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Neighborhood C Great Valley Parkway—Mountain House, California <br /> Annual Inspection Checklist—Page 2 (Site# 10 1854) <br /> YES NO <br /> 12 Is there evidence of raising of food(cattle,food crops)? <br /> 13 Is there evidence of drilling for drinking water, oil, or gas without prior written <br /> approval by the Department? <br /> 14 Is there evidence of Excavation? [If excavation was noted in the vicinity of the <br /> Remediation System, explain in detail on attached pages the purposes of the <br /> excavation, when it was performed, and who at the Department approved the <br /> Soil Management Plan.] <br /> 15 Have there been any violations of the Deed Restrictions? [If yes, describe in <br /> detail on an attached page the steps taken to return to compliance.] <br /> 16 Have the slopes been modified, or impacted by weather or other causes? <br /> 17 Is there evidence of erosion? <br /> Explain all yes responses in detail and attach to this checklist. Reference the question number to the <br /> detailed explanation. <br /> Document the locations of any cracked pavement, potholes, or areas of standing water with drawings <br /> and/or photos. Include information on steps taken to repair any deficiencies in the Cap. <br /> I certify(or declare) under penalty of perjury under the Laws of the State of California that the foregoing <br /> is true and correct. <br /> Signed Date <br /> Inspector Representative of Owner <br /> Title <br /> Number of attached pages: <br /> (This form shall be retained until twenty(20)years after removal of all restrictions from the Property) <br /> XAProject\7000_p j\7319 Mountain House Developers\7319C Neighborhood C SMP\Reports\O&M Plan\O&M checklist.docx <br />