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X  C       XXwA1-j|F} `@E|F}Fn|F}wyC3/j| k p@E k 3y     s   C b $#C  sCommonwealthofMassachusetts    @ &E&ExecutiveOfficeofEnvironmentalAffairsn#&&Ej#Ԁ&E&MEPAOffice#&&E#l,t   ӌ̌  bl,Cb  #%w C/#C %wԀ#%w C#  %w^#Environmental L| ЀNotificationForm##^##%w # XX %w   C b $$bC#%w XXX# %w&E&TheinformationrequestedonthisformmustbecompletedtobeginMEPAReviewinaccordancewith h theprovisionsoftheMassachusettsEnvironmentalPolicyAct,301CMR11.00.#&&E##%w #  %w B r *q  ddd Xdd Xdd X$$q,: +  ;( l  sKd;?14 <DL!T$?XXX|&XXXX|&X&XX| ProjectName: M:"   sK d (M Street:," B r  (   ,*O !  d d: %%O,4,D+  7( 2 b  8d7Municipality: @-j d d@Watershed: O@"j  8 d 8dOUniversalTranverseMercatorCoordinates: @- d d@Latitude:Longitude: O@"  8 d 8dOEstimatedcommencementdate: @- d d@Estimatedcompletiondate: VE'  8 d 8dVApproximatecost: @-d d@Statusofprojectdesign:I(&XX|%completeX|&X(I2(& 8  d 2*`"#  d d4D !%%`,: +  ;(  sd;Proponent: D1"Eu s d (DStreet:," ] (   ,*O$%  d d: "#%%O,4,D4, 4+  7( M} 8d7Municipality: 6'd 6State: :' d:ZipCode:2(& 8 d 2*q&'  d d4D4 4$%%%q,: +  ;( u sd;NameofContactPersonFromWhomCopiesofthisENFMayBeObtained: M:" s d (M," 0 (   ,*O()  d d: &'%%O,4,D+  7(   8d7Firm/Agency: @-(Xd d@Street:7-+(X 8 d 7*`*+  d d4D()%%`,4,D4, 4+  7( H 8d7Municipality: <-Pd d<State: @-Pd d@ZipCode:2(&P 8 d 2*q,-  d d4D4 4*+%%q, 4,D4,u D+  9( @p 8Kd9B.4 <x(08"XBPhone: >-x d d> H.p x(08"XxXH Fax: @-x!d d@ E14 <DL!T$XEEmail:7-+x" 8K d 7*q./  d d 4D4u D,-%%q,: ZZ+  ," " (, &E&&XX|#&E&&&E # E1t( O =(08"XEDoesthisprojectmeetorexceedamandatoryEIRthreshold(I(&&Esee301CMR11.03&E&(I)?&")&&&E # ( *O01  d d: ZZ./$$O,ZZ,\ ZZ,7ZZ+  ," # (,c@t(4 O =<(08"t( O wXc&E&)&&" ' $3 'f1t( O =(08" t4 O =<Xf% 2 w6C3/Z \ @ H@E  w%2Yes   %  LC  H@ CW4 t( O =(08"t( O wXW% 7 w6C3/Z \ @ H@Ew%7*No&")&&&E & ( *q89  d dZZ\ ZZ7ZZ01 $ $q,: ZZ+  ," & (, LC  HPCf@t4 O =<(08" t( O wXf&E&)&&"HasthisprojectbeenfiledwithMEPAbefore?&")&&&E' ( *O:;  d d: ZZ89$$O,ZZ, ZZ,ZZ+  ," ' (,u@t(4 O =<(08" tX O =<Xu&E&)&&" '(3 'f1t( O =(08" t4 O =<Xfw6C3/Z \ @ H@E  wYes(EOEANo.򀀀)  ) C  HPCw6C3/Z \ @ H@EwNo&")&&&E* ( *q<=  d dZZ ZZZZ:;$$q,: ZZ+  ,"  * (,C  HP Cc@t4 O =<(08"t( O wXc&E&)&&"HasanyprojectonthissitebeenfiledwithMEPAbefore?&")&&&E + ( *O>?  d d: ZZ<=$$O,ZZ, ZZ,ZZ+  ," !+ (,r=t(4 O =(08" tX O =<Xr&E&)&&" '!,3 'c1t( O =(08" t4 O =Xcw6C3/Z \ @ H@E ! !wYes(EOEANo.򀀀)  !- C  HP!Cw6C3/Z \ @ H@E!!wNo&")&&&E!. 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(, C  HP" C&E&)&&"Q.t O =(08"t( O wXQIsthisanExpandedENF(I(&&Esee301CMR11.05(7)&E&(I)requesting:&")&&&E" / ( *OBC  d d: ZZ@A'$'$O,ZZ, ZZ,ZZ+  ," # / (, `@t(4 O =<(08"t O wX`&E&)&&"ԀaSingleEIR?(I(&&Esee301CMR11.06(8)&E&(I)  #!0 f1t( O =(08" t4 O =<Xfw6C3/Z \ @ H@E##wYes  #!1 C  HP#!Cw6C3/Z \ @ H@E## wNo&")&&&E 1'#!2 ( (1C  HP$"Cc@t(4 O =<(08"t( O wXc&E&)&&"ԀaSpecialReviewProcedure?(I(&&Esee301CMR11.09&E&(I)  $"3 f1t( O =(08" t4 O =<Xfw6C3/Z \ @ H@E$$ wYes  $"4 C  HP$"Cw6C3/Z \ @ H@E$$ wNo&")&&&E 1'$"5 ( (1C  HP%#Cc@t(4 O =<(08"t( O wXc&E&)&&"ԀaWaiverofmandatoryEIR?(I(&&Esee301CMR11.11&E&(I)  %#6 f1t( O =(08" t4 O =<Xfw6C3/Z \ @ H@E%% wYes  %#7 C  HP%# Cw6C3/Z \ @ H@E%% wNo&")&&&E 1'%#8 ( (1C  HP&$ Cc@t(4 O =<(08"t( O wXc&E&)&&"ԀaPhaseIWaiver?(I(&&Esee301CMR11.11&E&(I)  &$9 f1t( O =(08" t4 O =<Xfw6C3/Z \ @ H@E&&wYes  &$: C  HP&$ Cw6C3/Z \ @ H@E&&wNo&")&&&E&$; (  C  H@(% C&E&)&&"IdentifyanyfinancialassistanceorlandtransferfromanagencyoftheCommonwealth,includingtheagencynameandtheamountoffundingorlandarea(inacres):򀀀 })&= Ѐ W*'> Areyourequestingcoordinatedreviewwithanyotherfederal,state,regional,orlocalagency?πw6C3/Z \ @ H@E, ,wYes(Specify_________________________)w6C3/Z \ @ H@ES,S ,wNo  ,;)@ ListLocalorFederalPermitsandApprovals:򀀀 -*B Ѐ0 !(#t( O wX0X|&X&&EXu*X&XX|XX*XXu  X|&XXXt?  t?;@݌ s/,D Ќ0t( O wX!(#0&E&&XX|&E&&&E  WhichENForEIRreviewthreshold(s)doestheprojectmeetorexceed(I(&&Esee301CMR11.03&E&(I):  0 !(#t( O wX0X|&X&&EXX&XX|  A  AAB݌0t( O wX!(#0&")&XX&E&)&&"  *qFG  d dZZ ZZZZBC$$q, ZZ,ZZ,ZZ+  ,"  (,T14 <DL!T$t( O wXT% H w6C3/Z \ @ H@Eeew%H>DԀLand   C  HP Cw6C3/Z \ @ H@E[[w߀RareSpecies   C  HPCw6C3/Z \ @ H@Ew߀Wetlands,Waterways,&Tidelands&")&&&E 1' ( (1C  HPC&E&)&&"% I w6C3/Z \ @ H@Eeew%IhGԀWater   C  HPCw6C3/Z \ @ H@E[[w߀Wastewater   C  HPCw6C3/Z \ @ H@Ew߀Transportation&")&&&E 1' ( (1C  HPC&E&)&&"w6C3/Z \ @ H@Eeew߀Energy    C  HPCw6C3/Z \ @ H@E[[w߀Air    C  HPCw6C3/Z \ @ H@Ew߀Solid&HazardousWaste&")&&&E 1'  ( (1C  HPCH4,Z b  jr"z*"XH&E&)&&"% J w6C3/Z \ @ H@Eeew%JMԀACEC    C  HPCH14 <DL!T$,ZXHw6C3/Z \ @ H@E[[w߀Regulations    C  HPCw6C3/Z \ @ H@Ew߀Historical&Archaeological  C  H@CӀResources &")&&&E (  *qKL d d ZZZZZZFG$$q, |\,e\\,\\,\\,\|+  ;MM( f  wXd; 8B.7p x(08"XBXX)&&"X|&XXXSummaryofProjectSize    48&EnvironmentalImpacts IM6% "MMd dI q=4  B+ S` hp x (#7XBI(&XX|I((I    S    X|&X(IExistingSqT VT 4q=ӌ @M- Md d@Ќ  $ 7XS` X$X|&X&XX|X|&X&XX|    E.7p x(08"7XE Change IM6% "Md dI