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UV/UU/U6 15:46 FAX 203 942 0214 Siegfrted Eng Q007 <br /> Surface and Subsurface Contamination Report Questionnaire <br /> NOA Project Number: E06102A <br /> Property Location: Thomton Road, Thornton, CA 9524Z <br /> Page 5 <br /> > NEIL O. ANDERSON f:ASSOCIATES, INC. <br /> ENVIROMENTAL QUESTIONNAIRE AND DISCLOSURE STATEMENT <br /> PART 2: OWNER INFORMATION <br /> (To be completed by Owner or Owner's representative) <br /> 1. GENERAL INFORMATION <br /> 1_ Current owner of property <br /> Name: C A-/Zy- 6� K�-o n 400 <br /> Address: p() p)o>c -7, T AG�'�" <br /> Telephone: () <br /> Year purchased: <br /> 2. Previous owner(s) and contact information (if known): <br /> Name: <br /> Address: <br /> Telephone: <br /> Year purchased: <br /> 3. Other person with historical knowledge of property: <br /> Name: <br /> Address: <br /> Telephone: <br /> Relationship to property: <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 /> /(you have any questions about This Tieslionnaire.please contact Abby Racco at(209)367-3701 est 238 / <br />