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01141} Yes Maybe No 1 (17) Human llval.��! Will the pi aposal '2 iesult iii t'.• creation of any ,. 3 health hazard or potential health 1a 4 hazard (excluding mental health)? �C 5 6I Explanation: 7 H 9� (18) Aesthetics. Will the proposal '? 10 result in the obstruction of any 11 scenic vista or view open to the 12 public, or will the proposal re- 13 sult in the creation of an ' 14 aesthetically offensive site open y, 15 to public view? `z 16 17 18 Explanation: 47—r11C7- 19 f. 20 (19) Recreation. Will the proposal JR 21 resu=Ui an impact upon the ,V 22 quality.or quantity of existing sa; 23 recreational opportunities? a 24 25 Explanation: 26 ; 27 28 �(20) Arclirolo ical./IliStorical. Will the #f 29 proposal refit in an alteration of 30 a significant archeological or his- 31 torical site, structure, object 32 33 or building?. 34 Explanation.: 35 36 37 III. SIGNATURE ; t� 38 39 I. the undersigned, state that to the best of my knowledge 40 the above information is.true and complete. It is understood 41 that the lead ag+,ency•may withdraw any declaration of non-signi- 42 ficance'that it might issue in reliance upon this checklist 43 should'there be any misrepresentation or lack of full disclosure 44 on my part . . 45 46 Proponent: 47 48 WAC 1197-1.0-370 WITHDRAWAL OF AFFIRMATIVE TIIRES11OLD 49 DFTE1611HATIONV. If at .any time after the entry of a declara- R` 50 tion of significance, the proponent modifies -Hie proposal 51 so that, in the ,judgment of the leas agency, all significant 4. 52 adverse environmental impacts resulting; therefrom are elimin-'. s 53 ated, the declaration of significance Tall be withdrawn 54 and a declaration of non -significance enteredThe 55 5G .instead. lend agency shall also revise the registers at its SEPA public information.center accordingly, if the 57 pro- poiiimt of a proposal is a private applicant, the proposal 58 59 shall not be considered modified until all license applica- i tions for..the proposal are revised to reflect the modification. -37- I i i