Environmental Review at the Community Level

					                                                                                       CDBG-R Grant Number: __________________

                               Environmental Review at the Community Level
                                      For Categorically Excluded Projects
                                                                      CDBG-R

                                                                  Cover Page
1.Project Name and Location: (City and/or County)                              2.Grantee Name and Mailing Address:




3.Included in ERR packet: (Check if attached – some may not apply)             4. Check one:
    Double-sided ERR with original signature                                      Categorically excluded not subject to 58.5
    Map(s) of project area                                                        Categorically excluded subject to 58.5
    FEMA flood map
    Copy of letter to SHPO
    Copy of letter to THPO(s)
    Noise assessment
    Copy of letter(s) sent to reviewing agencies                               5.Chief Elected Official Signature (not electronic signature or stamp):
    Other:
                                                                               Printed name & title:

                                                                               Date:

6.Project Description: (Briefly describe the project. Include all contemplated actions which logically are either geographically or functionally a composite
part of the project, regardless of the source of funding. [24 CFR 58.32, 40 CFR 1508.25] )




7.Project Activities:                               CDBG-R Funds Budgeted                                Other Funds Budgeted




Total:
8.Preparer Contact Information                                                                           9.Preparer Signature:
Name:
Organization:
Address:
City:
State:
Zip:
Phone:                                                                                                   Date:
E-mail:
10.Comments by Division of Community Assistance Approving Officer:




11.DCA Approving Officer Signature:                                                                                     Date:




                                                                           -1-

                                        See “Environmental Additional Info” at www.nccommerce.com/cdbgforms
                                                                             CDBG-R Grant Number: __________________

Environmental Review Questionnaire
12.Planning
    o Is the project in compliance or conformance with local zoning?
            Yes      No       Not Applicable
        If no or not applicable, explain:


        Source Documentation:

    o   Is the project located within a coastal zone management (CZM)? NOTE: This regulation does not apply to actions involving
        existing single family homes where additional construction will not occur. The CZM authority applies only for new construction,
        conversion, major rehabilitation, and substantial improvement activities.
           Yes      No        Not Applicable (explain in Comments below)
    o   If your answer is YES, please provide an analysis to the Division of Coastal Management of how the proposed
        financial assistance would result in a project (when constructed) that would be consistent with the State’s coastal
        management program.
        Comments:


         Source Documentation:

    o   Is the project in compliance with the North Carolina Air Quality Implementation Plan (SIP)? NOTE: This does not apply to
        construction or replacement of water and/or sewer lines or housing activities without transportation facilities.
           Yes      No       Not Applicable
        Comments:


        Source Documentation:

    o   Are there any unresolved conflicts concerning the use of the site?
            Yes    No
        If your answer is YES, briefly explain,



13.Coastal Barrier Resources
    o Is the project located within a coastal barrier designated on a current FEMA flood map or Department of Interior coastal
       barrier resources map ?
          Yes      No
    o If your answer is YES, the law prohibits Federal funding of project in designated coastal barriers.
       Comments:


       Source Documentation:
14.Flood Management (24 CFR Part 55 ) (see Compliance Factors 3 and 4 of HUD Handbook 1390.2)
    o Is the project located within a floodplain designated on a current FEMA flood map?
          Yes     No
           o Identify FEMA flood map used to make this finding:
                          Community Name and Number:
                          Map Panel Number and Date of Map Panel:

    o   If the site is within a Special Flood Hazard Area (SFHA) and the rehabilitation costs are less 50% of the market value before
        rehabilitation, the floodplain decision making process does not apply. If the site is within a SFHA and the project is either an
        individual action (demo/reconstruction) or rehabilitation with costs that are equal to or exceed 50% of the market value before
        rehabilitation, the documentation must show compliance with 24 CFR § 55.20, which requires two public notices, study of
        alternatives and mitigation - use § 55.12 and the 8-step floodplain management decision making process (§ 55.20) to comply
        with 24 CFR Part 55.
        Comments:


         Source Documentation (attach § 55.20 analysis):




                                                                  -2-

                                  See “Environmental Additional Info” at www.nccommerce.com/cdbgforms
                                                                                CDBG-R Grant Number: __________________

