+------------+------------------+---+------------------+---+------------+
| **Draft    |                  |   |                  |   |            |
| Env        |                  |   |                  |   |            |
| ironmental |                  |   |                  |   |            |
| Impact     |                  |   |                  |   |            |
| Statement  |                  |   |                  |   |            |
| Prepared   |                  |   |                  |   |            |
| by:        |                  |   |                  |   |            |
| [\_\_\_]{. |                  |   |                  |   |            |
| underline} |                  |   |                  |   |            |
| [\_\       |                  |   |                  |   |            |
| _\_\_]{.un |                  |   |                  |   |            |
| derline}** |                  |   |                  |   |            |
|            |                  |   |                  |   |            |
| Author     |                  |   |                  |   |            |
| Firm       |                  |   |                  |   |            |
+------------+------------------+---+------------------+---+------------+
| *          |                  | * |                  |   | **Item     |
| *County:** |                  | * |                  |   | No.:**     |
|            |                  | R |                  |   |            |
|            |                  | o |                  |   |            |
|            |                  | u |                  |   |            |
|            |                  | t |                  |   |            |
|            |                  | e |                  |   |            |
|            |                  | : |                  |   |            |
|            |                  | * |                  |   |            |
|            |                  | * |                  |   |            |
+------------+------------------+---+------------------+---+------------+
| **Desc     |                  |   |                  |   |            |
| ription:** |                  |   |                  |   |            |
+------------+------------------+---+------------------+---+------------+
| **Prime    |                  |   |                  |   |            |
| Con        |                  |   |                  |   |            |
| sultant:** |                  |   |                  |   |            |
+------------+------------------+---+------------------+---+------------+
| **Due      | #####            |   | ##### Su         | * |            |
| Date:**    |  Submittal Date: |   | bmittal Draft #: | * |            |
|            |                  |   |                  | A |            |
|            |                  |   |                  | p |            |
|            |                  |   |                  | p |            |
|            |                  |   |                  | r |            |
|            |                  |   |                  | o |            |
|            |                  |   |                  | v |            |
|            |                  |   |                  | a |            |
|            |                  |   |                  | l |            |
|            |                  |   |                  | D |            |
|            |                  |   |                  | a |            |
|            |                  |   |                  | t |            |
|            |                  |   |                  | e |            |
|            |                  |   |                  | : |            |
|            |                  |   |                  | * |            |
|            |                  |   |                  | * |            |
+------------+------------------+---+------------------+---+------------+

***[Instructions:]{.underline}***

**Draft Environmental Impact Assessment Prepared by:** Name of
author/firm that prepared the study. **County:** Name of county(ies)
within which the project is located.

**Route:** Name of highway for which the project is intended. Include
route designation and number as applicable (i.e. US 60, Winchester Rd.)

**Item No.:** Item number as it appears in the contract and Six Year
Plan, which corresponds with the project.

**Description:** Official description of the project as it appears in
the Six Year Plan.

**Prime Consultant:** Name of the Phase I Design and Environmental
Consultant (prime contract holder) for the project.

**Due Date:** Date that the DEIS is due as agreed upon in contract
negotiation.

**Date of Submittal/Submittal Draft Number:** Date of submittal and
draft being submitted (1^st^, 2^nd^, 3^rd^) in appropriate sections.

**Approval Date:** Date DEIS is approved by FHWA (***DEA use only***).

**For "Page Number(s)" column:** Identify page numbers where information
from all applicable areas of focus can be found.

**For "Completed" column:** use **Y** for yes and **NA** for not
applicable as necessary ***(Consultant's responsibility)***.

**For "DEA" Column:** DEA will use **√** for all areas that adequately
address concerns, and **"I"** for those that are insufficient in
coverage.

**"Comment" page:** Discuss supplemental information, guidance or
instructions, if any, that required deviation from the checklist.
Discuss all categories, which contain "NA" in the "Complete" columns of
this format. Comments regarding the content and format of this form
and/or its applicability may also be submitted in the comments section.

"Commitments to be Implemented" page: Identify any commitments that are
documented within the study. Specify the nature of the commitment, to
whom it was or should be made, when the commitment should be enacted
upon, etc.

"Mitigation and Special Issues" page: Identify mitigation measures that
are specified within the report, if any. Also, identify any special
issues that are addressed within the document that should be considered
by the Project Team as it makes decisions regarding the project.

##### "Signature" page: Signatures of Prime Consultant and KYTC/DEA Environmental Project Manager/Reviewer will attest that the Draft Environmental Impact Statement meets the requirements set forth in this checklist. Signatures of KYTC Project Manager and District Environmental Coordinator ensure that the findings of the report, including impacts to the project and mitigation measures have been presented to the project development team and are acceptable.

Completed form is to be delivered to KYTC with the document. Previous
checklists for the document, or a copy thereof, shall be attached to the
current checklist.

+-----+---+---+----------------------------------------------------------+
| #   | > | > | ## CATEGORY                                              |
|     |   |   |                                                          |
| #   | * | * | ##                                                       |
|     | * | * |                                                          |
| #   | C | D |                                                          |
|  Pa | o | E |                                                          |
| ge  | m | A |                                                          |
| Num | p | * |                                                          |
| ber | l | * |                                                          |
| (s) | e |   |                                                          |
|     | t |   |                                                          |
|     | e |   |                                                          |
|     | * |   |                                                          |
|     | * |   |                                                          |
+-----+---+---+----------------------------------------------------------+
| **  |   |   | #### Title Page                                          |
| Ins |   |   |                                                          |
| ert |   |   | -   Identify level of Environmental Documentation (DEIS) |
| ch  |   |   |                                                          |
| eck |   |   | -   Adequate project description (route, termini, city   |
| m   |   |   |     or county, and state)                                |
| ark |   |   |                                                          |
| and |   |   | -   Include State and Federal Project Item Number        |
| p   |   |   |                                                          |
| age |   |   | -   Statement: "Submitted Pursuant To 42 U.S.C. 4332     |
| num |   |   |     (2)(c) By The U.S. Department of Transportation,     |
| ber |   |   |     Federal Highway Administration and Kentucky          |
| (s) |   |   |     Transportation Cabinet, Division of Environmental    |
| as  |   |   |     Analysis                                             |
| a   |   |   |                                                          |
| ppr |   |   | -   Identify Cooperating Agency(s)                       |
| opr |   |   |                                                          |
| iat |   |   | -   Date of Submittal (month and year)                   |
| e** |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   | **Signature Page**                                       |
|     |   |   |                                                          |
|     |   |   | -   Identify level of Environmental Documentation (EIS)  |
|     |   |   |                                                          |
|     |   |   | -   Include project description (route, termini, city or |
|     |   |   |     county, and state)                                   |
|     |   |   |                                                          |
|     |   |   | -   Include State and Federal Project Item Number        |
|     |   |   |                                                          |
|     |   |   | -   Statement: "Submitted Pursuant To 42 U.S.C. 4332     |
|     |   |   |     (2)(c) By The U.S. Department of Transportation,     |
|     |   |   |     Federal Highway Administration and Kentucky          |
|     |   |   |     Transportation Cabinet, Division of Environmental    |
|     |   |   |     Analysis                                             |
|     |   |   |                                                          |
|     |   |   | -   Identify Cooperating Agency(s)                       |
|     |   |   |                                                          |
|     |   |   | -   Signature line for FHWA and KYTC                     |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   | **Project Impact Profile**                               |
|     |   |   |                                                          |
|     |   |   | -   Fill out Project Impact Profile Sheet and attach to  |
|     |   |   |     document                                             |
|     |   |   |                                                          |
|     |   |   | -   Identify further work required for unresolved issues |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+

