This is a suggested format that may be used by Responsible Entities to document completion of a Categorically Excluded Subject to Section 58.5 environmental review

Project Information
Project Name: Cameron Sewer Upgrades
Responsible Entity: Cameron Parish Police Jury (CPPJ)
Grant Recipient (if different than Responsible Entity):
State/Local Identifier: B-21-DZ-22-0001/12LDRC7703
Preparer: Ellen Ibert, EHP Specialist, Royal Engineers & Consultants
Certifying Officer Name and Title: Katie Armentor, CPPJ Parish Administrator
Grant Recipient (if different than Responsible Entity):
Consultant (if applicable): Royal Engineers and Consultants, LLC
Direct Comments to: eibert@royal.us or karmentor@cameronpj.org

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