<p> EQ-102 Revised 6/6/05</p><p>TO: FILE FROM: John Muse VDOT District Environmental Manager (select from list http://www.virginiadot.org/business/Environmental_District_Contacts.asp) DATE: / / </p><p>PROGRAMMATIC CATEGORICAL EXCLUSION DOCUMENTATION</p><p>Route: State Route number, or if urban, Street Name Project Number: Number assigned by VDOT From: Start termini To: End termini Federal Project: Number assigned by VDOT County/City: Location of project PPMS/UPC ID: Number assigned by VDOT</p><p>The subject project meets the criteria for Programmatic Categorical Exclusion in accordance with:</p><p>23 CFR 771.117 (c)(1) See FHWA list of CE’s in 23 CFR 771.117 (c). Agreement approved by the Federal Highway Administration on December 29, 2004 (d)(1) (select from list in attachment).</p><p>PCE Agreement.pdf</p><p>Description of CE Category: Project Description: </p><p>USGS Map Indicate location of project N/A (For Non-highway construction only)</p><p>IMPACTS: If any YES boxes are checked, the PCE will not be applicable. YES NO Significant Impacts to Planned Growth or Land Use. Consult with locality planning office. If significant impacts, PCE form cannot be  used. Relocations. Are any residential, commercial, or non-profit relocations necessary?  Source: Identify and document where information was obtained. Substantial Land Acquisition If substantial land acquisitions, PCE form  cannot be used. USCG Construction Permit, USACE Individual Section 404 Permit. If Coast Guard or Individual permits are required, PCE form cannot be used.  Source: Identify and document where information was obtained. Adverse Effect on Historic Properties. Consult with VA Dept. of Historic Resources for this information. If Adverse Effect, PCE form cannot be used.  Source: Identify and document where information was obtained. EQ-102 Revised 6/6/05</p><p>Use of Land Protected by Section 4(f). See FHWA Policy paper  Significant Air, Noise or Water Quality Impacts. If significant impacts, PCE form cannot be used.  Source: Identify and document where information was obtained. Significant Impacts on Travel Patterns. If significant impacts, PCE  form cannot be used. Changes in Interstate Access Control. If significant impacts, PCE form  cannot be used. Individual or Cumulative Significant Environmental Impacts. If  significant impacts, PCE form cannot be used.</p>