Laserfiche WebLink
Phase I /TSA Environmental Site Assessment (ESA) Questionnaire Date: <br /> Project Address: <br /> Interviewee: <br /> Page 7 of 8 <br /> (15.) Does the owner or occupant of the property have any knowledge of any past environmental site <br /> assessments of the property or facility. (Phase I, II, sampling etc.) ❑Yes ❑No Unknown <br /> If Yes, did the assessment indicate the presence of hazardous substances or petroleum products on, <br /> or contarnination of, the property or recommended further assessment of the property? <br /> []Yes ❑No rUnknown <br /> Can you provide AGE with a copy (or copies) of any previous environmental assessments and/or <br /> documents in relation to the property? ❑Yes ®No <br /> (16.) Does the owner or occupant of the property have any knowledge of any past, threatened or <br /> pending lawsuits or administrative proceedings concerning a release or threatened release of any <br /> hazardous substances or petroleum products involving the property by any owner or occupant of the <br /> property? ❑Yes ❑No ]Unknown -If yes, describe: <br /> (17a.) Does the property discharge waste water,on or adjacent to the property,other than storm water, <br /> into a storm water sewer system? ❑Yes ❑No EUnknown -If yes, describe: <br /> (17b.) Does the property discharge waste water,on or adjacent to the property,other than storm water, <br /> into a sanitary sewer system? F]Yes ❑No [Unknown -If yes, describe: <br /> (18.) Did you observe evidence or do you have any prior knowledge that any hazardous substances or <br /> petroleum products, unidentified waste materials, tires, automotive or industrial batteries, or any other <br /> waste materials have been dumped above grade, buried and/or burned on the property? <br /> ❑Yes ❑No (Unknown -If yes, describe: <br /> Advanced GcoE.nvironmental.Inc. <br />