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f <br /> 1 <br /> 5 , .Will the project: <br /> ectional odors: No <br /> a , generate obj No <br /> b. generate any discharge into surface waters:No <br /> c , generate or store hazardous materials: No <br /> d. expose people to any haNaordous materials or situations: <br /> e. displace people: or natural resources: No <br /> f , use significant amounts of energy <br /> g, cause congestion on roadways or at interchanges or intersec- <br /> tions: NO <br /> ❑ SIGNATURE <br /> I certify under penalty of perjury that I am (check one) : <br /> Owner (owner includes partner, trustee, trustor , or <br /> Legal Property <br /> corporate officer . ) <br /> ach proof of the owner 's consent to file <br /> Owner ' s legal agent (att <br /> the application ) , <br /> and that t oregoing is true and correct. <br /> (Date ) <br /> rg -ate <br /> X <br /> z <br /> I <br /> I <br /> Private Rights-of-Way <br /> -10- (8/86 ) <br />