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ENVIRONMENTAL INFORMATION CIWMB 502 (Rev. 9/02) <br /> Page 4 of 4 <br /> ENVIRONMENTAL SETTING CON'T <br /> Describe any existing vegetation at the facility and on adjacent properties. If any threatened or endangered species occur in the <br /> project area or on adjacent properties, identify the species and indicate how they will be impacted by the proposed project. These <br /> vegetation es should be shown in the photographs submitted. <br /> On-site: <br /> Adjacent properties: <br /> Describe existing wildlife at the facility and on adjacent properties. If any threatened or endangered species occur in the project area <br /> or on adjacent properties, identify the species and indicate how the will be impacted b the proposed project. <br /> On-site: <br /> Adjacent properties: <br /> F <br /> anges in the project site and surrounding area will occur or are likely to occur because of construction and operation of your <br /> Include in your answer such things as appropriate numberand size/age of trees to be removed or areas of vegetation/brush <br /> rel; area or extent of trenchin radin ,excavation, lowin ,or road,dam or buildin construction;etc. <br /> Have any archeological reports been prepared for this project? <br /> ❑ Yes If Yes,Name of Report: Date: <br /> ❑ No If No,will you be preparing an archeological report to satisfy another public agency? <br /> ❑ No ❑ Yes If Yes,Agency Name: <br /> Do you know of any archeological or historic sites located within the general project area? <br /> ❑ No ❑ Yes If Yes,explain: <br /> OPERATOR CERTIFICATION <br /> certify that this document and all attachments were prepared under my direction or supervision. I have inquired of the person or <br /> persons who manage the system or those persons directly responsible for gathering the information, and certify that the information <br /> submitted is, to the best of my knowledge and belief, true, accurate and complete. <br /> Facility Operator or Agent Signature: <br /> Date: <br /> Typed Name&Title. <br />