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E1IVIRONMENTAL INFORMATION CIWMB 502 (Rev. 9/02) Page 2 of 4 PROJECT DESCRIPTION CON'T Discuss all items checked Yes or Maybe and include as attachments to your submittal. Yes No Maybe Substantial alteration of ground contours? ❑ ❑ ❑ Change in scenic views or vistas from existing residential areas or public lands or roads? ❑ ❑ ❑ Generation of significant amounts of solid waste or litter? ❑ ❑ ❑ Changes in dust,ash,smoke,fumes,or odors in vicinity? ❑ ❑ ❑ Alteration of existing drainage patterns? ❑ El ❑ Facility sited on sloped terrain? ❑ ❑ ❑ Use or disposal of potentially hazardous materials,such as flammables,explosives,or toxic ❑ ❑ ❑ substances? Substantial change in demand for municipal services(police,fire,water,vector control,sewage, ❑ ❑ :qo etc.)?Proximity to wetlands,drainage,or bodies of water? GOVERNMENTAL REQUIREMENTS Before a final decision can be made on your Waste Tire Facility Permit Application, we must consider, as a responsible agency, the information contained in an environmental document prepared in compliance with the requirements of the CEQA. If an environmental document has been prepared for your project by another agency, we must consider it. If one has not been prepared, a determination must be made as to who is responsible for the preparation of the environmental document for your project. The following questions will aid us in the determination. Contact your city/county planning or public works department for the following information: Assessor's Parcel Number(s): County Zoning Designation: Is the project site consistent with the jurisdiction's Zoning designation? ❑ Yes ❑ No Is the project site consistent with the jurisdiction's General Plan? ❑ Yes ❑ No Was an environmental document prepared for the General Plan? ❑ Yes ❑ No If yes,what type of document was prepared? ❑ EIR ❑ Negative Declaration Date: Was a Notice of Determination filed with city/county clerk? ❑ No ❑ Yes Fif attach a copy. Will the city/county have to issue any permits or approvals for your project? ❑ No ❑ Yes if Yes,check appropriate box: ❑ Grading Permit ❑ Zoning Change ❑ General Plan Change ❑ Other: