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Page 1 of 2 <br />Project Name: <br />Project No. <br /> <br /> <br />ENVIRONMENTAL SITE ASSESSMENT QUESTIONNAIRE <br />FOR CLIENT <br /> <br /> <br />To evaluate the potential for possible environmentally related impacts and site contamination the following information is <br />requested. This questionnaire is to be completed by the user of the phase one environmental site assessment, or their <br />authorized representative. <br /> <br />PART I <br /> <br />1. Property address and Assessor’s Parcel Number (APN): <br /> <br /> <br /> <br /> <br /> <br /> <br />2. Current property owner (name, address, voice/fax number): <br /> <br /> <br /> <br /> <br /> <br /> <br />3. Date current property owner assumed title of property: <br /> <br /> <br /> <br /> <br /> <br /> <br />4. Current property development/improvements: <br /> <br /> <br /> <br /> <br /> <br /> <br />5. Past property use, development/improvements: <br /> <br /> <br /> <br /> <br /> <br /> <br />6. Neighboring property uses: <br /> <br /> <br /> <br /> <br /> <br /> <br />Oakwood Shores – Area 1 <br />12921.000.003 <br />241-520-16 <br />Oakwood LT Ventures II LLC <br />12-9-2009 <br />vacant field <br />unknown <br />Water district facility