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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 /> 6., Page 11 <br /> 2. Have pesticides, herbicides or other agricultural chemicals been mixed, ❑ Yes 52No <br /> formulated, rinsed, or disposed of on the property? If so, please <br /> describe the locations where such pesticides, herbicides or chemicals <br /> were mixed, formulated, rinsed, or disposed, and the type of <br /> pesticides, herbicides or chemicals mixed, formulated, rinsed or <br /> disposed of at each location. <br /> L.. <br /> �. 3. Has any soil or groundwater analysis been performed to detect ❑ Yes !o <br /> pesticides, herbicides or chemicals used at the site? If so, please <br /> provide a summary of the findings or attach the report(s). <br /> r <br /> r <br /> ENDORSEMENTS: <br /> Part 2 <br /> As the present owner of the property or as an officer or general partner of the present owner of the <br /> property (or the duly authorized representative of such owner), I am familiar with all of the operations <br /> presently conducted on the property, and hereby certify thaxto the best of my knowledge, <br /> information, and belief the information disclosed ab ve 's and correct. <br /> t�� -b to <br /> Owner or Key Site M nager ignature Date <br /> Uc7rn.e- �5G1, t <br /> Owner or Key Site Manager's Name (please print) <br /> 6. Title, Company <br /> r <br /> ti /jyou have any questions about this questionnaire,please contact Tina Cheney at(209)367-3701 ext.233. <br />