Laserfiche WebLink
Rev 2/23/2001 <br /> Page 3 of 6 <br /> 1 as Are there current] an registered or unregistered Yes N n <br /> � y Y $ g � Unk <br /> storage tanks(above or underground) located on the <br /> property, <br /> lob 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 /> a located on the property2 <br /> 1 1 a Are there currently any vent pipes, fill pipes, or access Yes No 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 /> 1 I b Did you observe evidence or do you have any prior Yes (N3 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 00 Unk <br /> located within the facility that are stained by substances <br /> other than water or are emitting foul odors' <br /> ^� 12b Did you observe evidence or do you have any prior Yes No 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 odors9 <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 /> 1 13 b 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 /> s knowledge that the well has been designated as <br /> j contaminated by any government environmental health <br /> agency? <br /> y 14 Does the owner or occupant of the property have any Yes G 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 located on the property <br /> 15a Has the owner or occupant of the property been Yes Unk <br /> s 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 /> s <br /> initials <br /> r� <br />