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ENV!RQNMENTAL INFORMATION CIWMB 502 (Rev.9/02) Page 4 of 4 ENVIRONMENTAL SETTING CON'T Describe any existing vegetation at the facility and on adjacent properties. If any threatened or endangered species occur in the project area or on adjacent properties, identify the species and indicate how they will be impacted by the proposed project. These vegetation types should be shown in the photographs submitted. On-site: Adjacent properties: Describe existing wildlife at the facility and on adjacent properties. If any threatened or endangered species occur in the project area or on adjacent properties,identify the species and indicate how they will be impact d by the proposed project. On-site: Adjacent properties: What changes in the project site and surrounding area will occur,or are likely to occur because of construction and operation of your project? Include in your answer such things as appropriate number and size/age of trees to be removed or areas of vegetation/brush removal;area or extent of trenching,grading,excavation,plowing,or road,dam or building construction;etc. Have any archeological reports been prepared for this project? ❑ Yes If Yes,Name of Report: Date: ❑ No If No,will you be preparing an archeological report to satisfy another public agency? ❑ No ❑ Yes I If Yes,Agency Name: Do you know of any archeological or historic sites located within the general project area? ❑ No ❑ Yes If Yes,explain: OPERATOR CERTIFICATION 1 certify that this document and all attachments were prepared under my direction or supervision. 1 have inquired of the person or persons who manage the system or those persons directly responsible for gathering the information, and certify that the information submitted is, to the best of my knowledge and belief, true, accurate and complete. Facility Operator or Agent Signature: Typed Name&Title: Date: