KAISERSLAUTERN, Germany — After a delay of more than a year, the first tangible step has been taken toward replacing the Army’s aging Landstuhl Regional Medical Center in Germany.

Workers on Monday began cutting trees at the site chosen for the new hospital, an unused ammunition storage area where hundreds of dilapidated Cold War-era bunkers sit nestled in the forest near Ramstein Air Base.

Though the building phase isn’t expected to begin for two more years, the clearing of the site alone appeared to offer some relief to German and American officials and engineers, whose plans to start tree cutting in the fall of 2012 were thwarted, first by a lawsuit and then by a lengthy environmental review.

“This is a real milestone,” Mark Ray, a spokesman for U.S. Army Europe, said Tuesday at the site, a back corner of the Army’s Rhine Ordnance Barracks. “We don’t necessarily consider it the beginning of construction, but it is a major milestone in terms of moving the project forward and ensuring that we will build it.”

Christoph Strohschneider, head of the German federal building directorate that is overseeing the project, said major site work is required before construction can start on the new hospital, for which the U.S. Congress has approved $990 million.

As many as 200 of the reinforced concrete ammunition bunkers covering the site will have to be demolished, Strohschneider said, and huge amounts of earth have to be moved. Workers will then have to install utility lines and build roads.

Construction of the hospital building should begin in 2016 if there aren’t any unforeseen delays, Strohschneider said, “and hopefully we will finish in 2021.”

The current projection calls for the building to be fully occupied and in use sometime in 2022, Ray said.

Strohschneider and Army officials said the $990 million price tag is a hard cap that they can’t go over. Another large-scale project, the Kaiserslautern Military Community Center across the street at Ramstein Air Base, was plagued by delays and cost overruns that officials hope to avoid with the new hospital.

German officials and the Army Corps of Engineers, which is overseeing the contract for the construction of the as-yet unnamed hospital, said there are mechanisms in place to ensure they don’t go over budget this time.

“If parts of the project end up costing more” than anticipated, Ray said, other parts of the project may be scaled back or eliminated.

The Army Corps of Engineers is planning for a hospital with 120 exam rooms, 68 beds and nine operating theaters, though those plans could change.

The hospital’s design is at most a fifth complete, according to Army officials. Strohschneider’s building directorate is responsible for overseeing the design as well as the build.

Jürgen Reincke, a spokesman for an environmental group that sought to halt the project after a key environmental requirement was waived, said his group was not entirely happy with the beginning of tree clearing, but still considered his organization’s efforts a victory.

Reincke’s Nature and Biodiversity Conservation Union successfully sued to reinstate a public review process that forced German authorities to take a deeper look at the hospital’s environmental impact. That review resulted in additional measures to protect wildlife.

In all, Ray said, the U.S. will spend about $16 million to mitigate the project’s effects on the environment.

“At the bottom line, it was a compromise,” Reincke said. “And, as in any compromise, it is a give and take.”

Reporter Marcus Kloeckner contributed to this report.

millham.matthew@stripes.com Twitter: @mattmillham

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