Total  IMM6% "Md dI StatePermits&     Approvals @64 " X w MMd @*NO dd |\e\\\\\\\|KL$$,%|\,L|,LL,LL+  GMP2    8dddG LAND  SM@/ ; "MPddd dS&E&&XX|w6C3/Z \ @ H@E1 1 wb&&EԀOrderofConditions#&E&bY# 1' ; Md 1C  HP ; C   ;   ;  8 *QR dd%|\L|LLLLNO$$, |\,e\\,\\,\\,L|+  ;M(  ;  8d;Totalsiteacreage I6%C s Md dI UP@%C s d dddU _PJ/C s Pddd ddd_ MM:/C s Pddd Mw6C3/Z \ @ H@E1E 15 wb&&EԀSupercs% y edingOrderof C s   4C  H@4d CӀConditions#&E&b]# VMC%4d  8 M 8dV JNewacresoflandaltered UP@%Dt !Md dddUI(&&E S@/Dt "Pddd dS UP@%Dt #d dddU MM:/Dt $Pddd M&E&(Ib&&Ew6C3/Z \ @ H@E1F16 w߀Chapter91License#&E&b`# VMC%Dt % 8 M 8dVC  HPf CAcresofimperviousarea C0%f &Md CI(&&E C0f ' dC I6%f (d dI CM0%f )d C&E&(Ib&&Ew6C3/Z \ @ H@E1h1X!w߀401WaterQuality f *  JC  H@gCӀCertification#&E&bc# VMC%g+ 8 M 8dV JSquarefeetofnewbordering w, vegetatedwetlandsalteration UP@%Q-Md dddUI(&&E S@/w.Pddd dS UP@%w/d dddU MM:/w0Pddd M&E&(Ib&&Ew6C3/Z \ @ H@E1y1i"w߀MHDorMDCAccess w1  JC  H@xCӀPermit#&E&bVg# VMC%x2 8 M 8dV JSquarefeetofnewother 3 wetlandalteration UP@%b4Md dddUI(&&E S@/S6Pddd dS UP@%S8d dddU MM:/S:Pddd M&E&(Ib&&Ew6C3/Z \ @ H@E11z#w߀WaterManagement ;  JC  H@CӀActPermit#&E&bj# VMC%< 8 M 8dV JAcresofnewnonwater = dependentuseoftidelandsorwaterways UP@%=m?Md dddUI(&&E S@/TAPddd dS UP@%TCd dddU MM:/TEPddd M&E&(Ib&&Ew6C3/Z \ @ H@E11{$w߀NewSourceApproval F w6C3/Z \ @ H@E11|%wDEPorMWRA G  JC  H@CӀSewerConnection/̀ExtensionPermit#&E&bkn#," SI 8  M ,*ST dd |\e\\\\\\L|QR$$,%|\,L|,LL,LL+  GMP2 KI 8dddGC  HPS CX|&X&&E STRUCTURES  DM1/SJ"MPddd Db&XX|w6C&3/Z \ @ H@E1U1E&w߀OtherPermits SK #X|&Xbr#b&XX|C  H@K!CӀ(includingLegislative KL #X|&Xbs#/&XX|ԀApprovals#X|&X/it#&E&&XX|)!Specify:#X|&X&&Et# +!MM +  SN SO 8 *UV dd%|\L|LLLLST$$, |\,e\\,\\,\\,L|+  ;M( O 8d;&E&&XX|Grosssquarefootage @-5PMd d@I(&&E @-5Qd d@ @-5Rd d@ :M'5Sd :Ѐ MM:5T 8 M 8dM J&E&(INumberofhousingunits @-'WUMd d@I(&&E @-'WVd d@ @-'WWd d@ :M''WXd :Ѐ MM:'WY 8 M 8dM&E&(IMaximumheight(infeet) @-IyZMd d@I(&&E @-Iy[d d@ @-Iy\d d@ :M'Iy]d :Ѐ," Iy^ 8  M ,*WX dd |\e\\\\\\L|UV$$,%|\,L|,LL,LL+  GMP2 # S^ 8dddGX|&X(I TRANSPORTATION  MM:/[ _"MPddd MЀ +![ `M +  [ a [ b 8 *YZ dd%|\L|LLLLWX$$, |\,e\\,\\,\\,L|+  ;M( [!b 8d;&E&&XX|Vehicletripsperday @-!cMd d@I(&&E :'!dd : :'!e d: :M'!fd :X|&X(IԀ#I(&XX|M# MM:!g 8 M 8dM&E&(IParkingspaces :'"hMd : 4!"i 4 :'"j d: :M'"kd :X|&X&&EԀ#&E&&XX|#," "l 8  M ,*[\ dd |\e\\\\\\L|YZ$$,%|\,L|,LL,LL+  GMP2 # l 8dddGX|&X&&E WASTEWATER  MM:/$3!m"MPddd MЀπ +!$#"oM +  $3!p $3!q 8 *]^ dd%|\L|LLLL[\$$, |\,e\\,\\,\\,L|+  ;M( %##q 8d;&E&&XX|Gallons/day(b&&EGPD&E&b)ofwateruse @-+&[#rMd d@I(&&E @-+&[#sd d@ @-+&[#td d@ 1M+&[#ud 1 MM:+&[#v 8 M 8dM&E&(IGPDwaterwithdrawal I6%M'}$wMd dI @-M'}$xd d@ @-M'}$yd d@ 1MM'}$zd 1 MM:M'}${ 8 M 8dMGPDwastewatergeneration/treatment I6%I)y&}Md dII(&&E @-o(%~d d@ @-o(%d d@ 1Mo(%d 1 IMM6o(% 8 M 8dI&E&(ILengthofwater/sewermains k*' (inmiles) IM6%E+u(MMd dII(&&E @M-k*'Md d@ @M-k*'Md d@ 1MMk*'Md 1," k*' 80  MM ,  H14 <DL!T$7XHX|&X(IX|&X&XX|     b&XX|݌̌ ! 7XX!I(bI((I   b(ICb H14 <DL!T$7XHXXCX|&XXX     b&XX|CONSERVATIONLAND: WilltheprojectinvolvetheconversionofpublicparklandorotherArticle97public P-* naturalresourcestoanypurposenotinaccordancewithArticle97?݌̌ ! 7XX!bbCb    E.7p x(08"7XEbCԀw6C3/Z \ @ H@E/ /'wYes(Specify__________________________________)w6C3/Z \ @ H@E/ /(wNo /I, C  HP"C q=JWillitinvolvethereleaseofanyconservationrestriction,preservationrestriction,agriculturalpreservationrestriction,orwatershedpreservationrestriction? q=H14 <DL!T$7XHӀw6C3/Z \ @ H@E)wYes(Specify__________________________________)w6C3/Z \ @ H@E*wNo  C  H@X#CX &XrX2X&XX    E14 <DL!T$XEX2XXX2X &XXX2            r&XX RARESPECIES: DoestheprojectsiteincludeEstimatedHabitatofRareSpecies,VernalPools,Priority Hx SitesofRareSpecies,orExemplaryNaturalCommunities? x `Ԍ̌  XXX &XrX2X&XX    B.Gp x(08"XB wcXX2rcԀw6C3/Z \ @ H@E--+wYes(Specify__________________________________)w6C3/Z \ @ H@E..,wNo  C  H@$C w   H14 <DL!T$GXHX &XrX &X&XX           w  r&XX HISTORICAL/ARCHAEOLOGICALRESOURCES :Doestheprojectsiteincludeanystructure,siteor h  districtlistedintheStateRegisterofHistoricPlaceortheinventoryofHistoricandArchaeologicalAssetsoftheCommonwealth? wm UԌ̌ ! GXX!rrrr    q=E.7p x(08"GXEӀw6C3/Z \ @ H@E  -wYes(Specify__________________________________)w6C3/Z \ @ H@E  .wNo     q= q=B+ S` hp x (#7XBrrrr  *  Ifyes,doestheprojectinvolveanydemolitionordestructionofanylistedorinventoriedhistoricorarchaeological   resources?*ס q=ӌ̌$ 7XS` X$rrrr   E.Gp x(08"7XE wӀw6C3/Z \ @ H@E-J-:/wYes(Specify___________________________________)w6C3/Z \ @ H@EJ:0wNo Hx   w C  H@@ %CH14 <DL!T$GXH  E14 <DL!T$XEX &XrX &X&XX           }  r&XX AREASOFCRITICALENVIRONMENTALCONCERN: IstheprojectinoradjacenttoanAreaofCritical   EnvironmentalConcern? }p XԌ̌  XXrrrr   B.Gp x(08"XB wӀw6C3/Z \ @ H@E[j[Z1wYes(Specify__________________________________)w6C3/Z \ @ H@E\j\Z2wNo h  w C  H@0`&CH14 <DL!T$GXHX &Xr PROJECTDESCRIPTION&TY&&XX &2)&&&TY:&TY&)&&2 Theprojectdescriptionshouldinclude (a) adescriptionoftheprojectsite,  P  (b) adescriptionofbothonsiteandoffsitealternativesandtheimpactsassociatedwitheach F alternative,and (c) potentialonsiteandoffsitemitigationmeasuresforeachalternative(Youmay   attachoneadditionalpage,ifnecessary.)   