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Surface and Subsurface Contamination Report Questionnaire <br /> NOA Project Number: E06044A <br /> Property Location: 31103 Grooms Road, Oakdale, CA 95361 <br /> Page 5 <br /> NEIL 0. ANDERSON It ASSOCIATES, INC. <br /> ENVIROMENTAL QUESTIONNAIRE AND DISCLOSURE STATEMENT <br /> PART 2: OWNER INFORMATION <br /> (To be completed by Owner or Owner's representative) <br /> I. GENERAL INFORMATION <br /> 1. Current owner of property <br /> Name: vQ `ne v�u��Z "`�"�r`� C LJ- I Z <br /> Address: 3( 1 T (p <br /> Telephone: c " ---C�mk Q <br /> (200( ) %Lf J -05 <br /> Year purchased: 1 -7 3 <br /> 2. Previous owner(s) and contact information (if known): <br /> C i , �G <br /> Name: C�uux ick <br /> Address: CP4:7-Se & <br /> Telephone: <br /> _ Year urchased: h <br /> rzkza�,l� inn 1�iSa�s Coa�� '�21� �fU�S , <br /> 3. Other person with historical knowledge of property: <br /> Name: <br /> Address: <br /> Telephone: <br /> Relationship to property: <br /> C <br /> 4. Please describe current use(s) of property: 42:c tck-c-r,& <br /> 5. Please describe any other known past use(s) of property, and approximate dates of each use: <br /> Ifyou have any questions about this questionnaire,please contact Tina Cheney at(209)367-3701 est. 133. <br /> r <br />