2020-03 NAHC AB52 Consultation Request FormLocal Government Tribal Consultation List Request
Native American Heritage Commission
1550 Harbor Blvd, Suite 100
West Sacramento, CA 95691
916-373-3710
916-373-5471 – Fax
nahc@nahc.ca.gov
Type of List Requested
☐ CEQA Tribal Consultation List (AB 52) – Per Public Resources Code § 21080.3.1, subs. (b), (d), (e) and 21080.3.2
☐ General Plan (SB 18) - Per Government Code § 65352.3.
Local Action Type:
___ General Plan ___ General Plan Element ___ General Plan Amendment
___ Specific Plan ___ Specific Plan Amendment ___ Pre-planning Outreach Activity
Required Information
Project Title:____________________________________________________________________________
Local Government/Lead Agency: ___________________________________________________________
Contact Person: __________________________________________________________________________
Street Address: ___________________________________________________________________________
City:_____________________________________________________ Zip:__________________________
Phone:____________________________________ Fax:_________________________________________
Email:_____________________________________________
Specific Area Subject to Proposed Action
County:________________________________ City/Community: ___________________________
Project Description:
Additional Request
☐ Sacred Lands File Search - Required Information:
USGS Quadrangle Name(s):____________________________________________________________
____________________________________________________________
Township:___________________ Range:___________________ Section(s):___________________