w&2)&&&TY _   _8  w$c$W E14 <DL!T$XEX2X)&&2X2XXX2  Wl  X &XXX2LANDSECTION!allproponentsmustfilloutthissectionWl7݌ 8 Ќ  XX&TY&&XX &2)&&&TY  wc)&&2rcI.Thresholds/Permits    w X?+ ` hp x (#X?A.Doestheprojectmeetorexceedanyreviewthresholdsrelatedto land (see301CMR11.03(1)  ___Yes___No;ifyes,specifyeachthreshold:  H  XE14 <DL!T$XE wII.ImpactsandPermits     w X?+ ` hp x (#X?A.Describe,inacres,thecurrentandproposedcharacteroftheprojectsite,asfollows: X-p x (#X- XExisting󀀀Change󀀀Total (#   h  X?+ ` hp x (#X? wXFootprintofbuildings h     ________  ________ x ________ h 0  Roadways,parking,andotherpavedareas  ________  ________ x ________ 0   Otheralteredareas(describe)    ________  ________ x ________     wX XwUndevelopedareas     7 ________  ________  ________    Xw wX XE.4` hp x (#` XE wB.Hasanypartoftheprojectsitebeeninactiveagriculturaluseinthelastthreeyears?  X___Yes___No;ifyes,howmanyacresoflandinagriculturaluse(withagriculturalsoils)willbeconvertedtononagriculturaluse? XK14 <DL!T$4` XK w 4 B.4` hp x (#XB wC.Isanypartoftheprojectsitecurrentlyorproposedtobeinactiveforestryuse?  XC b $$bCӀ___Yes___No;ifyes,pleasedescribecurrentandproposedforestryactivitiesandindicatewhetheranypartofthesiteisthesubjectofaDEMapprovedforestmanagementplan: XK14 <DL!T$4` XK w w X?+ ` hp x (#X?D.DoesanypartoftheprojectinvolveconversionoflandheldfornaturalresourcespurposesinaccordancewithArticle97oftheAmendmentstotheConstitutionoftheCommonwealthtoanypurposenotinaccordancewithArticle97?___Yes___No;ifyes,describe: XE14 <DL!T$XE w w X?+ ` hp x (#X?E.Isanypartoftheprojectsitecurrentlysubjecttoaconservationrestriction,preservationrestriction,agriculturalpreservationrestrictionorwatershedpreservationrestriction?__Yes___No;ifyes,doestheprojectinvolvethereleaseormodificationofsuchrestriction?___Yes___No;ifyes,describe: XE14 <DL!T$XE w w X?+ ` hp x (#X?F.DoestheprojectrequireapprovalofanewurbanredevelopmentprojectorafundamentalchangeinanexistingurbanredevelopmentprojectunderM.G.L.c.121A?___Yes___No;ifyes,describe: XE14 <DL!T$XE w w X?+ ` hp x (#X?G.DoestheprojectrequireapprovalofanewurbanrenewalplanoramajormodificationofanexistingurbanrenewalplanunderM.G.L.c.121B?Yes___No___;ifyes,describe: XE14 <DL!T$XE w w X?+ ` hp x (#X?H.Describetheproject'sstormwaterimpactsand,ifapplicable,measuresthattheprojectwilltaketocomplywiththestandardsfoundinDEP'sStormwaterManagementPolicy: X E14 <DL!T$XE X ?+ ` hp x (#X?I.IstheprojectsitecurrentlybeingregulatedunderM.G.L.c.21EortheMassachusettsContingencyPlan?Yes___No___;ifyes,whatistheReleaseTrackingNumber(RTN)? X?+ ` hp x (#X? XB+ ` hp x (#` XBJ.IftheprojectissiteiswithintheChicopeeorNashuawatershed,isitwithintheQuabbin,Ware,orWachusettsubwatershed?___Yes___No;ifyes,istheprojectsitesubjecttoregulationundertheWatershedProtectionAct?___Yes___No XE14 <DL!T$XE w 4 w X?+ ` hp x (#X?C b $$bCK.Describetheprojectsotherimpactsonland: X?+ ` hp x (#X?  H14 <DL!T$` XH ?+ ` hp x (#X? X   H1` hp x (#` XH rrcr      rc 󀀀 III. . Consistency   -)5  ӌ .X*6 Ќ X rrrr$ $  cr X  XX K1` hp x (#XK cccc   Q  H.` hp x (#XHrcԀA.Identifythecurrentmunicipalcomprehensivelanduseplanandtheopenspaceplananddescribe 8 theconsistencyoftheprojectanditsimpactswiththatplan(s):E.X` hp x (#XE Q;ݹ ӌ̌ XX rrcr  rcB.IdentifythecurrentRegionalPolicyPlanoftheapplicableRegionalPlanningAgencyanddescribe X theconsistencyoftheprojectanditsimpactswiththatplan:H.X` hp x (#X` XHE+ ` hp x (#X` XE  XӀC.Willtheprojectrequireanyapprovalsunderthelocalzoningbylaworordinance(i.e.textormapamendment,specialpermit,orvariance)?Yes___No___;ifyes,describe:   x ̀ D.Willtheprojectrequirelocalsiteplanorprojectimpactreview? @     C b $$bC  ___Yes___No;ifyes,describe: wH4JR Z bj #XHK4JR Z bj #JXKW H14 <DL!T$JXHX &XrX2X&XX    W\  X &XXX2RARESPECIESSECTION#X2X&XX L#W\*݌ `(  Ќ ! JXX!cXX2rc  I.Thresholds/Permits w XE.` hp x (#JXEA.Willtheprojectmeetorexceedanyreviewthresholdsrelatedto rarespeciesorhabitat (see301   CMR11.03(2))?___Yes___No;ifyes,specify,inquantitativeterms: X w w   B.Doestheprojectrequireanystatepermitsrelatedto rarespeciesorhabitat ?___Yes___No  8  X C.Ifyouanswered"No"tobothquestionsAandB,proceedtothe Wetlands,Waterways,and  TidelandsSection .Ifyouanswered"Yes"toeitherquestionAorquestionB,fillouttheremainder X oftheRareSpeciessectionbelow.  X   X wII.ImpactsandPermits    w XA.DoestheprojectsitefallwithinPriorityorEstimatedHabitatinthecurrentMassachusettsNaturalHeritageAtlas(attachrelevantpage)?___Yes___No.Ifyes, XB+ ` hp x (#XB1.WhichrarespeciesareknowntooccurwithinthePriorityorEstimatedHabitat(contact:EnvironmentalReview,NaturalHeritageandEndangeredSpeciesProgram,Route135,Westborough,MA01581,allowing30daysforreceiptofinformation):2.Haveyousurveyedthesiteforrarespecies?