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SU0000011 SSCRPT
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2600 - Land Use Program
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MS-01-17
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SU0000011 SSCRPT
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Last modified
5/7/2020 11:27:32 AM
Creation date
9/9/2019 10:46:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0000011
PE
2622
FACILITY_NAME
MS-01-17
STREET_NUMBER
6255
Direction
N
STREET_NAME
TULLY
STREET_TYPE
RD
City
LINDEN
Zip
95240
APN
09103014
ENTERED_DATE
8/8/2001 12:00:00 AM
SITE_LOCATION
6255 N TULLY RD
RECEIVED_DATE
5/22/2001 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\T\TULLY\6255\MS-01-17\SU0000011\SSC RPT.PDF
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EHD - Public
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h Cc n <br /> TRANSACTION SCREEN QUESTIONNAIRE <br /> Page 2 of 5 <br /> Owner Occupant Observed During Site <br /> Question: (Dave Taylor) (Dave Taylor) Visit <br /> (Explain "Yes" answers belowl YES NO UNK YES NO UNK YES NO UNK <br /> 10. Are there currently, or to the best of your <br /> knowledge have there been previously, any registed or J <br /> unregisted storage tanks (above or underground) located <br /> on the property? <br /> 11. Are there currently, or to the best of your <br /> knowledge have there been previously, any vent pipes, f ! 1 <br /> fill pipes, or access ways indicating a fill pipe protruding <br /> from the ground on the property or adjacent to any <br /> structure located on the property? <br /> 12. Are there currently, or to the best of your <br /> knowledge have there been previously, any flooring, f r <br /> drains, or walls located within the facility that are stained Y Y <br /> by substances other than water or are emitting foul <br /> odors? <br /> 13. If the property is served by a private well or non- <br /> public water system, have contaminants been identified <br /> in the well or system that exceed guidelines applicable to <br /> the water system or has the well been designated as <br /> contaminated by any government environmentallhealth <br /> agency? <br /> 14. Does the owner or occupant of the property have <br /> any knowledge of environmental liens or governmental <br /> notification relating to past or recurrent violations of 1f <br /> environmental laws with respect to the property or any <br /> facility located on the property? <br /> 15. Has the owner or occupant of the property been <br /> informed of the past or current existence of hazardous <br /> substances or petroleum products or environmental <br /> violations with respect to the property or any facility <br /> located on the property? <br /> 16. Does the owner or occupant of the property have <br /> any knowledge of any environmental site assessment of <br /> the property or facility that indicated the presence of <br /> hazardous substance or petroleum products on, or <br /> contamination of, the property or recommended further <br /> assessment of the property? <br /> 17. Does the owner or occupant of the property know of <br /> any past, threatened or pending lawsuits or <br /> administrative proceedings concerning a release or <br /> threatened release or any hazardous substance or <br /> petroleum product involving the property by any owner or <br /> occupant of the property? <br /> 18. Does the property discharge waste water on or <br /> adjacent to the property other than storm water into a <br /> sanitary sewer system? <br /> 19. To the best of your knowledge, have any hazardous + <br /> substances or petroleum products, unidentified waste Y Y <br /> kI materials, tires, automotive or industrial batteries or an <br /> G:\Data\GROUNDZE\PHASEI\siegandtqs.doc <br />
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