Historic Site Environmental Assessment

1. Site Identification

Site Name Location / Address Date of Assessment Assessed By

2. Description of Historic Site

Brief Description Historical Significance

3. Environmental Context

Surrounding Environment Current Land Use

4. Identified Environmental Factors

Factor	Description or Notes
Air Quality
Water Resources
Soil Conditions
Biodiversity
Noise
Other

5. Potential Environmental Impacts

Describe potential environmental risks or impacts affecting the site

6. Mitigation Measures

Proposed actions to reduce potential impacts

7. Summary and Recommendations

8. Attachments / References

List any documents, maps, or sources referenced