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Get Form 2006 38 2007-2024

Form RD 2006-38 Rev. 07-07 Rural Development Environmental Justice EJ and Civil Rights Impact Analysis CRIA Certification 1. Applicant s name and proposed project description Attach a map of the proposal s area of effect identifying location or EJ populations location of the proposal area of impact or Attach results of EJ analysis from the Environmental Protection Agency s EPAs EnviroMapper with proposed project location and impact footprint delineated* 4. Does the applicant s proposal or Agency action directly indirectly or cumulatively affect the quality and/or level of services provided to the community Yes No N/A 5. Is the applicant s proposal or Agency action likely to result in a change in the current land use patterns types of land use development densities etc 6. Does a demographic analysis indicate the applicant s proposal or Agency s action may disproportionately affect a significant minority and/or low-income populations If answer is no skip to item 12. If answer is yes continue with items 7 through 12. 7. Identify describe and provide location of EJ population 8. If a disproportionate adverse affect is expected to impact an EJ population identify type/level of public outreach implemented* 9. Identify disproportionately high and adverse impacts on EJ populations. 10. Are adverse impacts appreciably more severe or greater in magnitude than the adverse impacts expected on nonminority/low-income populations 11. Are alternatives and/or mitigation required to avoid impacts to EJ populations If yes describe 12. I certify that I have reviewed the appropriate documentation and have determined that No major EJ or civil rights impact is likely to result if the proposal is implemented* Name and Title of Certifying Official Date. Applicant s name and proposed project description Attach a map of the proposal s area of effect identifying location or EJ populations location of the proposal area of impact or Attach results of EJ analysis from the Environmental Protection Agency s EPAs EnviroMapper with proposed project location and impact footprint delineated* 4. Does the applicant s proposal or Agency action directly indirectly or cumulatively affect the quality and/or level of services provided to the community Yes No N/A 5. Does the applicant s proposal or Agency action directly indirectly or cumulatively affect the quality and/or level of services provided to the community Yes No N/A 5. Is the applicant s proposal or Agency action likely to result in a change in the current land use patterns types of land use development densities etc 6. Is the applicant s proposal or Agency action likely to result in a change in the current land use patterns types of land use development densities etc 6. Does a demographic analysis indicate the applicant s proposal or Agency s action may disproportionately affect a significant minority and/or low-income populations If answer is no skip to item 12. Does a demographic analysis indicate the applicant s proposal or Agency s action may disproportionately affect a significant minority and/or low-income populations If answer is no skip to item 12. If answer is yes continue with items 7 through 12. 7. Identify describe and provide location of EJ population 8. .

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