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Phase I (TSA Environmental Site Assessment (ESA) Questionnaire Date: <br /> Project Address: <br /> Interviewee: <br /> Page 6 of 8 <br /> (11a.) If the property is served by a private well or non-public water system, is there evidence or do you <br /> have prior knowledge that contaminants have been identified in the well or system that exceed <br /> guidelines applicable to the water system? ❑ Yes ❑ No �Unknown Non-applicable <br /> -If yes, describe: <br /> (11 b.) If the property is served by a private well or non-public water system, is there evidence or do you <br /> have prior knowledge that the well has been designated as contaminated by any government <br /> environmental/health agency? ❑Yes E]No RJUnknown Non-applicable <br /> -If yes, describe: <br /> (12.) Does the owner or occupant of the property have any knowledge of environmental liens or <br /> governmental notification relating to past or recurrent violations of environmental laws with respect to <br /> the property or any facility located on the property? ❑Yes ❑No [Unknown <br /> -If yes, describe: <br /> (13.) Has the owner or occupant of the property been informed of the current or past existence of <br /> hazardous substances or petroleum products with respect to the property or any facility located on the <br /> property? ❑Yes ❑ No ®Unknown -If yes, describe: <br /> (14.) Has the owner or occupant of the property been informed of the current or past existence of <br /> environmental violations with respect to the property or any facility located on the property? <br /> ❑ Yes ❑ No Unknown -If yes, describe: <br /> Advanced Geo Environmental.Inc. <br />