NIST-1101B NIST Construction Grant Program Environmental Compliance

OMB CONTROL NUMBER: 0693-XXXX EXPIRATION DATE: XX/XX/XXXX
NIST-1101B DAO 203-26	U.S. DEPARTMENT OF COMMERCE NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY
NIST CONSTRUCTION GRANT PROGRAM ENVIRONMENTAL COMPLIANCE QUESTIONNAIRE
The National Environmental Policy Act (NEPA) (42 U.S.C. 4321-4347) and the Council on Environmental Quality’s (CEQ) Regulations for Implementing NEPA (40 CFR 1500-1508) require that an environmental analysis be completed for all major federal actions significantly affecting the environment. NEPA applies only to the actions of federal agencies. Those actions may include a federal agency’s decision to fund non-federal projects under grants and cooperative agreements. In order to determine NEPA compliance requirements for a project receiving National Institute of Standards and Technology (NIST) funding, NIST must assess information which can only be provided by the federal financial assistance (grant) applicant. NEPA requires that a number of items be considered prior to funding and conducting any activity. The following Environmental Compliance Questionnaire provides federal financial assistance applicants and NIST staff with a tool to ensure that project and environmental information is obtained. NIST staff will use the information provided in answers to the questionnaire to determine compliance requirements for NEPA and conduct subsequent NEPA analysis as needed. Applicants should answer the questions to the best of their ability with as much detail as possible. Many questions have a “yes” or “no” response. If the response is “no” the applicant does not need to elaborate on their answer. If the response is “yes” the question will have a second part asking the applicant to provide more information. Applicants should use the space provided to answer the questions. If the applicant needs additional space, additional pages may be attached to the questionnaire, indicating which question is being continued.
Organization Name: Project Title:
1. Provide a brief description of the proposed activity. Detailed project description: (please be as specific as possible; include   breakdown of tasks, scope of project, schedule (for example, date   construction begins, duration of activities, completion date), budget, points of contact, and any permits required ):
2. Provide a brief description of the location of the proposed activity. You should, provide a description and plan diagram and or map of the proposed impacted area. Also, identify whether the proposed activity involves dredging, excavation, or placement of fill? If yes, describe the activity and how it will be conducted.
3. Would the proposed activity occur within a unique geographic area of notable recreational, ecological, scientific, cultural, historical, scenic, or aesthetic importance (e.g., critical habitat designated under the Endangered Species Act; park or refuge lands; wild or scenic rivers; wetlands; prime or unique farmland; sites listed on the National Register of Natural Landmarks; sites listed or eligible for the National Register of Historic Places; sites that are ecologically significant or critical areas including areas that are normally inundated by water or areas within the 100-year flood plain)? If yes, describe the area, including the name or designation if known.
4. Would the proposed activity affect districts, sites, highways, structures, or objects listed in or eligible for listing in the National Register of Historic Places or cause loss or destruction of significant scientific, cultural, or historical resources? If yes, describe the impact. Also explain whether and how it was determined if any of those properties had the potential to occur within the affected area.
5. Provide a description of potential alternatives to the proposed activity (e.g., alternative times, locations, methods, etc.).
6. Has any National Environmental Policy Act (NEPA) or other environmental compliance documentation been completed? If yes, list the environmental compliance documentation that has been completed and provide copies of the documentation as appropriate. Also, is a state environmental policy act compliance document (mini-NEPA) required? If yes, state when this document was completed or will be completed and identify who is preparing the document.
7. Would the proposed activity or environmental impacts of the activity be subject to public controversy? For example, landowners, whose land may be affected by the project, are not in support of the project. If yes, describe the potential controversy.
8. Is the proposed activity related to other activities (both NIST and non-NIST) that together may cumulatively adversely impact the environment? For example, the proposed activity is one of a series of projects that together may cause a change in the pattern of pollutant discharge, traffic generation, economic change, flood plain change, or land use. If yes, briefly describe the other activities and discuss how the related projects would have cumulative impacts on the environment.
9. Do federal funds from other sources/agencies provide support for the proposed activity or projects related to the proposed activity? If yes, name the sources/agencies, the amount of funding, and the percentage of total funding each agency is providing for the project.
Name and title of applicant’s authorized representative: ______________________________________________ Signature of applicant’s authorized representative: __________________________________________________ Date signed: ________________________________________________________________________________