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Environmer=i inf nim n For- <br /> Part i <br /> IIA.,M: u14 7. 1-988 <br /> (.a be C.:m�pleted B? dpplicaat) <br /> NCTM Is c..opLet:ng :is acres, ase add+ticaal sheets i. aecsssa_-7. <br /> Answer a'_= gtes t-Ons to the hest oL _vaur abilit l. I! a gMsst_c <br /> is not appL:cahle to vocr pro:ec-, wr:ts UA (not appL:cable ) . <br /> Please do not leave hLaaks . Inc=mIats Ior=s cannot he ac_spt_ <br /> P=BSCN PCB's ?RCP=Z cwUm tl=Z'r OF OWNER <br /> Sam 3r=e 3�0am (,-.or grmk 3ndes{I{ca) <br /> Address 1. 0. 3c-.T Z67- <br /> Ci-.-7 <br /> 67.City Stoat-x <br /> State/Zip Cd 95201 <br /> Phone (209) 9i►8-47 Z? <br /> A_ PRC MCw. OFS.."'M�—PITICS <br /> Z_ Type at application: Q IIse Permit, [� Maicr Subdivi-sion, <br /> -- Q Zone. Fisc?a«;Aicatio ., Cz Dlinor Subdivision. Q Site XPP=Val, <br /> Q Zone variance, Q otR�T - <br /> Z. Project location: East of Highway 99 and sonrh of ML#MT 88 <br /> Desc=ibe the project; i.e., ikiag made and mar-=* of Bsa. <br /> Ideat�ay saecific graject c�poneats: 9n esfsting sinsS.Ie carol of <br /> Taad cossist�^_A of 'S 67 awes is to be di-..aed into four var:,ans s3.:aa rte_ <br /> 3cIIIdi..--Q The �--m-easl= of Tiilccm 3eac <br /> aceage of project: 35.67 # of �^ `ffi parceLs- Z <br /> Asstssor Pa.-csl #(3) : T 0I-n2 T-&0 and 101-Z!0-02 <br /> 4. if there �_s an e:cstiag = assessing aav aspect of vcur project <br /> site, provide tit-70 and data: wo -- <br /> S. Otber pe— its and aaprovals (Cataty. 8egioaal. State and ?ode- ?) <br /> :erti:ed <br /> !or t:is pra;acr: <br /> R{ei.STd4 �8 <br /> nem <br /> San <br /> Cal- s <br /> r7+? �� gnat+ ^e••ai n+t San .;oaQ1lLn Caanty ?aD.L-c 40r= <br /> ,- _ (6/86 <br />