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Rev 2/23/2001 <br /> e <br /> Page 4 of 6 <br /> i <br /> 15b Has the o � r car occupN�ofepropertybeen Yes No Unlcinformed of the�rrent existhazardous substances <br /> or petroleum products respect to the property or any <br /> facility located on the <br /> t� <br /> l 5c Has the owner r occupa of the property been Yes (:N Unk <br /> informed of the past ce of environmental violations <br /> a with respect to the property or any facility located on the <br /> pr operty <br /> 15d Has the owne occupant f the properly been Yes No Unk <br /> informed of the cur t existe a of environmental <br /> violations with respect ie property or any facility <br /> located on the property) _ <br /> 16 Does the owner{or occupant the property have any Yes No Unk <br /> knowledge of any vrronm al Site Assessment of the <br /> property of facility ilia as icated the presence of hazardous <br /> substances or petroleum products on, or contamination of, <br /> the property or recommended further assessment of the <br /> property� <br /> 17 Does the owner r occupDanttheproperty lcnavv of Yes Na Unlcany past, threatened, endsuits or administrative <br /> l proceedings concerning a release or threatened release of <br /> any hazardous substance or petroleum products involving <br /> the property by any owner or occupant of the property" <br /> l 8a Does the property discharge wastewater, on or Yes No Unk <br /> adjacent to the property, other than storm water, into a ell <br /> storm water sewer system? 77-11 [0,) <br /> 18b Does the property discharge wastewater, on or Yes No Unk <br /> adjacent to the property, other than storm water, into a 1 l <br /> b' sanitary sewer system? <br /> �1 <br /> 19 Did you observe evidence or do you have any prior Yes No j Unk <br /> knowledge that any hazardous substances or petroleum <br /> products, unidentified waste materials, tires, automotive or <br /> $ industrial batteries, or any other waste materials have been <br /> dumped above grade, buried and/or burned on the <br /> property <br /> 20 is there a transformer, capacitor, or any hydraulic Yes Na Unk <br /> equipment for which there are any records indicating the <br /> 3 presence of PCBs? <br /> initials <br />