+-----+---+---+----------------------------------------------------------+
| #   | > | > | ## CATEGORY                                              |
|     |   |   |                                                          |
| #   | * | * | ##                                                       |
|     | * | * |                                                          |
| #   | C | D |                                                          |
|     | o | E |                                                          |
| #   | m | A |                                                          |
|  Pa | p | * |                                                          |
| ge  | l | * |                                                          |
|     | e |   |                                                          |
| #   | t |   |                                                          |
| Num | e |   |                                                          |
| ber | * |   |                                                          |
| (s) | * |   |                                                          |
+-----+---+---+----------------------------------------------------------+
| **  |   |   | **Executive Summary**                                    |
| Ins |   |   |                                                          |
| ert |   |   | -   A brief description of the proposed FHWA action      |
| ch  |   |   |     indicating route, termini, type of improvement,      |
| eck |   |   |     number of lanes, length, county, city, state, etc.   |
| m   |   |   |                                                          |
| ark |   |   | -   A description of any major actions proposed by other |
| and |   |   |     governmental agencies in the same geographic area as |
| p   |   |   |     the proposed FHWA action                             |
| age |   |   |                                                          |
| num |   |   | -   Discuss all reasonable alternatives considered       |
| ber |   |   |     including the preferred alternative and the basis    |
| (s) |   |   |     for its selection, if applicable.                    |
| as  |   |   |                                                          |
| a   |   |   | -   Summarize all major environmental impacts, both      |
| ppr |   |   |     beneficial and adverse                               |
| opr |   |   |                                                          |
| iat |   |   | -   Discuss any areas of controversy, including those    |
| e** |   |   |     raised by agencies and the public                    |
|     |   |   |                                                          |
|     |   |   | -   Discuss any unresolved issues (permit approvals,     |
|     |   |   |     land transfers, Section 106, etc.)                   |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   | **Table of Contents**                                    |
|     |   |   |                                                          |
|     |   |   | -   List areas of focus and appropriate page numbers     |
|     |   |   |     where the information can be found                   |
|     |   |   |                                                          |
|     |   |   | -   Listing of exhibits, figures, and tables             |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+

+-----+---+---+----------------------------------------------------------+
| #   | > | > | ## CATEGORY                                              |
|     |   |   |                                                          |
| #   | * | * | ##                                                       |
|     | * | * |                                                          |
| #   | C | D |                                                          |
|     | o | E |                                                          |
| #   | m | A |                                                          |
|  Pa | p | * |                                                          |
| ge  | l | * |                                                          |
|     | e |   |                                                          |
| #   | t |   |                                                          |
| Num | e |   |                                                          |
| ber | * |   |                                                          |
| (s) | * |   |                                                          |
+-----+---+---+----------------------------------------------------------+
| **  |   |   | **Purpose and Need**                                     |
| Ins |   |   |                                                          |
| ert |   |   | -   Identify the Purpose and Need of the project         |
| ch  |   |   |                                                          |
| eck |   |   | -   Discuss project description and setting              |
| m   |   |   |                                                          |
| ark |   |   | -   Description of existing facility                     |
| and |   |   |                                                          |
| p   |   |   | -   Briefly describe the project history including       |
| age |   |   |     actions taken to date (intermediate planning,        |
| num |   |   |     scoping etc.)                                        |
| ber |   |   |                                                          |
| (s) |   |   | Identify and provide discussion on the following, as it  |
| as  |   |   | pertains to the Purpose and Need:                        |
| a   |   |   |                                                          |
| ppr |   |   | -   Logical termini/independent utility                  |
| opr |   |   |                                                          |
| iat |   |   | -   System Linkage                                       |
| e** |   |   |                                                          |
|     |   |   | -   Safety/accident analysis data                        |
|     |   |   |                                                          |
|     |   |   | -   Roadway deficiencies                                 |
|     |   |   |                                                          |
|     |   |   | -   Modal Interrelationships -- How will the proposed    |
|     |   |   |     facility interface with and serve to complement      |
|     |   |   |     airports, rail road facilities, mass transit         |
|     |   |   |     services, etc.                                       |
|     |   |   |                                                          |
|     |   |   | -   Level of service/capacity/congestion mitigation      |
|     |   |   |                                                          |
|     |   |   | -   Status of the project relative to the six year plan  |
|     |   |   |     and STIP                                             |
|     |   |   |                                                          |
|     |   |   | -   Economic development enhancement                     |
|     |   |   |                                                          |
|     |   |   | -   Mandated by legislation, if applicable               |
|     |   |   |                                                          |
|     |   |   | -   Provide an Exhibit showing the project area          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+

+-----+---+---+----------------------------------------------------------+
| #   | > | > | ## CATEGORY                                              |
|     |   |   |                                                          |
| #   | * | * |                                                          |
|     | * | * |                                                          |
| #   | C | D |                                                          |
|  Pa | o | E |                                                          |
| ge  | m | A |                                                          |
| Num | p | * |                                                          |
| ber | l | * |                                                          |
| (s) | e |   |                                                          |
|     | t |   |                                                          |
|     | e |   |                                                          |
|     | * |   |                                                          |
|     | * |   |                                                          |
+-----+---+---+----------------------------------------------------------+
| **  |   |   | **Alternatives Considered but Eliminated**               |
| Ins |   |   |                                                          |
| ert |   |   | -   Clearly summarize basis for eliminating other        |
| ch  |   |   |     alternative previously considered but rejected       |
| eck |   |   |     during the project development process (using 3E's:  |
| m   |   |   |     engineering, environment, economic)                  |
| ark |   |   |                                                          |
| and |   |   |                                                          |
| p   |   |   |                                                          |
| age |   |   |                                                          |
| num |   |   |                                                          |
| ber |   |   |                                                          |
| (s) |   |   |                                                          |
| as  |   |   |                                                          |
| a   |   |   |                                                          |
| ppr |   |   |                                                          |
| opr |   |   |                                                          |
| iat |   |   |                                                          |
| e** |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   | ##### Alternatives                                       |
|     |   |   |                                                          |
|     |   |   | ##### The No Build Discussion                            |
|     |   |   |                                                          |
|     |   |   | -   Discuss anticipated LOS/ADT/capacity/congestion      |
|     |   |   |                                                          |
|     |   |   | ```{=html}                                               |
|     |   |   | <!-- -->                                                 |
|     |   |   | ```                                                      |
|     |   |   | -   Discuss safety and maintenance improvements, both    |
|     |   |   |     beneficial and adverse.                              |
|     |   |   |                                                          |
|     |   |   | -   Discuss whether or not the No Build Alternative will |
|     |   |   |     satisfy the Purpose and Need                         |
|     |   |   |                                                          |
|     |   |   | -   Discuss current Pedestrian and Bicycle Facilities.   |
|     |   |   |     Also discuss the beneficial and adverse impact the   |
|     |   |   |     no build alternative, if chosen, would have on these |
|     |   |   |     facilities.                                          |
|     |   |   |                                                          |
|     |   |   | -   Discuss beneficial and adverse impacts that          |
|     |   |   |     Congestion Management, Mass Transit, and light rail  |
|     |   |   |     will have on the no build alternative, if chosen.    |
|     |   |   |                                                          |
|     |   |   | -   Discuss Public Transit                               |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+

+-----+---+---+----------------------------------------------------------+
| #   | > | > | ## CATEGORY                                              |
|     |   |   |                                                          |
| #   | * | * |                                                          |
|     | * | * |                                                          |
| #   | C | D |                                                          |
|  Pa | o | E |                                                          |
| ge  | m | A |                                                          |
| Num | p | * |                                                          |
| ber | l | * |                                                          |
| (s) | e |   |                                                          |
|     | t |   |                                                          |
|     | e |   |                                                          |
|     | * |   |                                                          |
|     | * |   |                                                          |
+-----+---+---+----------------------------------------------------------+
| **  |   |   | ##### Build Alternatives                                 |
| Ins |   |   |                                                          |
| ert |   |   | -   Describe each alternative from their respective      |
| ch  |   |   |     logical termini points                               |
| eck |   |   |                                                          |
| m   |   |   | -   Discuss typical sections/design features for each    |
| ark |   |   |     alternative. Include interchanges, additional        |
| and |   |   |     collector roads, shoulder and pavement widths,       |
| p   |   |   |     Access, grade, turn lanes, etc.                      |
| age |   |   |                                                          |
| num |   |   | -   Discuss design speeds, anticipated LOS, and traffic  |
| ber |   |   |     data                                                 |
| (s) |   |   |                                                          |
| as  |   |   | -   Include comparative table to identify the            |
| a   |   |   |     environmental impacts of each alternative            |
| ppr |   |   |                                                          |
| opr |   |   | -   Discuss opportunities for providing pedestrian and   |
| iat |   |   |     bicycle facilities                                   |
| e** |   |   |                                                          |
|     |   |   | ```{=html}                                               |
|     |   |   | <!-- -->                                                 |
|     |   |   | ```                                                      |
|     |   |   | -   Discuss Congestion Management, Mass Transit, and     |
|     |   |   |     light rail options for the project.                  |
|     |   |   |                                                          |
|     |   |   | ```{=html}                                               |
|     |   |   | <!-- -->                                                 |
|     |   |   | ```                                                      |
|     |   |   | -   Statement that the final selection of an alternative |
|     |   |   |     will be made only after consideration of impacts and |
|     |   |   |     public hearing comments                              |
|     |   |   |                                                          |
|     |   |   | -   Sufficient (legible, understandable) exhibits        |
|     |   |   |     showing alternatives                                 |
|     |   |   |                                                          |
|     |   |   | -   Discuss 4(f) avoidance alternative(s), if necessary  |
|     |   |   |                                                          |
|     |   |   | -   Identify Preferred Alternative, if applicable, and   |
|     |   |   |     provide justification                                |
|     |   |   |                                                          |
|     |   |   | -   Include comparative table of estimated project cost  |
|     |   |   |     (design, right-of-way, utilities, construction) for  |
|     |   |   |     each alternative                                     |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+
|     |   |   |                                                          |
+-----+---+---+----------------------------------------------------------+

