008424
5
6
1 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
31+.
35
36
37.
38
39
40
41
42
43
44
45
46
47
48
j 49
50
51
52
53
54
55
56
57
56
59
6C
61
6"e
• 61
61
II.
Do you 44ave any plans for future additions, expansion,
or further activity related to or connected with this `1
proposal? If yes, explain: C srvi,
N
o you now o any p atisy others which m,iy affect
the property covered by.your proposal? If yes, explain:.
MQ
Attach any ocher application Lorin t at ' as been coin-
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:
%tJV ILO u tN+1-AL ass Ess rA �' FoR M�
ENVIRONMENTAL IMPACTS
f
(Explanations of all "yes" and "maybe" answers are
required) Yes Maybe
No
(1) Earth. Will the proposal result in:{tj
(a) Unstable earth conditions or in
X
,
changes in geologic substructures?
(b) Disruptions, displacements, com-
paction or overcovering of the soil?t:
(c) Change in topography or ground
surface relief features?
d) The destruction, covering or•
modification of'any unique geologic
or physical features?
(e) Any increase in wind or water,
erosion of soils, either on or off
K
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:
4
(a) Air emissions or deterioration X
of ambient air quality?
(b) The creation of. objectionable X
odors? .--
(c) • Alteration of air movement,
moisture or temperature, or any
change ill c'1mate, either locally X .
or regionally? 1`
Explanation:
-32-