Exhibit 22-N Funding Allocation Checklist (Local ATP Projects) PPNO:_____________________________ Project ID: _____________________________ Brief Project Description:______________________________ _____________________________ _____________________________ Output/Outcome: _______________________________ _______________________________ (Action taken/quantifiable benefits or results) This checklist is to be completed by the local agency and attached to the Request for Funding Allocation. TYPE OF PROJECT (Select only one) Infrastructure (IF) Non-Infrastructure (NI) Combined IF & NI TYPE OF FUNDING 1. Indicate type of funding Federal-only (Skip to question #3) Federal/Local (Skip to question #3) Federal/State (Skip to question #3) State-only 2. Is the project approved by ATP Manager for State-only funding? Yes No to question #3 If “Yes” continue If project is not eligible for State-only funded “No” your Environmental Clearance Requirements 3. Is this request limited to funding for the Environmental Studies component? Yes No If to question #10. “Yes”, go If completed CEQA Environmental Document is required. “No,” a For certain types of projects that do not result in either direct or indirect change in the physical environment, a formal CEQA document may not be needed. An example of this type of project is installing bicycle racks on buses. Consult Caltrans Environmental office for interpretations. 4. Has the local agency made a final CEQA determination that the project is exempt? Yes No
Exhibit 22-N Funding Allocation Checklist (Local ATP Projects) PPNO:_____________________________ Project ID: _____________________________ Brief Project Description:______________________________ _____________________________ _____________________________ Output/Outcome: _______________________________ _______________________________ (Action taken/quantifiable benefits or results) This checklist is to be completed by the local agency and attached to the Request for Funding Allocation. TYPE OF PROJECT (Select only one) Infrastructure (IF) Non-Infrastructure (NI) Combined IF & NI TYPE OF FUNDING 1. Indicate type of funding Federal-only (Skip to question #3) Federal/Local (Skip to question #3) Federal/State (Skip to question #3) State-only 2. Is the project approved by ATP Manager for State-only funding? Yes No If “Yes” continue to question #3 If “No” your project is not eligible for State-only funded Environmental Clearance Requirements 3. Is this request limited to funding for the Environmental Studies component? Yes No If “Yes”, go to question #10. If “No,” a completed CEQA Environmental Document is required. For certain types of projects that do not result in either direct or indirect change in the physical environment, a formal CEQA document may not be needed. An example of this type of project is installing bicycle racks on buses. Consult Caltrans Environmental office for interpretations. 4. Has the local agency made a final CEQA determination that the project is exempt? Yes No