+----+---+---+---+---+-----------------------------------------------------------+
| #  | > |   | > |   | ## CATEGORY                                               |
|    |   |   |   |   |                                                           |
| #  | * |   | * |   |                                                           |
|    | * |   | * |   |                                                           |
| #  | C |   | D |   |                                                           |
| Pa | o |   | E |   |                                                           |
| ge | m |   | A |   |                                                           |
|  N | p |   | * |   |                                                           |
| um | l |   | * |   |                                                           |
| be | e |   |   |   |                                                           |
| r( | t |   |   |   |                                                           |
| s) | e |   |   |   |                                                           |
|    | * |   |   |   |                                                           |
|    | * |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
| ** |   |   |   |   | **Affected Environment and Environmental Consequences**   |
| In |   |   |   |   |                                                           |
| se |   |   |   |   | #####                                                     |
| rt |   |   |   |   |                                                           |
| c  |   |   |   |   | ##### Air Quality                                         |
| he |   |   |   |   |                                                           |
| ck |   |   |   |   | -   Discuss current conditions and attainment status of   |
| ma |   |   |   |   |     the project area                                      |
| rk |   |   |   |   |                                                           |
| a  |   |   |   |   | -   Discuss studies that have been conducted and which    |
| nd |   |   |   |   |     air quality model was used                            |
| pa |   |   |   |   |                                                           |
| ge |   |   |   |   | -   State that conformity determinations are based on the |
| n  |   |   |   |   |     latest planning assumption                            |
| um |   |   |   |   |                                                           |
| be |   |   |   |   | -   Place Air Quality Conformity statement in document.   |
| r( |   |   |   |   |     Project must be in conforming TIP (give page number)  |
| s) |   |   |   |   |                                                           |
| as |   |   |   |   | -   Discuss regional compliance with National Ambient Air |
| a  |   |   |   |   |     Quality Standards (NAAQS)                             |
| pp |   |   |   |   |                                                           |
| ro |   |   |   |   | -   Discuss current and anticipated carbon monoxide       |
| pr |   |   |   |   |     levels for each alternative                           |
| ia |   |   |   |   |                                                           |
| te |   |   |   |   | -   Demonstrate that the project does not cause or        |
| ** |   |   |   |   |     contribute to any new localized CO violations or      |
|    |   |   |   |   |     increase the frequency or severity of any existing CO |
|    |   |   |   |   |     non-attainment and maintenance areas                  |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Discuss cumulative and indirect impacts               |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Discuss mitigation, minimization, or avoidance        |
|    |   |   |   |   |     options that would minimize environmental impacts to  |
|    |   |   |   |   |     air quality                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+

+----+---+---+---+---+-----------------------------------------------------------+
| #  | > |   | > |   | ## CATEGORY                                               |
|    |   |   |   |   |                                                           |
| #  | * |   | * |   |                                                           |
|    | * |   | * |   |                                                           |
| #  | C |   | D |   |                                                           |
| Pa | o |   | E |   |                                                           |
| ge | m |   | A |   |                                                           |
|  N | p |   | * |   |                                                           |
| um | l |   | * |   |                                                           |
| be | e |   |   |   |                                                           |
| r( | t |   |   |   |                                                           |
| s) | e |   |   |   |                                                           |
|    | * |   |   |   |                                                           |
|    | * |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
| ** |   |   |   |   | ##### Noise                                               |
| In |   |   |   |   |                                                           |
| se |   |   |   |   | -   Discuss current conditions, including existing        |
| rt |   |   |   |   |     ambient noise levels                                  |
| c  |   |   |   |   |                                                           |
| he |   |   |   |   | -   Discuss studies that have been conducted to analyze   |
| ck |   |   |   |   |     noise impacts                                         |
| ma |   |   |   |   |                                                           |
| rk |   |   |   |   | -   Identify sensitive noise receptors (schools,          |
| a  |   |   |   |   |     churches, hospitals, businesses, etc)                 |
| nd |   |   |   |   |                                                           |
| pa |   |   |   |   | -   Compare existing and predicted noise levels with      |
| ge |   |   |   |   |     noise abatement criteria (NAC) for each alternative.  |
| n  |   |   |   |   |     ***[Provide table]{.underline}***.                    |
| um |   |   |   |   |                                                           |
| be |   |   |   |   | -   Discuss noise impacts for each alternative            |
| r( |   |   |   |   |                                                           |
| s) |   |   |   |   | -   Discuss reasonable and feasible noise abatement       |
| as |   |   |   |   |     measures that would likely be incorporated into the   |
| a  |   |   |   |   |     project (i.e., noise barrier walls, berms, truck      |
| pp |   |   |   |   |     restrictions, vertical separations, speed limits),    |
| ro |   |   |   |   |     and associated cost. If no prudent solution is        |
| pr |   |   |   |   |     reasonably available, discuss why.                    |
| ia |   |   |   |   |                                                           |
| te |   |   |   |   | -   Statement that final decision on implementation of    |
| ** |   |   |   |   |     abatement measures will be made after completion of   |
|    |   |   |   |   |     the project design and the public involvement process |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Statement regarding contractor requirements to        |
|    |   |   |   |   |     restrict or reduce transmission of noise during       |
|    |   |   |   |   |     construction activity                                 |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Discuss cumulative and indirect impacts               |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Provide exhibit that shows sensitive noise receptors  |
|    |   |   |   |   |     and location where noise receptor monitoring took     |
|    |   |   |   |   |     place                                                 |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+

+----+---+---+---+---+-----------------------------------------------------------+
| #  | > |   | > |   | ## CATEGORY                                               |
|    |   |   |   |   |                                                           |
| #  | * |   | * |   |                                                           |
|    | * |   | * |   |                                                           |
| #  | C |   | D |   |                                                           |
| Pa | o |   | E |   |                                                           |
| ge | m |   | A |   |                                                           |
|  N | p |   | * |   |                                                           |
| um | l |   | * |   |                                                           |
| be | e |   |   |   |                                                           |
| r( | t |   |   |   |                                                           |
| s) | e |   |   |   |                                                           |
|    | * |   |   |   |                                                           |
|    | * |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
| ** |   |   |   |   | > **Water Quality and Stream Impacts**                    |
| In |   |   |   |   |                                                           |
| se |   |   |   |   | -   Establish baseline conditions including water quality |
| rt |   |   |   |   |     analysis, existing streams, and aquatic and riparian  |
| c  |   |   |   |   |     habitat                                               |
| he |   |   |   |   |                                                           |
| ck |   |   |   |   | -   Discuss studies that have been conducted              |
| ma |   |   |   |   |                                                           |
| rk |   |   |   |   | -   Discuss water quality analysis, existing streams, and |
| a  |   |   |   |   |     aquatic and riparian habitat                          |
| nd |   |   |   |   |                                                           |
| pa |   |   |   |   | -   Discuss potential impacts for each alternative        |
| ge |   |   |   |   |     (channel changes, culverts, bridges, filling, etc.)   |
| n  |   |   |   |   |                                                           |
| um |   |   |   |   | -   Include comparative table which shows water quality   |
| be |   |   |   |   |     impacts for each alternative                          |
| r( |   |   |   |   |                                                           |
| s) |   |   |   |   | -   Discuss roadway runoff                                |
| as |   |   |   |   |                                                           |
| a  |   |   |   |   | -   Discuss consultation with DOW, USACE, and any other   |
| pp |   |   |   |   |     appropriate agencies                                  |
| ro |   |   |   |   |                                                           |
| pr |   |   |   |   | -   Identify and discuss public water sources, wells, and |
| ia |   |   |   |   |     groundwater runoff                                    |
| te |   |   |   |   |                                                           |
| ** |   |   |   |   | -   Discuss non-point source pollutants                   |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Identify sole source aquifers                         |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Discuss efforts to avoid, minimize, and mitigation    |
|    |   |   |   |   |     any impacts                                           |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Discuss permits that may be required                  |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Discuss cumulative and indirect impacts               |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Provide an exhibit which identifies the water         |
|    |   |   |   |   |     resources within the corridor(s)                      |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+

