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1 <br /> Rev 2/23/2001 <br /> Page 2 of 6 <br /> 4b Did you observe evidence or do you have any prior Yes No Unk <br /> i t knowledge that any adjoining property has been used as a -3 �� [.L,e,.,—z <br /> gasoline station,motor repair facility, dry cleaners, photo i A-w-►1 /0�- <br /> developing laboratory,junkyard or landfill, or as a waste yn �" �� e <br /> treatment, storage, disposal, processing, or recycling <br /> facility (if applicable, identify which)? <br /> s 5a Are there currently any damaged or discarded Yes No Unk <br /> automotive or industrial batteries, pesticides,paints, or <br /> other chemicals in individual containers of>5 gal(19L) in <br /> volume or 50 gal (190L) in the aggregate, stored on or used <br /> ' at the property or at this facility? <br /> 5b Did you observe evidence or do you have any prior Yes No Unk <br /> knowledge that there have been previously any damaged or <br /> discarded automotive or industrial batteries,pesticides, <br /> paints, or other chemicals in individual containers of>5 gal <br /> (I 9L)in volume or 50 gal (190L) in the aggregate, stored <br /> on or used at the property or at this facility? <br /> 6a Are there currently any industrial drums(typically 55 Yes No Unk <br /> gal (208L))or sacks of chemicals located on the property or <br /> at the facility? <br /> 6b Did you observe evidence or do you have any prior Yes No Unk <br /> 4 # knowledge that there have been previously any industrial <br /> drums (typically 55 gal (208L))or sacks of chemicals <br /> located on the roe or at the facility? <br /> � property�Y �' <br /> 7a Did you observe evidence or do you have any pnor Yes GN-o Unk <br /> knowledge that fill dirt has been brought onto the property <br /> that originated from a contaminated Site9 <br /> 7b Did you observe evidence or do you have any prior Yes 9-N Usk <br /> 1 knowledge that fill dirt has been brought onto the property <br /> 3 that is of an unknown origin? <br /> 8a Are there currently any pits,ponds, or lagoons located Yes Nod Unk <br /> r on the property in connection with waste treatment or waste <br /> disposal? <br /> 8b Did you observe evidence or do you have any prior Yes Unk <br /> knowledge that there have been previously any pits,ponds, <br /> or lagoons located on the property in connection with waste <br /> treatment or waste disposal? <br /> 9a Is there currently any stained soil on the property? Yes Unk <br /> 9b Did you observe evidence or do you have any prior Yes Nom Unk <br /> knowledge that there has been previously any stained soil <br /> s on the property? <br /> r � <br /> Initials <br />