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May 25 2004 1r57PM Chasneti Consulting (2091 668-2596 p. 2 <br /> May 24,2004 U <br /> FOR: Mr.Parrainder Gillon <br /> 3130 West Byrom koad <br /> Tracy,CA 95377 <br /> PROJECT: Proposed Two Parcel Split at 23607 Hensen Road--Racy.CA <br /> SUBJECT: Surface and Subsurface Cmuamination Report for the Sm Joaquin County Environmental Health <br /> Dcpartrnenc. <br /> Please fax this document back to Chesney Consulting upon completion <br /> 1. Is there, or has there ever been to yow-lmowledgt,my type of above ground or underground storage tanks <br /> on the subj ect properly, or any type of buried containers. <br /> No <br /> Z, Please provide a list of the pesticides,if any,that have been applied to the subjectlaoperty acreage in the <br /> past three years. Are ptsttcides1hetbicide6 mixed on the property before sptayirsg'7 If so,where? Are <br /> peetfcidet applird to property surrounding the subject property? Arc there my wells(domcatic or irrigation) <br /> on the property? <br /> Pesdeidos: <br /> Wella:_ 9ln rin�I"/ Ill L1X <br /> 3. What fertilizers are applied to the property acreage? What amount of nitrogen fertilizer is applied,if my? <br /> Non e <br /> 4. Are euy hazardous rnalcriila secretion the property? If so,where! Are you aware of any hazardous moterial <br /> release on,or around your Property? <br /> f9azandous Mamrlals: ,(,[j <br /> Hazardous Matcrida Rcicaac:_, ti O <br /> 5. How lonngg have you owned the property and who were the prior owners,if known? Do you know the current <br /> zoning of the property? Whist activities have taken place on the property since you have owned it and known <br /> Previous,activities <br /> SY� h pr / r_ <br /> Length of Owuerehip; I Pnor Owners. Q Pr R .S'Z,2I(per Current Zaaiog:�PGtY+'1 <br /> Current Activities; Gl+e AQ <br /> Ptcvious Activities:// ii -- err:n�2ytGP <br /> SignedDatt:�1�n1� — <br /> Thank you for your tune. If there akrould be any questions on completing this Ei vuoruntmal Questionnaire,please <br /> give me a call. If additional space is needed,please use the back of tutu form <br /> Siacerely, <br /> Don Chtsney,RE.A. <br /> P. O. Bor3794 • 7tvfaek,CA 95381 • Office (209)668-1403 • for.(209) 668-.598 <br /> i <br /> TO 39Vd LZT8PE860Z TE :TZ b00Z/LZ/SO <br />