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<br /> Describe air pollutants that may result from the project(e.g-,construction related dust,vehicle trips Per day,fireplaces,incinaators,etc-):
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<br /> Describe any hazardous nnataiaWwastes that will be present ort-site:
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<br /> Del any items of historical or archaeological interest ou-site(cg.,cemeteries or structures)-
<br /> Describe any on-site or off-site sources of noise or vibration(G-g•,f veway DOl heavy eWipnims,etc.):
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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):
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<br /> Describe any on-site or off-site source of odor(e.g.,agricultural wa-stesr
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<br /> Describe any displacement of people that will be caused by the project(e g.,numbers of people,housing units):
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<br /> SIGNATURE: i ctrtify under penalty of perjury that 1 am(cheek are):
<br /> o Ictal property owner(owner includes partner,trustee,trustor,or corporate ollScer)of the property(s)Involved
<br /> in thls application,or
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