Exhibit A-1 Initial Study Checklist Cover Sheet

The following information is to be provided as a word processing document along with the Initial Study checklist form:

  1. Project Title Include LAFCO short-term title for project
  2. Lead Agency Name and Address
  3. Contact Person and Phone No.
  4. Project Location
    • Regional map
    • Detailed local map with agency boundaries including sphere of influence
    • Site boundaries
  5. Project Sponsor’s Name and Address
  6. General Plan Designation
  7. Zoning
  8. Description of Project:
  9. Surrounding Land Uses and Setting
  10. Agencies whose Approval is Needed
    • Agencies that will use the environmental document
    • Permits required
    • Related environmental review and consultation requirements of these agencies
  11. Will the project require a federal permit, be jointly carried out by a federal agency, receive federal funding or occur on any part of federal land? If yes, provide the appropriate information.
  12. Environmental Factors Potentially Affected:
    □ Aesthetics □ Agricultural Resources □ Air Quality
    □ Biological Resources □ Cultural Resources □ Geology/Soils
    □ Hazards & Haz. Materials □ Hydrology/Water Quality □ Land Use Planning
    □ Minerals Resources □ Noise □ Pop./Housing
    □ Utilities/Service Systems □ Mandatory Findings of Significance