RISK-BASED ENVIRONMENTAL SCOPING TEMPLATE

Wisconsin Department of Transportation

February 2020

Section One: Use of the Risk-Based Environmental Scoping Template (Template)

The Template is:

a risk-based scoping tool that shall be used to complete the environmental scope certification process during the Project Definition phase for any SHR-funded program project to determine if additional time should be factored into a project schedule for the NEPA or WEPA environmental documentation portion of the Project Delivery phase*

an aid for planners and project managers in determining if agency coordination and public involvement should occur early during the Project Definition phase or if agency coordination and public involvement is appropriate to initiate once the NEPA or WEPA phase formally begins during the Project Delivery phase

an optional risk-based scoping tool that can be used to determine if additional time should be factored into a project schedule for the NEPA or WEPA environmental documentation portion of other non-SHR funded projects or planning studies where draft or final NEPA or WEPA environmental documentation is an identified deliverable*

Section Two: Project Information

Please provide the following information about the project if known.

Design and Construction IDs	Legal Description (Township, Range, Section)	County
Project Name	Project Termini/Location Being Evaluated by the Template
Name of Route or Facility to be Improved	Facility Classification
Anticipated NEPA/WEPA Document Type (CEC, PCE, ER, EA or EIS)	Funding Source(s) (check all that apply)
☐State	☐Federal	☐Local
Name of Individual/Firm Preparing this Environmental Scoping Template	Environmental Scoping Template Preparation Date	Date/Anticipated Date the Proposed Project Was/Will Be Programmed into State Transportation Improvement Program (STIP)

Section Three: Description of the Project and Improvement Type (include a project location map)

Provide a brief description of the results of the completed safety, structures and pavement certifications (if applicable). Identify the range of alternatives considered if the certifications resulted in multiple alternatives that could address the project need. If a WisDOT preferred alternative has been identified, briefly explain how the results of the project certifications led to this decision:

Section Four: Risk Analysis

Indicate if the environmental impact category listed in the table below is anticipated to be No Risk Known, Low Risk or High Risk for the project. The Blue Language versions of the WisDOT ER/EA Template and Factor Sheets found on the WisDOT website provide resources to help the preparer make risk decisions for each environmental impact category. Coordination with the Region Environmental Coordinator (REC) will also help the project manager or scoping engineer build a reasonable project schedule and budget.

No Risk Known:

A review of the project area, check of the critical resource database of a resource agency or other available sources of information indicates the Environmental Impact Category does not pose a risk to the project and requires no further coordination.

Low Risk:

The review of the project area, check of the critical resource database of a resource agency or other available sources of information indicates nothing has been identified pertinent to the Environmental Impact Category or there are no known resources in the project area, but additional investigation will need to be completed as part of the NEPA or WEPA process to confirm this finding.

High Risk:

A review of the project area, check of the critical resource database of a resource agency or other available sources of information indicates impacts associated with the identified Environmental Impact Category or critical resources located within the project area may occur. Additional investigation will need to be completed as part of the NEPA or WEPA process to confirm this finding. Early coordination with the resource/governmental agency having jurisdiction over the resources(s) and/or public should be considered.

Any box checked High Risk indicates that additional time could be required for NEPA/WEPA approval. Additionally, if a High Risk box is checked, consider initiating appropriate agency coordination and/or public involvement early during the Project Definition phase rather than waiting until the Project Delivery phase.

