HomeMy WebLinkAboutSummary_Form_for_Document_Submittal_finSummary Form for Electronic Document Submittal Form F
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Lead agencies may include 15 hardcopies of this document when submitting electronic copies of Environmental Impact
Reports, Negative Declarations, Mitigated Negative Declarations, or Notices of Preparation to the State Clearinghouse
(SCH). The SCH also accepts other summaries, such as EIR Executive Summaries prepared pursuant to CEQA Guidelines
Section 15123. Please include one copy of the Notice of Completion Form (NOC) with your submission and attach the
summary to each electronic copy of the document.
SCH #:
Project Title:
Lead Agency:
Contact Name:
Email:Phone Number:
Project Location:
Project Description (Proposed actions, location, and/or consequences).
Identify the project’s significant or potentially significant effects and briefly describe any proposed mitigation measures that
would reduce or avoid that effect.
City County
Revised September 2011
continued
If applicable, describe any of the project’s areas of controversy known to the Lead Agency, including issues raised by
agencies and the public.
Provide a list of the responsible or trustee agencies for the project.