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