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Fill <br /> ENVIRONMENTAL SITE ASSESSMENT QUESTIONNAIRE Page 3 <br /> r <br /> ` <br /> 23.Does the owner or occupant of the property have any knowledge of Yes No Unknown <br /> environmental liens or governmental notification relating to past or <br /> 4 recurrent violations of environmental laws with respect to the property or <br /> t any facility located on the property? <br /> 24.Has the owner or occup nt of the property been informed of the past or Yes No Unknown <br /> F, current existence of hazardous substances or petroleum products or <br /> environmental violations with respect to the property or any facility located <br /> an the property? <br /> 25.Does the owner or occupant of the property have any knowledge of any Yes Unknown <br /> environmental site assessment of the property or facility that indicated the <br /> presence of hazardous substances or petroleum products on,or <br /> contamination of,the property or recommended further assessment of the <br /> j property? <br /> 26.Does the owner or occupant of the property know of any past, Yes No Unknown <br /> r threatened,or pending lawsuits or administrative proceedings concerning a <br /> release or threatened release of any hazardous substance or petroleum <br /> products involving the property by any owner or occupant of the property? <br /> E 27.Is there an active or abandoned on-site septic system in place? Yes No <9 <br /> �ow <br /> 28.Does the property discharge waste water on or adjacent to the property Yes Unknown <br /> other than storm water into a sanitary sewer system? <br /> 29.To the best of your knowledge,have any hazardous substances or Yes Unknown <br /> petroleum products,unidentified waste materials,tires,automotive or <br /> industrial batteries or any other waste materials been dumped above grade, <br /> Of buried and/or burned on the property? <br /> i <br /> 30.Is there a transformer,capacitor,or any hydraulic equipment for which Yes No U <br /> there are any records indicating the presence of PCBs? <br /> FJ _,J602`%� W,6 6 0s <br /> Preparer Name Company <br /> 0 <br /> FJTitle Date <br /> 0 <br /> F <br />