003921
2
4
5
7
8
9
10
11
12
13
_ �14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
6!
i 66
10. Do you have any plans for future additions, expansion,
or further activity related to or connected with this
proposal? If yes, explain: No
11. Do you know of any p ans_by o ers which may attect
the property covered by your proposal? If yes, explain:
No
12. Attach any otter appiUcation form that has Deen com-
pleted regarding the proposal; if none has been com-
pleted, but is expected to be filed at some future
date. describe the nature of such application form:
None
II. ENVIRONMENTAL IMPACTS
(Expl"aiiations of all "yes" and "maybe" answers are
required)
Yes Maybe No
(1) L•'arth. Will the proposal result in:
(a) Unstable earth conditions or in
changes in geologic substructures? _
X
(b) Disruptions, displacements, com-
paction or overcovering of .the soil?
X
(c) Change in topography or ground
X
surface relief features?
(d) The destruction, covering or
modification of'any unique geologic
X
or physical features?
("e) Any increase in wind or water
erosion of soils, either on or off
X
the site?
(f) Changes in deposition or ero-
sion of beach sands, or changes
in siltation, deposition or erosion
which may modify the channel of a
river or stream or the bed'of the
X
ocean or any bay, inlet or lake?
Explanation:,
(2) Air. Will the.proposal result in:
(a) Air emissions or deterioration
X
of ambient air quality?
._
(b) The creation of objectionable
odors?
R
(c) Alteration of air movement,
moisture or temperature, or any
change in c'imate, either locally
X
or regionally?
Explanation:
i
• R
.
/t