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APPENDIX I RECEIVED <br /> ENVIRCNMENTAL CBEC.MISr FM <br /> AUG 1 <br /> (To Be Completed By Lead Agency) 1991 <br /> ENVIRONMEN AL HEALTH <br /> I. Background <br /> PERMIT/S RVICES <br /> 1. Name of Proponent <br /> 2. Address and Phone Number of Proponent <br /> 3. Date of Checklist Submitted <br /> 4. Agency Requiring Checklist <br /> 5. Name of Proposal, if applicable <br /> II. Environmental Impacts <br /> (Explanations of all "yes" and "maybe" answers are required on attached <br /> sheets.) <br /> Yes Mayle No <br /> 1. Earth. Will the proposal result in: <br /> a. Unstable earth conditions or in changes in <br /> geologic substructures? <br /> b. Disruptions, displacements, compaction or <br /> overcovering of the soil? <br /> c. Change in topography or ground surface <br /> relief features? <br /> d. The destruction, covering or modification <br /> of any unique geologic or physical features? <br /> e. Any increase in wind or water erosion of <br /> soils, either on or off the site? _ <br /> f. Changes in deposition or erosion of beach <br /> sands, or changes in siltation, deposition or <br /> erosion which may modify the channel of a <br /> river or stream or the bed of the ocean or <br /> any bay, inlet or lake? _ <br /> g. Exposure of people or property to geologic <br /> hazards such as earthquakes, landslides, <br /> mudslides, ground failure, or similar hazards? <br /> 288 <br />