HomeMy WebLinkAboutA- 6 Environmental Checklist Form
CITY/RVPUB/2020/313785 FORM "J"
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ENVIRONMENTAL CHECKLIST FORM
1. Project Title: 613 –615 North Azusa Avenue: Dr. Ralph Reyes Professional Dental Practice
2. Lead Agency Name and Address:
City of Azusa Redevelopment Agency, 213 East Foothill Boulevard, Azusa Calif. 91702
3. Contact Person and Phone Number: Jose Amador, Assistant Director of Economic
Development/Redevelopment (626) 812-5101
4. Project Location: 613 –615 North Azusa Avenue
5. Project Sponsor's Name and Address:
Dr. Ralph Reyes (“Developer”)
105 East Tenth Street
Azusa, Ca 91702
6. General Plan Designation: Central Business District 7. Zoning: Central Business District
7. Description of Project: (Describe the whole action involved, including but not limited to later
phases of the project, and any secondary, support, or off-site features necessary for its
implementation. Attach additional sheet(s) if necessary.)
The proposed project involves the new construction of a mixed-use commercial and multi-family
residential building containing approximately 7,787 square feet of gross building area. The building
will house a 3,862 square foot of medical office space the first floor. The second floor will contain
three residential rental units ranging in size from 890 to 910 square with exterior balconies ranging in
size from 30 to 45 square feet. Also included on the second floor is a large conference room and
administrative office that will serve the medical uses on the first floor. Three parking carports will be
provided for the apartment uses at the rear of the property.
8. Surrounding Land Uses and Setting: (Briefly describe the project's surroundings.)
The subject site is located in the Downtown core area of Azusa. Surrounding land uses include
commercial, office, and residential uses. The structure is located on Azusa Avenue, Azusa’s main
north-south traffic thoroughfare.
9. Other public agencies whose approval is required (e.g., permits, financing approval, or
participation agreement):
Following Redevelopment Agency Board/City Council action on the proposed DDA, the project will be
required to be submitted to the City of Azusa Community Development Department, for planning,
zoning, and building plan check review and approval.
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ENVIRONMENTAL FACTORS POTENTIALLY AFFECTED:
The environmental factors checked below would be potentially affected by this project, involving at least
one impact that is a "Potentially Significant Impact" as indicated by the checklist on the following pages.
Aesthetics
Agriculture Resources Air Quality
Biological Resources
Cultural Resources Geology / Soils
Hazards & Hazardous Materials Hydrology / Water Quality
Land Use / Planning
Mineral Resources Noise
Population / Housing
Public Services Recreation
Transportation / Traffic
Utilities / Service Systems Mandatory Findings of Significance
DETERMINATION (To be completed by the Lead Agency):
On the basis of this initial evaluation:
I find that the proposed project COULD NOT have a significant effect on the environment, and a
NEGATIVE DECLARATION will be prepared.
I find that although the proposed project could have a significant effect on the environment, there will
not be a significant effect in this case because revisions in the project have been made by or agreed
to by the project proponent. A MITIGATED NEGATIVE DECLARATION will be prepared.
I find that the proposed project MAY have a significant effect on the environment, and an
ENVIRONMENTAL IMPACT REPORT is required.
I find that the proposed project MAY have a "potentially significant" or "potentially significant unless
mitigated" impact on the environment, but at least one effect 1) has been adequately analyzed in an
earlier document pursuant to applicable legal standards, and 2) has been addressed by mitigation
measures based on the earlier analysis as described on attached sheets. An ENVIRONMENTAL
IMPACT REPORT is required, but it must analyze only the effects that remain to be addressed.
I find that although the proposed project could have a significant effect on the environment, because
all potentially significant effects (a) have been analyzed adequately in an earlier EIR or NEGATIVE
DECLARATION pursuant to applicable standards, and (b) have been avoided or mitigated pursuant to
that earlier EIR or NEGATIVE DECLARATION, including revisions or mitigation measures that are
imposed upon the proposed project, nothing further is required.
________________________________
Signature Date
Printed Name For
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EVALUATION OF ENVIRONMENTAL IMPACTS:
1) A brief explanation is required for all answers except "No Impact" answers that are adequately
supported by the information sources a lead agency cites in the parentheses following each question.
A "No Impact" answer is adequately supported if the referenced information sources show that the
impact simply does not apply to projects like the one involved (e.g. the project falls outside a fault
rupture zone). A "No Impact" answer should be explained where it is based on project-specific factors
as well as general standards (e.g. the project will not expose sensitive receptors to pollutants, based
on a project-specific screening analysis).
