiguration, remodeling, equipment
use and replacement.

**Group A-7c**

Categorical Exclusion CX-B, Environmental Assessment (EA), Environmental
Impact Statement (EIS): Pilot Test Facilities Construction, Pilot Scale
Research, Field Scale Demonstration, or Commercial Scale Application.
Work typically involves facility construction, site
preparation/excavation/groundbreaking, and/or demolition. This work
would include construction, retrofit, replacement, and/or major
modifications of laboratories, test facilities, energy system
prototypes, and power generation infrastructure. Work may also involve
construction and maintenance of utilities system right-of-ways, roads,
vehicle test facilities, commercial buildings/properties, fuel
refinery/mixing facilities, refueling facility, power plants,
underground wells, and pipelines, and other types of energy research
related facilities. This work may require new or modified regulatory
permits, environmental sampling and monitoring requirements, master
planning, public involvement, and environmental impact review. Includes
work specific to DOE Site Operations and Lab operation activities
involving building and facilities construction, replacement,
decommissioning/demolition, site preparation, land use changes, or
change in research facilities mission or operations.

Other (please describe):      

8\. Summarize the objectives of the proposed work. List activities
planned at the location as covered by this Environmental Questionnaire.

     

9\. List all other locations where work would be performed by the
primary contractor of the project and primary subcontractor(s). (Note:
An environmental questionnaire may be required for each
[new]{.underline} location after reviewing the SOW/SOPO, project scope,
tasks, and environmental affects).

     

10\. Identify major materials that would be used and produced by the
project when projects are larger than lab or bench scale.

> Materials Used (input) (Estimate Quantity) Materials Produced (output)
> (Estimate Quantity)
>
> Coal (     ) Wastewater (     )
>
> Natural Gas (     ) Air Emissions (     )
>
> Oil (     ) Solid Waste (     )
>
> Electricity (     ) Hazardous Waste (     )
>
> Water (     ) Others  \-- List (     )
>
> Others -- List (     )

**B. PROPOSED PROJECT ALTERNATIVES**

[]{.mark}

1\. If applicable, list any project alternative considered to achieve
the project objectives.

     

**C. PROJECT LOCATION**

1\. Provide a brief description of the project location (physical
location, surrounding area, adjacent structures).

     

2\. Attach a project site location map of the project work area. Project
site photos and topographical maps may be requested for further review.

     

**D. ENVIRONMENTAL IMPACTS**

This section is designed to obtain information concerning environmental
impacts and regulatory compliance of a proposed project. NEPA procedures
require evaluations of possible effects (including land use, energy
resource use, natural, historic and cultural resources, and pollutants)
from proposed projects on the environment. The website has valuable
information concerning environment impacts and regulatory compliance.

**1. Land Use**

a\. Characterize present land use where the proposed project would be
located.

> Urban Industrial Commercial Agricultural
>
> Suburban Rural Residential Research Facilities
>
> Forest University Campus Other

b\. Identify the total size of the facility, structure, or system and
what portion would be used for the proposed project.

c\. Describe planned construction, installation, and/or demolition
activities, i.e., roads, utilities system right-of-ways, parking lots,
buildings, laboratories, storage tanks, fueling facilities, underground
wells, pipelines, or other structures.

> No construction would be anticipated for this project.

     

d\. Describe how land use would be affected by operational activities
associated with the proposed project.

No land areas would be affected.

     

e\. Describe any plans to reclaim areas that would be affected by the
proposed project.

> No land areas would be affected.
>
>      

f\. Would the proposed project affect any unique or unusual landforms
(e.g., cliffs, waterfalls, etc.)?

> No Yes (describe)      

g\. Would the proposed project be located in or near local, state, or
federal parks; forests; monuments; scenic waterways; wilderness;
recreation facilities; or tribal lands?

> No Yes (describe)      

**2. Construction Activities and/or Operation**

a\. Identify project structure(s), power line(s), pipeline(s), utilities
systems(s), right-of-way(s) or road(s) that will be constructed and
clearly mark them on a project site map or topographic map as
appropriate.

None

     

b\. Would the proposed project require the construction of waste pits or
settling ponds?

> No Yes (describe and identify location, and estimate surface area
> disturbed)      

c\. Would the proposed project affect any existing body of water?

> No Yes (describe)      

d\. Would the proposed project impact a floodplain or wetland?