___Yes___No;ifyes,pleaseincludetheresultsofyoursurvey.3.IfyourprojectiswithinEstimatedHabitat,haveyoufiledaNoticeofIntentorreceivedanOrderofConditionsforthisproject?___Yes___No;ifyes,didyousendacopyoftheNoticeofIntenttotheNaturalHeritageandEndangeredSpeciesProgram,inaccordancewiththeWetlandsProtectionActregulations?___Yes___No  w w XE.` hp x (#` XEB.Willtheproject"take"anendangered,threatened,and/orspeciesofspecialconcerninaccordancewithM.G.L.c.131A(seealso321CMR10.04)?___Yes___No;ifyes,describe: X w w XC.Willtheprojectalter"significanthabitat"asdesignatedbytheMassachusettsDivisionofFisheriesandWildlifeinaccordancewithM.G.L.c.131A(seealso321CMR10.30)?___Yes___No;ifyes,describe: X w w XD.Describetheproject'sotherimpactsonrarespeciesincludingindirectimpacts(forexample,stormwaterrunoffintoawetlandknowntocontainrarespeciesorlightingimpactsonraremothhabitat): X w wW H14 <DL!T$XHX &XrX2X&XX    WN  H4JR Z bj #XHX &XXX2WETLANDS,WATERWAYS,ANDTIDELANDSSECTIONWN݌ 8,(3 Ќ $ XJX$r&XX rr   w I.Thresholds/Permits  -)5  w XE.` hp x (#XEA.Willtheprojectmeetorexceedanyreviewthresholdsrelatedto wetlands,waterways,and .*6 tidelands (see301CMR11.03(3))?___Yes___No;ifyes,specify,inquantitativeterms: 8  X w w X B.Doestheprojectrequireanystatepermits(oralocalOrderofConditions)relatedto wetlands,  waterways,ortidelands ?___Yes___No;ifyes,specify whichpermit:  X  X w"fg" X wC.Ifyouanswered"No"tobothquestionsAandB,proceedtothe WaterSupplySection .Ifyou   answered"Yes"toeitherquestionAorquestionB,fillouttheremainderoftheWetlands,Waterways,  andTidelandsSectionbelow.   x  XII.WetlandsImpactsandPermits  @    XA.Describeanywetlandresourceareascurrentlyexistingontheprojectsiteandindicatethemonthesiteplan: X w w XB.Estimatetheextentandtypeofimpactthattheprojectwillhaveonwetlandresources,andindicatewhethertheimpactsaretemporaryorpermanent: X wCoastalWetlands    h   Area(insquarefeet)orLength(inlinearfeet)   LandUndertheOcean   h   _____________________________________ H  DesignatedPortAreas   h   _____________________________________ H CoastalBeaches    h   _____________________________________  CoastalDunes    h   _____________________________________  BarrierBeaches    h   _____________________________________ h CoastalBanks    h   _____________________________________ h0 RockyIntertidalShores   h   _____________________________________ 0 SaltMarshes    h   _____________________________________  LandUnderSaltPonds   h   _____________________________________  LandContainingShellfish   h   _____________________________________ P FishRuns `     h   _____________________________________ P LandSubjecttoCoastalStormFlowage  _____________________________________  InlandWetlands p Bank     _____________________________________ p8 BorderingVegetatedWetlands h   _____________________________________ 8  LandunderWater    h   _____________________________________ ! IsolatedLandSubjecttoFlooding h   _____________________________________ " BorderingLandSubjecttoFlooding  _____________________________________ X# RiverfrontArea    h   _____________________________________ X $  w  C.Isanypartoftheproject w   ` 1.alimitedproject?___Yes___No   ` 2.theconstructionoralterationofadam?___Yes___No;ifyes,describe: w   ` 3.fillorstructureinavelocityzoneorregulatoryfloodway?___Yes___No B+ ` hp x (#XB4.dredgingordisposalofdredgedmaterial?___Yes___No;ifyes,describethevolumeofdredgedmaterialandtheproposeddisposalsite: XE.` hp x (#` XE w 5.adischargetoOutstandingResourceWaters?___Yes___No w XE+ ` hp x (#` XE6.subjecttoawetlandsrestrictionorder?___Yes___No;ifyes,identifythearea(insquarefeet):  ($/ " fg88h`  XE.` hp x (#` XE"# X#D.DoestheprojectrequireaneworamendedOrderofConditionsundertheWetlandsProtectionAct(M.G.L.c.131A)?___Yes___No;ifyes,hasaNoticeofIntentbeenfiledoralocalOrderofConditionsissued?___Yes___No;ifyes,listthedateandDEPfilenumber:______________.WastheOrderofConditionsappealed?___Yes___No.WilltheprojectrequireavariancefromtheWetlandsregulations?___Yes___No. X ẁE.Willtheproject: wE.` hp x (#` XE   ` 1.besubjecttoalocalwetlandsordinanceorbylaw?___Yes___No B.`  hp x (#XB 2  1  .3   alteranyfederallyprotectedwetlandsnotregulatedunderstateorlocallaw? x @   C b $$bC--؀___Yes___No;ifyes,whatisthearea(ins.f.)? Q4JR Z bj #`  XQ w w XE.` hp x (#JXEF.Describetheproject'sotherimpactsonwetlands(includingnewshadingofwetlandareasorremovaloftreecanopyfromforestedwetlands): X w III.WaterwaysandTidelandsImpactsandPermits w XE.X` hp x (#XE A.Isanypartoftheprojectsitewaterwaysortidelands(includingfilledformertidelands)thatare   subjecttotheWaterwaysAct,M.G.L.c.91?___Yes___No;ifyes,isthereacurrentChapter91licenseorpermitaffectingtheprojectsite? ___Yes___No;ifyes,listthedateandnumber: H   XK4JR Z bj #XXK w  w2  A  .3   & DoestheprojectrequireanewormodifiedlicenseunderM.G.L.c.91?