2) All answers must take account of the whole action involved, including off-site as well as on-site,
cumulative as well as project-level, indirect as well as direct, and construction as well as operational
impacts.
3) Once the lead agency has determined that a particular physical impact may occur, then the checklist
answers must indicate whether the impact is potentially significant, less than significant with mitigation,
or less than significant. "Potentially Significant Impact" is appropriate if there is substantial evidence
that an effect is significant. If there are one or more "Potentially Significant Impact" entries when the
determination is made, an EIR is required.
4) "Negative Declaration: Less Than Significant With Mitigation Incorporated" applies where the
incorporation of mitigation measures has reduced an effect from "Potentially Significant Impact" to a
"Less than Significant Impact." The lead agency must describe the mitigation measures, and briefly
explain how they reduce the effect to a less than significant level (mitigation measures from Section
XVII, "Earlier Analyses," may be cross-referenced).
5) Earlier analyses may be used where, pursuant to the tiering, program EIR, or other CEQA process, an
effect has been adequately analyzed in an earlier EIR or negative declaration. Section 15063(c)(3)(D).
In this case, a brief discussion should identify the following:
a) Earlier Analyses Used. Identify and state where they are available for review.
b) Impacts Adequately Addressed. Identify which effects from the above checklist were within the
scope of and adequately analyzed in an earlier document pursuant to applicable legal standards,
and state whether such effects were addressed by mitigation measures based on the earlier
analysis.
c) Mitigation Measures. For effects that are “Less than Significant with Mitigation Measures
Incorporated,” describe the mitigation measures, which were incorporated or refined from the
earlier document and the extent to which they address site-specific conditions for the project.
6) Lead agencies are encouraged to incorporate into the checklist references to information sources for
potential impacts (e.g. general plans, zoning ordinances). Reference to a previously prepared or
outside document should, where appropriate, include a reference to the page or pages where the
statement is substantiated.
7) Supporting Information Sources. A source list should be attached, and other sources used or
individuals contacted should be cited in the discussion.
8) This is only a suggested form, and lead agencies are free to use different formats; however, lead
agencies should normally address the questions from this checklist that are relevant to a project’s
environmental effects in whatever format is selected.
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9) The explanation of each issue should identify:
a) the significance criteria or threshold, if any, used to evaluate each question; and
b) the mitigation measure identified, if any, to reduce the impact to less than significance.
SAMPLE QUESTIONS
Issues:
Potentially
Significant
Impact
Less Than
Significant
With
Mitigation
Incorporated
Less Than
Significant
Impact
No
Impact
I. AESTHETICS. Would the project:
a) Have a substantial adverse effect on a scenic
vista?
b) Substantially damage scenic resources,
including, but not limited to, tress, rock
outcroppings, and historic buildings within a
state scenic highway?
c) Substantially degrade the existing visual
character or quality of the site and its
surroundings?
d) Create a new source of substantial light or glare,
which would adversely affect day or nighttime
views in the area?
I. (a-d) The proposed project involve the full
renovation/rehabilitation of an existing single-story
structure, with a minor addition to the rear of the
structure. The renovation will upgrade the visual
character of the area, adding exterior building
façade improvements, lighting, and other positive
visual features.
II. AGRICULTURE RESOURCES. In determining
whether impacts to agricultural resources are
significant environmental effects, lead agencies
may refer to the California Agricultural Land
Evaluation and Site Assessment Model (1997)
prepared by the California Dept. of Conservation as
an optional model to use in assessing impacts on
agriculture and farmland. Would the project:
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a) Convert Prime Farmland, Unique Farmland, or
Farmland of Statewide Importance (Farmland),
as shown on the maps prepared pursuant to the
Farmland Mapping and Monitoring Program of
the California Resources Agency, to non-
agricultural use?
b) Conflict with existing zoning for agricultural use,
or a Williamson Act contract?
c) Involve other changes in the existing
environment, which, due to their location or
nature, could result in conversion of Farmland,
to non-agricultural use?
II. (a-c) The proposed project involves the renovation
of an existing structure in its existing urbanized
context and condition. There is no impact as a
result of the project on any agricultural or farmland
resources.
III. AIR QUALITY. Where available, the significance
criteria established by the applicable air quality
management or air pollution control district may be
relied upon to make the following determinations.
