\ US Environmental Protection Agency
(W : WIFIA Program
	PEA Environmental Questionnaire

VERSION: February 2021

WIFIA PEA SRF ENVIRONMENTAL QUESTIONNAIRE

INSTRUCTION GUIDE

The Programmatic Environmental Assessment (PEA) Environmental Questionnaire helps verify the applicability
of the PEA for Water Infrastructure Finance and Innovation Act (WIFIA) State Revolving Fund (SRF) projects.

General Guidance for the WIFIA Borrower	

•	Completing the PEA questionnaire can be an iterative process. The document may be revised after
its initial submittal to incorporate project changes or clarifying questions made by WIFIA.

•	The borrower should submit a completed PEA questionnaire (attached as Appendix B) including all
relevant information and supporting documents listed in this checklist.

•	Individual projects listed in Section A of Appendix B, Environmental Questionnaire, may be replaced
with different eligible projects by an SRF prospective borrower after the WIFIA Loan Agreement
(WLA) has been executed, with EPA review and approval as consistent with terms outlined in the
WLA.

•	When submitting the Environmental Questionnaire, ensure that:

o All questions have been answered fully based on all available information,
o All resource impacts have been evaluated and responses are filled in for each row.
o All supporting documentation references and citations is provided.

•	Additional pages may be attached as necessary.

Impact Assessment Guidance	

Assess anticipated impacts for each environmental resource. For each resource select either no impact,

less than significant impact, or significant impact as described below and consistent the PEA. Impacts

may be associated with construction and/or operation of the project.

•	No Impact: Select "no impact or N" if there is no potential for the project to affect a resource (e.g., the
project falls outside a coastal zone).

•	Less Than Significant Impact: Select "less than significant impact or LS" box if the incorporation of
mitigation measures will reduce an effect from "significant impact" to "LS".

•	Significant Impact: Select "significant impact or S" box if impacts remain significant despite the
incorporation of mitigation measures, or if impacts fall outside the scope of those considered in the PEA.
Select "S" for a proposed project that is likely to have significant effects or when the significance of likely
effects is unknown.

•	Impact Overview: Provide a brief impact overview for each resource category with "LS" or "S". An
overview is not required for resource categories marked with "N". Narrative descriptions may be
included in the space provided or additional pages may be added.

o Include a brief description of project mitigation measures, best management practices (BMPs) or
standard operating procedures (SOPs) to avoid, minimize or compensate for impacts.

Definitions for the Env Questionnaire	

•	WIFIA Borrower- the entity applying to the WIFIA program

•	WIFIA Project- the scope of work or grouping of individual SRF projects comprising the WIFIA loan

•	SRF Projects- the individual SRF projects brought to the SRF by entities or sponsors that are not the WIFIA
borrower

WIFIA

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\ US Environmental Protection Agency
(W : WIFIA Program
	PEA Environmental Questionnaire

APPENDIX B: ENVIRONMENTAL QUESTIONNAIRE FOR
WIFIA CREDIT ASSISTANCE TO SRF PROGRAMS

This questionnaire, which will be completed by prospective borrowers and reviewed by the WIFIA program,
supports the Programmatic Environmental Assessment (PEA) "tiering" framework, the PEA's associated
preliminary Finding of No Significant Impact (FONSI), and project-specific NEPA documentation for the WIFIA
program.

1.	WIFIA Borrower name: Click or tap hereto enter text.

2.	SRF Program Type(s): ~ Clean Water SRF ~ Drinking Water SRF

3.	Provide an overview of the State Environmental Review Process (SERP). Provide a copy of the SERP or
SRF Operating Agreement with EPA.

Click or tap here to enter text.

4.	What procedures, methodology or tools are used by the WIFIA Borrower to assess and determine the
impacts of projects within the state environmental review process?

Click or tap here to enter text.

5.	Use the attached Section A SRF Project Impact Summary Spreadsheet to identify individual SRF projects,
including project sponsor or entity, that will be included in the WIFIA loan. For each SRF project, identify
any potential impacts for each resource category. This spreadsheet will provide an overview of the
determinations for SRF project comprising the WIFIA project that EPA will verify as part of its
environmental review.

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Programmatic Environmental Assessment of the

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A. SRF PROJECT IMPACT SUMMARY TABLE

For each SRF borrower please identify each project name and indicate in the table below if there are significant impacts to each of the resource
topics discussed above. Complete instructions can be found in the Excel version of this table.





"N" indicates no impacts to a resource,

"LS" indicates adverse impacts that are less than significant to a resource,
"S" indicates significant impacts to a resource.

Only for Resources
indicated with "LS" or
"S"



SRF
Borrower

Project
Name

Land Use

Air Quality

Noise/Vibration

Geological/Soil Resources

Water Resources

Biological Resources

Cultural Resources

Socioeconomics/ EJ

Traffic/ Transportation

Utilities/ Community
Resources

Hazardous and Toxic
Materials and Waste

Human Health and Safety

Other Considerations

Impact
Overview

Mitigation
Measu res,
BMPs,
SOPs

SRF Impact
Determina
tion and
Date of
Determina
tion





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Programmatic Environmental Assessment of the

WIFIA Program

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