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Environmental Information Form <br /> Part B <br /> DATE <br /> (To be Completed By Applicant ) <br /> NOTE: In completing this form, use additional sheets if necessary. <br /> Answer all questions to the best of your ability. If a question <br /> is not applicable to your project, write NA (not applicable ) . <br /> Please do not leave blanks . Incomplete forms cannot be accepted. <br /> PERSON COMPLETING FORM X PROPERTY OWNER AGENT OF OWNER <br /> Name Randall J. Humphreys, et al <br /> Address P. 0. Box 3340 <br /> City Ontario, <br /> State/Zip CA. 91761 <br /> Phone (714)984-9800 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q use Permit, Q Major Subdivision, <br /> Q Zone Reclassification, D Minor Subdivision, M Site Approval , <br /> QZone variance, E:] Other: <br /> 2 . Project location: South side of Louise Ave. , approx. 500 ' east of McKinley Ave. <br /> Describe the project; i .e. , request being made and nature of use . <br /> Identify specific project components : A facility for the storage, <br /> mixing and distribution of aggregate rock, sand, cement and concrete. <br /> 3 . Total acreage of project: 25 # of existing parcels : 1 <br /> Assessor Parcel # (s ) : 195-280-13 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date: None <br /> 5 . Other permits and approvals (County, Regional , State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> Dust Abatement, etc. , San Joaquin County Air Pollution Control District <br /> (See attached Schedule of Operating Permits) <br /> Site Approval Application - 5 - ( 6/86 ) <br />