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SR0082963_SSCR
EnvironmentalHealth
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2600 - Land Use Program
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SR0082963_SSCR
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Last modified
12/17/2020 4:01:13 PM
Creation date
12/3/2020 8:36:00 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCR
RECORD_ID
SR0082963
PE
2603
STREET_NUMBER
54
Direction
W
STREET_NAME
CONEJO
STREET_TYPE
CT
City
MOUNTAIN HOUSE
Zip
95391
APN
25426048
ENTERED_DATE
12/2/2020 12:00:00 AM
SITE_LOCATION
54 W CONEJO CT
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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Rev.6/26//2001 <br /> Page 3 of 5 <br /> 10a. Arethe ently any registered or unregistered (Ye)s No Unk <br /> storage tan (abov r underground) located on the <br /> property? <br /> 10b. Did you observe evidence or do you have any prior YesNo Unk <br /> knowledge that there have been previously any registered <br /> or unregistered storage tanks(above or underground) <br /> located on the property? <br /> I 1 a. Are there currently any vent pipes, fill pipes, or access 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 /> 11 b. Did you observe evidence or do you have any prior YesNo 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 DNo 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 odors? <br /> 13a. If the property is served by a private well, or non- Yes No �Un , <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 /> 13b. If the property is served by a private well, or non- YesNo Unk <br /> public water system, is there evidence or do you have prior <br /> knowledge that the well has been designated as <br /> contaminated by any government environmental/health <br /> agency? <br /> 14. Does the owner or occupant of the property have any Yes CN)o 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 YesNo 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 /> } <br /> Initials �� <br />
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