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5 . Will the project: <br /> a generate objectional odors : Cko <br /> b. generate any discharge into surface waters : rlo <br /> c . generate or store hazardous materials: no <br /> d. * expose people to any hazardous materials or situations : <br /> e . displace people: (-)o <br /> f . use significant amounts of energy or natural resources : J <br /> g . cause congestion on roadways or at interchanges or intersec- <br /> tions : t^,o <br /> ❑ SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> ❑ Legal Property Owner (owner includes partner, trustee, trustor , or <br /> corporate officer . ) <br /> Owner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application) , <br /> and that the foregoing is true and correct . <br /> - iG -BG <br /> _Ann a�a� <br /> (Sign ure ) (Date ) <br /> General Plan Map Amendment 14 ( 6-86 ) <br />