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DRAFT (August 7, 1990) <br /> <br /> A'ITACHMENT B <br /> MITIGATION MONITORING PLKN <br />SAMPLE COMPLIANCE VERIFICATION FORM <br /> <br />Mitigation Measure: <br /> <br />Impact I~sue: <br /> <br />.(Earth, Water, Traffic, etc.) <br /> <br />Location: Onsite Off. site <br /> <br />Administrative <br /> <br />Project Phase: Design <br /> <br />Construction <br /> <br />Ol~rafi,on <br /> <br />Description of Activity/Method of Implementation: <br /> <br />Disposition: <br /> <br />Mitigation m~ure for the above-not~ project phase implc nented. <br />No further action is required. <br /> <br />Mitigation measure for the above-not~ project phase is not fully <br />implemented. Further action required. (Please explain below) <br /> <br />The mitigation measure for the above-noted project phase is not <br />in compliance. Further action required. (Please explain below) <br /> <br />Comments/Revisions: <br /> <br />Completed by: <br /> <br />Name: <br /> <br />Title: <br /> <br />Date: <br /> <br />Approved by:. <br /> <br />Name: <br /> <br />Title: <br /> <br />.Date: <br /> <br />G:.LCM]~.BB <br /> <br /> <br />