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| 14. Identify the typical habiiat types that occur on, or are likely to be found on the project site, Check all that apply: "]Shoretine I] Forest ry} Agricultural/grasslands Cl Early mid-suecessional CWetland = [CT Urban Suburban 15, Boos the siteof the proposed action contain any apecie s of animal, or assoolated habitats, listed by the State Federal government as threatened of endan gered? or NO YES Jog ow“< aS LJ 16. [s the project site lovated in the [00-y Wreaiclz Ole ear flood. plan? (7, Will the proposed action create storm water discharge, elther from point or non-point source If Yes, s? a. Will storm water discharges flow to adjacent properties? b, Will storm water discharges be directed to iL. if Yes, briefly desoribe: conveyatice systems ait od storm drains)? Din Water - Wi Hl How t0 abel Leroi hs. sor id 18 Does the proposed action include construction or other activites that would result in the Impoundment or other liquids (e.2., retention pond, waste of water NO j YRS lagoon, If Yes, explain the purpose and size of the impoundment: dam)? IM a 19, Has the site of the proposed action or an adjoining property been the location of an active at closed Management fhoility? solid waste NO | YRS If Yea, describe: Bi Cy 20,Has the site of the proposed action or an adjoining property been the subject of remediation completed) for hazardous waste? (ongoing or NO | YES If Yes, desoribe: ' a shy, or ee ix LI 1 CERTINY THAT THE IN FORMATION PROVIDED ABOVE IS TRUE AND ACCU MY KNOWLEDGE RATE TO THE BEST OF Applicant? ati ADL paw 4/4/PoIg Signature: _Title: Execatve Direc or PRINT FORM Page 3 of 3