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(Signature) (Date) <br />i_ A e.c.Gn Vis_ <br />14. <br />Identify and describe any potentially hazardous geologic/soil conditions: <br />15. <br />Is any portion.of the site subject to a 100 -year flood? Yes No. <br />If so, what flood zone? <br />16. <br />Identify and describe, below, any existing and/or projected on-site ambient noise <br />levels which exceed adopted noise <br />standards (plot noise contours on proposed tentative maps or on a site plan for the project, if applicable): <br />a. Do on-site ambient noise levels from existing land uses (locally regulated noise sources) located on-site or off-site <br />exceed adopted noise standards? Yes No _)!�,_ If so, describe: <br />b. Does or will transportation -related noise exceed 60 dB Ldn at any exterior <br />location or 45 dB Ldn at any interior <br />location? ? Yes No _?< If so, describe: <br />17. <br />Indicate by checking (✓),whether the following public facilities/infrastructure, utilities, and services are presently or readily <br />- <br />available to the project site and,whether the,proposedproject can be adequately served without substantial improvements or <br />expansion of existing facilities and services. If new or expanded/modified facilities or <br />services are necessary, explain below. <br />Yes No <br />N/A <br />a. Water supply/treatment facilities ❑ <br />❑ <br />b. Wastewater collection/treatment facilities - ❑ <br />❑ <br />. .,. o - f <br />C. Storm drainage, flood control facilities ❑ <br />❑ <br />d. Soled waste collecbon/disposaVrecycling services ❑ <br />❑ <br />e. *If <br />nergy/cOmmunication Services ❑ <br />❑ <br />C., Public/private roadway and access facilities ❑ <br />❑ <br />g Public/private parking facilities _ ❑ <br />❑ <br />4 <br />❑ <br />h Other public7pnvate transportation servicesQSI <br />❑ <br />(public tram, rai lway, water or air transjport; etc)__" <br />_ <br />�< �Fire and emergency medical services ❑ <br />❑ <br />Police/law enforcement services ❑ <br />❑. <br />Parks ani recreation services <br />13 <br />�t <br />Library services . ❑ <br />- . <br />❑ <br />_ . <br />m �= General govemment services - ❑ <br />❑ <br />n School facilities ® <br />❑ <br />(Signature) (Date) <br />i_ A e.c.Gn Vis_ <br />