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<br /> related dust.vehicle trips per day,fireplaces,inc¢uerators,etc.):
<br /> Dcsuibe air pollutants that may result from the project(e.&,cortistru
<br /> Describe any hazardous matenaWwastes that will be pent on-site:
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<br /> Describo any items of historical or archaeological interest ou-site(e.g.,��
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<br /> Describe any on site or o$site sources of noise or vibration(e,.g/,freeway noise,heavy equipment�.et�c.):IPI
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<br /> Describe any on-site or off-site sources of light or glare(e.g•,parking lot lighting,or reflective materials used):
<br /> Describe any on-site or off-sitz source of odor(e.g-agricultural wastes):
<br /> Describe any fdisplacement of people 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 perjury that I am(check one):
<br /> ludes partner,trustee,trustor,or corporate officer)of the property(s)(evolved
<br /> O Legal property owner(owner inc
<br /> in this application,or
<br /> -2-
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