Would the project:
a) Conflict with or obstruct implementation of the
applicable air quality plan?
b) Violate any air quality standard or contribute
substantially to an existing or projected air
quality violation?
c) Result in a cumulatively considerable net
increase of any criteria pollutant for which the
project region is nonattainment under an
applicable federal or state ambient air quality
standard (including releasing emissions, which
exceed quantitative thresholds for ozone
precursors)?
d) Expose sensitive receptors to substantial
pollutant concentrations?
e) Create objectionable odors affecting a
substantial number of people?
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IV. BIOLOGICAL RESOURCES. Would the project:
a) Have a substantial adverse effect, either directly
or through habitat modifications, on any species
identified as a candidate, sensitive, or special
status species in local or regional plans,
policies, or regulations, or by the California
Department of Fish and Game or U.S. Fish and
Wildlife Service?
b) Have a substantial adverse effect on any
riparian habitat or other sensitive natural
community identified in local or regional plans,
policies, and regulations or by the California
Department of Fish and Game or U.S. Fish and
Wildlife Service?
c) Have a substantial adverse effect on federally
protected wetlands as defined by Section 404 of
the Clean Water Act (including, but not limited
to, marsh, vernal pool, coastal, etc.) through
direct removal, filling, hydrological interruption,
or other means?
d) Interfere substantially with the movement of any
native resident or migratory fish or wildlife
species or with established native resident or
migratory wildlife corridors, or impede the use of
native wildlife nursery sites?
e) Conflict with any local policies or ordinances
protecting biological resources, such as a tree
preservation policy or ordinance?
f) Conflict with the provisions of an adopted
Habitat Conservation Plan, Natural Community
Conservation Plan, or other approved local,
regional, or state habitat conservation plan?
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IV. (a-f) The proposed project involves the
renovation/rehabilitation of an existing structure with
a small addition in its existing urbanized context and
condition. In its existing condition and location, no
unique habitant, species, or other biological
resource will be impacted or affected by the
proposed project.
V. CULTURAL RESOURCES. Would the project:
a) Cause a substantial adverse change in the
significance of a historical resource as defined
in ' 15064.5?
b) Cause a substantial adverse change in the
significance of an archaeological resource
pursuant to ' 15064.5?
c) Directly or indirectly destroy a unique
paleontological resource or site or unique
geologic feature?
d) Disturb any human remains, including those
interred outside of formal cemeteries?
VI. GEOLOGY AND SOILS. Would the project:
a) Expose people or structures to potential
substantial adverse effects, including the risk of
loss, injury or death involving:
i) Rupture of a known earthquake fault, as
delineated on the most recent Alquist-Priolo
Earthquake Fault Zoning Map issued by the
State Geologist for the area or based on other
substantial evidence of a known fault? Refer to
Division of Mines and Geology Special
Publication 42.
ii) Strong seismic ground shaking?
iii) Seismic-related ground failure, including
liquefaction?
iv) Landslides?
b) Result in substantial soil erosion or the loss of
topsoil?
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c) Be located on a geologic unit or soil that is
unstable, or that would become unstable as a
result of the project, and potentially result in on-
or off-site landslide, lateral spreading,
subsidence, liquefaction or collapse?
d) Be located on expansive soil, as defined in
Table 18-1-B of the Uniform Building Code
(1994), creating substantial risks to life or
property?
e) Have soils incapable of adequately supporting
the use of septic tanks or alternative wastewater
disposal systems where sewers are not
available for the disposal of wastewater?
VI. (a-e). The renovation/rehabilitation of the existing
structure and the condition of the building addition
will be subject to all applicable Building Code
requirements to ensure proper structural integrity.
The subject site and building are located in a
liquefaction zone; the project may require a soils
report to confirm appropriate recommendations for
building foundation.
VII. HAZARDS AND HAZARDOUS MATERIALS.
Would the project:
a) Create a significant hazard to the public or the
environment through the routine transport, use,
or disposal of hazardous materials?
b) Create a significant hazard to the public or the
environment through reasonably foreseeable
upset and accident conditions involving the
release of hazardous materials into the
environment?
c) Emit hazardous emissions or handle hazardous
or acutely hazardous materials, substances, or
waste within one-quarter mile of an existing or
proposed school?
d) Be located on a site which is included on a list of
hazardous materials sites compiled pursuant to
Government Code section 65962.5 and, as a
result, would it create a significant hazard to the
public or the environment?
