V – (The following forms are filled out for a generic water supply construction project, but the forms can be used for any project type.) Project: [Project Name] Date: ORDER NAME DESCRIPTION Activity 1 Illustrative Example: Site Mobilization; site preparation/clearing; pipeline, Preparation and intake, pump, and treatment station construction Construction (trenching/directional drilling in uplands, wetlands, streams); building access/service roads Activity 2 Activity 3 Activity 4 INPUTS OUTPUTS Action 1 Illustrative Example Site Preparation and Construction – Energy: Air emissions: Electricity Dust fuel Vehicle/generator exhaust Welding/cutting gases Welding fumes Water: Discharges to water: Source water Contaminated stormwater and wash water (silt, oils, etc.) Equipment wash-down water (ground) Fill material Drilling mud make-up water (ground) Water from de-watering Materials: wastes: Pipe Used or excess materials/supplies/consumables (see inputs) Pipe fittings Excavated soil Gravel Used drilling mud Sand Concrete Supplies/consumables: Spills and hazards: Welding rod Potential fuels and chemical spills (see inputs) Lumber (forms) Potential occupational hazard from dam building, equipment movement, handling pipe, Gloves, rags trenching, drilling, welding Construction stakes Disturbing buried contaminants, e.g., old Silt straw bales asbestos pipes, contaminated soils Pallets
V – (The following forms are filled out for a generic water supply construction project, but the forms can be used for any project type.) Project: [Project Name] Date: ORDER NAME DESCRIPTION Activity 1 Illustrative Example: Site Preparation and Construction Mobilization; site preparation/clearing; pipeline, intake, pump, and treatment station construction (trenching/directional drilling in uplands, wetlands, streams); building access/service roads Activity 2 Activity 3 Activity 4 INPUTS OUTPUTS Action 1 – Illustrative Example Site Preparation and Construction Energy: Electricity fuel Welding/cutting gases Air emissions: Dust Vehicle/generator exhaust Welding fumes Water: Source water Equipment wash-down water (ground) Drilling mud make-up water (ground) Discharges to water: Contaminated stormwater and wash water (silt, oils, etc.) Fill material Water from de-watering Materials: Pipe Pipe fittings Gravel Sand Concrete wastes: Used or excess materials/supplies/consumables (see inputs) Excavated soil Used drilling mud Supplies/consumables: Welding rod Lumber (forms) Gloves, rags Construction stakes Silt straw bales Pallets Spills and hazards: Potential fuels and chemical spills (see inputs) Potential occupational hazard from dam building, equipment movement, handling pipe, trenching, drilling, welding Disturbing buried contaminants, e.g., old asbestos pipes, contaminated soils
EIA%20Tool_Revised_4Dec2017_FINAL.DOCX