NPS-28: CULTURAL RESOURCE MANAGEMENT GUIDELINE

ASSESSMENT OF ACTIONS HAVING AN EFFECT ON CULTURAL RESOURCES

A. DESCRIPTION OF UNDERTAKING

1. Park:__________________________ Park district (optional) ________________

2. Work/Project Description:
a. Project name ___________________ date ________ park project no(s.) _______
b. Describe project and area of potential effects (as defined in 36 CFR 800.2[c]); explain why work/project is needed.

3. Has the area of potential effects been surveyed to identify cultural resources?

___ No
___ Yes Source or reference _______________________
Check here if no known cultural resources will be affected. (If this is because area has been disturbed, please explain or attach additional information to show the disturbance was so extensive as to preclude intact cultural deposits.)

4. Potentially Affected Resource(s):

Name and number(s): _______________________ location: ____________
NR status: _____
Name and number(s): _______________________ location: ____________
NR status: _____ (REPEAT FOR EACH AFFECTED RESOURCE)

5. The proposed action will: (check as many as apply)
_____ Destroy, remove, or alter features/elements from a historic structure
_____ Replace historic features/elements in kind
_____ Add nonhistoric features/elements to a historic structure
_____ Alter or remove features/elements of a historic setting or environment (inc. terrain)
_____ Add nonhistoric features/elements (inc. visual, audible, or atmospheric) to a historic setting or cultural landscape
_____ Disturb, destroy, or make archeological resources inaccessible
_____ Disturb, destroy, or make ethnographic resources inaccessible
_____ Potentially affect presently unidentified cultural resources
_____ Begin or contribute to deterioration of historic features, terrain, setting, landscape elements, or archeological or ethnographic resources
_____ Involve a real property transaction (exchange, sale, or lease of land or structures)
_____ Other (please specify)

6. Measures to prevent or minimize loss or impairment of historic/prehistoric properties:
(Remember that setting, location, and use may be relevant.)

7. Supporting Study Data:
(Attach if feasible; if action is in a plan, EA or EIS, give name and project or page number.)

8. Attachments: [  ] Maps [  ] Archeological survey, if applicable [  ] Drawings [  ] Specifications [  ] Photographs [  ] Scope of Work [  ] Site plan [  ] List of Materials [  ] Samples [  ] Other _______________________________

Prepared by_______________________________ Date ________
Title _______________________________ Telephone ________

B. REVIEWS BY CULTURAL RESOURCE SPECIALISTS

The park 106 coordinator requested review by the park's cultural resource specialist/advisers as indicated by check-off boxes or as follows:

SPECIALISTS: Your comments here (or attached) show that you have reviewed this proposal for conformity with requirements of Section 106, with the 1995 Servicewide PA (if applicable), and applicable parts of the Secretary of the Interior's Standards and Guidelines for Archeology and Historic Preservation, the NPS Management Policies, and the NPS Cultural Resource Management Guideline, and have given your best professional advice about this project and the issues relevant to the Section 106 process, including identification and evaluation of historic properties and further consultation needs.

[ ] ARCHEOLOGIST
Name:
Date:
Comments:

Check if project does not involve ground disturbance [ ] Assessment of Effect: _____ No Effect _____ No Adverse Effect _____ Adverse Effect __________ Programmatic Exclusion
Recommendations for conditions or stipulations:

[ ] CURATOR
Name:
Date:
Comments

Assessment of Effect: _____ No Effect _____ No Adverse Effect _____ Adverse Effect __________ Programmatic Exclusion
Recommendations for conditions or stipulations:

[ ] ETHNOGRAPHER
Name:
Date:
Comments:

Assessment of Effect: _____ No Effect _____ No Adverse Effect _____ Adverse Effect __________ Programmatic Exclusion
Recommendations for conditions or stipulations:

[ ] HISTORIAN
Name:
Date:
Comments:

Assessment of Effect: _____ No Effect _____ No Adverse Effect _____ Adverse Effect __________ Programmatic Exclusion
Recommendations for conditions or stipulations:

[ ] HISTORICAL ARCHITECT
Name:
Date:
Comments:

Assessment of Effect: _____ No Effect _____ No Adverse Effect _____ Adverse Effect __________ Programmatic Exclusion
Recommendations for conditions or stipulations:

Check if project meets Secretary's Standards [ ]
Recommendations for conditions or stipulations:

[ ] HISTORICAL LANDSCAPE ARCHITECT
Name:
Date:
Comments:

Assessment of Effect: _____ No Effect _____ No Adverse Effect _____ Adverse Effect __________ Programmatic Exclusion
Recommendations for conditions or stipulations:

Check if project meets Secretary's Standards [ ]
Recommendations for conditions or stipulations:

[ ] OTHER ADVISERS
Name:
Title or area of specialty:
Date:
Comments:

Assessment of Effect: _____ No Effect _____ No Adverse Effect _____ Adverse Effect __________ Programmatic Exclusion
Recommendations for conditions or stipulations:

C. PARK SECTION 106 COORDINATOR'S REVIEW AND RECOMMENDATIONS

1. Assessment of Effect:

_____ No Effect _____ No Adverse Effect _____ Adverse Effect

2. Compliance requirements:

[ ] A. STANDARD 36 CFR PART 800 CONSULTATION
Further consultation under 36 CFR Part 800 is needed.

[ ] B. PROGRAMMATIC EXCLUSION UNDER THE 1995 SERVICEWIDE PROGRAMMATIC AGREEMENT (PA)

The above action meets all conditions for a programmatic exclusion under Stipulation IV of the 1995 Servicewide PA for Section 106 compliance.

