003971 �.*'�
1 (17) Numan Hc:ilth. Will the proposal
2 resu t r rr tie creation of any
3 health hazard or potential health
4� hazard (excluding mental health)?
�'
Yes •_ .ybe
X
6 Explanation:
7
8
9 (18) Aesthetics. Will the proposal
10 resT n the obstruction. of any '
11 scenic vista or view open to the
12t 'public, or will the proposal re- •
1.3 sult in the creation of an
14 aesthetically offensive site o e
15
p n
,to public view?
16
�
' 17
Explanation:
18
. 19
20
(19)
Recreation. 41i11 the proposal
21
resuT�i'n-an impact upon the
22
23
quality or quantity of existing
24
recreational opportunities?
X
25
Explanation:
26
27
28
`(20)
Archeolo icnl/Jiistorical. Will the
29
30
proposa resu t in an a terati.on of
31
a significant archeolobical or his-
torical site, structure, object
33
or building?
�
34
�
Explanation:
35
36
37
III. S1GNA'1'URI.
38
. 39 ,
40,,
I,
the above
tha underi;iJ;ned, state that to the best.•
information. is true and complete. It
of my knowledge
41
42
that `the
fi.cance that
is
lead agency may withdraw any, c ration
it might .issue in reliance o h'
understood
of non-signi-
n t is checklist
43 `should there'be any misrepresentation lack of fu dis sure
44 on my part . �--C�'
45 I /L, �;.G_.
4E
4i
4f
45
5C
51
52
53
s 54
55
56
57
58
' S9
Proponent:
D��.�.,
• krAC 197-10-370 WITIIDP�IIWAL Oi: �C-�-rt�rLATIVL THRESHOLD
D>rTirItl•1LIT1'IUN. i at any time after the entry of a declara-
tion of significance, the proponent modifies the proposal
so that, in the judgment of the lead agency, all significant
adverse environmental impacts resulting therefrom are elimin-
ated, the declaration of signii'i.cance ,hall ba withdrawn
and a declaration of'non-significance entered instead. The
lead agency shall also revise the registers at its SEPA
public information center accordingly. If the pro-
ponent of a proposal is a I�ri.vate applicant, the .proposal
shall not be considered modified until all license applica-
tions for the proposal are revised to reflect the modification.
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