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1 � <br /> . Ycs Nr�b�_ t:a , • <br /> . . — , -- i <br /> (19) Recre�Cion. 'dill the prupos�l re�ult in an impact upou the quality � I <br /> or quantity oF existing recre�tional opportcnitics? _ I <br /> P.xplana[ionc <br /> (20) Archeolo�;ica]/lltstorical. 41i11 the propo�al result in nn alteration <br /> of a signiticant archcologic�l or tiistorical site, strucCure, objecl � <br /> or buildin�? _ <br /> ' , Explana[ion: <br /> I <br /> � <br /> . . i <br /> III. SIGNATURE i <br /> � I, the undersigned, statc that to the best of my knowledge tl�e above inEormation is <br /> tzue and complete. I[ is understood that the lead aeency may withdraw any declara[ion ot non- I <br /> significance that it might issue in .eliance upon this checklis[ should theze be any misrepreser.- i <br /> iation or lacl: of full disc?osure on ny part. <br /> Proponent. 4� I <br /> - j <br /> IV. DGCLARATI0:1 OF RESPONSIBLE OFPICIAL: _ <br /> The abwe described project is a r,.ajor action with (significant, insignificant) <br /> impact and (will, will not) tequire an Environcaental Impact Statement. <br /> „J <br /> Responsible Official . <br /> � ' .�-,� <br /> . <br /> ' � � 7 <br />