15.Historic Preservation (see Compliance Factors 2 of Handbook 1390.2)
    o Have you notified the State Historic Preservation Office (SHPO) of the project and requested their comments? NOTE: For
    hook-up grants, SHPO only wants to review projects in which mature trees and/or original landscaping elements, such as stone or
    masonry walls, would be damaged or destroyed.
           Yes      No
       If no, please explain why comments are not necessary?

    o   Is the property listed on or eligible for listing on the National Register of Historic Places?
           Yes      No
    o   Is the property located within or directly adjacent to an historic district?
           Yes      No
    o   Does the property’s area of potential effects include an historic district or property?
           Yes      No

    o   If your answer is YES to any of the above questions, you must submit a State Historic Evaluation Form directly to
        SHPO. Please attach copies with your ERR.
        NOTE: For projects with adverse effects (36 CFR § 800.6), the documentation must include a memorandum of agreement
        with the SHPO and, where applicable, Advisory Council on Historic Preservation.

    o   Have you notified the Catawba Indian Nation Tribal Historic Preservation Officer (THPO) of the project and requested their
        comments (for any project involving ground disturbance)?
            Yes      No
    o   If yes, please attach copies of your findings and their response.
        If no, please explain why comments are not necessary?

    o   Have you notified the Eastern Band of Cherokee IndiansTribal Historic Preservation Officer of the project and requested their
        comments (for any project in the 27 western counties involving disturbance of soil not classified as urban soil)?
            Yes      No
    o   If yes, please attach copies of your findings and their response.
        If no, please explain why comments are not necessary?

    o   What kind, if any, site preparation has already been conducted on the site:

    o   Has the area been previously surveyed by an archaeologist?          Yes         No
        If so, give name of principal investigator and date of survey:

    o   What buildings/structures on site now? Please give the structures’ age (abandoned barns, farmhouse, tobacco sheds, bridges
        etc.)


    o   Will any of these structures be demolished? (Indicate which)


    o   Will any of these structures be rehabilitated or renovated? (Indicate which)


    o   Please include photographs of all structures if project activities include rehabilitation, acquisition, clearance or demolition.
        Comments:

        Source Documentation:
16.Noise Abatement (See Compliance Factor 1 of Handbook 1390.2)
    o   Is the project located near a major noise source, e.g., civil airports (within 5 miles), military airfields (15 miles), major highway
        or busy roads (within 1,000 feet), or railroads (within 3,000 feet)? NOTE: The documentation must include a map that shows
        whether the site is within 3,000 feet of a railroad, 1,000 feet of a major highway, or 15 miles or an airport. Use the calculator
        at: http://www.hud.gov/offices/cpd/environment/dnlcalculator.cfm
           Yes       No
    o   If your answer is YES, comply with 24 CFR 51, Subpart B, which requires a noise assessment for proposed new
        construction. New construction includes demolition and onsite relocation. Use adopted DNL contours if the noise
        source is an airport. Use the calculator at: http://www.hud.gov/offices/cpd/environment/dnlcalculator.cfm.
        Comments:


        Source Documentation (attach Noise Assessment Guidelines worksheets):


                                                                     -3-

                                    See “Environmental Additional Info” at www.nccommerce.com/cdbgforms
                                                                               CDBG-R Grant Number: __________________

17.Hazardous Industrial Operations (See Compliance Factor 5 of Handbook 1390.2)
    o   Are industrial facilities handling explosive or fire-prone materials such as liquid propane, gasoline or other storage tanks
        adjacent to or visible from the project site?
           Yes       No
    o   If your answer is YES, use HUD Hazards Guide and comply with 24 CFR Part 51, Subpart C. NOTE: This regulation
        does not apply to actions involving existing single family homes if the project is not increasing the number of families
        occupying the house – the documentation should state there is no potential increase in occupancy so compliance with this
        part is not required (24 CFR § 51.200).
        Comments:

    o   Source Documentation (attach Acceptable Separation Distance worksheets):
18.Airport Hazards (See Compliance Factor 5 of Handbook 1390.2)
    o   Is the project within 3,000 feet from the end of a runway at a civil airport?
           Yes      No
    o   Is the project within 2 ½ miles from the end of a runway at a military airfield?
           Yes      No

    o   If your answer is YES to either of the above questions, comply with 24 CFR Part 51, Subpart D . NOTE: If the site is
        within an airport clear zone or accident potential zone funding is discouraged for major rehab. The Part 58 Certifying Official
        may allow the acquisition and minor rehabilitation project (24 CFR § 51.304) but the occupant must sign the special
        notification form that advises the occupant of the risk involved in living in an airport clear zone or accident potential zone (24
        CFR § 51.303[a][3]).
        Comments:


