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Local Assistance Procedures Manual Exhibit 6 -A <br />Preliminary Environmental Study (PES) Form <br />18. <br />Is there a potential for agricultural wetlands to occur within or adjacent to the construction area? <br />❑ <br />❑ <br />M <br />19. <br />Is there a potential for the introduction or spread of invasive plant species? <br />® <br />❑ <br />❑ <br />Sections 4(f) and 6(f) <br />20. <br />Are there any historic sites or publicly owned public parks, recreation areas, wildlife or waterfowl <br />❑ <br />❑ <br />M <br />refuges (Section 4[t]) within or immediately adjacent to the construction area? <br />21. <br />Does the project have the potential to affect properties acquired or improved with Land and Water <br />❑ <br />❑ <br />N <br />Conservation Fund Act (Section 6[t]) funds? <br />Visual Resources <br />22. <br />Does the project have the potential to affect any visual or scenic resources? <br />❑ <br />M <br />❑ <br />Relocation <br />Impacts <br />23. <br />Will the project require the relocation of residential or business properties? <br />M <br />❑ <br />❑ <br />Land Use, Community, and Farmland Impacts <br />24. <br />Will the project require any right of way, including partial or full takes? Consider construction <br />N <br />❑ <br />❑ <br />easements and utility relocations. <br />25. <br />Is the project inconsistent with plans and goals adopted by the community? <br />❑ <br />❑ <br />N <br />26. <br />Does the project have the potential to divide or disrupt neighborhoods/communities? <br />❑ <br />❑ <br />N <br />27. <br />Does the project have the potential to disproportionately affect low- income and minority <br />❑ <br />M <br />❑ <br />populations? <br />28. <br />Will the project require the relocation of public utilities? <br />M <br />❑ <br />❑ <br />29. <br />Will the project affect access to properties or roadways? <br />N <br />❑ <br />❑ <br />30. <br />Will the project involve changes in access control to the State Highway System (SHS)? <br />❑ <br />❑ <br />M <br />31. <br />Will the project involve the use of a temporary road, detour, or ramp closure? <br />M <br />❑ <br />❑ <br />32. <br />Will the project reduce available parking? <br />N <br />❑ <br />❑ <br />33. <br />Will the project construction encroach on state or federal lands? <br />❑ <br />❑ <br />M <br />34. <br />Will the project convert any farmland to a different use or impact any farmlands? <br />❑ <br />❑ <br />N <br />Cultural <br />Resources <br />35. <br />Is there National Register listed, or potentially eligible historic properties, or archaeological <br />❑ <br />❑ <br />❑ <br />resources within or immediately adjacent to the construction area? <br />(Note: Caltrwis PQS ansmvers question #35) <br />36. <br />Is the project adjacent to, or would it encroach on Tribal land? <br />❑ <br />❑ <br />N <br />Page 6 -71 <br />EPP 08 -02 19E-64 May 30, 2008 <br />