> No Yes (describe)      

e\. Would the proposed project cause runoff/sedimentation/erosion?

> No Yes (describe)      

f\. Describe any instability (e.g., subsidence, perma-frost, erosion,
faulting/fracturing) affecting building construction, site development,
and/or project operation.

     

**3. Vegetation and Wildlife Resources**

a\. Identify any State‑ or Federal-listed endangered or threatened plant
or animal species affected by the proposed project.

> None

b\. Would any threatened or endangered species habitat be affected by
the proposed project?

> No Yes (describe)

c\. Describe any impacts that construction would have on any other types
of sensitive or unique habitats.

> No planned construction No habitats None Impact (describe)      

d\. Would any unnatural substances/materials be introduced into ground
or surface waters, soil, or other earth/geologic resource because of
project activities? How would these foreign substances/materials affect
the water, soil, and geologic resources.

No Yes (describe)      

e\. Would any migratory animal corridors be impacted or disrupted by the
proposed project?

> No Yes (describe)      

**4. Socioeconomic and Infrastructure Conditions.**

a\. Would local socio-economic changes result from the proposed project?

> No Yes (describe)      

b\. Would the proposed project generate increased traffic use of roads
through local neighborhoods, urban or rural areas.?

> No Yes (describe)      

c\. Would the proposed project require new transportation access (roads,
rail, etc.)? Describe location, impacts, costs.

> No Yes (describe)      

d\. Would the proposed project create a significant increase in local
energy usage?

> No Yes (describe)      

**5. Historical/Cultural Resources**

a\. Describe any historical, archeological, or cultural sites in the
vicinity of the proposed project; note any sites included on the
National Register of Historic Places.

None

     

b\. Would construction or operational activities planned under the
proposed project disturb any historical, archeological, or cultural
sites?

> No planned construction No historic sites Yes (describe)       No
> Impact (Discuss)      

c\. Has the State Historic Preservation Office been contacted with
regard to this project?

> No Yes (describe)      

d\. Would the proposed project interfere with visual resources (e.g.,
eliminate scenic views) or alter the present landscape?

> No Yes (describe)      

**6. Atmospheric Conditions/Air Quality**

a.  Identify air quality conditions in the immediate vicinity of the
    proposed project with regard to attainment of National Ambient Air
    Quality Standards (NAAQS). This information is available under the
    located at or

  ------------------ -------------------------- ------------------------------
                     [Attainment]{.underline}   [Non-Attainment]{.underline}

  O~3~ - 1 Hour                                 

  O~3~ -- 8 Hour                                

  SO~x~                                         

  PM-2.5                                        

  PM-10                                         

  CO                                            

  NO~2~                                         

  Lead                                          

                                                
  ------------------ -------------------------- ------------------------------

b\. Would proposed project require issuance of new or modified local,
state, or federal air permits to perform project related work and
activities?

> No Yes (describe)      

c\. Would the proposed project be in compliance with local and state air
quality requirements?

> No (explain)       Yes

d\. Would the proposed project be classified as either a New Source or a
major modification to an existing source?

> No Yes (describe)      

e\. What types of air emissions, including fugitive emissions, would be
anticipated from the proposed project, and what would be the maximum
annual rate of emissions for the project?

> (Maximum per year) (Total for project)
>
> SO~x\      \      ~

NO~x\      \      ~

PM-2.5 ~     \      ~

PM-10 ~     \      ~

CO ~     ~ ~     ~

CO~2\      \      ~

Lead ~     ~ ~     ~

H~2~S ~     ~ ~     ~

Organic solvent vapors or other volatile organic compounds. List      

Hazardous air pollutants. List      

Other. List      

> None

f\. Would any types of emission control or particulate collection
devices be used?

> No Yes (describe, including collection efficiencies)      

g\. If no control devices are used, how would emissions be vented?

     

**7. Hydrologic Conditions/Water Quality**

a\. What is the closest body of water to the proposed project area and
what is its distance from the project site?

     

b\. What sources would supply potable and process water for the proposed
project?

     

c\. Quantify the daily or annual amount of wastewater that would be
generated by the proposed project.

> None
>
> Non-contact cooling water (      gallons)
>
> Process water (      gallons)
>
> Sanitary and/or grey water (      gallons)
>
> Other -- describe       (      gallons)

d\. What would be the major components of [each]{.underline} type of
wastewater (e.g., coal fines)?

