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---- <br /> ' PLAN MAF' AMENDMENT <br /> " < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> _ Hazardous Materials <br /> Describe any hazardous m_a_teriais/wastes that will be present on-site:: <br /> None <br /> Other <br /> Describe any items of historical or archaeological Interest on-site(e.g.cemeteries or structures): <br /> None <br /> Describe any on-site or off-site sources of noise or vibration(e.g,freeway noise,heavy equipment,etc.): <br /> Traffic noise from Highway 99 and farming equipment(seasonal) <br /> Describe any on-site or off-site sources of light of glare(e.g,parking lot lighting,or reflective materials used): <br /> Headlights from street traffic. Future on site lighting will be directed to remain on site. <br /> Describe any on-site or off-site source of odor(e.g.agricultural wastes): <br /> None <br /> Describe any displacement of people that will be caused by the project(e.g.numbers of people,housing units): <br /> None <br /> AUTHORIZATION SIGNATURE$ <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY TILE AN APPLICATION. <br /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees <br /> from any claim,action or proceeding against the County arising from the Owner/Agent's project. <br /> I, further,certify under penalty of perjury that I am(check one): <br /> [X) Legal property owner(owner includes partner,trustee,grantor,or corporate officer)of the property(s)involved in <br /> this application, or <br /> [� Legal agent(attach proof of the owner's consent to the applicati l of the pro ty's involved In this application and <br /> have been authorized to file on their behalf,,and that the fore n a lic tateinents are true and correct, <br /> Print Name: _-� ��((,+/) Signature: Q ��J J2 C72 0 <br /> Print Name: Signature: ,T _ _ Date:.—_-_..... ....... <br /> Print Name: _ Signature: <br /> Print Name: _ _ Signature: <br /> Print Name: Siynalure: Date: <br /> F:IDEVSV0Planninq Application Fonnst Page 7 of 7 <br /> Plan Application Amondment,doc.(Rovisod 05-11-00 <br />