617.20Appendix B

Short Environmental Assessment Form

Instructions for Completing

Part 1- Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responsesbecome part of the application for approval or funding, are subject to public review, and may be subject to further verification.Complete Part I based on information currently available. If additional research or investigation would be needed to fullyrespond to any item, please answer as thoroughly as possible based on current information.

Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or usefulto the lead agency; attach additional pages as necessary to supplement any item.

Part 1- Project and Sponsor Information

Name of Action or Project:HiepStorageYard

Project Location (describe, and attach a location map):

Atthe intersectionof BurtsRoadand LongCloveRoad (aka LandmarkDrive)

Brief Description of Proposed Action:Constructionofa proposed170' x 280' open contractorstorage yardforstorage ofgarbage dumpsters.

Name of Applicant or Sponsor: Telephone: 845-596-2535

5 BurtsRoad, Inc. E-Mail: info@hiepsanitation.comAddress:

POBox220

CityIPO: I State: IZip Code:WestNyack NY 10954

1. Does the proposed action only involve the legislative adoption of a plan, local law, ordinance, NO YESadministrative rule, or regulation?

[l] DIf Yes, attach a narrative description of the intent of the proposed action and the environmental resources thatmay be affected in the municipality and proceed to Part 2. If no, continue to question 2.

2. Does the proposed action require a permit, approval or funding from any other governmental Agency? NO YESIf Yes, list agency(s) name and permit or approval:

0 1ZITownPlanningBoardforSite Planapproval,RCHealthDept.forMosquitoSuppression,RCPlanningBoardforGML-LongPath

3.a. Total acreage of the site of the proposed action? 1.569 acresb. Total acreage to be physically disturbed? 1.5 acresc. Total acreage (project site and any contiguous properties) owned

or controlled by the applicant or project sponsor? 1.569 acres

4. Check all land uses that occur on, adjoining and near the proposed action.DUrban oRural (non-agriculture) IZI Industrial D Commercial OResidentiaI (suburban)IZIForest DAgriculture oAquatic 1lI0ther (specify): Contractorstorage yardDParkland

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5. Is the proposed action, NO YES N/Aa. A permitted use under the zoning regulations? D [Z] Db. Consistent with the adopted comprehensive plan? D [(] D

6. Is the proposed action consistent with the predominant character of the existing built or natural NO YESlandscape? D [Z]

7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? NO YESIf Yes, identify: 0 D8. a. Will the proposed action result in a substantial increase in traffic above present levels? NO YES

[Z] Db. Are public transportation service(s) available at or near the site of the proposed action? [{] Dc. Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? D [Z]

9. Does the proposed action meet or exceed the state energy code requirements? NO YESIf the proposed action will exceed requirements, describe design features and technologies:

D [Z]10. Will the proposed action connect to an existing public/private water supply? NO YES

If No, describe method for providing potable water: [{] DNobuildingsare proposed.

11. Will the proposed action connect to existing wastewater utilities? NO YES

If No, describe method for providing wastewater treatment: [{] DOwnerwillutilizeportablerestroomfacilitiesforsanitarywastes.

12. a. Does the site contain a structure that is listed on either the State or National Register of Historic NO YESPlaces? [Z] Db. Is the proposed action located in an archeological sensitive area? D 0

13. a. Does any portion of the site of the proposed action, or lands adjoining the proposed action, contain NO YESwetlands or other waterbodies regulated by a federal, state or local agency? [Z] D

b. Would the proposed action physically alter, or encroach into, any existing wetland or waterbody? [Z] DIf Yes, identify the wetland or waterbody and extent of alterations in square feet or acres:

14. Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply:D Shoreline IIIForest D Agricultural/grasslands IIIEarly mid-successionalD Wetland DUrban DSuburban

15. Does the site of the proposed action contain any species of animal, or associated habitats, listed NO YESby the State or Federal government as threatened or endangered? 0 D

16. Is the project site located in the 100 year flood plain? NO YES

III I I17. Will the proposed action create storm water discharge, either from point or non-point sources? NO YESIf Yes, D 0a. Will storm water discharges flow to adjacent properties? DNO IZlYES

b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)?If Yes, briefly describe: DNO IZlYES

Undergrounddetentionsystem proposed alongnorthwestcornerof site

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18. Does the proposed action include construction or other activities that result in the impoundment of NO YESwater or other liquids (e.g. retention pond, waste lagoon, dam)?

If Yes, explain purpose and size:

D [{]I IndergrDl IOddetention system proposed along northwest comer of the site will provide stormwater quantltz mitigation

19. Has the site of the proposed action or an adjoining property been the location of an active or closed NO YESsolid waste management facility?

If Yes, describe: [{] D20. Has the site of the proposed action or an adjoining property been the subject of remediation (ongoing or NO YES

completed) for hazardous waste?If Yes, describe: [{] DI AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MYKNOWLEDGE

APPliCantls'fZ!:0\ ~Y.!Ken DeGennaro, PE, CFM Date: 09/14/2017

Signature: ~-- ...• ~

PRINT FORM Page 3 of3

EAF Mapper Summary Report Thursday, September 14, 20171:35 PM

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Disclaimer: The EAF Mapper is a screening tool intended to assistproject sponsors and reviewing agencies in preparing an environmentalassessment form (EAF). Not all questions asked in the EAF areanswered by the EAF Mapper. Additional infonnation on any EAFquestion can be obtained by consulting the EAF Workbooks. Althoughthe EAF Mapper provides the most up-to-date digital data available toDEC. you may also need to contact local or other data sources in orderto obtain data not provided by the Mapper. Digital data is not asubstitute for agency determinations.

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-_._-------------------- ---! Part 1 I Question 7 [Critical Environmental INo[Area] I 'l--~-~"~---,·--~--------·~------,·-·--·-·----{-~--··'".-~~-,----.-.-~---.-.-~-~------.~~.---------.--.-~--------.---~.~:Part 1 I Question 12a [National Register of iNo i.iHistoric Places] I iiPart-1! Qu-;~tio~1-2b [Ar;;t:;~~logi~~1Sit;~--rye;---------------------- ----------- ...-- --------.-------~

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i Endangered Animal] l ii-·----"-------·~"-----·--"----~·---...----.J.-.-.-.-."--------- ..---·-"----"-"--.-------.-""--"--"--.-.-----.------------"--~Part 1 I Question 16 [100 Year Flood Plain] I No 1

i'P;rt1TQuesti~n 20 [Remedi~tion"Site] "I No -------------------------------.-.-----------".--------- __...1t~_._______ 1 , .•. __~ , .• ~~

Short Environmental Assessment Form --EAF Mapper Summary Report 1