> No wastewater produced
>
>      

e\. Identify the local treatment facility that would receive wastewater
from the proposed project.

> No discharges to local treatment facility
>
>      

f\. Describe how wastewater would be collected and treated.

     

g\. Would any run-off or leachates be produced from storage piles or
waste disposal sites?

> No Yes (describe source)      

h\. Would project require issuance of new or modified water permits to
perform project work or site development activities?

No Yes (describe)      

i\. Where would wastewater effluents from the proposed project be
discharged?

> No wastewater produced

     

j\. Would the proposed project be permitted to discharge effluents into
an existing body of water?

> No Yes (describe water use and effluent impact)      

k\. Would a new or modified National Pollutant Discharge Elimination
System (NPDES) permit be required?

> No Yes (describe)      

l\. Would the proposed project adversely affect the quality or movement
of groundwater?

> No Yes (describe)      

m.  Would the proposed project require issuance of an permit?

> Yes (describe)      

**8. Solid and Hazardous Wastes**

a.  Identify and estimate major nonhazardous solid wastes that would be
    generated from the project. Solid wastes are defined as any solid,
    liquid, semi-solid, or contained gaseous material that is discarded
    or has served its intended purpose, or is a manufacturing or mining
    by‑product (See at http://www.epa.gov/msw/ and at
    http://www.epa.gov/msw/states.htm).

    [Annual Quantity]{.underline}

None

Municipal solid waste, i.e., paper, plastic, etc. ([     ]{.underline})

> Coal or coal by‑products ([     )]{.underline}
>
> Other ‑‑ identify       ([     ]{.underline})

b\. Would project require issuance of new or modified solid waste and/or
hazardous waste related permits to perform project work activities?

No Yes (explain)      

c\. How and where would solid waste disposal be accomplished?

> On-site (identify and describe location)      
>
> Off-site (identify location and describe facility and treatment)      

d\. How would wastes for disposal be transported?

     

e\. Identify hazardous wastes that would be generated, used, or stored
under this project. Hazardous information can be found at website at
http://www.epa.gov/epaoswer/osw/hazwaste.htm.

None

     

f\. How would hazardous or toxic waste be collected and stored?

> None used or produced

     

g\. If hazardous wastes would require off-site disposal, have
arrangements been made with a certified TSD (Treatment, Storage, and
Disposal) facility?

Not required Arrangements not yet made Arrangements made with a
certified TSD facility (identify):      

**9. Health/Safety Factors**

a\. Identify hazardous or toxic materials that would be used in the
proposed project.

> None Hazardous or toxic substances that would be used (identify):
>      

b\. What would be the likely impacts of these project related hazardous
materials on human health and the environment?

None Yes (explain)      

c\. Would there be any special physical hazards or health risks
associated with the project?

> No Yes (describe)      

d\. Does a worker safety program exist at the location of the proposed
project?

> No Yes (describe)      

e\. Would safety training be necessary for any laboratory, equipment, or
processes involved with the project?

> No Yes (describe)      

f\. Describe any increases in ambient noise levels to the public from
construction and operational activities.

> None Increase in ambient noise level (describe)      

g\. Would project construction result in the removal of natural barriers
that act as noise screens?

> No construction planned No Yes (describe)      

h\. Would hearing protection be required for workers?

> No Yes (describe)      

**10. Environmental Restoration and/or Waste Management**

a\. Would the proposed project include CERCLA removals or similar
actions under RCRA or other authorities?

No Yes (describe)      

b\. Would the proposed project include siting, construction, and
operation of temporary pilot-scale waste collection and treatment
facilities or pilot-scale waste stabilization and containment
facilities?

No Yes (describe)      

c\. Would the proposed project involve operations of environmental
monitoring and control systems?

No Yes (describe)      

d\. Would the proposed project involve siting, construction, operation,
and decommissioning of a facility for storing packaged hazardous waste
for 90 days or less?

