PAST/FUTURE PROPOSALS BY THE APPLICANT Briefly list/describe any projects carried out in the last 5 years or planned for implementation in the next 5 years that are in any way related to the proposed activity or may impact the same receiving body of water. Include estimated adverse impacts. ______________________________________________ ____________________ Date Applicant’s Signature (Agent may not sign for Applicant) Should you have any questions regarding the water quality certification process, please contact: Kai Dunn at (760) Continued next See next page Revised January 2019cc: cc: (Continued) add additional page break when the list is continued to this page “cc”
PAST/FUTURE PROPOSALS BY THE APPLICANT Briefly list/describe any projects carried out in the last 5 years or planned for implementation in the next 5 years that are in any way related to the proposed activity or may impact the same receiving body of water. Include estimated adverse impacts. ______________________________________________ ____________________ Applicant’s Signature Date (Agent may not sign for Applicant) Should you have any questions regarding the water quality certification process, please contact: Kai Dunn at (760) Revised January 2019cc: Continued next See next page cc: (Continued) add additional page break when the “cc” list is continued to this page
401_apform_r7.docx