Forms and Templates

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Subject Area

• Middle-Mile Broadband Network (MMBN)
• PEAR
• Technical Studies/Guidance
  • Air Quality
  • Biology
  • Community Impact Assessment
  • Cultural Studies
  • Energy
  • Floodplain
  • Noise
  • Paleontology
  • Water Quality
• CEQA
• NEPA and NEPA Assignment
• Annotated Outlines/Re-Validation Form/Samples
• Writing Templates
• Notices
  • CEQA
  • NEPA
• Environmental Commitment Compliance

Middle-Mile Broadband Network (MMBN)

• MMBN CEQA Exemption/NEPA Categorical Exclusion Form (DOCX) (posted 03-18-25)
• MMBN Categorical Exclusion Checklist (DOCX) (posted 03-18-25)
• MMBN BLM Environmental Assessment Template (DOCX) (posted 03-18-25)

PEAR

• Blank PEAR Format (DOCX) (posted 07-02-20)
• Blank Mini-PEAR Format (DOCX) (posted 07-02-20)
• Attachment A - PEAR Environmental Studies Checklist (DOCX) (posted 06-24-20)
• Attachment B - Mitigation and Compliance Cost Estimate (MCCE) (DOCX) (posted (07-02-20)
• Attachment D - Caltrans staff should use the “Bottom Up Tool.” External partners should contact their local Caltrans district office for direction. 

Technical Studies/Guidance

Air Quality

• Air Pollution Standards Table (DOCX) (posted 05-29-20)
• Air Quality Report Annotated Outline (DOCX) (posted 06-10-24)
• Air Quality Conformity Analysis Annotated Outline (DOCX) (posted 06-25-24)
• Air Quality Conformity Analysis Cover Letter (sample) (DOCX) (posted 04-03-23)
• Air Quality Conformity Findings Checklist (DOCX) (posted 02-18-22)
• Air Quality Conformity Public Notice Language (PDF) (posted 06-30-20)
• Conformity Streamlining Exemption Form (DOCX) (posted 05-12-20)
• Ambient Air Quality Standards can be found on the California Air Resources Board website
• FHWA Submittal Package Checklist (DOCX) (posted 06-25-24)

Biology

• Quality Control and Assurance for Biological Technical Documents (PDF) (posted 07-11-23)
• Natural Environment Study (NES) (DOCX) (posted 08-12-22)
• NESMI (DOCX) (posted 08-12-22)
• Guidance for District Submittals for Alternative Natural Environment Study (Minimal Impact) (NES MI) - No Effect (PDF)
• Biological Assessment (BA) (DOCX) (posted 06-25-20)
• USFWS Biological Assessment Checklist (DOCX) (posted 10-28-20) 
• NMFS Biological Assessment Checklist (DOCX) (posted 10-28-20) 

Community Impact Assessment

• Community Impact Assessment (CIA) template (DOCX) (posted 02-21-25) 
• The following forms can be found on the Natural Resources Conservation Service website under FPPA Forms and Resources:
  • Form NRCS-CPA-106 (corridor type projects)
  • Form AD-1006 (non-corridor type projects)

Cultural Studies

• Cultural Resources Compliance Document templates

Energy

• Energy Analysis Report Annotated Outline (DOCX) (posted 01-31-24)
• Energy Analysis Technical Memo (DOCX) (posted 01-31-24)

Floodplain

• Floodplain Forms: Location Hydraulic Study (DOCX) (posted 06-23-20)
  • For Local Assistance projects, please use the form located on the Local Assistance page
• Floodplain Forms: Summary of Floodplain Encroachment Report (DOCX) (posted 06-23-20)
  • For Local Assistance projects, please use the form located on the Local Assistance page

Noise

• Annotated Noise Study Report Outline (DOCX) (posted 04-01-15)
  (to be completed by the Noise Specialist)
  • Figure 5.1 (PDF) (posted 05-21-20)
• Annotated Noise Abatement Decision Report Outline (DOCX) (posted 10-04-12)
  (to be completed by the Project Engineer)

Paleontology

• Paleontological Evaluation Report Template (DOCX) (posted 02-21-25)
• Paleontological Identification Report Template (DOCX) (posted 02-21-25)
• Paleontological Identification Report/Paleontological Evaluation Report Template (DOCX) (posted 02-21-25)

Water Quality

• Water Quality Assessment Report Template (DOCX) (posted 12-15-22)
• Water Quality Scoping Questionnaire (DOCX) (posted (12-15-22)

