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APPMI% I <br /> ENVIBONIMTAL CH=I3r FORM <br /> (To Be Completed By Lead Agency) <br /> I. Background <br /> 1. Name of Proponent GOLD BOND BUILDING PRODUCTS, INC. <br /> 2. Address and Phone Number of Proponent <br /> 2001 Rexford Road, Charlotte, NC 28211 <br /> 3. Date of Checklist Submitted <br /> 4. Agency Requiring Checklist Central Valley Regional Water Quality Control Board <br /> 5. Name of Proposal, if applicable Monitoring variance for #6 fuel <br /> underground storage tank. <br /> II. Environmental Impacts <br /> (Explanations of all "yes" and "maybe" answers are required on attached <br /> sheets.) <br /> Yes Maybe No <br /> 1. Barth. Will the proposal result in: <br /> a. Unstable earth conditions or in changes in <br /> geologic substructures? X <br /> b. Disruptions, displacements, compaction or <br /> overcovering of the soil? X <br /> c. Change in topography or ground surface <br /> relief features? X <br /> d. The destruction, covering or modification <br /> of any unique geologic or physical features? X <br /> e. Any increase in wind or water erosion of <br /> soils, either on or off the site? X <br /> f. Changes in deposition or erosion of beach <br /> sands, or changes in siltation, deposition or <br /> erosion which may modify the channel of a <br /> river or stream or the bed of the ocean or <br /> any bay, inlet or lake? X <br /> g. Exposure of people or property to geologic <br /> hazards such as earthquakes, landslides, <br /> mudslides, ground failure, or similar hazards? X <br /> 288 <br />