No Risk Known	Low Risk	High Risk	Environmental Document Type Considerations
☐	☐	☐	This project is likely to need a NEPA/WEPA document other than a Categorical Exclusion Checklist (CEC), Programmatic Categorical Exclusion (PCE) or Environmental Report (ER). Explain risk determination:
☐	☐	☐	This project is likely to have significant environmental impacts. Explain risk determination:
☐	☐	☐	This project is likely to have substantial controversy on environmental grounds. Explain risk determination:
No Risk Known	Low Risk	High Risk	Environmental Impact Category
☐	☐	☐	This project is likely to be inconsistent with federal, state or local laws, requirements or administrative determinations relating to environmental aspects of the project such as land use plans, transportation plans, bicycle/pedestrian plans, the coastal zone management plan, etc. Explain risk determination:
☐	☐	☐	This project is likely to modify access on the Interstate Highway System and require an interstate access justification report (IAJR). Explain risk determination:
☐	☐	☐	This project is likely to result in an extensive detour or have other unique Traffic Management Plan issues. Explain risk determination:
☐	☐	☐	This project is likely to require right-of-way acquisition (fee simple purchase, permanent or temporary easement, right of entry, gift or other means). Explain risk determination:
☐	☐	☐	This project is likely to result in displacements or relocations (either residential or commercial). Explain risk determination:
☐	☐	☐	This project is likely to have agency, airport, railroad, utilities, local unit of government or tribal coordination with unresolved issues, lengthy timelines or unusual/special concerns. Explain risk determination:
☐	☐	☐	This project has potential for disproportionately high adverse effects on a minority population or low-income population (environmental justice). Explain risk determination:
☐	☐	☐	This project is likely to result in the use of lands from a Section 4(f) property (publicly owned parks and recreation areas, publicly owned wildlife and waterfowl refuges and publicly or privately owned historic sites). Explain risk determination:
☐	☐	☐	This project is likely to disturb, or impact lands purchased with special conservation funding sources such as the Land and Water Conservation Fund program (Section 6(f)), Pittman/Robertson, Dingell/Johnson, Knowles-Nelson Stewardship Program or former Wetland Reserve Program (now part of the Agricultural Conservation Easement Program), etc. Explain risk determination:
☐	☐	☐	This project is likely to directly or indirectly impact an archeological site, burial site or historic structure. Explain risk determination:
☐	☐	☐	The project is likely to require more than ½ acre of land disturbance thus requiring an archaeological survey. Explain risk determination:
☐	☐	☐	This project is within the boundaries of a burial site. Explain risk determination:
☐	☐	☐	This project is likely to be located partially or entirely on tribal lands. Explain risk determination:
☐	☐	☐	This project is likely to directly or indirectly impact a resource of importance to a tribe (e.g. a traditional cultural property). Explain risk determination:
☐	☐	☐	This project is likely to directly or indirectly impact threatened or endangered species or critical habitat, requiring consultation with the U.S. Fish and Wildlife Service or Wisconsin DNR. Explain risk determination:
☐	☐	☐	This project is likely to result in a take or disturbance of habitat or nests protected by the Bald and Golden Eagle Protection Act (BGEPA). Explain risk determination:
☐	☐	☐	This project is likely to result in placement of fill in a wetland, stream, lake or other water of the U.S. below the ordinary high-water mark and will require a U.S. Army Corps of Engineers 404 permit under the Clean Water Act and/or 401 Water Quality Certification. Explain risk determination:
☐	☐	☐	This project is a bridge project over a navigable water and is likely to require a U.S. Coast Guard Section 9 permit. The United States Coast Guard requires permits be obtained for bridge projects over navigable waters which are generally a tributary of the Great Lakes or the Mississippi River. Explain risk determination:
☐	☐	☐	This project is likely to impact groundwater, springs or wells (including dewatering or groundwater monitoring wells from remediation projects). Explain risk determination:
☐	☐	☐	This project is likely to involve work in lands, waters or viewsheds of a Wild and Scenic River. Explain risk determination:
☐	☐	☐	This project is likely to encroach on a regulatory floodway or have work affecting the base floodplain (100-year flood) elevations of a water course or lake. Explain risk determination:
☐	☐	☐	This project is likely to include work in a community wellhead protection zone. Explain risk determination:
☐	☐	☐	This project is likely to acquire properties with hazardous materials or wastes. Explain risk determination:
☐	☐	☐	This project is likely to change or modify a property with a continuing obligation for hazardous materials. Explain risk determination:
☐	☐	☐	This project is likely to include utility or other infrastructure to be installed in or adjacent to a contaminated property. Explain risk determination:
☐	☐	☐	This project is likely to include complex utility relocations such as electric towers, high-pressure gas lines or steam vents. Explain risk determination:
☐	☐	☐	This project meets the criteria for a Type 1 project (see FDM 23-10-1.1) for noise, requiring a noise analysis. Explain risk determination:
☐	☐	☐	This project is in a rural non-attainment or maintenance area for ozone and will likely require a conformity determination per the rural conformity section of the WisDOT/WDNR Memorandum of Agreement regarding determination of conformity. Explain risk determination:
☐	☐	☐	This project is likely to have acquisitions from farm operations that require coordination with the Wisconsin Department of Agriculture, Trade and Consumer Protection (DATCP) and may require preparation of an agricultural impact statement (AIS). Explain risk determination:
☐	☐	☐	This project is likely to require a detailed indirect and cumulative effects analysis (WisDOT’s Pre-Screening Worksheet for EA and ER Projects For Determining the Need to Conduct a Detailed Indirect Effects Analysis can be used to make this determination). Explain risk determination:
☐	☐	☐	The project is likely to have impacts on existing bicycle and/or pedestrian facilities, ADA curb ramp compliance or transit facilities (e.g. sidewalks, bike lanes, multi-use paths, wide outside travel lanes or paved shoulders, transit stops or lanes, etc.) that would make replacement difficult. Explain risk determination:
☐	☐	☐	This project is likely to have temporary construction impacts on the use of other transportation modes or multi-modal connections (e.g. transit stops, transit connections, sidewalks, bicycle lanes, shared-use paths, etc.) that would require temporary closures, detours or transit stop/connection relocations. Explain risk determination:
☐	☐	☐	Other: Explain risk determination:
☐	☐	☐	Other: Explain risk determination:

Section Five: Summary and Next Steps (if any)

Provide a summary of the findings of this risk-based environmental scoping effort and indicate if early agency coordination and/or public involvement should be included as next steps:

Section Six: Preparer Identification

(Signature)
(Print Name)
(Date)

*This is not the environmental document for the proposed project. It is understood that if the proposed project is approved for funding, the appropriate environmental document will be prepared and approved.