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Environmental Information Form <br /> Part B <br /> DATE : <br /> (To be Completed By Applicant ) <br /> NOTE : In completing this form, use additional sheets if necessary. <br /> Answer all questions to the best of your ability . If a 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 Greg Lewis <br /> Address 23709 E. Brandt Rd. <br /> City Lodi, <br /> State/Zip CA. 95240 <br /> Phone 727-5577 <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application : Q Use Permit, Q Major Subdivision, <br /> [] Zone Reclassification, [] Minor Subdivision, Q Site Approval , <br /> E] Zone Variance , [7] Other : Quarry excavation. <br /> One mile North of East end of Brandt Rd. Southeast of Clements. <br /> 2 . Project location: 23809 E. Brandt Rd. Lodi, CA 95240 <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : The proposal is for the removal <br /> of scarce mineral resources, because marketable quantities of sand and grave <br /> are to be excavated and processed <br /> 3 . Total acreage of project: 500 acres # of existing parcels : Four <br /> Assessor Parcel # (s ) : (023-13-03)-Z023-16-02) (023-19-01) (023-19-02) <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date: None <br /> 5 . Other permits and approvals (County, Regional , State and Federal ) <br /> required for this project: <br /> PERMIT AGENCY <br /> Use Permit Application - 7 - ( 6/86 ) <br />