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Environmental Questionnaire 

OMB Control #0693-0093 Exp. Date 12/31/2026

The purpose of the Environmental Questionnaire is to assist the National Institute of Standards and 

Technology (NIST) CHIPS Program Office (CPO) in determining the appropriate level of environmental 

review required under the National Environmental Policy Act (NEPA) and related laws, such as the 

Endangered Species Act and the National Historic Preservation Act (NHPA). The applicant should submit 

a single Environmental Questionnaire for its entire application, with responses to questions A through Z 

for each project included in its application.

Please provide CPO with a sufficient level of documentation and analysis to inform CPO’s assessment of 

the appropriate level of NEPA review, which should include as much detail and information as is 

currently available, and may, in some cases, necessitate working with environmental experts or 

consultants to develop additional information. Documentation may include background research, 

results of record searches, field investigations, field surveys, and any past planning or studies. 

The Applicant is responsible for providing all necessary analysis and documentation to enable NIST to 

comply with NEPA and its implementing regulations. Submission of this Questionnaire by itself does not 

satisfy NIST’s NEPA obligations. The Questionnaire is not the Environmental Assessment or 

Environmental Impact Statement. CPO may request additional information or documentation from the

applicant to assist CPO in its environmental review. For questions regarding CPO’s NEPA requirements, 

please contact CPO at apply@chips.gov.

Applicants must provide information on the following items in the Environmental Questionnaire. For any 

question in which the Applicant asserts that an item is not applicable to a project, provide a brief 

supporting explanation.
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A. Project Description 

Please provide a brief summary of the proposed project(s) and each of the activities included in the 

proposed project(s), including the project schedule and a summary of any manufacturing process that 

will take place at the facility associated with the project. For each activity included in the project(s), 

describe both how that activity would benefit from the other project activities, and any value or utility 

that the activity will have independent of other activities. If the applicant anticipates that Federal funds 

will only be used for certain activities, identify specifically the activities the applicant plans to conduct 

using Federal funds.

If the proposed project(s) is part of a larger application or a project cluster, describe both how the 

project(s) would benefit from the other projects included in the application or project cluster, and any 

value or utility that the project will have independent of other projects.

B. Project Site/Affected Environment 

Describe the location’s address or coordinates, and the names of facilities. Provide a topographical map 

of the project area and a site map (with legend and north arrow) displaying the project location and 

boundaries, limits of disturbance, and existing and proposed project activities. (A GIS shapefile is 

preferrable, if available. If the specific locations of facilities and associated infrastructure are unknown, 

the applicant may provide a conceptual layout that describes the relative scale and proximity of project 

elements.)

Describe the following for the location where the project would take place: 

1. The nature of the site (e.g., urban, industrial, suburban, agricultural, university campus, 

manufacturing facility) and the current condition and/or use of the site;

2. The ownership or administration of the site and the surrounding lands, including whether any of 

the lands within or adjacent to the site are owned by any entity other than the applicant; if any 

of the lands are owned by a governmental entity, describe the management status of the lands 

(e.g., conservation lands, multiple-use lands, industrial lands);

3. Any existing facilities or buildings on the site, and whether those buildings would be demolished, 

modified, or reused without substantial external modification; 

4. Any new facilities or buildings proposed for the site, including utilities, roads, or other 

infrastructure or supporting facilities; and 

5. Whether work on the activity has already begun, or will begin before a funding decision is made.

C. Resource Consumption Rates and Effluent Emissions Streams and Impacts 

Describe all material inputs and outputs, including, for example, but not limited to, material resources, 

water consumption, electricity use.

D. Tribal, Historic, and Cultural Resources 

Indicate whether the project site, or any adjoining lands, are owned by or held in trust for any federally 

recognized Indian tribes, or are located within the exterior boundaries of a reservation. Describe any 
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known resources of tribal interest, or any known concerns raised by any federally recognized Indian 

tribes related to the project.

Identify any known historic, archeological, or cultural resources within or adjacent to the project site, 

including historic properties that are listed on or eligible for listing on the National Register of Historic 

Places, or considered to be of local or state significance. (In many states, the State Historic Preservation 

Office (SHPO) maintains GIS databases of historic properties and cultural resources.) Discuss the 

potential impacts of the project on any such resources within or adjacent to the project site, and any 

measures that you have identified that might mitigate these impacts. 

E. Project Setting 

Describe the general proposed project area.

F. Vegetation and Wildlife Resources. 

Identify native vegetation and wildlife found in the project area or its immediate vicinity. 

