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CEQA APPENDIX G - California Natural Resources Agency

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ceqa APPENDIX G: ENVIRONMENTAL CHECKLIST FORM. NOTE: The following is a sample form and may be tailored to satisfy individual agencies'. needs and project circumstances. It may be used to meet the requirements for an initial study when the criteria set forth in ceqa Guidelines have been met. Substantial evidence of potential impacts that are not listed on this form must also be considered. The sample questions in this form are intended to encourage thoughtful assessment of impacts, and do not necessarily represent thresholds of significance. 1. Project title: ________________________________________ __________________. 2. Lead Agency name and address: ________________________________________ _____________________________. ________________________________________ _____________________________. ________________________________________ _____________________________. 3. Contact person and phone number:_________________________________ _______.

Biological Resources Cultural Resources Geology /Soils Greenhouse Gas Emissions Hazards & Hazardous Materials Hydrology / Water Quality ... Agricultural Land Evaluation and Site Assessment Model (1997) prepared by the ... or Farmland of Statewide Importance (Farmland), as shown on the

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