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AFE TRACKING #: DATE: SUBMITTED BY: Yes No NA (Include applicable drawings and process descriptions as needed for clarity - if the project involves changes to the ammonia system, include equipment P&ID's and mark affected equipment tags.) The following checklist will help determine the need for modification of government issued facility permits and their operating conditions. The checklist will also aid in scheduling to ensure that appropriate permits and/or permit modifications are submitted and approved prior to equipment purchase or facility modifications or construction. The Project Manager is personally responsible for reviewing these questions and describing any impacts anticipated that might fall under the listed pro- grams. The Plant Controller will coordinate with the Technical Services Director of Environmental Operations, the Project Manager, and Plant Engineer on each project that has been determined to have a potential impact on the listed programs. This will ensure proper environmental mitigation has been put in place prior to project execution. Permits and permit modifications are issued at the discretion of the issuing agency. In every case, permit modifications need to be addressed early in the project to allow for issuance of changes - in some cases issuing agencies have up to 6 months to act on permits, including public notification periods. The Director of Technical Services, Environmental Operations will coordinate agency contacts for the purposes of permit issuance and modifications. Indicate below if the project will result in any of the following: (Attach complete explanation of "yes" answers.) Increase / decrease consumption of CIP chemicals (+/-5% plant total of bulk chemicals or 10% by department) Increase / decrease cow water demand or usage (+/-5% of total cow water generated by whey plant) Clean Water Act Increase / decrease plant process wastewater flow (+/-5% total plant flow or 10% department flow) Increase / decrease product losses to the drain (+/-5% total plant flow or 10% department BOD) Increase / decrease in brine from any system due to mechanical or process changes (+/-50 gallons in process) ENVIRONMENTAL STATEMENT CHECK LIST Increase / decrease the amount of any characteristic of sanitary wastewater (all changes to non process sewers) Project Scope Description The following information is required for preparation of an environmental statement: ENVIRONMENTAL Page ____ of ____ 108018207-02 11/27/2018 Ben Schlegelmilch Storage Freezer Ice Safety Improvements - Supplement 2 Hot Gas Lines