+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
| #  | > |   |   | > |   |   | # |                                                           |
|    |   |   |   |   |   |   | # |                                                           |
| #  | * |   |   | * |   |   |   |                                                           |
|    | * |   |   | * |   |   | C |                                                           |
| #  | C |   |   | D |   |   | A |                                                           |
| Pa | o |   |   | E |   |   | T |                                                           |
| ge | m |   |   | A |   |   | E |                                                           |
|  N | p |   |   | * |   |   | G |                                                           |
| um | l |   |   | * |   |   | O |                                                           |
| be | e |   |   |   |   |   | R |                                                           |
| r( | t |   |   |   |   |   | Y |                                                           |
| s) | e |   |   |   |   |   |   |                                                           |
|    | * |   |   |   |   |   |   |                                                           |
|    | * |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
| ** |   |   |   |   |   |   | # |                                                           |
| In |   |   |   |   |   |   | # |                                                           |
| se |   |   |   |   |   |   | # |                                                           |
| rt |   |   |   |   |   |   | # |                                                           |
| c  |   |   |   |   |   |   | # |                                                           |
| he |   |   |   |   |   |   |   |                                                           |
| ck |   |   |   |   |   |   | F |                                                           |
| ma |   |   |   |   |   |   | l |                                                           |
| rk |   |   |   |   |   |   | o |                                                           |
| a  |   |   |   |   |   |   | o |                                                           |
| nd |   |   |   |   |   |   | d |                                                           |
| pa |   |   |   |   |   |   | p |                                                           |
| ge |   |   |   |   |   |   | l |                                                           |
| n  |   |   |   |   |   |   | a |                                                           |
| um |   |   |   |   |   |   | i |                                                           |
| be |   |   |   |   |   |   | n |                                                           |
| r( |   |   |   |   |   |   | s |                                                           |
| s) |   |   |   |   |   |   |   |                                                           |
| as |   |   |   |   |   |   | - |                                                           |
| a  |   |   |   |   |   |   |   |                                                           |
| pp |   |   |   |   |   |   |   |                                                           |
| ro |   |   |   |   |   |   |   |                                                           |
| pr |   |   |   |   |   |   | I |                                                           |
| ia |   |   |   |   |   |   | d |                                                           |
| te |   |   |   |   |   |   | e |                                                           |
| ** |   |   |   |   |   |   | n |                                                           |
|    |   |   |   |   |   |   | t |                                                           |
|    |   |   |   |   |   |   | i |                                                           |
|    |   |   |   |   |   |   | f |                                                           |
|    |   |   |   |   |   |   | y |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | 1 |                                                           |
|    |   |   |   |   |   |   | 0 |                                                           |
|    |   |   |   |   |   |   | 0 |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | y |                                                           |
|    |   |   |   |   |   |   | e |                                                           |
|    |   |   |   |   |   |   | a |                                                           |
|    |   |   |   |   |   |   | r |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | f |                                                           |
|    |   |   |   |   |   |   | l |                                                           |
|    |   |   |   |   |   |   | o |                                                           |
|    |   |   |   |   |   |   | o |                                                           |
|    |   |   |   |   |   |   | d |                                                           |
|    |   |   |   |   |   |   | p |                                                           |
|    |   |   |   |   |   |   | l |                                                           |
|    |   |   |   |   |   |   | a |                                                           |
|    |   |   |   |   |   |   | i |                                                           |
|    |   |   |   |   |   |   | n |                                                           |
|    |   |   |   |   |   |   | s |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | u |                                                           |
|    |   |   |   |   |   |   | s |                                                           |
|    |   |   |   |   |   |   | i |                                                           |
|    |   |   |   |   |   |   | n |                                                           |
|    |   |   |   |   |   |   | g |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | N |                                                           |
|    |   |   |   |   |   |   | a |                                                           |
|    |   |   |   |   |   |   | t |                                                           |
|    |   |   |   |   |   |   | i |                                                           |
|    |   |   |   |   |   |   | o |                                                           |
|    |   |   |   |   |   |   | n |                                                           |
|    |   |   |   |   |   |   | a |                                                           |
|    |   |   |   |   |   |   | l |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | F |                                                           |
|    |   |   |   |   |   |   | l |                                                           |
|    |   |   |   |   |   |   | o |                                                           |
|    |   |   |   |   |   |   | o |                                                           |
|    |   |   |   |   |   |   | d |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | I |                                                           |
|    |   |   |   |   |   |   | n |                                                           |
|    |   |   |   |   |   |   | s |                                                           |
|    |   |   |   |   |   |   | u |                                                           |
|    |   |   |   |   |   |   | r |                                                           |
|    |   |   |   |   |   |   | a |                                                           |
|    |   |   |   |   |   |   | n |                                                           |
|    |   |   |   |   |   |   | c |                                                           |
|    |   |   |   |   |   |   | e |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | P |                                                           |
|    |   |   |   |   |   |   | r |                                                           |
|    |   |   |   |   |   |   | o |                                                           |
|    |   |   |   |   |   |   | g |                                                           |
|    |   |   |   |   |   |   | r |                                                           |
|    |   |   |   |   |   |   | a |                                                           |
|    |   |   |   |   |   |   | m |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | m |                                                           |
|    |   |   |   |   |   |   | a |                                                           |
|    |   |   |   |   |   |   | p |                                                           |
|    |   |   |   |   |   |   | s |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | - |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | I |                                                           |
|    |   |   |   |   |   |   | d |                                                           |
|    |   |   |   |   |   |   | e |                                                           |
|    |   |   |   |   |   |   | n |                                                           |
|    |   |   |   |   |   |   | t |                                                           |
|    |   |   |   |   |   |   | i |                                                           |
|    |   |   |   |   |   |   | f |                                                           |
|    |   |   |   |   |   |   | y |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | e |                                                           |
|    |   |   |   |   |   |   | n |                                                           |
|    |   |   |   |   |   |   | c |                                                           |
|    |   |   |   |   |   |   | r |                                                           |
|    |   |   |   |   |   |   | o |                                                           |
|    |   |   |   |   |   |   | a |                                                           |
|    |   |   |   |   |   |   | c |                                                           |
|    |   |   |   |   |   |   | h |                                                           |
|    |   |   |   |   |   |   | m |                                                           |
|    |   |   |   |   |   |   | e |                                                           |
|    |   |   |   |   |   |   | n |                                                           |
|    |   |   |   |   |   |   | t |                                                           |
|    |   |   |   |   |   |   | s |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | o |                                                           |
|    |   |   |   |   |   |   | f |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | p |                                                           |
|    |   |   |   |   |   |   | r |                                                           |
|    |   |   |   |   |   |   | o |                                                           |
|    |   |   |   |   |   |   | j |                                                           |
|    |   |   |   |   |   |   | e |                                                           |
|    |   |   |   |   |   |   | c |                                                           |
|    |   |   |   |   |   |   | t |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
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|    |   |   |   |   |   |   | # |                                                           |
|    |   |   |   |   |   |   | # |                                                           |
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|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | D |                                                           |
|    |   |   |   |   |   |   | i |                                                           |
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|    |   |   |   |   |   |   | c |                                                           |
|    |   |   |   |   |   |   | u |                                                           |
|    |   |   |   |   |   |   | s |                                                           |
|    |   |   |   |   |   |   | s |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | c |                                                           |
|    |   |   |   |   |   |   | u |                                                           |
|    |   |   |   |   |   |   | m |                                                           |
|    |   |   |   |   |   |   | u |                                                           |
|    |   |   |   |   |   |   | l |                                                           |
|    |   |   |   |   |   |   | a |                                                           |
|    |   |   |   |   |   |   | t |                                                           |
|    |   |   |   |   |   |   | i |                                                           |
|    |   |   |   |   |   |   | v |                                                           |
|    |   |   |   |   |   |   | e |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | a |                                                           |
|    |   |   |   |   |   |   | n |                                                           |
|    |   |   |   |   |   |   | d |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | i |                                                           |
|    |   |   |   |   |   |   | n |                                                           |
|    |   |   |   |   |   |   | d |                                                           |
|    |   |   |   |   |   |   | i |                                                           |
|    |   |   |   |   |   |   | r |                                                           |
|    |   |   |   |   |   |   | e |                                                           |
|    |   |   |   |   |   |   | c |                                                           |
|    |   |   |   |   |   |   | t |                                                           |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   | i |                                                           |
|    |   |   |   |   |   |   | m |                                                           |
|    |   |   |   |   |   |   | p |                                                           |
|    |   |   |   |   |   |   | a |                                                           |
|    |   |   |   |   |   |   | c |                                                           |
|    |   |   |   |   |   |   | t |                                                           |
|    |   |   |   |   |   |   | s |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   | ##### Wetlands                                            |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   | -   Establish baseline conditions (discuss and identify   |
|    |   |   |   |   |   |   |   |     location, type, quality, and function)                |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   | -   Discuss field studies that were conducted             |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   | -   Discuss results of National Wetland Inventory (NWI)   |
|    |   |   |   |   |   |   |   |     maps                                                  |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   | -   Discuss potential wetland impacts                     |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   | -   Discuss agency coordination and permits that may be   |
|    |   |   |   |   |   |   |   |     required                                              |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   | -   Discuss efforts to avoid and minimize impacts and     |
|    |   |   |   |   |   |   |   |     appropriate mitigation                                |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   | -   Include statement that exact determination of impacts |
|    |   |   |   |   |   |   |   |     to jurisdictional wetlands will be made in            |
|    |   |   |   |   |   |   |   |     conjunction with other resource agencies during final |
|    |   |   |   |   |   |   |   |     design                                                |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   | -   Discuss cumulative and indirect impacts               |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   | -   Table identifying wetland type, number of acres, and  |
|    |   |   |   |   |   |   |   |     approximate area of impact for each alternative       |
|    |   |   |   |   |   |   |   |                                                           |
|    |   |   |   |   |   |   |   | -   Include exhibit showing location of wetlands for each |
|    |   |   |   |   |   |   |   |     alternative                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |   |   |   |                                                           |
+----+---+---+---+---+---+---+---+-----------------------------------------------------------+

