The applicant shall provide the following information on the “Environmental Review” form, NHDES-W-03-261, January 2021, available at https://onlineforms.nh.gov/?FormTag=NHDES-W-03-261 or via the department’s web site at www.des.nh.gov:
- (a) The water system’s name, mailing address, and PWS identifier;
- (b) The short title for the project;
(c) An introductory paragraph that reads as follows, with the water system’s name filled in:
“The [PWS Name] has applied for funds through the State of New Hampshire Department of Environmental Services PFAS Remediation Loan Fund (PFAS RLF), in accordance with NH Code Admin. Rules Env-Dw 1400. This document fulfills the requirements of Env-Dw 1404.01(a)(4) relative to providing information on the environmental review required by Env-Dw 1406.”
- (d) An overview of the applicant’s water system and its customers, including the system’s source(s), capacity, number of service connections, and approximate population served;
- (e) An explanation of the need and justification for the proposed project;
- (f) A description of the scope of the proposed project, including estimated costs;
- (g) A list of each document that is available for public review that supplements the information provided pursuant to (d)-(f), above;
- (h) A summary of potential environmental impacts arising from the proposed project relative to air emissions, noise, surface water, groundwater, wetlands, wildlife, and habitat;
- (i) A summary of potential impacts on the community in terms of social and economic aspects, recreation, historic sites, and indirect impacts;
- (j) The date the applicant’s governing body authorized funding for the project or is expected to authorize such funding;
- (k) A statement that the applicant agrees to publish a public notice to initiate a 30-day comment period on the report; and
- (l) An 8.5-inch by 11-inch copy of a topographic map at a scale that clearly identifies the location of the project and maximum extent of disturbance.
Source. #13164, eff 1-26-21; ss by #13372, eff 4-21-22