No Yes (describe)      

**E. REGULATORY COMPLIANCE**

1\. For the following laws, describe any existing permits, new or
modified permits, manifests, responsible authorities or agencies,
contacts, etc., that would be required for the proposed project
(Information on the following environmental laws can be found at the
Major Environmental Law website :

a\. Resource Conservation and Recovery Act ():

> None Required (describe)      

b\. Comprehensive Environmental Response, Compensation, and Liability
Act (CERCLA):

> None Required (describe)      

c\. Toxic Substance Control Act (TSCA):

> None Required (describe)      

d\. Clean Water Act (CWA):

> None Required (describe)      

e\. Underground Storage Tank Control Program ():

> None Required (describe)      

f\. Underground Injection Control Program ():

None Required (describe)      

g\. Clean Air Act (CAA):

> None Required (describe)      

h\. Endangered Species Act (ESA):

> None Required (describe)      

i\. :

> None Required (describe)      

j\. Fish and Wildlife Coordination Act (FWCA):

> None Required (describe)      

k\. National Historic Preservation Act (NHPA):

> None Required (describe)      

l\. Coastal Zone Management Act (CZMA):

> None Required (describe)      

2\. Identify any other environmental laws and regulations (Federal,
state, [and]{.underline} local) for which compliance would be necessary
for this project, and describe the permits, manifests, and contacts that
would be required.

     

**F. DESCRIBE ANY ISSUES THAT WOULD GENERATE PUBLIC CONTROVERSY
REGARDING THE PROPOSED PROJECT.**

None

     

**G. WOULD THE PROPOSED PROJECT PRODUCE ADDITIONAL DEVELOPMENT, OR ARE
OTHER MAJOR DEVELOPMENTS PLANNED OR UNDERWAY, IN THE PROJECT AREA?**

No Yes (describe)      

**H. SUMMARIZE THE SIGNIFICANT IMPACTS THAT WOULD RESULT FROM THE
PROPOSED PROJECT.**

None (provide supporting detail)       Significant impacts (describe)
     

**IV. [CERTIFICATION BY PROPOSER]{.underline}**

I hereby certify that the information provided herein is current,
accurate, and complete as of the date shown immediately below.

SIGNATURE: [     ]{.underline} DATE: [     ]{.underline} /
[     ]{.underline} / [     ]{.underline}

> month day year

TYPED NAME: [     ]{.underline}

TITLE: [     ]{.underline}

ORGANIZATION: [     ]{.underline}

**V. [REVIEW AND APPROVAL BY DOE]{.underline}**

I hereby certify that I have reviewed the information provided in this
questionnaire, have determined that all questions have been
appropriately answered, and judge the responses to be consistent with
the efforts proposed. Based on the information in the questionnaire, I
conclude the following (check the appropriate box):

The proposed action falls under one or more of the categorical
exclusions (CXes) listed in Appendix A or B of Subpart D of the and
would not (1) violate applicable ES&H requirements, (2) require siting
of waste transportation, storage and disposal or recovery facilities,
(3) disturb hazardous substances (excluding naturally occurring
petroleum and natural gas), thus producing uncontrolled or unpermitted
releases, and (4) adversely affect environmentally sensitive resources.

> Additionally, the proposed action (1) would not present any
> extraordinary circumstances such that the action might have a
> significant impact upon the human environment, (2) is not connected to
> other actions with potentially significant impacts, and (3) is not
> related to other actions with cumulatively significant impacts.
>
> Based on the Environmental Questionnaire and these conclusions,
> Categorical Exclusion of the proposed action would be appropriate.

The proposed action does not qualify as a CX as identified in Subpart D
of DOE's NEPA Implementing Procedures; therefore, the proposed action
may require further documentation in the form of an Environmental
Assessment or Environmental Impact Statement.

PROJECT MANAGER:

SIGNATURE: [     ]{.underline} DATE: [     ]{.underline} /
[     ]{.underline} / [     ]{.underline}

