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Yes Maybe No <br />(e) Storm water drainage? _ <br />(f) Solid waste and disposal? _ <br />Explanation: <br />(17) Eiuman iiealth. 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 proposal re- <br />sult in the obstruction of any <br />scenic vista or view open to the <br />public; or will the proposal re- <br />sult in the creation of an aesthe- <br />tically offensive site open to <br />public view? <br />Explanation: <br />(19) Recreation. Will the proposal re- <br />sult in an impact upon the quality <br />or quantity of existing recrea- <br />tional opportunities? <br />Explanation: _ <br />(20) Archeological/Historical. Will the <br />.proposal result in an alteration of <br />a significant archeological or his- <br />torical site, structure, object or <br />building? <br />.Explanation: _ <br />III. SIGNATURE <br />I, the undersigned, state that to the best of my knowledge <br />the above information is true and complete. It is -understood that <br />the lead agency may withdraw any declaration of non-signficance <br />that it might issue in reliance upon this c ecklist should there <br />be any misrepresentation of lack of full diosure on: y pp'a: <br />Proponent: i.1J, <br />IV. DECLARATION OF RESPONSIBLE OFFICIAL <br />The above described project is a major action with <br />(significant,:insignificant) impact and (will, will not) require an <br />Environmental Impact Statement. <br />Responsible Official <br />I <br />