___Yes___No;ifyes,  howmanyacresoftheprojectsitesubjecttoM.G.L.c.91willbefornonwaterdependentuse?  XC b $$bC-- R Current ___Change___Total___ h E.` hp x (#JXE w w X' ,X` X'  C.Isanypartoftheproject h  0  B+ ` hp x (#,XB1.aroadway,bridge,orutilitylinetooronabarrierbeach?___Yes ______No;ifyes,  describe:2.dredgingordisposalofdredgedmaterial?___Yes___No;ifyes,volumeofdredgedmaterial______3.asolidfill,pilesupported,orbottomanchoredstructureinflowedtidelandsorotherwaterways?___Yes___No;ifyes,whatisthebasearea?_______ $ ,` X` X$ ` 4.withinaDesignatedPortArea?___Yes___No w$ , X,` X$$ ,X,` X$     ', X,` X'  *, X,` X* !  !D.Describetheproject'sotherimpactsonwaterwaysandtidelands: IV.Consistency : "  w XK.` hp x (#, XKA.IstheprojectlocatedwithintheCoastalZone?___Yes___No;ifyes,describetheproject'sconsistencywithpoliciesoftheOfficeofCoastalZoneManagement: X w w XB.IstheprojectlocatedwithinanareasubjecttoaMunicipalHarborPlan?___Yes___No;ifyes,identifytheMunicipalHarborPlananddescribetheproject'sconsistencywiththatplan: X w wW H14 <DL!T$XHX &XrX2X&XX    W  H4JR Z bj #XH#X2XXX2#X &XXX2WATERSUPPLYSECTIONW}݌ % * Ќ $ XJX$r&XX rr   w I.Thresholds/Permits &",  w XE.` hp x (#XE A. Willtheprojectmeetorexceedanyreviewthresholdsrelatedto watersupply (see301CMR 'P#- 11.03(4))?___Yes___No;ifyes,specify,inquantitativeterms: X w w XB.Doestheprojectrequireanystatepermitsrelatedto watersupply ?___Yes___No;ifyes, )%0 specify whichpermit: *p&1  X w w XC.Ifyouanswered"No"tobothquestionsAandB,proceedtothe WastewaterSection .Ifyou 8,(3 answered"Yes"toeitherquestionAorquestionB,fillouttheremainderoftheWaterSupplySection -(4 below.&& .X*6  X w II.ImpactsandPermits 8  w XE.X` hp x (#XE A.Describe,ingallons/day,thevolumeandsourceofwateruseforexistingandproposedactivities  attheprojectsite:   h        XK4JR Z bj #XXK w*  * R ' R '    Z     Existing  +  +Change j , ,Total  #  X @ij@  Withdrawalfromgroundwater    ________  ________ j ________ X   XE.` hp x (#JXEWithdrawalfromsurfacewater    ________  ________ x ________   Interbasintransfer   h     ________  ________ x ________  77Municipalorregionalwatersupply     ________  ________ x ________   x  wH.X` hp x (#` XH B.Ifthesourceisamunicipalorregionalsupply,hasthemunicipalityorregionindicatedthatthereis @   adequatecapacityinthesystemtoaccommodatetheproject?___Yes___No X    C.Iftheprojectinvolvesaneworexpandedwithdrawalfromagroundwaterorsurfacewatersource, w   ` 1.haveyousubmittedapermitapplication?___Yes___No;ifyes,attachtheapplication   ` 2.haveyouconductedapumptest?___Yes___No;ifyes,attachthepumptestreport w XD.Whatisthecurrentlypermittedwithdrawalattheproposedwatersupplysource(ingallons/day)?π򀀀Willtheprojectrequireanincreaseinthatwithdrawal?___Yes___No H  XK4JR Z bj #XXK w w XE.X` hp x (#JXEE.Doestheprojectsitecurrentlycontainawatersupplywell,adrinkingwatertreatmentfacility,watermain,orotherwatersupplyfacility,orwilltheprojectinvolveconstructionofanewfacility?___Yes___No.Ifyes,describeexistingandproposedwatersupplyfacilitiesattheprojectsite: (#  h0  XK4JR Z bj #XXK w   R 8 8    Z   9  9::Existing  :  :;;Change j ; ;Total  #     Watersupplywell(s)(capacity,ingpd)    ________  ________ j ________    Drinkingwatertreatmentplant(capacity,ingpd)  ________  ________ j ________ P  w  Watermains(length,inmiles) Z     ________  ________ j ________ P  XE.X` hp x (#JXEF.Iftheprojectinvolvesanyinterbasintransferofwater,whichbasinsareinvolved,whatisthedirectionofthetransfer,andistheinterbasintransferexistingorproposed? XK4JR Z bj #XXK w w  G.Doestheprojectinvolve w   R 1.newwaterservicebyastateagencytoamunicipalityorwaterdistrict?___Yes___No E.`  hp x (#JXE w2  1  .3   < aWatershedProtectionActvariance?___Yes___No;ifyes,how " manyacresof  C b $$bC--؀alteration?H+ ` hp x (#`  XH3.anonbridgedstreamcrossing1,000orlessfeetupstreamofapublicsurfacedrinkingwatersupplyforpurposeofforestharvestingactivities?___Yes___No K4JR Z bj #` XK w w XE.` hp x (#JXEH.Describetheproject'sotherimpacts(includingindirectimpacts)onwaterresources,quality,facilitiesandservices: X w III.Consistency 󀄄Describetheproject'sconsistencywithwaterconservationplansorotherplansto< %!+ <==??> ,K4` hp x (#XK w2  A  .3      >enhancewaterresources,quality,facilitiesandservices:> , w>C b $$bC>--> wW H14 <DL!T$XHX &XrX2X&XX    W!  H4JR Z bj #XH#X2XXX2#X &XXX2WASTEWATERSECTIONW!"݌ ($/ Ќ $ XJX$r&XX rr   w I.Thresholds/Permits  *p&1  w XE.` hp x (#XEA.Willtheprojectmeetorexceedanyreviewthresholdsrelatedto wastewater (see301CMR p+8'2 11.03(5))?___Yes___No;ifyes,specify,inquantitativeterms:  8,(3  X w w XB.Doestheprojectrequireanystatepermitsrelatedto wastewater ?___Yes___No;ifyes, -)5 ? i j 88k  ?