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Environmental Compliance Checklist

This document is an environmental compliance checklist for a proposed project. It collects information about the project location, scope of work, potential environmental impacts and hazards, waste generation and disposal methods, and signatures from the project manager and environmental point of contact. Key details include the project title and location, a description of construction activities and support facilities, checks for any environmental aspects that could be impacted such as air emissions, hazardous waste generation, and archaeological resources, and lists the types and disposal methods for any wastes expected to be generated from the project. The environmental point of contact then reviews the project and identifies any necessary hazard controls that should be implemented.

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178 views5 pages

Environmental Compliance Checklist

This document is an environmental compliance checklist for a proposed project. It collects information about the project location, scope of work, potential environmental impacts and hazards, waste generation and disposal methods, and signatures from the project manager and environmental point of contact. Key details include the project title and location, a description of construction activities and support facilities, checks for any environmental aspects that could be impacted such as air emissions, hazardous waste generation, and archaeological resources, and lists the types and disposal methods for any wastes expected to be generated from the project. The environmental point of contact then reviews the project and identifies any necessary hazard controls that should be implemented.

Uploaded by

NIJESH
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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ENVIRONMENTAL COMPLIANCE CHECKLIST

1. ADMINISTRATIVE INFORMATION Action Number:

Project Title: Date:

Lead Department: Estimated Start Work Date: Individual Preparing Checklist:

Project Engineer/Manager: Phone No.:

Project Location (Bldg No. /Area.): Environmental POC: Safety POC:

2. LOCATION OF PROPOSED ACTION: Describe the location at which the action will take place.
Attach maps where appropriate. If applicable, provide the square footage of the area(s) that will be
disturbed during construction activities (construction activities include any clearing, grading, excavating,
grubbing, stockpiling, and/or filling).

3. WORK SCOPE DESCRIPTION: Describe your proposed action’s work scope in detail, providing as
much specific information as possible. Also, include all support facilities/activities that would be involved, for
example, temporary power provided by a portable generator. Include attachments where appropriate.

SLAC-I-750-0A15R-002 R001
Page |1
4. ENVIRONMENTAL ASPECTS/POTENTIAL SOURCES OF IMPACT: Check the appropriate box for
any environmental hazard or impact associated with the project.

ENVIRONMENTAL ASPECT/IMPACT Yes ENVIRONMENTAL ASPECT/IMPACT Yes


√ √
1. Air emissions: Could the project generate 10. Industrial and Hazardous Waste Generation,
emissions from combustion, dust, greenhouse Management, Storage, Transport and Disposal:
gases, ozone-depleting substances, or chemical Will any unused or spent chemicals, fuel, oils,
gases? solvents, PCBs, lead, asbestos, or other hazmat
require handling as waste?
2. Chemical Use, Storage, and Inventory: Will 11. Biohazards: Will the project use or generate
the project require the use of lab chemicals, biological materials, such as microorganisms?
fuel, oils, coolants, cleaners, or solvents?
3. Soil and Groundwater Contamination: 12. Nanotechnology: Will the project use or
Could project activities impact soil and/or generate any nanosubstances?
groundwater in any way?
4. Discharge to Wastewater Systems: Could 13. Archeological Resource Disturbance:
the project discharge any material to the sanitary Could any project activities impact archeological
sewer? areas?
5. Surface and Stormwater Contamination: 14. Interaction with Wildlife/Habitat: Will the
Could material from the project contaminate project disturb soil in undeveloped areas or disrupt
stormwater or be discharged to the storm drain beehives, bird nests, or other wildlife areas?
system?
6. Radioactive Materials Reduction and 15. Noise: Could the project generate noise that
Radioactive Mixed-Waste Generation, would impact personnel or natural structures?
Management, Storage, Transportation and
Disposal: Will any radiological waste be
generated by the project?
7. Environmental Radiation and 16. Water/Sludge for discharge/disposal:
Radioactivity: Could any project activities Will the project involve boring or drilling
generate and/or release radioactivity? that would generate >300 gallons of
water/sludge that will require disposal or
discharge?
8a. Use, Reuse, and Recycling: Are any project 17. Other?
activities designed to minimize generation of
waste through reuse, recycling, and
environmentally preferable purchasing, such as
purchasing recycled-content materials?
8b. Conservation of Resources: Are any
project activities designed or expected/intended
to conserve natural resources such as water,
energy, fuel, etc.?
9. Construction, Renovation, and Demolition
By-Products: Will any project activities
generate construction debris or soil stockpiles by
clearing or excavation, or disturb lead- or
asbestos-containing materials?

