SEPA document templates (forms)
The following templates are based on applicable SEPA rule sections and other guidance materials. Lead agencies are encouraged to modify these templates for their own use and add information for clarification and completeness.
SEPA templates
The list below provides some sample SEPA document templates that can be downloaded. Please note that SEPA lead agencies may have their own versions. This means private applicants should check with the particular lead local or state agency reviewing their proposal.
Lead agencies: Please include your letterhead or agency title at the top of these templates when you distribute for review.
| Templates | Format |
|---|---|
| Environmental Checklist with added help links and instructions | doc |
| Supplemental Orca Checklist with added help links | doc |
| Determination of Nonsignificance (DNS) | doc |
| Mitigated Determination of Nonsignificance (MDNS) | doc |
| Determination of Significance/EIS Scoping Notice (DS) | doc |
| Sample Notice of Application with Optional DNS (NOA/ODNS) | doc |
| Determination of Significance and Adoption of Existing Environmental Document | doc |
| Determination of Nonsignificance and Adoption of Existing Environmental Document | doc |
| Notice of Action Taken (NAT) | doc |
| Revised Determination of Nonsignificance | doc |
| SEPA Withdrawal Notice | doc |
| Notice of Assumption of Lead Agency Status | doc |
| Optional Worksheet for Nonproject Review | doc |
Related links
Contact information
SEPA Help
sepahelp@ecy.wa.gov
360-407-6922