I certify that a site inspection was conducted for each site involved in this proposal and to the best of my knowledge, the information provided in this LWCF Proposal Description and Environmental Screening Form (PD/ESF) is accurate based on available resource data. All resulting notes, reports and inspector signatures are stored in the state’s NEPA file for this proposal and are available upon request. On the basis of the environmental impact information for this LWCF proposal as documented in this LWCF PD/ESF with which I am familiar, I recommend the following LWCF NEPA pathway: This proposal qualifies for a Categorical Exclusion (CE). CE Item #: Explanation: This proposal requires an Environmental Assessment (EA) which is attached and has been produced by the State/sponsor in accordance with the LWCF Program Manual. This proposal may require an Environmental Impact Statement (EIS). NPS guidance is requested per the LWCF Program Manual. Reproduce this certificate as necessary. Complete for each LWCF appraisal or waiver valuation. Appraisal/Waiver Valuation Review $ Date of appraisal transmittal letter/waiver: Property Address: Real property value: Effective date of value: A State-certified Review Appraiser has reviewed the appraisal and has determined that it was prepared in I certify that: conformity with the Uniform Appraisal Standards for Federal Land Acquisitions. OR The State has reviewed and approved a waiver valuation for this property per 49 CFR 24.102(c)(2)(ii). SLO/ASLO Original Signature: Date: Name Title Agency
I certify that a site inspection was conducted for each site involved in this proposal and to the best of my knowledge, the information provided in this LWCF Proposal Description and Environmental Screening Form (PD/ESF) is accurate based on available resource data. All resulting notes, reports and inspector signatures are stored in the state’s NEPA file for this proposal and are available upon request. On the basis of the environmental impact information for this LWCF proposal as documented in this LWCF PD/ESF with which I am familiar, I recommend the following LWCF NEPA pathway: This proposal qualifies for a Categorical Exclusion (CE). CE Item #: Explanation: This proposal requires an Environmental Assessment (EA) which is attached and has been produced by the State/sponsor in accordance with the LWCF Program Manual. This proposal may require an Environmental Impact Statement (EIS). NPS guidance is requested per the LWCF Program Manual. Reproduce this certificate as necessary. Complete for each LWCF appraisal or waiver valuation. Appraisal/Waiver Valuation Review Property Address: $ Date of appraisal transmittal letter/waiver: Real property value: Effective date of value: I certify that: A State-certified Review Appraiser has reviewed the appraisal and has determined that it was prepared in conformity with the Uniform Appraisal Standards for Federal Land Acquisitions. OR The State has reviewed and approved a waiver valuation for this property per 49 CFR 24.102(c)(2)(ii). SLO/ASLO Original Signature: Date: Name Title Agency
10-904-LWCF-Proposal-Description-and-Environmental-Screening-Form-09192016.docx