+----+---+---+---+---+-----------------------------------------------------------+
| #  | > |   | > |   | ## CATEGORY                                               |
|    |   |   |   |   |                                                           |
| #  | * |   | * |   |                                                           |
|    | * |   | * |   |                                                           |
| #  | C |   | D |   |                                                           |
| Pa | o |   | E |   |                                                           |
| ge | m |   | A |   |                                                           |
|  N | p |   | * |   |                                                           |
| um | l |   | * |   |                                                           |
| be | e |   |   |   |                                                           |
| r( | t |   |   |   |                                                           |
| s) | e |   |   |   |                                                           |
|    | * |   |   |   |                                                           |
|    | * |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
| ** |   |   |   |   | ##### Wild and Scenic Rivers                              |
| In |   |   |   |   |                                                           |
| se |   |   |   |   | -   Establish baseline conditions (identify designated    |
| rt |   |   |   |   |     wild and scenic rivers)                               |
| c  |   |   |   |   |                                                           |
| he |   |   |   |   | -   Discuss involvement with any stream designated as     |
| ck |   |   |   |   |     "wild and scenic river"                               |
| ma |   |   |   |   |                                                           |
| rk |   |   |   |   | -   Discuss Section 4(f) and 6(f) involvement, if         |
| a  |   |   |   |   |     applicable                                            |
| nd |   |   |   |   |                                                           |
| pa |   |   |   |   | -   Discuss coordination between highway agency and       |
| ge |   |   |   |   |     National Park Service, if applicable                  |
| n  |   |   |   |   |                                                           |
| um |   |   |   |   | -   Discuss cumulative and indirect impacts               |
| be |   |   |   |   |                                                           |
| r( |   |   |   |   | -   Provide Exhibit showing location and impact of wild   |
| s) |   |   |   |   |     and scenic river, if applicable                       |
| as |   |   |   |   |                                                           |
| a  |   |   |   |   |                                                           |
| pp |   |   |   |   |                                                           |
| ro |   |   |   |   |                                                           |
| pr |   |   |   |   |                                                           |
| ia |   |   |   |   |                                                           |
| te |   |   |   |   |                                                           |
| ** |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   | #####                                                     |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | ##### Federally Threatened and Endangered Species         |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Establish baseline conditions (terrestrial            |
|    |   |   |   |   |     ecosystems; habitat types, quality and distribution   |
|    |   |   |   |   |     etc.)                                                 |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Discuss studies that have been conducted              |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Discuss coordination with USFWS, KDFWR, and KNPC.     |
|    |   |   |   |   |     Include coordination letters in appendix.             |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Identify any federally threatened or endangered       |
|    |   |   |   |   |     species and/or designated or proposed critical        |
|    |   |   |   |   |     habitat that may be impacted                          |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Identify any state protected/special concern species  |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Discuss how the project would affect wildlife         |
|    |   |   |   |   |     migration patterns, if applicable                     |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Include exhibit showing location of critical habitat, |
|    |   |   |   |   |     if present                                            |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Discuss Biological Assessment (BA) requirements and,  |
|    |   |   |   |   |     if applicable, Section 7 Consultation requirements    |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Discuss mitigation and/or avoidance alternatives for  |
|    |   |   |   |   |     impacts to T&E species or critical habitat, if        |
|    |   |   |   |   |     necessary                                             |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | -   Discuss cumulative and indirect impacts               |
|    |   |   |   |   |                                                           |
|    |   |   |   |   | ##                                                        |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+
|    |   |   |   |   |                                                           |
+----+---+---+---+---+-----------------------------------------------------------+

+----+---+---+-----------------------------------------------------------+
| #  | > | > | ## CATEGORY                                               |
|    |   |   |                                                           |
| #  | * | * |                                                           |
|    | * | * |                                                           |
| #  | C | D |                                                           |
| Pa | o | E |                                                           |
| ge | m | A |                                                           |
|  N | p | * |                                                           |
| um | l | * |                                                           |
| be | e |   |                                                           |
| r( | t |   |                                                           |
| s) | e |   |                                                           |
|    | * |   |                                                           |
|    | * |   |                                                           |
+----+---+---+-----------------------------------------------------------+
| ** |   |   | ##### Historic Structures or Districts                    |
| In |   |   |                                                           |
| se |   |   | -   **Discuss studies that were conducted in determining  |
| rt |   |   |     historic characteristics of the area**                |
| c  |   |   |                                                           |
| he |   |   | -   Describe Area of Potential Effect \[APE\] (include    |
| ck |   |   |     KYTC and SHPO approval letter in the Appendices)      |
| ma |   |   |                                                           |
| rk |   |   | -   Identify properties potentially eligible or           |
| a  |   |   |     determined to be eligible for the National Register   |
| nd |   |   |                                                           |
| pa |   |   | -   Discuss potential effects on each historic property   |
| ge |   |   |     for each alternative                                  |
| n  |   |   |                                                           |
| um |   |   | -   Reference coordination with SHPO regarding            |
| be |   |   |     eligibility and effects (include letters in Appendix) |
| r( |   |   |                                                           |
| s) |   |   | -   Discuss any adverse effects and avoidance             |
| as |   |   |     alternatives or minimization and mitigation, if       |
| a  |   |   |     required                                              |
| pp |   |   |                                                           |
| ro |   |   | -   Discuss coordination with FHWA if the project is      |
| pr |   |   |     determined to have an adverse effect on an historic   |
| ia |   |   |     structure or district                                 |
| te |   |   |                                                           |
| ** |   |   | -   Reference MOA in Appendix, if applicable              |
|    |   |   |                                                           |
|    |   |   | -   Discuss cumulative and indirect impacts               |
|    |   |   |                                                           |
|    |   |   | -   Provide exhibit which identifies APE, and all         |
|    |   |   |     Historic Structures and/or Districts within the       |
|    |   |   |     project corridor                                      |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+

+----+---+---+-----------------------------------------------------------+
| #  | > | > | ## CATEGORY                                               |
|    |   |   |                                                           |
| #  | * | * |                                                           |
|    | * | * |                                                           |
| #  | C | D |                                                           |
| Pa | o | E |                                                           |
| ge | m | A |                                                           |
|  N | p | * |                                                           |
| um | l | * |                                                           |
| be | e |   |                                                           |
| r( | t |   |                                                           |
| s) | e |   |                                                           |
|    | * |   |                                                           |
|    | * |   |                                                           |
+----+---+---+-----------------------------------------------------------+
| ** |   |   | ##### Archaeological Sites                                |
| In |   |   |                                                           |
| se |   |   | -   Discuss Area of Potential Effect (APE)                |
| rt |   |   |                                                           |
| c  |   |   | ```{=html}                                                |
| he |   |   | <!-- -->                                                  |
| ck |   |   | ```                                                       |
| ma |   |   | -   Discuss archaeological investigations that were       |
| rk |   |   |     conducted for each alternative                        |
| a  |   |   |                                                           |
| nd |   |   | -   Describe all archaeological sites identified,         |
| pa |   |   |     including significance and/or value of the site       |
| ge |   |   |                                                           |
| n  |   |   | -   Identify any sites potentially eligible or determined |
| um |   |   |     to be eligible for National Register                  |
| be |   |   |                                                           |
| r( |   |   | -   Discuss any parcel(s) for which Phase I could not be  |
| s) |   |   |     completed due to lack of property owner permission    |
| as |   |   |     (document efforts to access property)                 |
| a  |   |   |                                                           |
| pp |   |   | -   Identify sites recommended for additional work (Phase |
| ro |   |   |     II)                                                   |
| pr |   |   |                                                           |
| ia |   |   | -   Reference coordination with SHPO regarding            |
| te |   |   |     archaeological sites and recommendations for further  |
| ** |   |   |     work (include letters in Appendix)                    |
|    |   |   |                                                           |
|    |   |   | -   Include MOU in Appendix for any sites that require    |
|    |   |   |     additional work                                       |
|    |   |   |                                                           |
|    |   |   | -   Discuss cumulative and indirect impacts               |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   | ##### Section 106                                         |
|    |   |   |                                                           |
|    |   |   | -   Identify consulting parties, including federally      |
|    |   |   |     recognized Native American tribes                     |
|    |   |   |                                                           |
|    |   |   | -   Discuss efforts to consult with Native American       |
|    |   |   |     tribes, local governmental agencies, the public and   |
|    |   |   |     other interested parties                              |
|    |   |   |                                                           |
|    |   |   | -   Discuss an involvement that other                     |
|    |   |   |     agencies/organizations (public groups, citizens       |
|    |   |   |     advisory groups, resource agencies, etc.) may have    |
|    |   |   |     had throughout the project process                    |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+

