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<br />� Deirn'be air pollutants that may resuh&vrn the project(ag,carutructian related dust,Vehicle hips Pa�Y>�repl�
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<br /> Desa>'be any hazlrdous nutmuLlslwastea that will be present on-site:
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<br /> DeaQibe spy On-site or o$-Site sources ofnoise or Vibration =wa L. finoise,( $. y �.bea vY equlpinCnt.EtC.): t
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<br /> Describe any on-site or off-site sources of light or glare(e.g.,parking lot fighting or mfleWve materials used):
<br /> Describe spy on-site or off-situ:source of odor(e.g.,agricultural wastes):
<br /> Describe any displsoatnent ofpoople that will be caused by the project(e g.,numbers of people,housing units):
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<br /> SIGNATURE: I certify under penalty of perjm7 that ram(check one):
<br /> o Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s)Involved i
<br /> in this application,or
<br /> _1_
<br /> a
<br /> - 1
<br />
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