> i j 88k   i j 88k   i j 88k   i j 88k   i j 88k   i j 88k  >= i j 88k  =; i j 88k   i j 88k  ;: i j 88k   i j 88k  :9 i j 88k  98 i j 88k  87 i j  8   k  7specify whichpermit: .X*6 @ i j 88k  X w@@ w X@C.Ifyouanswered"No"tobothquestionsAandB,proceedtothe TransportationTraffic 8 GenerationSection .Ifyouanswered"Yes"toeitherquestionAorquestionB,fillouttheremainder  oftheWastewaterSectionbelow. X w II.ImpactsandPermits  X   w XE.X` hp x (#XEA.Describe,ingallons/day,thevolumeanddisposalofwastewatergenerationforexistingandproposedactivitiesattheprojectsite(calculateaccordingto310CMR15.00): x   (#    ` EEE.X` hp x (#XXEӹ w XN4JR Z bj #X` XN  A R A R     Z B  B  Existing  C  CChange j D DTotal  #  @   Dischargetogroundwater(Title5) Z     ________  ________ j ________    Dischargetogroundwater(nonTitle5)    ________  ________ j ________     wӀDischargetooutstandingresourcewater    ________  ________ j ________  `  ЀDischargetosurfacewater Z     ________  ________ j ________ `(   wMunicipalorregionalwastewaterfacility     ________  ________ j ________  (    TOTAL  R     Z     ________  ________ j ________     wH1XR Z bj #JXH JE.X` hp x (#XXEJ I IFBFG2  A  .3  GH.HI I & Istheresufficientcapacityintheexistingcollectionsystemtoaccommodatetheproject? H   E.X` hp x (#XXEC b $$bCG--G___Yes___No;ifno,describewherecapacitywillbefound: X w wH.X` hp x (#X` XHC.Istheresufficientexistingcapacityattheproposedwastewaterdisposalfacility?___Yes___No;πifno,describehowcapacitywillbeincreased:E.X` hp x (#XXE w wH.X` hp x (#X` XHD.Doestheprojectsitecurrentlycontainawastewatertreatmentfacility,sewermain,orotherwastewaterdisposalfacility,orwilltheprojectinvolveconstructionofanewfacility?___Yes___No.Ifyes,describeasfollows: P  XK4JR Z bj #XXK w   R K K    Z L  L  Existing  M  MChange j N NTotal  #  P Wastewatertreatmentplant(capacity,ingpd)  ________  ________ j ________   wӀSewermains(length,inmiles) Z     ________  ________ j ________   wTitle5systems(capacity,ingpd) Z     ________  ________ j ________ p  w XE.X` hp x (#JXEE.Iftheprojectinvolvesanyinterbasintransferofwastewater,whichbasinsareinvolved,whatisthedirectionofthetransfer,andistheinterbasintransferexistingorproposed? XK4JR Z bj #XXK w w XF.DoestheprojectinvolvenewsewerservicebyanAgencyoftheCommonwealthtoamunicipalityorsewerdistrict?___Yes___No X w w XG.Isthereanycurrentorproposedfacilityattheprojectsiteforthestorage,treatment,processing,combustionordisposalofsewagesludge,sludgeash,grit,screenings,orothersewageresidualmaterials?___Yes___No;ifyes,whatisthecapacity(intonsperday): X w   R     Z     Existing  O  OChange j P PTotal  #  $l * Storage R     Z     ________  ________ j ________ l%4!+ Treatment,processing   Z     ________  ________ j ________ 4&!, Combustion    Z     ________  ________ j ________ &"- Disposal R     Z     ________  ________ j ________ '#.  w XH.Describetheproject'sotherimpacts(includingindirectimpacts)onwastewatergenerationandtreatmentfacilities: X wQQR% ` R  .*7 III.Consistency 󀄄Describemeasuresthattheproponentwilltaketocomplywithfederal,state, 8 regional,andlocalplansandpoliciesrelatedtowastewatermanagement: w XA.Iftheprojectrequiresasewerextensionpermit,isthatextensionincludedinacomprehensivewastewatermanagementplan?___Yes___No;ifyes,indicatetheEOEAnumberfortheplananddescribetherelationshipoftheprojecttotheplan X w wW H14 <DL!T$JXHX &XrX2X&XX    W8G  H4JR Z bj #XH#X2XXX2T##X &XXX2TRANSPORTATIONTRAFFICGENERATIONSECTIONW8GH݌  x Ќ $ JXJX$r&XX rr  #crH# wrc I.Thresholds/Permits h 0  ^DE^ XE.` hp x (#JXE A.Willtheprojectmeetorexceedanyreviewthresholdsrelatedto trafficgeneration (see301 0   CMR11.03(6))?___Yes___No;ifyes,specify,inquantitativeterms: X XB.Doestheprojectrequireanystatepermitsrelatedto statecontrolledroadways ?___Yes P  ___No;ifyes,specify whichpermit: P   X XC.Ifyouanswered"No"tobothquestionsAandB,proceedtothe RoadwaysandOther   TransportationFacilitiesSection .Ifyouanswered"Yes"toeitherquestionAorquestionB,fillout p  theremainderoftheTrafficGenerationSectionbelow. X II.TrafficImpactsandPermits   A.Describeexistingandproposedvehiculartrafficgeneratedbyactivitiesattheprojectsite: w   `     h     Existing  Change x Total  (#  X  wNumberofparkingspaces   h     _______  ________ x _______ X   XNumberofvehicletripsperday    ________  ________ x ________    XITELandUseCode(s): XB.Whatistheestimatedaveragedailytrafficonroadwaysservingthesite? XV B( / hp x (#` XBVYYRoadwayYYVV `    Z h Z[[Existing  [ p [Change  \  \Total   wV VU /  / U1.____________________   h ________  ________  ________  W    W2.____________________   h ________  ________  ________ ` X    X3.____________________   h ________  ________  ________ `(   w XH.` hp x (#` XHC.Describehowtheprojectwillaffecttransit,pedestrianandbicycletransportationfacilitiesandservices: X III.Consistency 󀄄Describemeasuresthattheproponentwilltaketocomplywithmunicipal,regional, "& state,andfederalplansandpoliciesrelatedtotraffic,transit,pedestrianandbicycletransportationfacilitiesandservices: wW K14 <DL!T$` XKX &XrX2X&XX   WU  H4JR Z bj #XH#X2XXX2I#X &XXX2ROADWAYSANDOTHERTRANSPORTATIONFACILITIESSECTIONWUV݌ 0% * Ќ '` XJX'r&XX rr  #crVW# wrcI.Thresholds  &",  w XH.