HomeMy WebLinkAboutPES City Signature PageLocal Assistance Procedures Manual Exhibit 6-A
Preliminary Environmental Study (PES) Form
E. Preliminary Environmental Document Classification (NEPA)
Based on the evaluation of the project, the environmental document to be developed should be:
Check one:
❑ Environmental Impact Statement (Note: Engagement with participating agencies in accordance with 23 USC 139 required)
❑ Compliance with 23 USC 139 regarding Participating Agencies required
❑ Complex Environmental Assessment
❑ Routine Environmental Assessment
❑ Categorical Exclusion without required technical studies.
❑ Categorical Exclusion with required technical studies
(if Categorical Exclusion is selected, check one of the following) :
❑ Section 23 USC 326
n23 CFR 771 activity
F123 CFR 771 activity (d)
❑ Activity listed in the Section 23 USC 326
Section 23 USC 327
F. Public Availability and Public Hearing
Check as applicable:
® Not Required
❑ Notice of Availability of Environmental Document
❑ Public Meeting
❑ Notice of Opportunity for a Public Hearing
❑ Public Hearing Required
G. Signatures
Local Agency Staff and/or Consultant Signature
(Signature of Preparer) (Date) (Telephone No)
(Name)
Local Agency Project Engineer Signature
This document was prepared under my supervision, according to the Local Assistance Procedures Manual, Exhibit 6-13,
"Instructions for Completing the Preliminary Environmental Study Form."
of Local Agency)
I
(Llbte) '(Telephone No)
Page 6-81
OB 13-02 March 14, 2013