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� <br /> r � � . • _ �as `!a•;be `�o <br /> (19) ftec:eation, b'111 tha proposal result in an .r.pact upon the quai? cy <br /> or quantity oE exist.ng reczeational oppor[unitizs? K <br /> E;cplana[ion: <br /> � <br /> (20) Archeolo¢ical/HisCorical. Will the proposal r.sult in an altera[ion <br /> of a significant archeological or hisccrical site, structure, objecc <br /> or building? � <br /> Explanation: <br /> III. SIG;fATURE ' <br /> I, the undersigned , s[ate khat to the best of ^�y knovledge ehe abcve infor.oa[ion is <br /> Crue and compie[e. It is understood [hat the lead agency may wichdrau any declaratior. of non�- <br /> eiqnificance tha[ i[ might issue in reliance upon this checklist should there be any misreprese^ <br /> tation or lack of full disclosure on my par[. <br /> Proponen[:C'/� C� fs�ic�vi � <br /> �2 <br /> IV. DECL,UUTION OF RESPONSISLE OFFICIAL: <br /> The above descr:bed projecc is a major action with (significanc, insignificant) <br /> impac[ and (will, will rtot) require an Environmen[a1 Impac[ 5[a[ement. <br /> Responsible Official <br /> L . J <br /> �_ - <br />