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_ • U } les M_ aybe �;o <br /> ('19) � Fiecreation. Will [he proposal result in an impact up n the quali[y � <br /> or quantity o: e::isting recreationa'_ oppertunities? _ � <br /> Explanation: <br /> (20) Archeological/His[orical. Will the proposal result in an alteration <br /> of a signiEicant archeological or historical site, struc[ure, object <br /> or building? — � <br /> Explanation: <br /> III. SIGNATW.E <br /> I, [he undersigned, state that to the hest of ury knowl.edge the above information is <br /> true and cor�ple[e. It is unders[ood that the lead agency �y withdraw any declaration of aea- <br /> signi;ic2nce that it might issue in reliance upon this checklist s}�ould there be any misrepresen- <br /> tation or lack of :ull disclosure on ny pa;t. <br /> Proponent: / <br /> IV. DECL�.��T_IOV Op RESPOSSI3L'c OFFICIAI.: <br /> The above described project is a c�jor ac[ion �„-i[h (significant, insignificant) <br /> impact and (will, will not) require an Environmental I��ac[ Statement. <br /> Res?onsible Official <br />