APPLICABLE EXCLUSION: Exclusion IV.B _____ (Specify 1-13 or IV.C addition to thelist of exclusions.)

[ ] C. PLAN-RELATED UNDERTAKING

Consultation and review of the proposed undertaking were completed in the context of a plan review process, in accordance with the 1995 Servicewide PA and 36 CFR Part 800.
Specify plan/EA/EIS: __________________________

[ ] D. UNDERTAKING RELATED TO ANOTHER AGREEMENT
The proposed undertaking is covered for Section 106 purposes under another document such as a statewide agreement established in accord with 36 CFR 800.7 or counterpart regulations.
Specify: __________________________

[ ] E. STIPULATIONS/CONDITIONS
Following are listed any stipulations or conditions necessary to ensure that the assessment of effect above is consistent with 36 CFR Part 800 criteria of effect or to avoid or reduce potential adverse effects.

Recommended by Park Section 106 coordinator:
  Name ____________________________________________________
  Title ____________________________________________________
  Date _____________________

D. SUPERINTENDENT'S APPROVAL

The proposed work conforms to the NPS Management Policies and Cultural Resource Management Guideline, and I have reviewed and approve the recommendations, stipulations, or conditions noted in Section C of this form.

Name/Signature of Superintendent ____________________________________________________
Date _______________________

SUPPLEMENTAL GUIDANCE

The Section 106 process is described in regulations promulgated by the Advisory Council on Historic Preservation as 36 CFR Part 800. PLEASE SEE ESPECIALLY 36 CFR 800.4-6, 800.8, and 800.9. Additional guidance published by the Advisory Council includes Section 106, Step by Step and Preparing Agreement Documents. Both of these discuss information and documentation needs involved in Section 106. The following discussion is not a substitute for those documents, but a brief set of reminders.

This form may be used for actions that are undertakings as defined for purposes of Section 106. It is a model that may be altered to suit the needs of a particular park and its advisers. It may or may not be the most effective format for documenting Section 106 compliance, depending on the complexity and planning needs or history of the undertaking. It can be a starting point for the review process within NPS, and it may be used to document programmatic exclusions under the 1995 Servicewide Programmatic Agreement (stipulation IV). For some cases, a memorandum, more detailed report, or NEPA document that includes information meeting documentation requirements in 36 CFR Part 800 may be necessary or preferable.

The form is designed to follow, in a condensed way, the basic questions that should be asked and answered in meeting responsibilities under 36 CFR Part 800. The basic questions are:

A. What is the project and how did the park identify it as an undertaking subject to Section 106?

(As defined in 36 CFR 800.2[o], an undertaking means a project, activity, or program that can result in changes in the character or use of properties listed or eligible for listing in the National Register of Historic Places. If in doubt about whether a project is an undertaking subject to Section 106 review, the park's Section 106 coordinator should consult the state historic preservation officer (SHPO) or others in the park's group of CRM advisers on Section 106.)

B. Does the park know whether the project's "area of potential effects" includes properties in or eligible for the National Register of Historic Places?

(Did the park define the area of potential effects in a comprehensive way? What historic properties will be affected by this undertaking? How did NPS identify those properties; did NPS make a reasonable and good-faith effort to ensure that no places that might be eligible for the National Register have been overlooked? Did NPS have enough information to evaluate the Register eligibility of properties in the area? Documentation may include descriptions of those properties and of efforts to identify them, such as National Register forms and reports or narratives summarizing the resources and survey efforts.)

C. How will the project affect any such eligible historic properties?

(How did the park and its advisers apply the criteria of effect and adverse effect in 36 CFR 800.9? How did the park get the advice of the SHPO, and of other interested persons, on this point?)

D. Did the park provide opportunities for comment by local governments, Indian tribes, other interested persons and the public that were appropriate to the scale and type of the undertaking and the known or expected public interests?

E. If the undertaking would have adverse effects, how did the park and its advisers consider alternatives that would avoid or mitigate the potential for adverse effects?

Generally, Section 106 consultation results in an agreement document of the types described in the Council's Preparing Agreement Documents. That booklet provides suggestions for writing agreement documents and sample formats, as well as some standard language for conditions and stipulations.

Decisions about which CRM disciplines and technical skills are relevant to the project at hand are important. This form should reflect information showing how the park made decisions about which CRM specialists should participate in and advise on individual projects. It should be used to indicate how CRM specialists have been involved in those decisions. This does not mean, however, that every one of the park's CRM advisers must comment on every undertaking.

ITEM BY ITEM:

No. 2: "Area of potential effects" is defined in 36 CFR 800.2(c) as "the geographic area or areas within which an undertaking may cause changes in the character or use of historic properties, if any such properties exist."

No. 4: In the first blank, please include applicable park facility or site numbers or IDLCS, IDCLI, ARI, & HABS/HAER numbers. For location, please note UTM coordinates, if available, or township, range, and section if applicable and available. If neither of these is readily available, other location description may be used. In the last blank, specify National Register status of affected resource(s), entering the appropriate number from the list below:

(1) listed in Register and documented
(2) listed but not documented
(3) determined eligible by the Keeper of the Register
(4) determined ineligible by the Keeper
(5) found eligible for 106 purposes through consultation with the SHPO
(6) found not eligible for 106 purposes through consultation with the SHPO
(7) a designated National Historic Landmark
(8) within a Register-eligible district–please name district
(0) status unknown by person completing Part A of the form