POWAY —— A draft report says a proposed expansion of Pomerado Hospital could significantly affect the environment, but that there are ways to avoid or minimize the potential impact.

A full environmental impact report on the $140 million project in Poway is therefore unnecessary, the report states.

The Palomar Pomerado Health district owns and operates Pomerado Hospital as well as Palomar Medical Center in Escondido. Pomerado Hospital's proposed expansion is a significant part of a larger, $753 million project that will renovate and add to the hospital district's facilities.

Construction of a hospital to replace Palomar Medical Center as the district's flagship is the central piece of the overall project. But debate over where the new hospital should go has delayed that project, so Pomerado Hospital's expansion is therefore likely to break ground first.

Scheduled to be done in two phases starting around the end of the year and finishing by 2010, the Pomerado's expansion will double the hospital's size and add five more buildings. They include an outpatient building, a new patient tower and two parking garages.

Hospital district officials said Mike Shanahan, director of facilities, planning and development for the hospital district, was out of town Thursday and unavailable for comment.

The draft report, prepared for the district by the San Diego office of PBS&J, a national development consulting company, states that the expansion will have an environmental impact. Among them: increased noise and traffic, the destruction of sensitive habitat, and disturbances to the nests of California gnatcatchers or raptors on the list of potential effects on the environment.

The possible unearthing of prehistoric remains or artifacts is also cited as a possible impact. According to the report, the hospital's property once housed a prehistoric village, the remnants of which were destroyed when Pomerado was built in 1975.

The report concludes that the environmental impact of the project can be minimized by improvements to roads and intersections near the hospital, and the screening of loud equipment that will be mounted on the hospital's roof.

The consultants also recommend that an archaeologist monitor all grading and digging on the hospital property, and that construction work be stopped temporarily if the nests of protected birds are found on the property during the January-to-July breeding season.

The report was done in accordance with the California Environmental Quality Act. The act requires that the report to go through a 30-day public review and comment period before the health district's board of directors can vote on whether to approve it, meaning that the project can go forward.

Palomar Pomerado Health officials met the letter of the law concerning public notification with a Sept. 12 legal ad that announced the report's completion and availability. Unlike local cities and other public agencies typically do, however, the hospital district issued no news releases about the report before scheduling a review of it by a committee of the board of directors on Monday.

The district will have to seek construction permits and other clearances from the city of Poway before the hospital's expansion gets under way. City planner Jason Martin said the district consulted with the city on the initial environmental report.

"They asked us for comments and shared a copy of it with us so our comments and ideas and positions on things could be incorporated into the document," he said. "We generally agree with the conclusions of the document."

About a half-dozen city residents attended a neighborhood meeting the city held for people who live within a 500-foot radius of the hospital, Martin said. Guests had questions about the project's timing but raised no environmental concerns, he said.

The report is available for public review and comment through Tuesday at Palomar Pomerado Health's facilities, planning and development at 15255 Innovation Drive in Carmel Mountain Ranch or the city's Development Services Department at 13325 Civic Center Drive.

Comments received and Palomar Pomerado Health's responses to them will be incorporated into the report before a final draft is presented to the district's board of directors. They will be asked to certify the document at the board's November meeting.

Contact staff writer Andrea Moss at (760) 739-6654 or amoss@nctimes.com.