+----+---+---+-----------------------------------------------------------+
| #  | > | > | ## CATEGORY                                               |
|    |   |   |                                                           |
| #  | * | * |                                                           |
|    | * | * |                                                           |
| #  | C | D |                                                           |
| Pa | o | E |                                                           |
| ge | m | A |                                                           |
|  N | p | * |                                                           |
| um | l | * |                                                           |
| be | e |   |                                                           |
| r( | t |   |                                                           |
| s) | e |   |                                                           |
|    | * |   |                                                           |
|    | * |   |                                                           |
+----+---+---+-----------------------------------------------------------+
| ** |   |   | ##### Land Use                                            |
| In |   |   |                                                           |
| se |   |   | #####                                                     |
| rt |   |   |                                                           |
| c  |   |   | -   Discuss existing land use. Include Regional Summary.  |
| he |   |   |                                                           |
| ck |   |   | -   Discuss project compatibility with existing land use  |
| ma |   |   |     plans                                                 |
| rk |   |   |                                                           |
| a  |   |   | -   Discuss comprehensive development plans for the area, |
| nd |   |   |     if applicable                                         |
| pa |   |   |                                                           |
| ge |   |   | -   Discuss growth inducement (current development        |
| n  |   |   |     trends; indirect effects of the project on land use   |
| um |   |   |     patterns, population density and growth rate)         |
| be |   |   |                                                           |
| r( |   |   | -   Discuss anticipated changes in land use, if           |
| s) |   |   |     applicable.                                           |
| as |   |   |                                                           |
| a  |   |   | -   Discuss cumulative and indirect impacts               |
| pp |   |   |                                                           |
| ro |   |   | -   Provide exhibit, which shows current land use of the  |
| pr |   |   |     study area (include farmland, community, recreational |
| ia |   |   |     facilities by type)                                   |
| te |   |   |                                                           |
| ** |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+

+----+---+---+-----------------------------------------------------------+
| #  | > | > | ## CATEGORY                                               |
|    |   |   |                                                           |
| #  | * | * |                                                           |
|    | * | * |                                                           |
| #  | C | D |                                                           |
| Pa | o | E |                                                           |
| ge | m | A |                                                           |
|  N | p | * |                                                           |
| um | l | * |                                                           |
| be | e |   |                                                           |
| r( | t |   |                                                           |
| s) | e |   |                                                           |
|    | * |   |                                                           |
|    | * |   |                                                           |
+----+---+---+-----------------------------------------------------------+
| ** |   |   | ##### Community/Social Impacts                            |
| In |   |   |                                                           |
| se |   |   | -   Establish baseline conditions (existing neighborhoods |
| rt |   |   |     and communities)                                      |
| c  |   |   |                                                           |
| he |   |   | -   Discuss population (past, present, and future trends) |
| ck |   |   |                                                           |
| ma |   |   | -   Discuss age distribution                              |
| rk |   |   |                                                           |
| a  |   |   | -   Discuss community cohesion                            |
| nd |   |   |                                                           |
| pa |   |   | -   Discuss impacts to the elderly, disabled,             |
| ge |   |   |     non-drivers, transit-dependent, etc.                  |
| n  |   |   |                                                           |
| um |   |   | -   Identify family or socially interdependent clusters   |
| be |   |   |     (two or more residents share phone, car, etc.)        |
| r( |   |   |                                                           |
| s) |   |   | -   Discuss employment, income, and labor force           |
| as |   |   |                                                           |
| a  |   |   | -   Discuss community resources (parks, churches,         |
| pp |   |   |     shopping, schools, emergency services, libraries,     |
| ro |   |   |     etc.)                                                 |
| pr |   |   |                                                           |
| ia |   |   | -   Provide exhibit identifying (parks, churches,         |
| te |   |   |     shopping, schools, emergency services, libraries,     |
| ** |   |   |     etc.)                                                 |
|    |   |   |                                                           |
|    |   |   | -   Discuss impacts on travel patterns, accessibility,    |
|    |   |   |     community facilities, and overall public safety       |
|    |   |   |                                                           |
|    |   |   | -   Discuss social and cultural loss to the community by  |
|    |   |   |     those displaced, if applicable                        |
|    |   |   |                                                           |
|    |   |   | -   Discuss impacts on economic vitality in project area  |
|    |   |   |     and on established business districts                 |
|    |   |   |                                                           |
|    |   |   | -   Reference any consultation with community, city or    |
|    |   |   |     county officials                                      |
|    |   |   |                                                           |
|    |   |   | ```{=html}                                                |
|    |   |   | <!-- -->                                                  |
|    |   |   | ```                                                       |
|    |   |   | -   Discuss mitigation, minimization, or avoidance        |
|    |   |   |     options that would minimize impacts                   |
|    |   |   |                                                           |
|    |   |   | ```{=html}                                                |
|    |   |   | <!-- -->                                                  |
|    |   |   | ```                                                       |
|    |   |   | -   Discuss cumulative and indirect impacts               |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+

+----+---+---+-----------------------------------------------------------+
| #  | > | > | ## CATEGORY                                               |
|    |   |   |                                                           |
| #  | * | * |                                                           |
|    | * | * |                                                           |
| #  | C | D |                                                           |
| Pa | o | E |                                                           |
| ge | m | A |                                                           |
|  N | p | * |                                                           |
| um | l | * |                                                           |
| be | e |   |                                                           |
| r( | t |   |                                                           |
| s) | e |   |                                                           |
|    | * |   |                                                           |
|    | * |   |                                                           |
+----+---+---+-----------------------------------------------------------+
| ** |   |   | **Relocation Impacts**                                    |
| In |   |   |                                                           |
| se |   |   | -   Identify number & type of relocations (residential,   |
| rt |   |   |     commercial, industrial, non-profit, etc.) for each    |
| c  |   |   |     alternative                                           |
| he |   |   |                                                           |
| ck |   |   | -   Discuss housing price ranges and owner/tenant status  |
| ma |   |   |     for those properties to be displaced                  |
| rk |   |   |                                                           |
| a  |   |   | -   Discuss available decent, safe and sanitary housing   |
| nd |   |   |     and commercial/industrial facilities based on current |
| pa |   |   |     market data. Provide price ranges and owner/tenant    |
| ge |   |   |     status                                                |
| n  |   |   |                                                           |
| um |   |   | -   Discuss coordination with the MPO or other            |
| be |   |   |     governmental agencies to identify any other proposed  |
| r( |   |   |     projects or activities that would compete for         |
| s) |   |   |     available comparable housing                          |
| as |   |   |                                                           |
| a  |   |   | -   Explain Relocation Assistance Program (Last Resort    |
| pp |   |   |     Housing, if applicable), Title VI of the Civil Rights |
| ro |   |   |     Act of 1966                                           |
| pr |   |   |                                                           |
| ia |   |   | -   Include statement, if applicable, that the            |
| te |   |   |     acquisition and relocation program will be conducted  |
| ** |   |   |     in accordance with the Uniform Relocation Assistance  |
|    |   |   |     and Real Property Acquisition Policies Act of 1970    |
|    |   |   |                                                           |
|    |   |   | -   Include a table to summarize relocations for each     |
|    |   |   |     alternative                                           |
|    |   |   |                                                           |
|    |   |   | -   Discuss mitigation, minimization, or avoidance        |
|    |   |   |     options that would minimize impacts                   |
|    |   |   |                                                           |
|    |   |   | -   Discuss cumulative and indirect impacts               |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+