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e) For a project located within an airport land use
plan or, where such a plan has not been
adopted, within two miles of a public airport or
public use airport, would the project result in a
safety hazard for people residing or working in
the project area?
f) For a project within the vicinity of a private
airstrip, would the project result in a safety
hazard for people residing or working in the
project area?
g) Impair implementation of or physically interfere
with an adopted emergency response plan or
emergency evacuation plan?
h) Expose people or structures to a significant risk
of loss, injury or death involving wildland fires,
including where wildlands are adjacent to
urbanized areas or where residences are
intermixed with wildlands?
VII. (a-h). The proposed project and planned land
uses will not create a condition whereby hazards and/or
hazardous materials will be created.
VIII. HYDROLOGY AND WATER QUALITY. Would
the project:
a) Violate any water quality standards or waste
discharge requirements?
b) Substantially deplete groundwater supplies or
interfere substantially with groundwater
recharge such that there would be a net deficit
in aquifer volume or a lowering of the local
groundwater table level (e.g., the production rate
of pre-existing nearby wells would drop to a
level which would not support existing land uses
or planned uses for which permits have been
granted)?
c) Substantially alter the existing drainage pattern
of the site or area, including through the
alteration of the course of a stream or river, in a
manner, which would result in substantial
erosion or siltation on- or off-site?
d) Substantially alter the existing drainage pattern
of the site or area, including through the
alteration of the course of a stream or river, or
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substantially increase the rate or amount of
surface runoff in a manner which would result in
flooding on- or off-site?
e) Create or contribute runoff water which would
exceed the capacity of existing or planned storm
water drainage systems or provide substantial
additional sources of polluted runoff?
f) Otherwise substantially degrade water quality?
g) Place housing within a 100-year flood hazard
area as mapped on a federal Flood Hazard
Boundary or Flood Insurance Rate Map or other
flood hazard delineation map?
h) Place within a 100-year flood hazard area
structures, which would impede or redirect flood
flows?
i) Expose people or structures to a significant risk
of loss, injury or death involving flooding,
including flooding as a result of the failure of a
levee or dam?
j) Inundation by seiche, tsunami, or mudflow?
VIII. (a-j). Completion of the project will not result in any
negative impacts with respect to hydrology or water
quality.
IX. LAND USE AND PLANNING. Would the project:
a) Physically divide an established community?
b) Conflict with any applicable land use plan,
policy, or regulation of an agency with
jurisdiction over the project (including, but not
limited to the general plan, specific plan, local
coastal program, or zoning ordinance) adopted
for the purpose of avoiding or mitigating an
environmental effect?
c) Conflict with any applicable habitat conservation
plan or natural community conservation plan?
IX. (a-c) Completion of the project and the associated
land uses will be fully consistent with the General
plan and zoning ordinance for the area, a well as
the Downtown Azusa Vision and Positioning
Strategy, prepared to focus the City’s efforts on
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attracting unique businesses and uses to the
Downtown district.
X. MINERAL RESOURCES. Would the project:
a) Result in the loss of availability of a known
mineral resource that would be of value to the
region and the residents of the state?
b) Result in the loss of availability of a locally-
important mineral resource recovery site
delineated on a local general plan, specific plan
or other land use plan?
XI. NOISE. Would the project result in:
a) Exposure of persons to or generation of noise
levels in excess of standards established in the
local general plan or noise ordinance, or
applicable standards of other agencies?
b) Exposure of persons to or generation of
excessive groundborne vibration or
groundborne noise levels?
c) A substantial permanent increase in ambient
noise levels in the project vicinity above levels
existing without the project?
d) A substantial temporary or periodic increase in
ambient noise levels in the project vicinity above
levels existing without the project?
e) For a project located within an airport land use
plan or, where such a plan has not been
adopted, within two miles of a public airport or
public use airport, would the project expose
people residing or working in the project area to
excessive noise levels?
f) For a project within the vicinity of a private
airstrip, would the project expose people
residing or working in the project area to
excessive noise levels?
XI. (a-f) Completion of the project will not create
substantial increase in noise levels, either
during construction or following completion of
the project.
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XII. POPULATION AND HOUSING. Would the project:
a) Induce substantial population growth in an area,
either directly (for example, by proposing new
homes and businesses) or indirectly (for
example, through extension of road or other
infrastructure)?
b) Displace substantial numbers of existing
housing, necessitating the construction of
replacement housing elsewhere?
c) Displace substantial numbers of people,
necessitating the construction of replacement
housing elsewhere?
