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ENVIFON'.1ENTAL IN1=CFiMA71CN FQFM <br /> b. ,-es of emissions and sources assoc'ated with project <br /> 1> les eL / C�r�s Eni 5sio�l5 <br /> C. Fuel sources (and amounts) to be consumed by or as a result of the completed prcje- <br /> D1L=5aL (2.00rt.) <br /> OTp �> <br /> s � 500 6-rA <br /> d. Will the project result in substantial air emissions or deterioration of a-::ient air qua ii-. <br /> tic 19 Yes C "- <br /> 4. How r.;uch agricultural land will be removed from production? hC) .-1 <br /> Irl ted N�A Not irrigated H A& <br /> 5. Will tie project: <br /> a. Generate objectional odors: No 9 Yes ❑ <br /> b. Generate any discharge into surface waters: No ® Yes C <br /> C. Generate or store hazardous materials: No ❑ Yes 1R <br /> d. Expose people to any hazardous materials or situations: No CK Yes ❑ <br /> e. Displace people: No CK Yes ❑ <br /> f. Use significant amounts of energy or natural resources: No ® Yes ❑ <br /> g. Cause congestion on roadways or at interchanges or intersections: <br /> No ® Yes ❑ <br /> If yes is answered for any of the above, please describe: <br /> Uu1;>ER.CJP-0U"1> Sgorz-�b —dulls 0097A10 PrAZAP-bOvS N1�t—�Wnis <br /> RECEIVED <br /> SIGNATURE JUN 13 1997 <br /> I certify under penalty of perjury that I am, (check one) Ans'd............ <br /> Legal Property Owner (owner includes partner, trustee, trustor, or ccnorate officer) <br /> Owner's Legal Agent (attach proof of the owner's consent to file) <br /> and that the foregoing is true and correct. <br /> ,ol Mt s-z-C)-i <br /> 4(Stature) (Date) <br />