+----+---+---+-----------------------------------------------------------+
| #  | > | > | ## CATEGORY                                               |
|    |   |   |                                                           |
| #  | * | * |                                                           |
|    | * | * |                                                           |
| #  | C | D |                                                           |
| Pa | o | E |                                                           |
| ge | m | A |                                                           |
|  N | p | * |                                                           |
| um | l | * |                                                           |
| be | e |   |                                                           |
| r( | t |   |                                                           |
| s) | e |   |                                                           |
|    | * |   |                                                           |
|    | * |   |                                                           |
+----+---+---+-----------------------------------------------------------+
| ** |   |   | ##### Farmland                                            |
| In |   |   |                                                           |
| se |   |   | -   Establish baseline conditions (identify farmland in   |
| rt |   |   |     project corridor)                                     |
| c  |   |   |                                                           |
| he |   |   | -   Discuss consultation with the Soil Conservation       |
| ck |   |   |     Service and, as appropriate, state and local          |
| ma |   |   |     agricultural agencies                                 |
| rk |   |   |                                                           |
| a  |   |   | -   Discuss impacts to farmland                           |
| nd |   |   |                                                           |
| pa |   |   | -   Include NRCS LESA Form AD 1006                        |
| ge |   |   |                                                           |
| n  |   |   | -   Discuss feasible alternative to avoid farmland        |
| um |   |   |     impacts if LESA score exceeds 160 points              |
| be |   |   |                                                           |
| r( |   |   | -   Discuss cumulative and indirect impacts               |
| s) |   |   |                                                           |
| as |   |   | -   Provide exhibit, which identifies prime farmland in   |
| a  |   |   |     the project corridor.                                 |
| pp |   |   |                                                           |
| ro |   |   |                                                           |
| pr |   |   |                                                           |
| ia |   |   |                                                           |
| te |   |   |                                                           |
| ** |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   | ##### Environmental Justice                               |
|    |   |   |                                                           |
|    |   |   | -   Establish baseline conditions                         |
|    |   |   |                                                           |
|    |   |   | -   Include statement that project complies with          |
|    |   |   |     Executive Order 12898, Environmental Justice guidance |
|    |   |   |                                                           |
|    |   |   | -   Discuss race, color, and national origin of the area. |
|    |   |   |                                                           |
|    |   |   | -   Identify impacts to minority and/or low-income        |
|    |   |   |     population. **Do not show on map or exhibit**         |
|    |   |   |                                                           |
|    |   |   | -   Discuss avoidance, minimization and mitigation, if    |
|    |   |   |     applicable                                            |
|    |   |   |                                                           |
|    |   |   | -   Discuss cumulative and indirect impacts               |
|    |   |   |                                                           |
|    |   |   | -   Provide Table showing impacts to minority and/or      |
|    |   |   |     low-income populations for each alternative           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+

+----+---+---+-----------------------------------------------------------+
| #  | > | > | ## CATEGORY                                               |
|    |   |   |                                                           |
| #  | * | * |                                                           |
|    | * | * |                                                           |
| #  | C | D |                                                           |
| Pa | o | E |                                                           |
| ge | m | A |                                                           |
|  N | p | * |                                                           |
| um | l | * |                                                           |
| be | e |   |                                                           |
| r( | t |   |                                                           |
| s) | e |   |                                                           |
|    | * |   |                                                           |
|    | * |   |                                                           |
+----+---+---+-----------------------------------------------------------+
| ** |   |   | ######                                                    |
| In |   |   |                                                           |
| se |   |   | ###### Pedestrian and Bicycle Facilities                  |
| rt |   |   |                                                           |
| c  |   |   | ###### Establish baseline conditions (identify existing f |
| he |   |   | acilities and their use for recreation or transportation) |
| ck |   |   |                                                           |
| ma |   |   | ###### Discuss oppor                                      |
| rk |   |   | tunities for providing pedestrian and bicycle facilities  |
| a  |   |   |                                                           |
| nd |   |   | ###### Discuss cumulative and indirect impacts            |
| pa |   |   |                                                           |
| ge |   |   |                                                           |
| n  |   |   |                                                           |
| um |   |   |                                                           |
| be |   |   |                                                           |
| r( |   |   |                                                           |
| s) |   |   |                                                           |
| as |   |   |                                                           |
| a  |   |   |                                                           |
| pp |   |   |                                                           |
| ro |   |   |                                                           |
| pr |   |   |                                                           |
| ia |   |   |                                                           |
| te |   |   |                                                           |
| ** |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   | ##### UST/Hazardous Materials                             |
|    |   |   |                                                           |
|    |   |   | -   Establish baseline conditions (identify known and     |
|    |   |   |     potential sites)                                      |
|    |   |   |                                                           |
|    |   |   | -   Discuss coordination with resource agencies           |
|    |   |   |                                                           |
|    |   |   | -   Identify sites recommended for Phase II site          |
|    |   |   |     assessments and/or remediation                        |
|    |   |   |                                                           |
|    |   |   | -   Discuss KYTC process for remediation (if remediation  |
|    |   |   |     is necessary)                                         |
|    |   |   |                                                           |
|    |   |   | -   Include discussion of cost estimates for each site    |
|    |   |   |     identified                                            |
|    |   |   |                                                           |
|    |   |   | -   Include summary table of sites and identify           |
|    |   |   |     associated alternative                                |
|    |   |   |                                                           |
|    |   |   | -   Include exhibit showing location of all sites         |
|    |   |   |                                                           |
|    |   |   | -   Discuss cumulative and indirect impacts               |
|    |   |   |                                                           |
|    |   |   | ######                                                    |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   | ######                                                    |
|    |   |   |                                                           |
|    |   |   | ###### Visual Impacts                                     |
|    |   |   |                                                           |
|    |   |   | -   Establish baseline conditions (existing view shed)    |
|    |   |   |                                                           |
|    |   |   | -   Discuss impacts the selected alternative will have on |
|    |   |   |     the existing viewshed                                 |
|    |   |   |                                                           |
|    |   |   | -   Discuss cumulative and indirect impacts               |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+

+----+---+---+-----------------------------------------------------------+
| #  | > | > | ## CATEGORY                                               |
|    |   |   |                                                           |
| #  | * | * |                                                           |
|    | * | * |                                                           |
| #  | C | D |                                                           |
| Pa | o | E |                                                           |
| ge | m | A |                                                           |
|  N | p | * |                                                           |
| um | l | * |                                                           |
| be | e |   |                                                           |
| r( | t |   |                                                           |
| s) | e |   |                                                           |
|    | * |   |                                                           |
|    | * |   |                                                           |
+----+---+---+-----------------------------------------------------------+
| ** |   |   | ###### Energy                                             |
| In |   |   |                                                           |
| se |   |   | -   Discuss cost/benefit analysis of reasonable           |
| rt |   |   |     alternatives (page 35 of TA)                          |
| c  |   |   |                                                           |
| he |   |   |                                                           |
| ck |   |   |                                                           |
| ma |   |   |                                                           |
| rk |   |   |                                                           |
| a  |   |   |                                                           |
| nd |   |   |                                                           |
| pa |   |   |                                                           |
| ge |   |   |                                                           |
| n  |   |   |                                                           |
| um |   |   |                                                           |
| be |   |   |                                                           |
| r( |   |   |                                                           |
| s) |   |   |                                                           |
| as |   |   |                                                           |
| a  |   |   |                                                           |
| pp |   |   |                                                           |
| ro |   |   |                                                           |
| pr |   |   |                                                           |
| ia |   |   |                                                           |
| te |   |   |                                                           |
| ** |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   | ###### Impacts of Construction Activities                 |
|    |   |   |                                                           |
|    |   |   | -   Discuss potential adverse impacts (noise, traffic     |
|    |   |   |     congestion, detours, etc.)                            |
|    |   |   |                                                           |
|    |   |   | -   Discuss sedimentation and erosion control plan as it  |
|    |   |   |     relates to construction activities                    |
|    |   |   |                                                           |
|    |   |   | ```{=html}                                                |
|    |   |   | <!-- -->                                                  |
|    |   |   | ```                                                       |
|    |   |   | -   Discuss waste and borrow sites                        |
|    |   |   |                                                           |
|    |   |   | Refer to *[KYTC Standard Specs for Road and Bridge        |
|    |   |   | Construction]{.underline}*                                |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   | # Mitigation Measures                                     |
|    |   |   |                                                           |
|    |   |   | -   Identify mitigation commitments for each viable       |
|    |   |   |     alternative                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   | **The Relationship Between Local Short-term Uses of Man's |
|    |   |   | Environment and Maintenance and Enhancement of Long Term  |
|    |   |   | Productivity**                                            |
|    |   |   |                                                           |
|    |   |   | -   Explain that transportation improvements are based on |
|    |   |   |     state and/or local comprehensive planning, which      |
|    |   |   |     consider(s) the need for present and future traffic   |
|    |   |   |     requirements within the context of present and future |
|    |   |   |     land use development. **(See G24 of the Technical     |
|    |   |   |     Advisory T6640.8a)**                                  |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   | **Irreversible and Irretrievable Commitments of Resources |
|    |   |   | Which Would be Involved in the Proposed Action**          |
|    |   |   |                                                           |
|    |   |   | -   Discuss the proposed action's irreversible and        |
|    |   |   |     irretrievable commitment of resources. (See G25 of    |
|    |   |   |     the Technical Advisory T6640.8a)                      |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+

