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Sent. ey:SERUICECENTER Jul-08-98 02:38Pm from 6088373914 608 267 1540 Page 4 <br /> I <br /> i • <br /> Initial Site Inspection (IS!) Procedures Checklist <br /> T <br /> L PROJECT INFORMATION <br /> C.:ntact Name: � 4 r r • •, ii a Consultant . •- '. <br /> Representing: S c.4 a—.r - Name: -, 1A <br /> Address: <br /> . 4� _ •�"1a�.:N. ��_ Address: <br /> �11:Y -r1.Q,t i,�)l <br /> c 355.0-22,71- <br /> P?one #: (OS -2:5'7 - ,305O ' . Phone #:. <br /> Facility Type: f.lan 64' ': r)1J Site Location: — <br /> (*.u.,$.C6aq Tprvq c,„ y) <br /> U. ISI REQUEST INFORMATION • <br /> 'S; N Has the applicant provided information required•in chi; NR 502, 503 or 509, depending.on project type)? <br /> Date ISI request received ""�`��' .q <br /> Y I(s) Did the applicant send a cc py of the request to the central office? • <br /> Did the applicant include tit following: ' <br /> Y Authorized contact, type of facility and operation being proposed <br /> Property ownership, location to i4-'4 and present land use Zf �g <br /> Endangered Resources Letter Date of letter: -,A.., 1 <br /> Historical Society Later Date of letter: '.�•o_ . V013/98 <br /> f - Topographical map tor recent air photo)showing relief, surface waters, floodplains, existing land <br /> use conditions and al water supply wells and residences located within one mile of the proposed <br /> boundaries of the proposed facility. <br /> y Preliminary identification of all known potential conflicts with the applicable locational & <br /> performance standar1 is of the NR 500 series of codes. <br /> J Identification of all airports within 5 miles (for putrescible waste disposal facilities) <br /> (j N Was all information listed above provided w/IS! request? (Note; 151 shouldn't be done until required information is provided.) <br /> If no - dates that additional information is requested and received: / / - / / _ <br /> Y I N( Did applicant identify any potential conflicts with the locational standards? If yes, describe. <br /> Y ;Z) Did the Historical Society or Bureau of Endangered Resources request surveys? HS l— BER ri <br /> If yes, what concerns were -wised: <br /> • <br /> - 1 - Updated September 1996 <br />