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X72 <br /> b Rev 2/23/2001 <br /> Patin ] of G <br /> TRANSACTION SCREEN QUESTIONNAIRE <br /> SITE <br /> This questionnaire has been prepared by Condor Earth Technologies, Inc (Preparer) by request <br /> from CLIENT (User) in order to obtain information regarding the proposed SITE (Site) The <br /> objective of this questionnaire is to provide the User with information regarding the presence or <br /> likely presence of any hazardous substances or petroleum products on the property that may <br /> resent a material <br /> risk of harm t <br /> po public health or to the environment lnforination provided by <br /> this questionnaire will be used to identify recognized environmental conditions existing on the <br /> Site that may or may not require additional research The questionnaire is provided on a <br /> voluntary basis by the respondent as part of a customary practice for conducting an <br /> Environmental Site Assessment on a specific parcel of real estate Please respond to the best of <br /> your ability To provide further information, please describe reason for any affirmative answers <br /> on a separate sheet of paper <br /> RESPONDENT(CHECK ONE) <br /> [Owner ❑ Occupant ❑ Preparer(during Site visit) <br /> f <br /> Question Answer <br /> la Is this Site used for alx <br /> � triaNo Unk <br /> body lSks <br /> 1 b Is any adjoinniing,prop��ussed for an industrial use9 No Unk <br /> r2a Did you observe evidence or do you have any prior Yes No nk <br /> knowledge that the property has been used for an industrial <br /> use in the past? <br /> 2b Did you observe evidence of do you have any prior 670? No Unk <br /> knowledge that any adjoining property has been used for an <br /> industrial use in the past? <br /> 3a Is the property used as a gasoline station, motor repair es No Unk <br /> facility, dry cleaners, photo developing laboratory, <br /> ,Junkyard of landfill, or as a waste treatment,storage, <br /> disposal, processing, or recycling facility(if applicable, <br /> identify which)? <br /> 3bIs property used as a gasoline station, es No Unk <br /> otor�11 <br /> ry cleaners, photo developing <br /> a oraf landfill, or as a waste treatment, <br /> storage, disposal, processing, or recycling facility(if <br /> applicable, identify which)? <br /> 4a Did you observe evidence or do you have any prior es No Unk <br /> knowledge that t erty has been used as a gasoline <br /> statio or repair facili dry cleaners, photo developing <br /> labo , un cy andfill,or as a waste treatment, <br /> storage, disposal, processing, or recycling facility(if <br /> applicable, identify which)? <br /> F ' <br /> initials _t l <br />