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_ � . - <br /> ' • . � - - _ Y�e ' Ma be . No � . <br /> � , ` (e) Storm water drainage? �// <br /> (£) Solid waste and disposal? ` �/ <br /> ' � ' Explanation: ' ' <br /> (17) Human Health. Y7i11 the proposal • � <br /> , • result in the creation of. any <br /> . health hazard or potential health / <br /> hazard (excluding mental health) ? • ✓ <br /> • �cplanation: <br /> ' (18) Aesthetics. Will the proAosal re- . •. <br /> ' sult in the obstruction o� any <br /> sc�znic vista or view open,to the ' , � <br /> . ptihlic, o= will the proposal re- ' <br /> . sult in the creation of an aesthe- , • , <br /> � tically offensive site open to — � ' � <br /> public view? <br /> FScplanation: � ' <br /> ' . (19) , Recreation. 4Ii11 the pr000sal re= '� <br /> sult in an impact uoon the quality <br /> , or quantity of existing recrea- • . / � <br /> tional apportunities? _ (/ <br /> • Explanation: � <br /> (20) Archeological/fiistorical. Will the ' <br /> • ' , • ,proposal result in an alteration of <br /> . a 'significant archeological or his- . ' <br /> torical site, structure, object or - • • / <br /> , building? v ' <br /> � Lli <br /> Explanation: ' <br /> ITI. SIGNATURE • <br /> ;, I, the undersigned, state that to the best� of my knowledge <br /> the above information is true and comolete. . 2t is understood that <br /> , the lead agency may withdraca any declaration of non-signficance ' <br /> that it might issue in reliance upon this checkl'ist should there <br /> be any misrepiesentation of lack of full dis osure on my part. <br /> ' ' Proponent�- ��-�` <br /> IV. DECL11Itc'1TICN OF RESPONSIBLE OFFICIAL: ' . <br /> The above described project is a riajor action .with <br /> . (Significant,� insignificant) impact and (will, will not) require an <br /> Envirornnental Impact Statement. � • <br /> , . ` ' � ' ' Responsible Official . • <br />