Dd Form 2993 - Environmental Baseline Survey (Ebs) Checklist Page 12

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i. HISTORICAL AND CULTURAL RESOURCES

(Take photographs and note the location using grid coordinates or global positioning system. Note the areas of significance on the site sketch or

map overlay. Describe the general surface appearance and disturbances such as irregular holes and trenches from vandalism and looting or regular

emplacements from recent military or other use.)

Note: If it is determined that the historical or cultural resource must be protected to prevent damage or looting by pot-hunters or black market

antiquities dealers, it is likely that documentation of the site should be annotated in Section 14 as classified information.

(1) HISTORICAL RESOURCES

(Document historical buildings, monuments and artifacts on display in buildings or museums. Look for clues in the landscape regarding undocumented artifacts,

ancient features, ruins, rock art, and ancient writing or pictographs. Note the presence of artifacts in the ground or undisturbed as part of an archeological site,

such as ancient pottery, stone tools or jewelry, decorative art or beads, carved bone, or wood. Note earthen mounds that are not part of the natural topography,

caves, or rock shelters often containing archeological remains. Note ancient storage and trash pits. Note remnants of walls, floors, and collapsed ceilings which

will typically be constructed of mud-brick or stone as wood disintegrates in a few years in most environments. Note rock surfaces that are decorated with paint,

pecked renderings, or inscriptions.)

(2) CULTURAL RESOURCES

(Anything that is significant to the local population is a cultural resource. Document individual burials, burial grounds, and cemeteries which may be marked or

unmarked. Document areas of religious significance. List and describe all known parks, forests and/or animal preserves, and recreational areas in or around the

site. Interviews with the local nationals are imperative to this documentation.)

(3) ASSESS IMPACT LEVEL

Level 1: No impact. There are no resources present or the proposed mission would avoid them if present.

Level 2: Less than significant impact. Resources are present but proposed mission would only have minor effects without the need for mitigating actions.

Level 3: Less than significant impact with mitigation incorporation. Resources are present but with the implementation of mitigating actions effects can be

minimized to an acceptable level, such as power lines to be installed can be routed around sensitive resource concentrations.

Level 4: Potentially significant impact. The proposed action would likely cause a substantial adverse change in the significance of a historical or archeological

resource, disturb a known religious, traditional, or cultural resource or disturb any human remains, including those interred outside of formal cemeteries.

(a)

(b)

Cultural Resource (Describe resource.)

Assess Impact Level (Enter level and explain.)

(4) General Notes

(Enter general notes regarding historical and cultural resources. List any host nation or local subject matter expert and point of contact information for cultural

properties or resources from academia, museums, government agencies, local citizens, and so forth.)

DD FORM 2993, AUG 2015

Page 12 of 20 Pages

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