20231288 Ver 1_Richmond 142 MCDC signed_20230915

MINIMUM CRITERIA DETERMINATION CHECKLIST
The following questions provide direction in determining when the Department is
required to prepare environmental documents for state -funded construction and
maintenance activities. Answer questions for Parts A through C by checking either
"Yes" or "No". Complete Part D of the checklist when Minimum Criteria Rule
categories 98, 12(i) or 915 are used.
TIP Project No.:n/a
State Project NO.:BP8.R016.1
Project Location:SR 1321 (Research Farm Rd) over Naked Creek
Project Description: Replacement of bridge #142 in Richmond County.
Anticipated Permit or Consultation Requirements: NWP #3 & 13
Special Proj ect Information: B R I D G E EPLAC EMENT
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PART A: MINIMUM CRITERIA
M&M� to be completed by the Engine YES NO
1. Is the proposed project listed as a type and class of activity allowed under ® ❑
the Minimum Criteria Rule in which environmental documentation is not
required?
If the answer to number 1 is "no", then the project does not qualify as a
minimum criteria project. A state environmental assessment is required.
If yes, under which category? 9
If either category #8, #12(1) or #15 is used complete Part D of this checklist.
PART B: MINIMUM CRITERIA EXCEPTIONS
tems 2 — 4 to be completed by the Engineer.
YES
NO
2. Could the proposed activity cause significant changes in land use
❑
❑
concentrations that would be expected to create adverse air quality
impacts?
3. Will the proposed activity have secondary impacts or cumulative
❑
❑
impacts that may result in a significant adverse impact -to human health
or the environment?
4. Is the proposed activity of such an unusual nature or does the proposed
❑
❑
activity have such widespread implications, that an uncommon concern
for its environmental effects has been expressed to the Department?
Item 5-8 to be completed by Division Environmental Office
5_ Does the proposed activity have a significant adverse effect on wetlands; ❑ ❑X
surface waters such as rivers, streams, and estuaries; parklands; prime or
unique agricultural lands; or areas of recognized scenic, recreational,
archaeological, or historical value?
6. Will the proposed activity endanger the existence of a species on the ❑
Department of Interior's threatened and endangered species list?
7. Could the proposed activity cause significant changes in land use ❑ X❑
concentrations that would be expected to create adverse water quality or
ground water impacts?
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YES NO
8. Is the proposed activity expected to have a significant adverse effect on ❑ X❑
long-term recreational benefits or shellfish, finfish, wildlife, or their
natural habitats
If any questions 2 through 8 are answered "yes", the proposed project may not qualify as a
Minimum Criteria project. A state environmental assessment (EA) may be required. For
assistance, contact:
Manager, Environmental Analysis Unit
1598 Mail Service Center
Raleigh, NC 27699-1598
(919) 707 — 6000
Fax: [phone]
PART C: COMPLIANCE WITH STATE AND FEDERAL REGULATIONS
Items 9-12 to be complete by Division Environmental Officer.
YES NO
9. Is a federally protected threatened or endangered species, or its
❑
habitat, likely to be impacted by the proposed action?
10. Does the action require the placement of temporary or permanent
® ❑
fill in waters of the United States?
11. Does the project require the placement of a significant amount of
❑
fill in high quality or relatively rare wetland ecosystems, such as
mountain bogs or pine savannahs?
12. Is the proposed action located in an Area of Environmental
❑ 0
Concern, as defined in the coastal Area Management Act?
completed by the Engineer. M
13. Does the project require stream relocation or channel changes?
❑
Cultural Resources
14. Will the project have an "effect" on a property or site listed on the ❑
National Register of Historic Places?
15. Will the proposed action require acquisition of additional right of ❑
way from publicly owned parkland or recreational areas?
Questions in Part "C" are designed to assist the Engineer and the Division Environmental
Officer in determining whether a permit or consultation with a state or federal resource
agency may be required. If any questions in Part "C" are answered "yes", follow the
appropriate permitting procedures prior to beginning project construction.
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PART D:(To be completed when either category #8, 120) or #15 of the rules are
used.
Items 16- 22 to be completed by Division Environmental Officer.
16. Project length:
17. Right of Way width:
18. Project completion date:
19. Total acres of newly disturbed ground
surface:
20. Total acres of wetland impacts:
21. Total linear feet of stream impacts
22. Project purpose:
0.131 mi
60'
6/2025
NONE
84
Replace deficient bridge
If Part D of the checklist is completed, send a copy of the entire checklist document to:
State Roadside Environmental Engineer
Mail Service Center 1557
Raleigh, NC 27699-1557
[phone]
Fax [phone]
DocuSigned by:
09/11/2023
D524ABADOOCC476...
Reviewed by: Date:
Lead Engineer
'4tt-c Date: 9-11-2023
Division Environmental Officer
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