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Surface Subsurface Report Questionnaire Page 4 of 10 <br /> Riviera Estates,4100 Riviera Dr.,APN 109-040-20 <br /> Our Project Number: E07092A <br /> May 31, 2007 <br /> NEIL O.ANDERSON &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 F <br /> Name: t c�no aro G' k� c t(�F i cam-, 05-,o <br /> Address: X100 !e� CV. 5{pc�l�-ford �C{ AjjZp'-� <br /> Telephone: (Zvc-i'') q �S3 - 30 Z <br /> Year purchased: 2-000 <br /> 2. Previous owner(s)and contact information (if known): <br /> Name: rflY tYl�t�k-S <br /> Address: <br /> Telephone: L)V\'kc-vto� <br /> Year purchased: <br /> 3. Other person with historical knowledge of property: <br /> Name: Ann CV\o-vq,%n <br /> Address: 9 r 73(,o K'V')N ra- 'Dv' i �}oc k-t o�, CA- q 520`- <br /> Telephone: PCI) Lio-;f2_ y:70,1 <br /> Relationship to property: N '�11�160-le <br /> 4. Please describe current use(s) of property: i <br /> FcLvrni t� Re"A le.cnce- <br /> 5. Please describe any other known past use(s)of property, and approximate dates of each use: <br /> ,. 902.Tndust&Way•Lodi, G4 95290 <br /> 209 367 3701•Fax 209.333.8303 DZ007 Neil 0.Anderson&kzs ate5,Inc <br />