SFTF NEPA Review Checklist

Instructions: This form must be completed for each operation at the South Florida Testing Facility with the potential to impact the environment. This includes but is not limited to range operation, site maintenance and minor construction, and major site improvements/modifications. This form must be submitted to the site environmental manager prior to the operation, and during the project planning stage. This will allow sufficient time for environmental review and any necessary documentation.

Project POC Phone Number Code/Organization

Proposed Action (brief description, attach test plan if available) Repetitive? __ Yes __ No

Location of Proposed Action

60 ft range 600 ft range 1200 ft range Off-site ___

___ ___ ___ Location: ____________________________

Proposed Start Date Completion Date/On-going Operation

Category (check all that apply)

___ ISE ___R&D ___T&E ___Test Facility M&R ___ Fleet Support

___ Base Operating Support ___Acoustics ___Construction ___ Other:

___ NEPA Documentation was done externally (attach copy)

For acoustic operations, provide the following:

___ Passive ____ Active

Source frequency (kHz): ___________________________________________________________

If classified, provide range of frequencies that include project

Source output level (dB//μPa at 1 meter): ______________________________________________

If classified, provide range of source level that includes project

Source directivity: ________________________________________________________________

Length of transmission, duty cycle, etc.: ______________________________________________

Any other acoustic characteristics that may aid in environmental analysis: ___________________

_______________________________________________________________________________

Signature of Project P.O.C. Submission Date

____________________

Fax copy of this form to Bill Baxley, SFTF, (954) 926-4031, or email baxleywe@nswccd.navy.mil