SLAC-I-750-0A15R-002 R001
Page |2
5. FOR EACH ITEM CHECKED IN SECTION 4, DESCRIBE THE CORRESPONDING
CONTROLS TO BE IMPLEMENTED TO REDUCE POTENTIAL ENVIRONMENTAL IMPACTS
(e.g., spill prevention, erosion controls, air emission controls including dust suppression, selection of materials,
etc.). Provide details of the activities and impacts for each box and the proposed mitigations. Include
attachments where appropriate. Use the same number system for your input.

6. DESCRIBE SUSTAINABLE PRACTICES BEING IMPLEMENTED, INCLUDING


ENVIRONMENTALLY PREFERABLE PURCHASING (e.g, sustainable buildings, energy, water, and fuel
conservation and/or efficiency measures, purchasing of non-toxic or less toxic materials, purchasing of recycled
content and biobased products, energy- and water-efficient products, electronics stewardship, etc.)

7. WASTE MINIMIZATION: Describe waste management plans, including (1) recycling of non-
hazardous construction and demolition debris, and (2) plans for minimizing the generation of hazardous
waste (Class I), designated waste (Class II) or radiological or mixed wastes, both during the project
construction period and the project lifecycle.

SLAC-I-750-0A15R-002 R001
Page |3
8. DESCRIPTION OF WASTES AND DISPOSAL METHODS: Describe the type of waste (Radioactive,
RCRA, Mixed, etc.); the waste form (solid, liquid, gas, etc.); approximate amount of waste expected to be
generated; waste disposal method (offsite disposal, sanitary sewer, etc.).
Waste Type Waste Form Estimated amount to 1
Waste Disposal Method (offsite
(Solid, Liquid, Gas, Sludge) be generated (specify disposal, sanitary sewer, etc.)
(list all that apply) units of measure)
Radioactive
Mixed- having both radioactive and
hazardous contamination
Class I (hazardous)- includes
chemicals, oils, solvents, and highly
contaminated soil, concrete,
asphalt, sludge/water, etc.
Class II (non-hazardous)- includes
moderately contaminated soil,
concrete, asphalt, sludge/water,
etc.
Class III (non-regulated)- includes
unimpacted soil, concrete, asphalt,
sludge/water, etc.
PCBs-includes ballasts, oil, etc.
Lead-includes bricks, sheets, etc.
Asbestos (Friable)
Asbestos (Non-Friable)
Mercury (liquid, etc.)
Treated Wood
Biohazards, Nanosubstances
Universal Waste- includes spent
lamps, batteries, mercury
thermometers/switches
Non-metal recycling-includes soil,
untreated wood, concrete,
wallboard, cardboard, green waste,
etc.
Scrap metal recycling
Other

9. PROJECT SIGNATURE: This section is to be completed by the Project Manager or individual


completing this checklist.
I have reviewed this action and to the best of my knowledge have answered all questions completely to describe the proposed
action.

1 Completion of this column may require input from Waste Management Group.
SLAC-I-750-0A15R-002 R001
Page |4
Project Signature: __________________________ Date: _____________________
Please note: Any changes or unanticipated events to the project must be documented by updating this form.

10. ENVIRONMENTAL COMPLIANCE:

This section to be completed by the Environmental POC

I have reviewed the proposed project and, based on the information provided for this project, the
following hazard controls should be implemented:
k
Chec

Environmental Compliance
Hazard Control Issue Hazard Control Measure(s) to be Implemented
Air Permit
-New source
-Portable equipment
-Special conditions
Demolition/Renovation or Asbestos
Removal
-BAAQMD Notification
Excavation/Penetration Permit
Floodplain/Wetland/Outfall Controls
Hazardous Materials
-Purchase
-Use
-Storage
-Other alternatives/substitutes
NESHAPs (RAD) Controls
Spill Prevention
Stormwater Controls

Waste Management

Wetland Permits
-JARPA Permit
-Corps of Engineers Permit
-Other
Biologival Assessment

Historical Preservation

Other

Environmental POC Signature: ______________________ Date: _____________________

SLAC-I-750-0A15R-002 R001
Page |5

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