G. Conservation Areas 

Identify any designated or formally proposed conservation areas located near the project site, including 

federally designated areas such as national parks, national wildlife refuges, national conservation areas, 

national historic sites, or wilderness areas, or similar areas designated by state, tribal, or local 

governments. Provide information about any impacts to these areas, and any measures that you have 

identified that might mitigate these impacts.

H. Coastal Zones and Navigable Waters 

Indicate whether the project is located within a designated coastal zone subject to the Coastal Zone 

Management Act. (Information on coastal zone boundaries is available on the National Oceanic and 

Atmospheric Administration’s (NOAA) website.) Identify any shorelines, beaches, dunes, or estuaries 

within or adjacent to the project site(s). Indicate if there are any proposed overwater structures that 

could impact navigable waters. Identify any measures that you have identified that might mitigate these 

impacts.

I. Wetlands 

Identify any wetlands within or adjacent to the proposed project location. If available, provide an on-site 

wetland/waters delineation performed in accordance with the 1987 (or current version) U.S. Army Corps 

of Engineers Wetland Delineation Manual, as amended. Provide any correspondence from the U.S. Army 

Corps of Engineers (USACE), including any jurisdictional determination or permit documents. If the 

proposed project may impact wetlands, streams, or navigable waters, the applicant should contact 

USACE concerning any jurisdictional waters resources. Identify any measures that you have identified 

that might mitigate these impacts.

J. Floodplains 

State whether the proposed project is located within a mapped 100- or 500-year floodplain. Provide a 

Federal Emergency Management Agency (FEMA) floodplain map (with the map number and effective 

date) displaying the project location and boundaries, and existing and proposed project activities. 
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Floodplain maps can be viewed and printed from FEMA’s website. If FEMA floodplain maps do not exist 

in the project area, provide a letter from a professional engineer regarding the presence or absence of a 

100-year floodplain.

K. Endangered Species 

Identify any threatened, endangered, and candidate species located in or near the proposed project 

location, and any potential or existing habitat, including critical habitat designations in the project area. 

Identify the potential for direct or indirect impacts on these species, and any measures that you have 

identified that might mitigate these impacts. If an Effect Determination or Biological Assessment has 

been completed for any of the species listed, or if you have had any correspondence with the U.S. Fish 

and Wildlife Service (FWS) or the National Marine Fisheries Service (NMFS) related to the proposed 

project, please provide. 

Critical habitat designations, lists of protected species by county, and information on effect 

determinations are available on the FWS website. The FWS’s web-based Information, Planning, and 

Conservation System (IPaC) may also be useful for the early planning stage of a project. For proposed 

projects with possible impacts to fisheries and marine/coastal species, NMFS provides relevant 

information.

L. Land Use and Zoning 

Describe the present formal zoning designation and current land use of the proposed project site and 

adjacent land parcels. Identify any agricultural land parcels designated as “prime/unique agriculture 

lands” by the U.S. Department of Agriculture (USDA) under the Federal Farmlands Protection Act or a 

local equivalent. (Additional information may be found at the USDA’s Natural Resources Conservation 

Service website.)

M. Solid Waste Management 

Indicate the types and quantities of solid wastes the project facilities would produce. 

N. Hazardous or Toxic Substances 

Describe any toxic, hazardous, or radioactive substances that will be used or produced by the proposed 

project facilities. 

O. Impacts to Water Quality/Water Resources 

Describe surface and underground water resources at or near the project site; any impacts of the 

proposed project to these resources; and any measures that you have identified that might mitigate 

these impacts. 

P. Water Supply and Distribution System 

Indicate the source, quality, and supply capacity of local domestic and industrial/commercial water 

resources, and the amount of water that project facilities are expected to utilize. Note whether the 

water that is being supplied is in compliance with the Safe Drinking Water Act, and if not, what steps are 

being taken to ensure compliance.
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Q. Wastewater Collection and Treatment Facilities 

Describe the wastewater treatment facilities available for processing the additional effluent from the 

project. 

R. Environmental Justice & Socioeconomics 

Identify whether the proposed project would be in or near disadvantaged communities that are 

overburdened or underserved.1 Describe whether the proposed project may result in disproportionate 

and adverse human health or environmental impacts to overburdened and underserved communities, 

including minority, tribal, or low-income populations. In describing potential impacts, consider whether 

the proposed project will result in any changes in local socioeconomic conditions, including population, 

employment rates, cost of housing, and other relevant conditions. Identify any measures that you have 

identified that might mitigate these impacts.

