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Environmental Information i=orm <br /> Para B <br /> DATE: Dpremher 2n, 1Q38 <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 X PROPERTY OWNER AGENT OF OWNER <br /> Name William Beckman ET AL <br /> Address Call Box 3006 <br /> City Lodi <br /> State/Zip CA . 95241 <br /> Phone ( 209 ) 333-1661-Bank # <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: 0 Use Permit, Q Major Subdivision, <br /> Q Zone Reclassification, Q Minor Subdivision, Q Site Approval, <br /> Q Zone variance, Q Other: <br /> 2 . Project location: 19000 North Highway 88 - Lockeford . CA . <br /> Describe the project; i .e. , request being made and nature of use . <br /> Identify specific project components : Pr.oject proposes to remodel <br /> existing building on the site for use as a temporary full service <br /> hank wh-i 1 P i 1 anni ng a✓ ri rnnetr„ri- i nr+ Of n fari 1 i t.i Ps gnPs, <br /> forward _ <br /> 3 . Total acreage of project: 1 . 2 + - # of existing parcels: 1 <br /> Assessor Parcel Us ) : <br /> : <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date: No <br /> 5 . Other permits and approvals (County, Regional, State and Federal) <br /> required for this project: <br /> PERMIT AGENCY <br /> _ Septic Tank - Well San <Joaquin County health <br /> Si,reets c,M n. r Tna]i,ir rte„ . Public Work:: <br /> Buildings San Joaquin County Building -Dep- <br /> Site Approval Application - 5 - ( 6/86 ) <br />