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�1 <br /> .�'..""'_'�__:.._:".' '.:_'_'. . .. . � . � <br /> ~ ^ Yes Maybe No <br /> • . . . <br /> . i � . ✓ <br /> . (e) Stor.n water drainage? _ � i <br /> (f) Solid waste and disposal? _ <br /> 4 <br /> Explanation: <br /> (17) Iluman Health. Will the proposal <br /> • result in the creation of any <br /> health hazard or potential health � <br /> ' hazard (excluding mental health)? _, .— <br /> Explanation: <br /> (18) Aesthetics. Will the pronosal re- <br /> su t in t e obstruction of any <br /> . scenic vista or view open to the ' <br /> public, or will the proposal re- <br /> ault in the creation o£ an aesthe- � <br /> tfcally offensive site open to <br /> public view? • — — <br /> Explanati.on: • � <br /> (1g) RecreaCion. Will the proposal re- • <br /> su t n an impact upon the quality <br /> or quantity of existing recrea- ✓ <br /> t <br /> ' tional opportunities? � — ' <br /> • Explanation: <br /> (20) Archeolaaical/Historical. Will the <br /> proposal result xn an alteration of <br /> a 'significant archeological or his- ✓ <br /> � torical site, structure, object or <br /> . building? — —' <br /> , Explanation: , � <br /> III, SIGNATUR� � <br /> • I+ the undersigned, state that to the best of my knowledge <br /> the above informatioWithdraweannddeclaration of nonusignficancehat <br /> the lead agency may Y <br /> that it might issue in reliance upon this checklist should aT�rP <br /> be any misrepresentation of lack of full disclosure on my p <br /> Pro�onent: M. D. E. Partnenhi <br /> rY <br /> jV, DECLAR�ITION Or RESPONSIIILE OPFICIAL: 6 ' B ° en - AI <br /> The above described project is a r�aj <br /> (significant, insignificant) impact and (w�i 1, will not require an <br /> Environmental Impact Statement. . <br /> ' ' Responsible Official • <br />