S. Transportation (Streets, Traffic and Parking) 

Briefly describe the local street/road system serving the project site(s) and describe any new traffic 

patterns that may arise because of the project. Indicate if land use in the vicinity, such as residential, 

hospital, school, or recreational, will be affected by these new traffic patterns. Indicate if any existing 

capacities of these transportation facilities will be exceeded as a direct or indirect result of this project 

implementation, particularly in terms of car and truck traffic, and what the new Level of Service 

designation will be.

T. Air Quality 

Indicate types and quantities of air emissions (including odors or nanoscale materials) that would be 

produced by the project facilities, and any measures you have identified that might mitigate these 

impacts. Is the proposed project site classified as a “non-attainment” area for any criteria pollutants? If 

so, for which pollutants? Indicate any local topographical or meteorological conditions that may hinder 

the dispersal of air emissions.

U. Greenhouse Gases and their Environmental Effects 

Indicate the impact that the project would have on greenhouse gas emissions, and describe 

sustainability efforts to be incorporated into the project (i.e., renewable energy use) as well as any 

efforts to improve energy efficiency and to reduce emissions.

Also describe how climate resilience will be addressed; that is, how will the project adapt to impacts 

from climate change?

V. Noise 

Will operation of project facilities increase local ambient noise levels? If yes, indicate the estimated 

levels of increase, and the areas impacted including any sensitive receptors (e.g., hospitals, schools, 

1 Such communities can be identified using various tools for environmental justice analysis, including the Council on 

Environmental Quality’s Climate and Economic Justice Screening Tool, 

https://screeningtool.geoplatform.gov/en/about#3/33.47/-97.5, and the Environmental Protection Agency’s EJScreen, 

https://www.epa.gov/ejscreen.
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daycare facilities, housing for seniors, other residences) that may be affected. Indicate any measures 

that you have identified that might mitigate these impacts.

W. Health and Safety 

Please identify and describe: (1) any known or potential health and safety hazards to the public or 

project workers that may result from or are associated with your proposed project; and (2) any efforts 

that would be taken to mitigate these hazards.

X. Permits and other Government Agency Involvement 

Is any Federal agency other than NIST involved in any aspect of this project (e.g., funding, permitting, 

technical assistance, project located on federally administered land)? Identify any Federal, tribal, state, 

or local environmental permits, plans or reviews needed for the project (e.g., Clean Water Act 404 

permits, stormwater management plans, coastal zone management/shoreline management plan, Clean 

Air Act permits, Clean Water Act National Pollutant Discharge Elimination System (NPDES), etc.) and the 

status of any such permits. Attach copies of any such permits or permit applications.

Y. Public Notification/Controversy 

Provide evidence of the community’s awareness of the project, such as newspaper articles or public 

notification and/or public meetings, as applicable. Identify state, tribal, or local government agencies 

that will have oversight or interest in the project, as well as any nongovernmental organizations that 

have expressed opposition or support for the project. Attach any project related correspondence with 

these agencies, tribes, and organizations. If a formal public hearing has been held by any government 

agency, attach any available minutes, or notes from such hearings. Fully describe any public controversy 

or objections which have been made concerning this proposed project and discuss steps taken to 

resolve such objections.

Z. Environmental Experience and Approach 

Describe any experience in addressing and resolving environmental concerns during the performance of 

past projects of similar size and complexity including the obtaining of necessary permits. Describe any 

existing written environmental policies, procedures, or plans currently in place and considered essential 

to the conduct of the applicant’s commercial business operation. Discuss any directly related 

education/experience of key project members (e.g., air quality management; surface water and ground 

water management; solid waste management; ecological resources; cultural resources; environmental 

permit applications).
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BURDEN STATEMENT

A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a 

person be subject to a penalty for failure to comply with an information collection subject to the 

requirements of the Paperwork Reduction Act of 1995 unless the information collection has a currently 

valid OMB Control Number. The approved OMB Control Number for this information collection is 0693-

0093. Without this approval, we could not conduct this information collection. Public reporting for this 

information collection is estimated to be approximately 8 hours per response, including the time for

reviewing instructions, searching existing data sources, gathering, and maintaining the data needed, and 

completing and reviewing the information collection. All responses to this information collection are 

mandatory to obtain benefits. Send comments regarding this burden estimate or any other aspect of 

this information collection, including suggestions for reducing this burden to the National Institute of 

Technology at Cierra Bean, Business Operations Specialist, askchips@chips.gov.