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SUMMARY FORM FOR ELECTRONIC DOCUMENT SUBMITTAL <br />Lead agencies may include 15 hardcopies of this document when submitting electronic copies of environmental <br />documents to the State Clearinghouse (SCH). The SCH also accepts other summaries, such as EIR Executive Summaries <br />prepared pursuant to State CEQA Guidelines Section 15123. Please include one copy of the Notice of Completion Form <br />(NOC) with your submission and attach the summary to each electronic copy of the document. <br />State Clearinghouse Number: <br />Lead <br />Project Title: <br />Project Location (City and County): <br />Contact: <br />Provide a Project Description (Proposed actions, location, and/or consequences). <br />Identify the project's significant or potentially significant effects and briefly describe any proposed mitigation measures <br />that would reduce or avoid that effect. <br />If applicable, describe any of the project's areas of controversy known to the Lead Agency, including issues raised by <br />agencies and the public. <br />Provide a list of the responsible or trustee agencies for the project. <br />Electronic Submittal <br />75D-222 <br />FORM "Q" <br />