> month day year

TYPED NAME: [     ]{.underline}

**U.S. DEPARTMENT OF ENERGY**

**CATEGORICAL EXCLUSION (CX) DESIGNATION FORM**

+---+-------+---+---------------------+-----+---+---+-------------------+
| > |       | > |                     | >   | > |   |                   |
|   |       |   |                     | FY: |   |   |                   |
| A |       |   |                     |     |   |   |                   |
| c |       |   |                     |     |   |   |                   |
| t |       |   |                     |     |   |   |                   |
| i |       |   |                     |     |   |   |                   |
| o |       |   |                     |     |   |   |                   |
| n |       |   |                     |     |   |   |                   |
| > |       |   |                     |     |   |   |                   |
|   |       |   |                     |     |   |   |                   |
| o |       |   |                     |     |   |   |                   |
| r |       |   |                     |     |   |   |                   |
| > |       |   |                     |     |   |   |                   |
|   |       |   |                     |     |   |   |                   |
| P |       |   |                     |     |   |   |                   |
| r |       |   |                     |     |   |   |                   |
| o |       |   |                     |     |   |   |                   |
| j |       |   |                     |     |   |   |                   |
| e |       |   |                     |     |   |   |                   |
| c |       |   |                     |     |   |   |                   |
| t |       |   |                     |     |   |   |                   |
| > |       |   |                     |     |   |   |                   |
|   |       |   |                     |     |   |   |                   |
| N |       |   |                     |     |   |   |                   |
| o |       |   |                     |     |   |   |                   |
| . |       |   |                     |     |   |   |                   |
+---+-------+---+---------------------+-----+---+---+-------------------+
| > | >     |   |                     | >   |   |   | >                 |
|   |       |   |                     |  Pe |   |   |                   |
| T |       |   |                     | rfo |   |   |                   |
| i |       |   |                     | rma |   |   |                   |
| t |       |   |                     | nce |   |   |                   |
| l |       |   |                     | > P |   |   |                   |
| e |       |   |                     | eri |   |   |                   |
| : |       |   |                     | od: |   |   |                   |
+---+-------+---+---------------------+-----+---+---+-------------------+
| > |       |   | >                   | >   |   | > |                   |
|   |       |   |                     | Loc |   |   |                   |
| P |       |   |                     | ati |   |   |                   |
| e |       |   |                     | on: |   |   |                   |
| r |       |   |                     |     |   |   |                   |
| f |       |   |                     |     |   |   |                   |
| o |       |   |                     |     |   |   |                   |
| r |       |   |                     |     |   |   |                   |
| m |       |   |                     |     |   |   |                   |
| i |       |   |                     |     |   |   |                   |
| n |       |   |                     |     |   |   |                   |
| g |       |   |                     |     |   |   |                   |
| > |       |   |                     |     |   |   |                   |
|   |       |   |                     |     |   |   |                   |
| O |       |   |                     |     |   |   |                   |
| r |       |   |                     |     |   |   |                   |
| g |       |   |                     |     |   |   |                   |
| a |       |   |                     |     |   |   |                   |
| n |       |   |                     |     |   |   |                   |
| i |       |   |                     |     |   |   |                   |
| z |       |   |                     |     |   |   |                   |
| a |       |   |                     |     |   |   |                   |
| t |       |   |                     |     |   |   |                   |
| i |       |   |                     |     |   |   |                   |
| o |       |   |                     |     |   |   |                   |
| n |       |   |                     |     |   |   |                   |
| : |       |   |                     |     |   |   |                   |
+---+-------+---+---------------------+-----+---+---+-------------------+

**THE PROPOSED ACTION FALLS WITHIN THE FOLLOWING CX CLASS OF ACTIONS
FOUND IN APPENDIX A and/or B OF THE** **(CHECK ONE OR MORE):**

[General Administration/Management]{.underline} [Safety and
Health]{.underline}

A1 - Routine business actions B2.1 - Modifications to enhance workplace
habitability

A2 - Administrative contract amendments B2.2 - Installation/improvement
of building/equipment instrumentation

A4 - Interpretations/rulings for existing regulations B2.3 -
Installation of equipment for personnel safety and health

A5 - Regulatory interpretations without environmental effect B2.5 -
Facility safety and environmental improvements, replacement or

A6 - Procedural rulemakings upgrade of facility components, no change in
useful life

A7 - Transfer of property, use unchanged

A8 - Award of technical support/M&O/personal service contracts [General
Research]{.underline}

A9 - Info gathering, analysis, documentation, dissemination, and B3.1 -
Site characterization/environmental monitoring

training B3.3 - Research related to conservation of fish and wildlife

A10 - Reports on non-DOE legislation B3.4 - Transport packaging tests
for radioactive/hazardous material

A11 - Technical advice and planning assistance B3.6 - R&D or pilot
facility construction/operation/decommissioning

A12 - Emergency Preparedness planning B3.7 - New infill exploratory,
experimental oil/gas/geothermal well

A13 - Procedural Orders, Notices, and Guidelines construction/operation

A14 - Approval of technical exchange arrangements B3.8 - Outdoor
ecological/environmental research in small area

A15 - International umbrella agreements for energy R&D B3.9 - Certain
CCT demonstration activities, emissions unchanged

B3.11- Outdoor tests, experiments on materials and equipment components,

[Facility Operations]{.underline} no source, special nuclear, or
by-product materials

