Laserfiche WebLink
Surface and Subsurface Contamination Report Questionnaire <br /> NOA Project Number: P06068 <br /> Property Location: 2514 Juliet Road, Stockton, CA 95205 <br /> Page 5 <br /> NEIL 0. ANDERSON fx 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: j �� U Cc S <br /> ►. Address: 7't L <br /> Telephone: `Tj]2(oG' <br /> ` Year purchased: <br /> 2. Previous owner(s) and contact information (if known): <br /> Name: x <br /> Address: <br /> Telephone: <br /> Year purchased: <br /> ` 3. Other person with historical knowledge of property: <br /> Name: M 4 I1JCD� Oc- <br /> Address: ZS�G� �vt )�� �L2 ✓� <br /> Telephone: 4V:, —O7� {�G� <br /> Relationship to property: <br /> �. <br /> 4. Please describe current use(s) of property: <br /> 5. Please describe any other known past use(s) of property, and approximate dates of each use: <br /> Ncs� I�r—�r�w� • _ <br /> V lfyou have any questions about this questionnaire,please contact Tina Cheney a[(209)367-3707 ext. 233. <br />