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APPLICATION - SITE APPROVAL - { SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT FILE NUMBER: SA- Describe any items of historical or archaeoiogical interest on-site (e.g. cemeteries or structures): None Describe anv ort-site or o-11-site sources of noise or vibration e. .freeway noise, heavy equipment,etc. : Some freeway noise from I-5 ; some farm equipment noise Describe any on-site or off-site sources of light of glare(e.g. parkinglot lighting,or reflective materials used): None Describe any an-site or off-site source of odor(e.g. agricultural wastes), p Describe any displacement of people that will be caused by the project(e.g.numbers of people, housing units): Nom- A THO'�'],ZAT'IO:N,StG..,NATTUR -S ' ONLY THE QIP NER OF THE PROPEF'TY OR.AN AWTHORIZEQ AGENT'MAY FILE.AN A.PPLICATIOX I, the OwnerlAgent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees from any claim, action or proceeding against the Owner/Agent's project. I, further, certify under penalty of perjury that I am (check one). ❑ Legal property owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s) involved in this application, or EJ Legal agent (attach proof of the owner's consent to the application of the property's involved in this application and have been authorized to file on their behalf., and that the foregoing application statements are true and correct. Print Name: Donald W. 01 i ver Signature: pate: 12/15/05 Print Name: Signature: pate: Print Name: Signature: Date: Print Name: Signature: Date: Print Name: Signature: Date: FN6EVSVMPlanning Application FermslSlte Approval.(Revised 6-03-04) Page 5 of 9