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�°P ©G APPLICATION -- SITE APPROVAL { SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT bit FILE NUMBER: SA- Other Describe any items of historical or archaeological interest on-site(e.g. cemeteries or structures): No structures exist on-site. Moderate sensitivity for cultural resources according to CCIC. Undiscovered archeological artifacts could be buried. see attached IS/MND page 30. Describe any on-site or off-site sources of noise or vibration e . freeway noise heavy equipment, etc.): Noise during construction from heavy equipment, see attached IS/MND, page 49. Describe any on-site or off-site sources of light of glare(e g parkinglot lighting, or reflective materials used): No additional sources of light or reflective material will result from this project. see attached IS/ MND, page 15. Describe any on-site or off-site source of odor(e,g. agricultural wastes): Irrigation with treated effluent may result in odors if extended periods of low dissolved oxygen exist. Treated effluent dissolved oxygen levels are above the odor causing threshold. IS/MND page 21 . Describe any displacement of people that will be caused by the project(e.g. numbers of people, housing units No displacement of people will result from this project. AUTHORIZATION SIGNATURES ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees from any claim, action or proceeding against the Owner/Agent's project. I, further, certify under penalty of perjury that I am (check one): ❑ Legal property owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s) involved in this application, or ❑ Legal agent (attach proof of the owner's consent to the application of the property's involved in this application and have been authorized to file on their behalf., and that the foregoing application statements are true and correct. Print Name: Joseph Salzman Signature: Date: I Print Name: Signature: Date: i Print Name: Signature: Date: _ Print Name: Signature: Date: Print Name: Signature: Date: F:IDEVSVCiPlanning Application Forms\Sde Approval.(Revised 6-03-04) Page 5 of 9