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PLEIOMPLETE THE FOLLOWING QUESTIONS BY G' 3 US ANY Cuh.MENTS OR SUGGESTIONS FOR HOW WE CAN 1... _<OVE. Please indicate the nature of your business of aoolicable,check more than one): — Property developer — Flood/Water Control District — Sand E.Gravel — Public Agency Applicant _ Consultant — Law Office — Civic or Trade Organization — Farming/Ranching — Silviculture — Member of Legislature _ Public Agency _ Mining — Federal/State/Local Official — Personal/Private Project — Media _ Conservation Organization — Adjacent Property Owner — Native American — Other(describe): What Service(s)Did You Seek From the Corps? pr appilwble,check morn than one): Jurisdictionaltwetland determination — General Information - - Resolution of violation/non-compliance _ _ Pre-application Consultation Regulatory Program presentation — Nationwide general permit — _ Regional or programmatic general permit — Commented on Public Notice(permit application Standard IndMdual permit _ Other(describe): Letter of Permission Which Corps office(Dlstr/c4 Division,Headquarters,other)did you deal with? Name of person you contacted in our office(optional): Do you have any cornments or suggestions on the Regulatory Program? Information about you(optional): NamerTltle: Address: Telephone(Include area code): . May we contact you? YES _ NO _ Authorities: The government Performance and Results Act of 1993 and Executive Order(EO)12862,"Setting Customer Service Standards",dated September 11,1993. Purpose: To determine the quality of services our customers expect,as well as their satisfaction with USACE's existing services. Inforation provided on this forth will be used in evaluating the performance of the Comps Regulatory Program Routine Uses: This Information may be shared with the Office of Management and Budget,members of Congress,and other federal,state,and local government agencies. Disclosure: Providing requested information is voluntary. Failure to provide this information will not result in an adverse action. (Reverse of Eng Form 5065)