        Source Documentation:
19.Protection of Wetlands (E.O. 11990) (See Compliance Factors 3 and 4 of Handbook 1390.2)
    o   Are there drainage ways, streams, rivers, or coastlines on or near the site?
          Yes       No

    o   Are there ponds, marshes, bogs, swamps, or other wetlands on or near the site?
          Yes      No

    o   For projects proposing new construction and/or filling, the following applies:
        o Is the project located within a wetland designated on a National Wetland Inventory Map of the Department of Interior?
                 Yes            No
    o   If your answer is YES, E.O. 11990 , Protection of Wetlands, discourages Federal funding of new construction or filling
        in wetlands and compliance is required with the wetlands decision-making process (§ 55.20 of 24 CFR Part 55) . Use
        proposed Part 55 published in the Federal Register on January 1, 1990 for wetlands procedures). NOTE: This regulation
        does not apply to actions involving existing single family homes for acquisition, rehabilitation or resale without soil disturbance.
        If the foot print of the building is not expanded and the project involves no other activities that involve soil disturbance – the
        documentation should state there is no soil disturbance so there is no potential for impact to a wetland. If the footprint is
        expanded, the documentation must include a determination if the site could impact a wetland. If wetlands are present
        compliance with the EO is required.
        Comments:

        Source Documentation (attach § 55.20 analysis for new construction and/or filling) :
20.Toxic Chemicals and Radioactive Materials (See Compliance Factor 5 of Handbook 1390.2)
    o   Is the project near an industry disposing of chemicals or hazardous wastes?
           Yes        No
    o   Is the site listed on an EPA Superfund National Priorities or CERCLA or equivalent State list?
           Yes        No
    o   Is the site located within 3,000 feet of a toxic or solid waste landfill site?
           Yes        No
    o   Does the site have an underground storage tank?
           Yes        No

    o   If your answer is YES to any of the above questions, use current techniques by qualified professionals to undertake
        investigations determined necessary and comply with § 50.3 (i) .
        Comments:

        Source Documentation:
21.Endangered Species (See Environmental Factor 3.4 of Handbook 1390.2)
    o   Has the Department of Interior list of Endangered Species and Critical Habitats been reviewed?
          Yes     No
                                                                    -4-

                                   See “Environmental Additional Info” at www.nccommerce.com/cdbgforms
                                                                             CDBG-R Grant Number: __________________


    o   Is the project likely to affect any listed or proposed endangered or threatened species or critical habitats? NOTE: If the foot
        print of the building is not expanded and the project involves no other activities that involve soil disturbance, vegetation
        removal, or unusually loud noise, the documentation should state that a finding of no effect is being made (50 CFR §
        402.13[a]) because there is no potential for impact from single family rehabilitation.
           Yes       No

    o   If your answer is YES, compliance is required with Section 7 of the Endangered Species Act , which mandates
        consultation with the Fish and Wildlife Service in order to preserve the species.
        Comments:


        Source Documentation:
22.Sole Source Aquifers:
    o   Will the proposed project affect a sole source aquifer?
          Yes       No
        Comments: There are no sole source aquifers in North Carolina.


