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' l <br /> Environmental Information <br /> For Staff Use Only <br /> File No . <br /> Date Filed <br /> APPLICATION FORM PART B: <br /> ENVIRONMENTAL INFORMATION <br /> (To be Filled Out By Applicant ) <br /> NOTE: In completing this form, use additional sheets if necessary. <br /> Answer all questions to the best of your ability. If question <br /> is not applicable to your project, write NA (not applicable ) . <br /> Please do not leave blanks . Incomplete forms cannot be accepted. <br /> PERSON COMPLETING FORM PROPERTY OWNER X AGENT OF OWNER <br /> Name Mark Sloat, Dewante & Stowell Consulting Engineers <br /> Address 1910 S Street <br /> City Sacramento <br /> State/Zip CA 95514 <br /> Phone (916) 447-3261 <br /> TYPE OF APPLICATION Minor Subdivision <br /> PROJECT Construction of two wastewater effluent storage ponds and related <br /> appurtenances on a new 20 acre parcel. <br /> OTHER PERMITS AND APPROVALS (COUNTY, REGIONAL, STATE AND FEDERAL) <br /> REQUIRED FOR THIS PROJECT <br /> PERMIT - AGENCY <br /> Non-required <br /> -1- ( 9/85 ) <br /> Plan-44 (12/85) <br />