XII. (a-c) There is no impact on existing housing units
as a result of the project. Rather, the project will
add one additional housing unit in the Downtown
area, promoting a mix of uses, which will contribute
to enhancing the vitality of the district as various
renovation projects in the area continue to be
implemented.
XIII. PUBLIC SERVICES. Would the project:
a) Result in substantial adverse physical impacts
associated with the provision of new or
physically altered governmental facilities, need
for new or physically altered governmental
facilities, the construction of which could cause
significant environmental impacts, in order to
maintain acceptable service ratios, response
times or other performance objectives for any of
the public services:
Fire protection?
Police protection?
Schools?
Parks?
Other public facilities?
XIV. RECREATION. Would the project:
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a) Increase the use of existing neighborhood and
regional parks or other recreational facilities
such that substantial physical deterioration of
the facility would occur or be accelerated?
b) Does the project include recreational facilities or
require the construction or expansion of
recreational facilities which have an adverse
physical effect on the environment?
XV. TRANSPORTATION / TRAFFIC. Would the
project:
a) Cause an increase in traffic which is substantial
in relation to the existing traffic load and
capacity of the street system (i.e., result in a
substantial increase in either the number of
vehicle trips, the volume to capacity ratio on
roads, or congestion at intersections)?
b) Exceed, either individually or cumulatively, a
level of service standard established by the
county congestion management agency for
designated roads or highways?
c) Result in a change in air traffic patterns,
including either an increase in traffic levels or a
change in location that results in substantial
safety risks?
d) Substantially increase hazards due to a design
feature (e.g., sharp curves or dangerous
intersections) or incompatible uses (e.g., farm
equipment)?
e) Result in inadequate emergency access?
f) Result in inadequate parking capacity?
g) Conflict with adopted policies, plans, or
programs supporting alternative transportation
(e.g., bus turnouts, bicycle racks)?
XV. (a-g) The proposed project is a renovation/
rehabilitation of an existing Downtown structure
with a small addition to the rear of the building
2,244 s.f. in size. Taking into consideration the
existing commercial uses in the structure, the
net new building area and associated traffic
activity are anticipated to be negligible.
Adequate parking to support the project is
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located to the rear of the site.
XVI UTILITIES AND SERVICE SYSTEMS. Would
the project:
a) Exceed wastewater treatment requirements of
the applicable Regional Water Quality Control
Board?
b) Require or result in the construction of new
water or wastewater treatment facilities or
expansion of existing facilities, the construction
of which could cause significant environmental
effects?
c) Require or result in the construction of new
storm water drainage facilities or expansion of
existing facilities, the construction of which could
cause significant environmental effects?
d) Have sufficient water supplies available to serve
the project from existing entitlements and
resources, or are new or expanded entitlements
needed? In making this determination, the City
shall consider whether the project is subject to
the water supply assessment requirements of
Water Code Section 10910, et. seq. (SB 610),
and the requirements of Government Code
Section 664737 (SB 221).
e) Result in a determination by the wastewater
treatment provider, which serves or may serve
the project that it has adequate capacity to serve
the project’s projected demand in addition to the
provider’s existing commitments?
f) Be served by a landfill with sufficient permitted
capacity to accommodate the project’s solid
waste disposal needs?
g) Comply with federal, state, and local statutes
and regulations related to solid waste?
XVII MANDATORY FINDINGS OF SIGNIFICANCE
a) Does the project have the potential to degrade
the quality of the environment, substantially
reduce the habitat or a fish or wildlife species,
cause a fish or wildlife population to drop below
self-sustaining levels, threaten to eliminate a
plant or animal community, reduce the number
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or restrict the range of a rare or endangered
plant or animal or eliminate important examples
of the major periods of California history or
prehistory?
b) Does the project have impacts that are
individually limited, but cumulatively
considerable? (“Cumulatively considerable”
means that the incremental effects of a project
are considerable when viewed in connection
with the effects of past projects, the effects of
other current project, and the effects of probable
future projects.)
c) Does the project have environmental effects,
which will cause substantial adverse effects on
human beings, either directly or indirectly?
XVII (a-c) The project includes the renovation/rehabilitation of an existing 3,256 s.f. single-story structure
with the addition of approximately 2,244 s.f. to the rear of the existing structure. The proposed project is
designed to fit within the context and fabric of the Downtown district, adding uses which will promote
pedestrian activity within the district. The project I considered to be consistent with the City’s goal for
Downtown district revitalization.