` hp x (#` XHӀA.Willtheprojectmeetorexceedanyreviewthresholdsrelatedto roadwaysorother 'x#- transportationfacilities (see301CMR11.03(6))?___Yes___No;ifyes,specify,inquantitative x(@$. terms:  @)%/  X w w X B.Doestheprojectrequireanystatepermitsrelatedto roadwaysorothertransportation *&1 facilities ?___Yes___No;ifyes,specify whichpermit: +`'2 U D E 88d  UC.Ifyouanswered"No"tobothquestionsAandB,proceedtothe EnergySection .Ifyou `,((3 V D E 88d   D E  8   d  Vanswered"Yes"toeitherquestionAorquestionB,fillouttheremainderoftheRoadwaysSection (-(4 below.]] .*6 ^ D E 88d  ^V D E  8   d  V X w II.TransportationFacilityImpacts  8 ] D E 88d  ]  A.Describeexistingandproposedtransportationfacilitiesattheprojectsite:  _ ` _ `     h   `  ` p aaExistingaa  b x bChange c (# cTotal (#     oeso XE.` hp x (#XELength(inlinearfeet)ofneworwidenedroadway p ________  ________ ________ X  fe efggWidth(infeet)ofneworwidenedroadway   p ________  ________ ________   X  Othertransportationfacilities: w  B.Willtheprojectinvolveany w   ` 1.Alterationofbankorterrain(inlinearfeet)? p   ____________       ` 2.Cuttingoflivingpublicshadetrees(number)?  ____________  `     ` 3.Eliminationofstonewall(inlinearfeet)? p   ____________ `(   III.Consistency Describetheproject'sconsistencywithotherfederal,state,regional,andlocalplans   andpoliciesrelatedtotraffic,transit,pedestrianandbicycletransportationfacilitiesandservices,includingconsistencywiththeapplicableregionaltransportationplanandtheTransportationImprovementsPlan(TIP),theStateBicyclePlan,andtheStatePedestrianPlan: wW K14 <DL!T$` XKX &XrX2X&XX   We  H4JR Z bj #XH#X2XXX2X#X &XXX2ENERGYSECTIONWef݌ h0 Ќ '` XJX'r&XX rr  #cr=g# wrc I.Thresholds/Permits     w XH.` hp x (#` XHA.Willtheprojectmeetorexceedanyreviewthresholdsrelatedto energy (see301CMR11.03(7))?  ___Yes___No;ifyes,specify,inquantitativeterms: X w w X B.Doestheprojectrequireanystatepermitsrelatedto energy ?___Yes___No;ifyes,specify  @  whichpermit:   X w w XC.Ifyouanswered"No"tobothquestionsAandB,proceedtothe AirQualitySection .Ifyou ` answered"Yes"toeitherquestionAorquestionB,fillouttheremainderoftheEnergySectionbelow. `(   X w II.ImpactsandPermits  #   A.Describeexistingandproposedenergygenerationandtransmissionfacilitiesattheprojectsite:   `     h      p Existingh  h  Change i (# iTotal (#  H!%   Capacityofelectricgeneratingfacility(megawatts) p ________  ________ ________ "&  w  Lengthoffuelline(inmiles) h      p ________  ________ ________ "'   Lengthoftransmissionlines(inmiles)     p ________  ________ ________ #h(  w  Capacityoftransmissionlines(inkilovolts)   p ________  ________ ________ h$0 )   B.Iftheprojectinvolvesconstructionorexpansionofanelectricgeneratingfacility,whatare   ` 1.thefacility'scurrentandproposedfuelsource(s)? B+ ` hp x (#XB wl2lm2  1  .3  mj < jkknnthefacility'scurrentandproposedcoolingsource(s)?  C b $$bCm--mouvo XE.X` hp x (#` XEC.Iftheprojectinvolvesconstructionofanelectricaltransmissionline,willitbelocatedonanew,unused,orabandonedrightofway?___Yes___No;ifyes,pleasedescribe: XK4JR Z bj #XXK w w  D.Describetheproject'sotherimpactsonenergyfacilitiesandservices: w III.Consistency 󀄄Describetheproject'sconsistencywithstate,municipal,regional,andfederalplans -(4 andpoliciesforenhancingenergyfacilitiesandservices:i#e s u v #88t88wt  i .X*6 o#e s u v #88t88wt  чopp wW H14 <DL!T$JXHX &XrX2X&XX    Wv  H4JR Z bj #XH#X2XXX2oh#X &XXX2AIRQUALITYSECTIONWvw݌  Ќ $ JXJX$r&XX rr  #cr$x# wrc I.Thresholds  n u v 88wt  n w XE.` hp x (#JXE A.Willtheprojectmeetorexceedanyreviewthresholdsrelatedto airquality (see301CMR H 11.03(8))?___Yes___No;ifyes,specify,inquantitativeterms: X w  wqBqr2  A  .3  rs.st tuuDoestheprojectrequireanystatepermitsrelatedto airquality ?___Yes___No;ifyes,specify     whichpermit:  h   XC b $$bCr--rC.Ifyouanswered"No"tobothquestionsAandB,proceedtothe SolidandHazardousWaste 0   Section .Ifyouanswered"Yes"toeitherquestionAorquestionB,fillouttheremainderoftheAir    QualitySectionbelow. X w II.ImpactsandPermits P   w X A.Doestheprojectinvolveconstructionormodificationofamajorstationarysource(see310CMR   7.00,AppendixA)?___Yes___No;ifyes,describeexistingandproposedemissions(intonsperday)of: X w  v ` v `     h w  w  Existing  x  xChange x y yTotal 8 Particulatematter    h     ________  ________ x ________  Carbonmonoxide    h     ________  ________ x ________ X Sulfurdioxide    h     ________  ________ x ________ X  Volatileorganiccompounds h     ________  ________ x ________   Oxidesofnitrogen    h     ________  ________ x ________  Lead `     h     ________  ________ x ________ x Anyhazardousairpollutant h     ________  ________ x ________ x@ Carbondioxide    h     ________  ________ x ________ @  w  B.Describetheproject'sotherimpactsonairresourcesandairquality,includingnoiseimpacts: w III.Consistency  `(    A.Describetheproject'sconsistencywiththeStateImplementationPlan: w XB.Describemeasuresthattheproponentwilltaketocomplywithotherfederal,state,regional,andlocalplansandpoliciesrelatedtoairresourcesandairquality: X wzzW H14 <DL!T$XHX &XrX2X&XX    W   #X2XXX2Sy#X &XXX2SOLIDANDHAZARDOUSWASTESECTIONW ڇ݌ "& Ќ ! XX!r&XX rr  #cr#rc I.Thresholds/Permits  #(  w XA.Willtheprojectmeetorexceedanyreviewthresholdsrelatedto solidorhazardouswaste (see $X ) 301CMR11.03(9))?