        Source Documentation: http://www.epa.gov/region4/water/groundwater/r4ssa.html
23.Farmlands Protections (See Environmental Factor 3.3 of Handbook 1390.2)
    o   If the site or area is presently being farmed, does the project conform with the Farmland Protection Policy Act and HUD policy
        memo? NOTE: This regulation does not apply to actions involving existing single family homes because it does not involve a
        conversion of land use.
            Yes       No       NA (area not presently being farmed)

    o   If your answer is YES, compliance is required with 7 CFR Part 658, Department of Agriculture regulations
        implementing the Act.
        Comments:


        Source Documentation:
24.Flood Insurance
    o   Is the building located or to be located within a Special Flood Hazard Area identified on a current Flood Insurance Rate Map
        (FIRM)?
           Yes       No

    o   If your answer is YES, flood insurance protection is required for buildings located or to be located within a Special
        Flood Hazard Area as a condition of approval of the project. In addition, compliance with § 55.12 and the floodplain
        management decision making process (§ 55.20) is required (refer to the Flood Management item above).
             o Identify FEMA flood map used to make this finding:
                         Community Name and Number:
                         Map Panel Number and Date of Map Panel:
        Comments:


        Source Documentation:
25.Environmental Justice
    o   Is the project located in a predominantly minority and low-income neighborhood?
           Yes      No

    o   Does this project site or neighborhood suffer from disproportionately adverse environmental effects on minority and low-
        income populations relative to the community-at-large?
           Yes     No

    o   If the answer is YES, compliance is required with E.O. 12898, Federal Actions to Address Environmental Justice .
        Comments:

        Source Documentation:




                                                                  -5-

                                  See “Environmental Additional Info” at www.nccommerce.com/cdbgforms
                                                                      CDBG-R Grant Number: __________________


                                    DETERMINATION OF EXEMPTION
                                           (24 CFR 58.34)

I hearby certify that the following activities comprising the                  Program have been reviewed and
determined exempt per 24 CFR 58.34(a) as follows:

          (1)        Environmental and other studies, resource identification and the development of
                     plans and strategies;
          (2)        Information and financial services;
          (3)        Administrative and management activities;
          (4)        Public services that will not have a physical impact or result in any physical
                     change, including but not limited to services concerned with employment, crime
                     prevention, child care, health, drug abuse, education, counseling, energy
                     conservation and welfare or recreational needs;
          (5)        Inspections and testing of properties for hazard or defects;
          (6)        Purchase of Insurance;
          (7)        Purchase of tools;
          (8)        Engineering or design cost;
          (9)        Technical assistance and training;
          (10)       Assistance for temporary or permanent improvements that do not alter
                     environmental conditions and are limited to protection, repair or restoration
                     activities necessary only to control or arrest the effects from disasters, imminent
                     threats or physical deterioration:
          (11)       Payment of principal and interest on loans made or obligations guaranteed by
                     HUD;
          (12)       Any of the categorical exclusions listed in 58.35(a) provided that there are not
                     circumstances which require compliance with any other federal laws and
                     authorities cited in 58.5.

In accordance with 24 CFR 58.34 (b), no further approval form from HUD or the State is necessary
for the drawdown of funds to implement this program.
However, the responsible entity must still document in writing its compliance with and/or applicability
of the “other requirements” listed at 58.6 .


____________________________
Signature of Mayor or Chairman                                    Date




                                                           -6-

                            See “Environmental Additional Info” at www.nccommerce.com/cdbgforms
                                                                     CDBG-R Grant Number: __________________


                            Categorical Exclusion (Not Subject to 58.5)
                                         24 CFR 58.35 (b)

I hereby certify that the following activities comprising Program have been reviewed and
determined to be categorically excluded per 24 CFR 58.35 (b) as follows.

  (1) Tenant-based rental assistance

  (2) Supportive services including, but not limited to, health care, housing services, permanent
housing placement, daycare, nutritional services, short term payments for rent/mortgage/utility cost
and assistance in gaining access to local, state, federal government benefits and services

  (3) Operation cost, including but not limited to equipment purchase inventory financing, interest
subsidy, operation expenses and similar cost not associated with construction or expansion of
existing operations

   (4) Economic development activities including but not limited to equipment purchases, inventory
financing, interest subsidy, operating expenses and similar cost not associated with construction or
expansion of existing operations

   (5) Activities to assist home ownership of existing “or new dwelling units not assisted with federal”
including closing cost and down payment assistance to homebuyers interest buy downs and similar
activities that result in the transfer of title to a property

   (6) Affordable housing predevelopment construction including legal, consulting, developer and
other cost related to obtaining site options project financing administrative cost and fees for loan
commitments, zoning approvals, and other related activities, which do not have a physical impact.
Documentation indicating compliance with 24 CFR Part 58.6 attached (when applicable)




______________________________
Signature of Mayor of Chairman                                   Date




                                                          -7-

                           See “Environmental Additional Info” at www.nccommerce.com/cdbgforms
                                                                     CDBG-R Grant Number: __________________

                               Categorical Exclusion (Subject to 58.5)
                                          24 CFR 58.35 (a)

I hereby certify that the following activities comprising Program have been reviewed and
determined to be categorically excluded per 24 CFR 58.35 (a) as follows.

