3135-0112 NHPA NEPA Questionnaire

OMB No. 3135-0112. Expires TBD

NHPA AND NEPA QUESTIONNAIRE
8/11/25

All federally funded activities are subject to the National Historic Preservation Act (NHPA) and the National
Environmental Policy Act (NEPA). If you have been asked to complete this questionnaire, it means additional
information is needed to complete the review of your application/offer or award.
Certain types of activities garner a more in-depth NHPA or NEPA review, and additional steps may be
necessary to determine if your project is in compliance with NHPA and/or NEPA. Activities that often require
a more in-depth review are:
 Permanent Work – If you are planning an activity that is not temporary in nature, such as permanent
public art, additional review is required.


Murals – As murals can impact historic masonry and brick, additional review is often required.
Including the age of the building you plan to use for your mural will help with the review process.



Ground Disturbance – Ground disturbing activities may impact intact archaeological deposits. Due to
the sensitive nature of archaeology, the National Endowment for the Arts (NEA) makes efforts to
avoid ground disturbing activities in sensitive areas. Ground disturbing activities may include
excavation for public art, set up/rigging for outdoor events, large-scale landscape elements.



Historic Properties - A project involving or occurring near a property that is listed or eligible for
inclusion in the National Register of Historic Places may require additional review to ensure the
activities do not adversely affect the property.



Environmental Impacts – A project having a significant impact on the environment (e.g., work in
water, work in critical habitat) may require additional review.

This questionnaire is the first step in the NHPA/NEPA review process. Based on your responses, the NEA
will determine one of the following outcomes:
(1) There is no potential to affect historic properties;
(2) Based on an agreement that the NEA has with the Advisory Council on Historic Preservation
(ACHP), one or more approved exemptions can be applied to the project, confirming that the
project will have limited potential to affect historic properties; or
(3) The project has the potential to have an effect on historic properties. You will be required to
contact and work directly with your State Historic Preservation Office (SHPO), and potentially
initiate a Section 106 Review. NEA staff will work with you to ensure compliance.
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INSTRUCTIONS

Fill out the following form for every project location.
 Submit this form through REACH at https://reach.arts.gov/Login for the correct offer/award.
 One form may be used for multiple locations and/or activities for the offer/award.
 Include maps and photographs of each location and property.
 Be as concise as possible; any changes to the proposed project may require additional review.
 If you have questions regarding NHPA / NEPA or the process, contact neahistoricreview@arts.gov. Once the
review is concluded, you will receive an email indicating if your offer/award has been “cleared.”
FUNDS WILL NOT BE RELEASED UNTIL NHPA/NEPA REVIEW IS COMPLETED AND CLEARED.

Application/Award #:

Date:

Organization:

1. PROJECT LOCATION AND DESCRIPTION

QUESTIONS

In the field below, provide a very clear description of proposed activities at all location(s) including the address(es)
and/or GPS location(s).
ATTENTION: THE NHPA/NEPA REVIEW CANNOT BE COMPLETED UNTIL ALL ACTIVITIES/LOCATIONS ARE DETERMINED.

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2. INTERIOR ACTIVITIES

To determine if your project has the potential to affect historic properties.
 Do the proposed activities take place solely indoors in a facility intended for such activity (e.g.,
workshop in a classroom, performance in a theatre, art exhibit in an art gallery/museum)? If
your proposed activities involve additional activities, answer no.


Are the proposed activities temporary in nature? (Temporary means the proposed activities
will remain for a limited time and the location of the proposed activities will be returned to its
original condition and state)

3. OUTDOOR FESTIVALS AND PUBLIC EVENTS

Yes ☐ No ☐
Yes ☐ No ☐



Does your project involve an outdoor festival/public event? (If no, skip to question 4)



Will the activities take place on a hard surface? (If no, describe below)



Will the activities involve any ground disturbance, such as digging or trenching, for stages,
tents, and/or equipment? (If no, describe below)



Is any permanent hardware necessary? (If no, describe below)

4. OUTDOOR MURALS

Yes ☐ No ☐

Yes ☐ No ☐
Yes ☐ No ☐
Yes ☐ No ☐

Yes ☐ No ☐



Does your project involve an outdoor mural? (If no, skip to question 5)



What is the date of construction of the building/structure where mural
will be placed?

Click or tap here to enter text.



What is the material of the building/structure where the mural will be
placed (e.g., Brick, Stone, Concrete, Wood, Metal, etc.)?

Click or tap here to enter text.

Is the location of the mural on a historic property and/or located within a historic
district?
Provide any additional information regarding the proposed mural below.


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Yes ☐ No ☐ Unsure ☐

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5. OUTDOOR PUBLIC ART


Does your project involve outdoor public art? If no, skip to question 6)



Is the proposed public art permanent?



Does the proposed public art require permanent hardware, digging/trenching for
foundation/footings?
Will the proposed public art be located within a historic district?



Yes ☐ No ☐
Yes ☐ No ☐
Yes ☐ No ☐
Yes ☐ No ☐ Unsure ☐

Provide any additional information regarding the proposed public art below.

6. PERMANENT WAYFINDING SIGNS


Does your project involve erecting permanent wayfinding signs? (If no, skip to question 7)



Does the proposed wayfinding signs require permanent hardware, digging/trenching for
foundation/footings?



Will the proposed wayfinding signs be located within a historic district?

Provide any additional information regarding the proposed wayfinding signs below.

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Yes ☐ No ☐
Yes ☐ No ☐

Yes ☐ No ☐ Unsure ☐

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7. LANDSCAPING


Does your project involve landscape maintenance or rehabilitation? (If no, skip to question 8)



Does the proposed landscaping involve the creation of new gardens and/or large-scale
features? (If yes, provide additional information below)



Will the proposed landscaping be located within a historic district?

Provide any additional information regarding the proposed landscaping below.

Yes ☐ No ☐
Yes ☐ No ☐

Yes ☐ No ☐ Unsure ☐

8. REPAIRS/REPLACEMENTS



Does your project involve repairs or replacement of an existing facility? (If no, skip to question 9) Yes ☐ No ☐

Does the proposed repair/replacement use an in-kind material?

Will the proposed repair/replacement be located in a historic property and/or located
within a historic district?
Provide any additional information regarding repairs/replacements below.


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Yes ☐ No ☐

Yes ☐ No ☐ Unsure ☐

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9. ENVIRONMENTAL CONCERNS


Will the proposed activities have an impact on the environment? (If no, skip to question 10)



Do the proposed activities involve work in water?




Yes ☐ No ☐
Yes ☐ No ☐

Do the proposed activities involve work areas of known critical habitat for endangered Yes ☐ No ☐ Unsure ☐
species?
Do the proposed activities involve work in areas likely to be contaminated?
Yes ☐ No ☐ Unsure ☐

Provide any additional information regarding environmental concerns below.

10. TRIBAL LANDS


Will the proposed activities occur on tribal land? If yes, describe below.

Provide any additional information regarding activities on tribal land below.

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Yes ☐ No ☐

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Paperwork Reduction Act Statement
The public reporting burden for this collection of information is estimated at an average of one hour per response. This includes the
time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. We welcome any suggestions that you might have on improving the guidelines and making
them as easy to use as possible. Send comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: webmgr@arts.gov, attention: Reporting Burden. Note: Applicants/awardees are
not required to respond to the collection of information unless it displays a currently valid U.S. Office of Management and Budget
(OMB) control number.

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