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Rev 2/23/2001 <br /> Page 3 of 6 <br /> I Oa Are there currentlyre or unregistered Yes <br /> any registered g g Q Unk <br /> I storage tanks (above or underground) located on the <br /> property? <br /> I Ob Did you observe evidence or do you have any prior Yes No Unk <br /> knowledge that there have been previously any registered <br /> or unregistered storage tanks(above or underground) <br /> located on the property? <br /> Ila Are there currently any vent pipes, fill pipes, or access Yes Unk <br /> ways indicating a fill pipe protruding from the ground on <br /> the property or adjacent to any structure located on the <br /> property, <br /> w I 1 b Did you observe evidence or do you have any prior Yes No Unk <br /> knowledge that there have been previously any vent pipes, <br /> fill 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 /> 12a Are there currently any flooring, drains, or walls Yes Unk <br /> located within the facility that are stained by substances <br /> other than water or are emitting foul odors? <br /> ti 12b Did you observe evidence or do you have any prior Yes Unk <br /> knowledge that there have been previously any flooring, <br /> • drains, or walls located with the facility that are stained by <br /> substances other than water or are emitting foul odors? <br /> Iia 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 /> w <br /> 13b 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 /> 4 knowledge that the well has been designated as <br /> contaminated by any government environmental/health <br /> agency9 <br /> a 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 /> environmental laws with respect to the property or any <br /> facility Iocated on the property? <br /> I 5a Has the owner or occupant of the property been Yes No Unk <br /> informed 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 /> ` Initials �� <br />