___Yes___No;ifyes,specify,inquantitativeterms: X w w XB+ ` hp x (#XBB.Doestheprojectrequireanystatepermitsrelatedto solidandhazardouswaste ?___Yes___ &", No;ifyes,specify whichpermit: 'x#-  XH4JR Z bj #XH w w XC.Ifyouanswered"No"tobothquestionsAandB,proceedtothe HistoricalandArchaeological @)%/ ResourcesSection .Ifyouanswered"Yes"toeitherquestionAorquestionB,fillouttheremainder *%0 oftheSolidandHazardousWasteSectionbelow. Xx  88  xv  88  v w  .*6 z  88  zII.ImpactsandPermits  8  w XE.X` hp x (#JXEA.Isthereanycurrentorproposedfacilityattheprojectsiteforthestorage,treatment,processing,combustionordisposalofsolidwaste?___Yes___No;ifyes,whatisthevolume(intonsperday)ofthecapacity: XK4JR Z bj #XXK w   R    | Z |  Existing  { b {Change    Total   j  X     R Storage   Z   ________  ________  ________      R Treatment,processing} Z }~  ~________  ________  ________     R Combustion   Z ________  ________  ________  x    R Disposal   Z ________  ________  ________ x @  w XE.X` hp x (#JXEB.Isthereanycurrentorproposedfacilityattheprojectsiteforthestorage,recycling,treatmentordisposalofhazardouswaste?___Yes___No;ifyes,whatisthevolume(intonsorgallonsperday)ofthecapacity: XK4JR Z bj #XXK w   R     Z Existing   b Change    Total   j  (     R Storage   Z   ________  ________  ________      R Recycling   Z ________  ________  ________      R Treatment   Z ________  ________  ________ H     R Disposal   Z ________  ________  ________ H  w XC.Iftheprojectwillgeneratesolidwaste(forexample,duringdemolitionorconstruction),describealternativesconsideredforreuse,recycling,anddisposal: XE.` hp x (#JXE XH.` hp x (#` XHD.Iftheprojectinvolvesdemolition,doanybuildingstobedemolishedcontainasbestos?̀___Yes___NoE.` hp x (#XE w w X  E.Describetheproject'sothersolidandhazardouswasteimpacts(includingindirectimpacts): w III.Consistency DescribemeasuresthattheproponentwilltaketocomplywiththeStateSolidWaste  MasterPlan: wW K14 <DL!T$` XKX &XrX2X&XX   W͛  H4JR Z bj #XH#X2XXX2J#X &XXX2HISTORICALANDARCHAEOLOGICALRESOURCESSECTIONW͛݌ " Ќ '` XJX'r&XX rr  #cr(# wrc I.Thresholds/Impacts   H$  w XH.` hp x (#` XHA.Isanypartoftheprojectsiteahistoricstructure,orastructurewithinahistoricdistrict,ineithercaselistedintheStateRegisterofHistoricPlacesortheInventoryofHistoricandArchaeologicalAssetsoftheCommonwealth?___Yes___No;ifyes,doestheprojectinvolvethedemolitionofalloranyexteriorpartofsuchhistoricstructure?___Yes___No;ifyes,pleasedescribe: X w w XB.IsanypartoftheprojectsiteanarchaeologicalsitelistedintheStateRegisterofHistoricPlacesortheInventoryofHistoricandArchaeologicalAssetsoftheCommonwealth?___Yes___No;ifyes,doestheprojectinvolvethedestructionofalloranypartofsucharchaeologicalsite?___Yes___No;ifyes,pleasedescribe: X w w XC.Ifyouanswered"No"toallpartsofbothquestionsAandB,proceedtothe Attachmentsand )$/ Certifications Sections.Ifyouanswered"Yes"toanypartofeitherquestionAorquestionB,fillout )%0 theremainderoftheHistoricalandArchaeologicalResourcesSectionbelow. X w w XD.HaveyouconsultedwiththeMassachusettsHistoricalCommission?___Yes___No;ifyes,attachcorrespondence X w .X*6  w XE.Describeandassesstheproject'sotherimpacts,directandindirect,onlistedorinventoriedhistoricalandarchaeologicalresources: X w II.Consistency 󀄄Describemeasuresthattheproponentwilltaketocomplywithfederal,state, X  regional,andlocalplansandpoliciesrelatedtopreservinghistoricalandarchaeologicalresources: wX &XrATTACHMENTS:  x @  H1'` hp x (#XH #r&XX 瓦#$ ` ` XX$1.  `  Plan,atanappropriatescale,ofexistingconditionsoftheprojectsiteanditsimmediate h 0  context,showingallknownstructures,roadwaysandparkinglots,railrightsofway,wetlandsandwaterbodies,woodedareas,farmland,steepslopes,publicopenspaces,andmajorutilities.2. `  Planofproposedconditionsuponcompletionofproject(ifconstructionoftheprojectis P  proposedtobephased,thereshouldbeasiteplanshowingconditionsuponthecompletionofeachphase). 3. `  Original U.S.G.S.maporgoodquality color copy(8x11inchesorlarger)indicatingthe   projectlocationandboundariesH1'` hp x (#` ` XH4   ` ListofallagenciesandpersonstowhomtheproponentcirculatedtheENF,inaccordance p8 with301CMR11.16(2).  w-'w'` / X` ` X-5.   ` Other:   w w wQ14 <DL!T$'w'` / XQX &Xr CERTIFICATIONS: g  E1'` hp x (#XE #r&XX =# ! ` ` XX!$`  XX$'`   XX''`   XX'$`  XX$1.  ThePublicNoticeofEnvironmentalReviewhasbeen/willbepublishedinthefollowing W newspapersinaccordancewith301CMR11.15(1):  H.` hp x (#`  XH N (Name)     7     (Date)  #cr{#rc N  /      7 񀀀񀀀񀀀 w? 񀀀