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US Customs and Border Protection Ajo Housing Development ... - GSA

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Arizona's On-line Environmental Review Tool<br />

Search ID: m~ 20100430012069<br />

I00430012069<br />

Project<br />

Proj(.-ct Name: <strong>Border</strong> Patrol<br />

Parrol housing project<br />

Date: 4/30/20109:04:55 AM<br />

Print this Environmental<br />

Envirollmellial Review Receipt using your Internet<br />

Inlerne1 browser's<br />

print function <strong>and</strong> keep it<br />

il for<br />

tor your records.<br />

records_ Signature of<br />

ot this receipt<br />

indicates the signer has read <strong>and</strong> underst<strong>and</strong>s the information<br />

informalion<br />

provided.<br />

provided_<br />

Signature:<br />

SigTlalure: --<br />

-­ . __<br />

Person Conducting Search (if not<br />

nor applicant)<br />

Agencylorganization:<br />

Agency/organization:<br />

_<br />

Date:<br />

--------<br />

-------­ _<br />

Contact Name:<br />

__ _<br />

Proposed Date of Implementation:<br />

Implementalion: _ Address; Address: ~ _ _<br />

Please provide point of contact conlacl information regarding<br />

r.3garding this<br />

Environmental Review.<br />

City, State,<br />

Stale, Zip:<br />

_ _<br />

Application<br />

Appllcarion or organiz£Jtion<br />

organization responsible fOf for<br />

project implementation<br />

Phone:<br />

_ _<br />

Agency/organization:<br />

_ _<br />

E-mail:<br />

_ _<br />

Contact Name:<br />

_<br />

Address:<br />

__ _<br />

City, Slate. State,<br />

Zip:<br />

__<br />

Phone:<br />

_ _<br />

E-mail:<br />

_<br />

Page 7 of 7<br />

APPLICATION INITIALS:<br />

_

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