CEQA

• EIR Certification Form (DOCX) (posted 05-12-20)
• CEQA Checklist (DOCX) (posted 06-19-20)
• Negative Declaration (ND) (DOCX) (posted 03-02-20)
• Mitigated Negative Declaration (MND) (DOCX) (posted 03-02-20)
• Statement of Overriding Considerations Form (DOCX) (posted 05-12-20)
• Findings (DOCX) (posted 05-29-20)

NEPA and NEPA Assignment

• CEQA Exemption/NEPA Categorical Exclusion (CE/CE) Form (DOCX) (posted 06-02-22)
• Categorical Exclusion Checklist (DOCX) (posted 02-27-25)
• Internal Quality Certification (DOCX) (posted 1-2-25)
• External Readiness Certification (DOCX) (posted 11-19-21)
• District Quality Control Checklist (PDF) (posted 03-02-20)
• Instructions for Using Uniform Environmental Filing System (PDF)
• Template for Uniform Filing System Tabs (DOCX) (posted 06-24-20)
• Environmental Document Review Checklist (DOCX) (posted 06-19-20) 

Annotated Outlines/Re-Validation Form/Samples

• IS/EA Annotated Outline (DOCX) (posted 12-05-23)
• EIR/EA Annotated Outline (DOCX) (posted 12-05-23)
• EIR/EIS Annotated Outline (DOCX) (posted 12-05-23)
• NEPA Only EIS (DOCX) (posted 12-05-23)
• NEPA Only EA (DOCX) (posted 12-05-23)
• Climate Change Annotated Outline Capacity Increasing (DOCX) (posted 06-17-24)
• Climate Change Annotated Outline Non-Capacity Increasing (DOCX) (posted 06-17-24)
• Programmatic Section 4(f) Evaluation (DOCX) (posted 02-08-23)
• NEPA/CEQA Re-Validation Form (DOCX) (posted 09-24-24)
• Draft EIR/EIS Distribution List Sample (DOCX) (posted 04-27-16)
• Final EIR/EIS Distribution List Sample (DOCX) (posted 04-27-16)
• Sample Environmental Study Request (ESR) Form (DOCX) (posted 11-19-20)
• FONSI Sample (DOCX) (posted 06-02-22)
• The Title VI Policy Statements can be found on the Caltrans Title VI website

Writing Templates

• IS/EA Writing Template (DOCX) (posted 08-09-23)
• EIR/EA Writing Template (DOCX) (posted 08-09-23)
• EIR/EIS Writing Template (DOCX) (posted 02-27-25)
• NEPA Only EIS Writing Template (DOCX) (posted 02-27-25)
• NEPA Only EA Writing Template (DOCX) (posted 02-08-23)
• Streamlined EA Writing Template (DOCX) (posted 02-01-23)
• Stand-Alone Appendix Writing Template (DOCX) (posted 02-01-23)

Notices

CEQA

• Notice of Intent to Adopt a ND or MND: Follow the guidance in Chapter 11 and Appendix HH of the PDPM
• Notice of Exemption (NOE) (posted 10-14-24)
• Notice of Completion (NOC) (posted 10-14-24)
• Notice of Preparation (NOP) (posted 10-14-24)
• Notice of Determination (NOD) (posted 10-14-24)

NEPA

• Notice of Availability - FONSI (DOCX) (posted 02-05-20)
• Notice of Intent - EIS Sample (DOCX) (posted 06-29-20)
• Notice of Statute of Limitations on Claims (DOCX) (posted 09-01-23) 

Environmental Commitment Compliance

• PS&E / Ready to List Review Tool (DOCX) (posted 10-06-22)
• Certificate of Environmental Compliance at CCA (MS 600) (DOCX) (posted 10-06-22)
• Certificate of Environmental Compliance at Project Closeout (MS 800) (DOCX) (posted 09-10-24)
• Environmental Certification (DOCX) (posted 10-06-22)
• Environmental Commitments Record (ECR) Form (DOCX) (posted 05-08-23)
• Sample Environmental Commitments Record (ECR) (PDF) (posted 11-12-20)
• Stormwater TBMP Certification M460 (DOCX) (posted 10-06-22)
• Stormwater TBMP Certification M600 (DOCX) (posted 10-06-22)
• Stormwater TBMP Certification M800 (DOCX) (posted 10-06-22)