Environmental Review Program

Action Name*

Type of Document/Determination*

HRS §343-5(a) Trigger(s)*

Check all that apply.

Judicial district*

Tax Map Key(s) (TMK(s))*

Format: (X) X-X-XXX:XXX [(Division) Zone-Section-Plat:Parcel] separated by semicolons

Action type*

Agency
Applicant

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Permit(s)/approval(s)*

Check all that apply.

Other required permits and approvals*

If not applicable or not required, enter "none"

Discretionary consent required*

Identify the specific discretionary consent(s) (separate from "general" permits and approvals) that, along with a trigger, invokes Chapter 343, HRS.

Proposing/determining agency*

Agency jurisdiction*

Approving agency*

Agency contact name*

First Last

Agency contact email (for info about the action)*

Email address for receiving comments

If a URL is being provided to a web platform that will receive comments, please confirm this with an email to our office at [email protected].

Agency contact phone*

Agency address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Public Scoping Meeting information*

Date/Time Location

Accepting authority*

Accepting authority contact name*

First Last

Accepting authority contact email or URL*

Accepting authority contact phone*

Accepting authority address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Applicant*

Applicant contact name*

First Last

Applicant contact email*

Applicant contact phone*

Applicant address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is there a consultant for this action?*

Yes
No

Consultant*

Consultant contact name*

First Last

Consultant contact email*

Consultant contact phone*

Consultant address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Action summary*

Describe the action using no more than 1200 characters.

Reasons supporting determination*

Provide the agency's reasons supporting their determination (or refer to the section [e.g., the Significance Criteria discussion in an EA] within the document that does so).

Attached documents (signed agency letter & EA/EIS)*

Submit one .pdf of the signed agency letter and one unlocked, searchable, & ADA accessible .pdf of the EA/EIS document, and the EIS scoping meeting audio file, as appropriate. Maximum single file size: 300MB; maximum total upload: 1500MB. If the entire document is larger than 1500MB, please submit it as multiple PDFs, clearly labeled (e.g., Volume 1 of 2). If the entire submittal is larger than 1500MB, please notify our office that you will be completing multiple versions of this form with the additional clearly labeled files.

Drop files here or

Accepted file types: pdf, m4a, mp3, Max. file size: 1 GB.

ADA Compliance certification*

This is to certify that documents submitted are ADA accessible.

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Distribution list

Maximum file size: 1000MB

Max. file size: 2 GB.

Shapefile*

The location map for this Final EA is the same as the location map for the associated Draft EA.

Shapefile*

The location map for this Draft EIS is the same as the location map for the associated EIS Preparation Notice.

Shapefile*

The location map for this Final EIS is the same as the location map for the associated Draft EIS.

Shapefile*

The location map for this determination is the same as the location map for the associated Final EIS.

Shapefile*

The location map for this Withdrawal is the same as the location map for the determination being withdrawn.

Action location map*

Attach a .zip file that contains the shapefile file for the action location boundary.

Drop files here or

Accepted file types: zip, shp, Max. file size: 600 MB.

Authorized individual*

The name of the person making this submission, who has been given authority to do so on behalf of the proposing agency or applicant.

Authorization*

The above named authorized individual hereby certifies that he/she has the authority to make this submission.

Environmental Review Program

Submittal Form

Please contact us here for any questions or inquiries for the Environmental Review Program or the Environmental Advisory Council. Please allow 1 or 2 business days to respond. All office visits are by appointment only.

HRS Chapter 343 Submittal Form