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--- ---�-- -- <br />(19) Rrcrcacian. 417i1 thc propo.^.nl result in an impact upon [he quali.ty • •� <br />'or. quantity of cr.i�tinE recreacional opportunitics? ____ � <br />E•r.yl.anati.on: . <br />{20) Archcol.o�i.aal/Historical. Ylill the proposal r.esult in an a1Y.cration <br />of n siF;nfficant arclieological or historical .^.ite, structure, ohject <br />or buildin�? _ <br />:II. SIGtIhTUP,E <br />I, the undersigned, state that to t}�e best of iny knoorledge the above infonnalirni is <br />_cue and comp3ete. It is undersCood that Che leed agency ma}� wichdrao� any declaral•ion of no±i— <br />;ignificance that it miSht issue in reliance upon this checklist should tl�ere be any misrepresen- <br />=ation or izck of full disclosure on my part. <br />. , <br />Proponer.l: � <br />IV. DECLARATIO:; OF RESPO:d5I3I.� OPFICIF.L: <br />The above descrit?ed project is a aiajor aclion v.ith (significant, insignifi.cant) <br />impact and (c.•ill, will not) require an Envircnmcntal Impac:: Staten:erL. <br />Responsib].e Offici.al <br />0 <br />1' <br />.• <br />> >r <br />