B1.2 - Training exercises and simulation

B1.3 - Routine maintenance and custodial services [Conservation, Fossil,
and Renewable Energy Activities]{.underline}

B1.4 - Air conditioning installation for existing equipment B5.1 -
Actions to conserve energy, no indoor air quality degradation

B1.5 - Cooling water system improvements in existing structures B5.2 -
Modification to oil/gas/geothermal pumps and piping, no flow

B1.6 - Installation of runoff/spill control retention tanks and basins
changes, or air emission effects

B1.7 - Communication system and data processing equipment acquisition,
B5.3 - Modification (not expansion)/abandonment of oil storage access/

installation, operation, removal brine injection/gas/geothermal wells;
no site closure

B1.8 - Screened water intake/outflow structure mods, within permits B5.4
-Repair/replacement of pipeline sections within maintenance

B1.11 - Fence installation, no adverse effect on wildlife or water flow
provisions of a Section 404 permit

B1.12 - Detonation/burning of failed/damaged high explosives or B5.5 -
Short crude oil/gas/steam/geothermal pipeline const/oper within a

propellants in designated areas, within permits single industrial
complex/existing right-of-way

B1.13 - On-site pathway or short access road construction/acquisition
B5.6 - Oil spill cleanup operations

B1.15 - Support building or structure, non-waste storage, const/oper
B5.12 - Workover of existing oil, gas, geothermal wells to restore
production

B1.16 - Removal of asbestos in accordance with regulations

B1.17 - Removal of PCB items from aboveground structures [Environmental
Restoration/Waste Minimization]{.underline}

B1.18 - Water supply well const/oper, from existing field, no B6.1 -
Cleanup actions: small-scale, short-term (\< \$5MM and 5 years)

degradation B6.2 - Siting/construction/operation of temporary
pilot-scale waste

B1.21 - Noise abatement collection/treatment/stabilization/containment
facilities

B1.22 - Building relocation to developed area/demolition/disposal B6.3 -
Environmental control system improvements in existing structures,

B1.23 - Demolition/disposal of buildings, equipment, and structures
recycle/release/disposal within permitted facility

B1.24 - Transfer, disposition, or acquisition of uncontaminated B6.4 -
Packaged hazardous waste storage facility const/oper/decom

structures or equipment, environmental quality maintained B6.5 -
Const/oper/decom of on-site facility for characterizing/sorting or

B1.25 - Transfer, disposition, or acquisition of uncontaminated land
overpacking previously packaged waste (not high-level or spent

for habitat preservation/wildlife management nuclear fuel; no unpacking)

B1.26 - Small (\<250,000 GPD) WWT facility const/oper/decom B6.6 -
Modification of facility for storing, packaging, or repacking

B1.27 - Disconnection of utilities waste (not high-level or spent
nuclear fuel)

B1.28 - Placement of unused facilities in environmentally safe condition
B6.8 - Minor operational changes to minimize waste or reuse materials

B1.29 - Small on-site const/demolition waste disposal facility
const/oper/ B6.9 - Small-scale, temporary measures to reduce
contaminated GW

decom migration

B1.30 - Transfer/transportation actions, quantities incidental to
amounts B6.10 - Upgraded waste storage facility (\<50,000 ft ) for
existing waste

at receiving site const/oper/decom

B1.31 - Relocation/operation of machinery or equipment, similar use
[Other]{.underline}

B1.32 - Traffic flow adjustments, existing roads Specify category:

This action would not (1) violate applicable ES&H requirements, (2)
require siting of waste TSD or recovery facilities, (3) disturb
hazardous substances (excluding naturally

occurring petroleum and natural gas), thus producing uncontrolled or
unpermitted releases, and (4) adversely affect environmentally sensitive
resources. Furthermore, this

action (1) would not present any extraordinary circumstances such that
the action might have a significant impact upon the human environment,
(2) is not connected to other

actions with potentially significant impacts, and (3) is not related to
other actions with cumulatively significant impacts. Therefore, the
proposed action may be categorically

excluded from further review.

INITIATOR SIGNATURE: [     ]{.underline} DATE: [     ]{.underline} /
[     ]{.underline} / [     ]{.underline}

> month day year

TYPED NAME: [     ]{.underline}

NEPA Compliance Officer: [     ]{.underline} DATE: [     ]{.underline} /
[     ]{.underline} / [     ]{.underline}

> month day year