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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 Glen Qaumbach <br /> Address 323 blest Elm Street <br /> City Lodi <br /> State/Zip CA 95240 <br /> Phone (209)368-6618 <br /> A. PROJECT DESCRIPTION <br /> 1. Type of application: Q Use Permit, EJ Major Subdivision, <br /> Zone Reclassification, Q Minor Subdivision, Q Site Approval, <br /> Q Zone variance, Q Other : <br /> 2. Project location: South side 8-Mile Road West of S.P.R.R. line_ <br /> Describe the project; i .e. , request being made and nature of use . <br /> Identify specific project components : Industrial Subdivision <br /> 3 . Total acreage of project: 98 # of existing parcels : One <br /> Assessor Parcel # (s ) :— 092-020-12 <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 /> None that we are aware of. <br /> Major Subdivision - 7 - (6/86 ) <br />