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} <br /> Rev 2/23/2001 <br /> Page 3 of G <br /> f � � l Oa Are there currently any registered or unregistered YesNo- Unk <br /> storage tanks(above or underground) located on the <br /> property? <br /> 1 Ob Did you observe evidence or do you have any prior Yes Ng Unk <br /> knowledge that there has been previously, any registered or <br /> unregistered storage tanks (above or underground) located <br /> on theproperty,' <br /> ai <br /> I I a Are there currently any vent pipes, fill pipes, or access Yes No Unk <br /> ways indicating a fill pipe protruding from the grouted on <br /> the property or adjacent to any structure located on the <br /> property,' <br /> 11 b Did you observe evidence or do you have any prior Yes No Unk <br /> knowledge that there has been previously, any vent pipes- <br /> fill <br /> ipes_fll pipes, or access ways indicating a fill pipe protruding <br /> from the ground on the property or adjacent to any structure <br /> located on the property? <br /> x l2a Are there currently any flooring, drains, or walls Yes No Unk <br /> located within the facility that are stained by substances <br /> other that water or are ernittmg foul odors? <br /> 12b Did you observe evidence or do you have any prior Yes No Unk <br /> knowledge that there has been previously, any flooring, <br /> drains, or walls located with the facility that are stained by <br /> substances other that water or are emitting foul odors? <br /> �i <br /> 13a If the property is served by a private well, or non- Yes No Unk <br /> public water system, is there evidence or do you have prior <br /> knowledge that contaminants have been identified in the <br /> ` well or system that exceed guidelines applicable to the <br /> water system? <br /> r <br /> t 13b If the pioperty is served by a private well, or non- Yes No Unk <br /> public water system, is there evidence or do you have prior <br /> knowledge that the well has been designated as <br /> ; contaminated by any government environmental/health <br /> agency? <br /> 14 Does the owner or occupant of the property have any Yes No Unk <br /> knowledge of environmental liens or governmental ' <br /> notification relating to past or recurrent violations of <br /> env ironrn ental laws with respect to the property or any <br /> facility located on the property' <br /> 15a Has the owner or occupant of the property been Yes No Unk <br /> unformed of the past existence of hazardous substances or <br /> petroleum products with respect to the property or any <br /> facility located on the property? <br /> n <br /> Initials tom-- <br />