Laserfiche WebLink
V \/ <br /> ET_T'IRONvfENT'AL SITE INSPECTION QUESTIONNAIRE <br /> AGRICULTURAL PROPERTIES <br /> — Pave 1 of 10 <br /> The purpose of this questionnaire is to provide a format for reporting of environme Ital <br /> observations of site conditions. The owner/tenant is expected to answer all question: as <br /> completely as possible based personal knowledge of current and'or past site uses. <br /> I_ GENERAL RT ORIMATION <br /> Project #: <br /> Site Name: — <br /> Address: 2�ja— —efftm —aCy G4 9.t3� _ <br /> Pam Ip #^^--209 — 05 <br /> 13 — 9 <br /> ?erson Completing Questionnaire: Nfoi-es Lim _ <br /> T:rle: Owner <br /> Teicphone Number: G7q4 -917 -0 <br /> Date n l 17 0 200 <br /> SITE CONTACT <br /> NAME TITLE .4YFMATION <br /> tA/7ow OWW <br /> II. SITE DESCRIPTION/USEJUSTORY NIt R." <br /> A. Description <br /> 1. Provide a description of the current site (ie. existing structures. geograp tic <br /> conditions, uses, etc.). <br /> t� — ,Z S erSidevlce house AW _ <br /> crr�iaitIc L mdi f+o►?I — EE" wAout &#s <br /> 2. Attach a Plot Plan describing key features, if available. <br /> LJ 103 CII <br /> ivy <br /> C cac <br /> c:tno!!�ez�axn5E1a�11�1.tc`orvix:yuex.on l � �.~•' I.-^---"�"— <br /> InrAYC-RICI h i–n . <br /> TOO a+, 06•tfii6!OTS IFI 60:CT tOOZ GT t0 <br />