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DEPARTMENT OF HOMELAND SECURITY RI O.M.&NO.967 <br /> FEDERALIt MANAGEMENT EAGENCYEq*es October 31 2 <br /> APPUCUT F Ira O. WE <br /> FfMJB17 RAW B�rr . LOCAMN <br /> Faim,mug be f <br /> e (e.g,buimp, <br /> r- Yes <br /> 2.is tKe darwpmlc, y lowted wilhm a flox wastal ' a to have an kWd on,a i or vabmV <br /> Yes No r— Unsure <br /> comneffIs <br /> 3.Isthecbmaged bc&yDrdemofwark.lofadpcerAlo aCwsU Barrier ResourceSystem UruturanCtwuise rea? <br /> F Yes NaF- Unswe <br /> Conunents <br /> Wil the VWosed bclAy the , s ?(eS, matemais ba3bon,capady wse o ) <br /> Yes r— No UyRve <br /> Comments <br /> F Yes F No Fi thsure <br /> comments <br /> 6.is tKe damaged beiRy m National Regsier of or Ons ebbs,far ?Is it years?Are there a4wsiflar bukbmp <br /> nazu the sde? T—Yes [— her Unsure <br /> Ctolmolds <br /> F.Amthere any faisfine,or undistzbed ateas on,or new,the stfe?Are tefe,large tacts of. <br /> F Yes F No F Unsure <br /> caffffnaft <br /> B-Are there 3z.�.__ t cr eararf ter ed iletrt o ?' <br /> r—Yes r- No Unsure <br /> Comments <br /> gAre#we any other enviurmwmbi or .. cale ism <br /> Yes F No F t <br /> cammlems <br /> VEMA P, 2&-120, SOMOM OBSOUrm <br />