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` Environmental Information Form <br /> Part B <br /> DATE • JUNE 26, 1987 <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 XX PROPERTY OWNER AGENT OF OWNER <br /> Name ROBERT & DORIS LUNA <br /> Address 23050 HANSEN RD. <br /> City TRACY <br /> State/Zip CA 95376 <br /> Phone <br /> A. PROJECT DESCRIPTION <br /> 1 . Type of application: Use Permit, Q Major Subdivision, <br /> Q Zone Reclassification, F-X-T Minor Subdivision, Q Site Approval, <br /> Zone Variance, Q Other : <br /> 2. Project location: 23050 HANSEN RD. , TRACY, CA 95376 <br /> Describe the project; i .e . , request being made and nature of use . <br /> Identify specific project components : MINOR SUBDIVISION <br /> AND A MINIMUM LOT FRONTAGE DEVIATION <br /> 3 . Total acreage of project: 3.09 # of existing parcels : ONE <br /> Assessor Parcel # (s ) : 202 <br /> 4 . If there is an existing EIR assessing any aspect of your project <br /> site , provide title and date: N/A <br /> 5 . Other permits and approvals (County, Regional, State and Federal) <br /> required for this project : <br /> PERMIT AGENCY <br /> _ PRECIN ATTON TFST PEWTT HEALTH DEPT. <br /> WET.T. PEWIT HEALTH DEPT. <br /> SFPTTC' TANK PFWTT HEALTH DEPT. <br /> B1JTTnTNGPFFNTT BUILDING DEPT. <br /> Minor Subdivision - 7 - ( 6/86 ) <br />