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09/13/7004 12:49 2093345374 W(3P SOUTHWEST NOCAL PAGE 05 <br /> This questionnaire was answered: <br /> Via: ern"Person <br /> _Telephone Conversation <br /> _Sent Registered Mail or Overnight Service <br /> Fax <br /> This questi nnaire was answered by- <br /> Name: <br /> Signature: <br /> Title: <br /> Firm: <br /> Date: r <br /> This questionnaire was administered and completed by- <br /> Name;— John M.Terayskis,REA <br /> Signature: AQV <br /> Title:---R_cAistered�nvi�jonm'enftal Assessor <br /> Date.- <br /> Note: <br /> ate:Note: This Field Screen Questionnaire is based upon the American Society of Testing and Materials <br /> Transaction Screen )✓50.02.1. <br /> KEY SITE MANAGER QUESTIONNAIRE WGR Southwest,Inc. <br /> Site address Page 4 of 4 <br />