+----+---+---+-----------------------------------------------------------+
| #  | > | > | ## CATEGORY                                               |
|    |   |   |                                                           |
| #  | * | * |                                                           |
|    | * | * |                                                           |
| #  | C | D |                                                           |
| Pa | o | E |                                                           |
| ge | m | A |                                                           |
|  N | p | * |                                                           |
| um | l | * |                                                           |
| be | e |   |                                                           |
| r( | t |   |                                                           |
| s) | e |   |                                                           |
|    | * |   |                                                           |
|    | * |   |                                                           |
+----+---+---+-----------------------------------------------------------+
| ** |   |   | ######                                                    |
| In |   |   |                                                           |
| se |   |   | ##### List of Preparers                                   |
| rt |   |   |                                                           |
| c  |   |   | -   Include a list of state (and local agency) personnel, |
| he |   |   |     including consultants, who were primarily responsible |
| ck |   |   |     for preparing the DEIS or performing environmental    |
| ma |   |   |     studies, and a brief summary of their qualifications, |
| rk |   |   |     including educational background and experience.      |
| a  |   |   |                                                           |
| nd |   |   | -   Include the FHWA personnel primarily responsible for  |
| pa |   |   |     preparation or review of the DEIS and their           |
| ge |   |   |     qualifications                                        |
| n  |   |   |                                                           |
| um |   |   |                                                           |
| be |   |   |                                                           |
| r( |   |   |                                                           |
| s) |   |   |                                                           |
| as |   |   |                                                           |
| a  |   |   |                                                           |
| pp |   |   |                                                           |
| ro |   |   |                                                           |
| pr |   |   |                                                           |
| ia |   |   |                                                           |
| te |   |   |                                                           |
| ** |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   | ######                                                    |
|    |   |   |                                                           |
|    |   |   | ###### Distribution                                       |
|    |   |   |                                                           |
|    |   |   | -   List of Agencies, organizations, and Persons to Whom  |
|    |   |   |     Copies of the Statement are Sent                      |
|    |   |   |                                                           |
|    |   |   | -   Identify those entities that submitted comments on    |
|    |   |   |     the document                                          |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   | ######                                                    |
|    |   |   |                                                           |
|    |   |   | ###### Comments and Coordination                          |
|    |   |   |                                                           |
|    |   |   | -   Summary of correspondence (agencies and public)       |
|    |   |   |                                                           |
|    |   |   | -   Discuss the early coordination process, including     |
|    |   |   |     scoping                                               |
|    |   |   |                                                           |
|    |   |   | -   Discuss meetings held with community groups           |
|    |   |   |     (including minority and non-minority interests)       |
|    |   |   |                                                           |
|    |   |   | -   Discuss Public Involvement activities                 |
|    |   |   |                                                           |
|    |   |   | -   Discuss the key issues and pertinent information      |
|    |   |   |     received from the public and government agencies      |
|    |   |   |                                                           |
|    |   |   | ```{=html}                                                |
|    |   |   | <!-- -->                                                  |
|    |   |   | ```                                                       |
|    |   |   | -   Include all concurrence letters received from         |
|    |   |   |     government agencies                                   |
|    |   |   |                                                           |
|    |   |   | ```{=html}                                                |
|    |   |   | <!-- -->                                                  |
|    |   |   | ```                                                       |
|    |   |   | -   Include a summary of all comments received from the   |
|    |   |   |     above mentioned parties                               |
|    |   |   |                                                           |
|    |   |   | -   **Include responses to comments received**            |
|    |   |   |                                                           |
|    |   |   | -   **Discuss compliance with all applicable              |
|    |   |   |     environmental laws, Executive Orders, and other       |
|    |   |   |     related requirements**                                |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+

+----+---+---+-----------------------------------------------------------+
| #  | > | > | ## CATEGORY                                               |
|    |   |   |                                                           |
| #  | * | * |                                                           |
|    | * | * |                                                           |
| #  | C | D |                                                           |
| Pa | o | E |                                                           |
| ge | m | A |                                                           |
|  N | p | * |                                                           |
| um | l | * |                                                           |
| be | e |   |                                                           |
| r( | t |   |                                                           |
| s) | e |   |                                                           |
|    | * |   |                                                           |
|    | * |   |                                                           |
+----+---+---+-----------------------------------------------------------+
| ** |   |   | ######                                                    |
| In |   |   |                                                           |
| se |   |   | ##### Appendices                                          |
| rt |   |   |                                                           |
| c  |   |   | -   Summarizes methodologies and results of technical     |
| he |   |   |     analyses and research                                 |
| ck |   |   |                                                           |
| ma |   |   | -   Include coordination and concurrence letters          |
| rk |   |   |                                                           |
| a  |   |   |                                                           |
| nd |   |   |                                                           |
| pa |   |   |                                                           |
| ge |   |   |                                                           |
| n  |   |   |                                                           |
| um |   |   |                                                           |
| be |   |   |                                                           |
| r( |   |   |                                                           |
| s) |   |   |                                                           |
| as |   |   |                                                           |
| a  |   |   |                                                           |
| pp |   |   |                                                           |
| ro |   |   |                                                           |
| pr |   |   |                                                           |
| ia |   |   |                                                           |
| te |   |   |                                                           |
| ** |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   | ######                                                    |
|    |   |   |                                                           |
|    |   |   | **Section 4(f)/Programmatic 4(f) and or 6(f) Discussion** |
|    |   |   | (if applicable)                                           |
|    |   |   |                                                           |
|    |   |   | -   Discuss publicly owned parks, recreation areas, or    |
|    |   |   |     wildlife and waterfowl refuges, if applicable         |
|    |   |   |                                                           |
|    |   |   | ```{=html}                                                |
|    |   |   | <!-- -->                                                  |
|    |   |   | ```                                                       |
|    |   |   | -   Discuss both actual use and proximity impacts on each |
|    |   |   |     cultural and/or historic resource for each            |
|    |   |   |     alternative                                           |
|    |   |   |                                                           |
|    |   |   | -   Discuss avoidance alternatives which avoid each and   |
|    |   |   |     all sites                                             |
|    |   |   |                                                           |
|    |   |   | -   Measures taken to minimize harm to the historic       |
|    |   |   |     resource(s) and any required mitigation measures must |
|    |   |   |     also be discussed                                     |
|    |   |   |                                                           |
|    |   |   | -   Discuss results of coordination efforts with          |
|    |   |   |     jurisdictional parties over the 4(f) properties and   |
|    |   |   |     with the National Parks Service for 6(f) properties   |
|    |   |   |                                                           |
|    |   |   | -   Include MOU in appendices, if applicable              |
|    |   |   |                                                           |
|    |   |   | -   Identify and discuss any 6(f) impacts associated with |
|    |   |   |     the project                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+
|    |   |   |                                                           |
+----+---+---+-----------------------------------------------------------+

***Comments:*** Discuss supplemental information, guidance or
instructions that required deviation from the checklist. Discuss all
categories which contain "NA" in the "Complete" columns of this format.
Comments regarding the content and format of this form and/or its
applicability may also be submitted through this section.

***Commitments to be Implemented:*** Identify any commitments that are
documented within the study. Specify the nature of the commitment, to
whom it was or should be made, when the commitment should be enacted
upon, etc.

***Mitigation and Special Issues:*** Identify mitigation measures that
are specified within the report, if any. Also, identify any special
issues that are addressed within the document that should be considered
by the Project Team as it makes decisions regarding the project.

***Signature Page***

I have reviewed the project documentation and attest that those
responsible for its preparation are familiar with the requirements set
forth in the checklist above and that proper management controls were in
effect throughout the course of document development to assure that the
document is complete, thorough and addresses all applicable checklist
components.

#### *Prime Consultant* *Date* 

**Recommended for Approval By:**

#### *KYTC/DEA Environmental Project Manager/Reviewer Date*

### Team Review of Commitments

The findings of the report, including impacts to the project and project
commitments, have been presented to the Project Team and will be
considered during the development of this project.

*KYTC/District Environmental Coordinator Date*

*Project Manager Date*