   (1) Acquisition, repair, improvement, reconstruction, or rehabilitation of public facilities and
improvements (other than buildings) when the facilities and improvements are in placed and will be
retained in the same use without change in size or capacity of more than 20% (e.g. replacement of
water or sewer lines, reconstruction of curbs an sidewalk, repaving of streets)

  (2) Special projects directed to the removal of material and architectural barriers that restrict the
mobility of and accessibility to elderly and handicapped persons.

  (3) Rehabilitation of buildings and improvements when the following conditions are met:
                     (i)     In the case of multifamily residential buildings:
                             (A) Unit density is not changed more than 20%:
                             (B) The estimated cost of rehabilitation is less than 75% of the total
                                 estimated cost of replacement after rehabilitation.
                             (C) The project does not involve changes in land use from residential to
                                 non-residential: and
                     (ii)    In the case of non-residential structures, including commercial, industrial,
                             and public buildings:
                             (A) The facilities and improvements are in place and will not be changed
                                 in size or capacity by more than 20%: and
                             (B) The activity does not involve a change in land use, such as from non-
                                 residential to residential, commercial to industrial, of from one
                                 industrial use to another.

  (4) An individual action on a one to four family dwelling or an individual action on a project of five or
more units developed on scattered sites when the sites are more than 2,000 feet apart and there are
not more than four units on any one site.

   (5) Acquisition or disposition of an existing structure or acquisition of vacant land provided that the
structure or land acquired or disposed of will be retained for the same use.

  (6) Combination of the above activities.


______________________________
Signature of Mayor of Chairman                                   Date




                                                          -8-

                           See “Environmental Additional Info” at www.nccommerce.com/cdbgforms
                                                                        CDBG-R Grant Number: __________________

                                   Compliance Documentation Checklist
                                            24 CFR Part 58.6
                                          “Other requirements”

For “Exempt” and “Categorically Excluded not subject to” projects/activities, compliance with the
related laws and authorities listed in 58.5 is not required. However, recipients remain responsible for
addressing and carrying out any applicable compliance measures for the requirement listed in 58.6.
These requirements include:

(1) The Flood Disaster Protection Act of 1973 – Federal financial assistance for acquisition or
construction purposes (including rehab) may not be used in a special flood hazard area as identified
by FEMA unless:

       (i)     The community in which the area is situated is participating in the National flood
               Insurance program and;
       (ii)    Flood insurance protection is to be obtained as a condition of the approval of financial
               assistance to the property owner.

Is the project located within a special flood hazard area a designated on a current FEMA flood map?
   Yes            No

Identify FEMA map used to make your finding.
If the project is located in a special flood hazard area, has flood insurance been obtained?
    Yes            No

(2) The Coastal Barrier Resources Act - HUD assistance may not be used for most activities
proposed in the Coastal Barrier resources System.

Is the project located within a coastal barrier designated on a current FEMA flood map?
   Yes            No

If yes, Identify FEMA map used to make your finding.

NOTE: If your answer is yes, the law prohibits federal funding of Projects in designated coastal barriers unless it
is a functionally dependent use.

(3) Runway Clear Zones and Clear Zones – In all cases involving HUD assistance, subsidy, or
insurance for the purchase or sale of an existing property in a runway Clear Zone or Clear Zone the
responsible entity shall advise the buyer that the property is in a runway clear zone or clear zone,
what the implication of such a location are, and that there is a possibility that the property may, at
later date, be acquired by the airport. The buyer must sign a statement acknowledge receipt of this
information.

Is the project located in a Runway Clear Zone/Clear Zone?
   Yes            No

If so, has the buyer signed a statement of acknowledgment?
    Yes          No



                                                             -9-

                              See “Environmental Additional Info” at www.nccommerce.com/cdbgforms