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From Chinchiolo-5temilt 209-931-1017 Wed 12 Apr 20OG 04:18:27 PM POT <br /> Surface and subsurface Contamination Report Questionnaire <br /> { N oject Number: E06022A <br /> ! rope Location: 19801, z09b3 ft2f3719 Brennan Road, Ascalon, CA 95320 <br /> Page 11 <br /> Have pesticides, herbicides or other agricultural chemicals beejix <br /> Yes ❑ No <br /> formulated,rinsed,or disposed of on the property? if so, please <br /> describe the locations where such pesticides,herbicides or chemicals <br /> were mix fnrmukated, rinsed, or disposed,and the type of <br /> pest c des,herbicides or chemicals mixed,formulated, rinsed or <br /> disposed of at each location. -S7 <br /> ea�Yl+a�f �a�K AtFrFM►i�K+YyrIN �t7 ,pYofYLt1�W+Pu a <br /> r^ <br /> 1 Has any soil or groundwater analysis been performed to detect ❑Yes <br /> - provide a summary icides or chemicals seed at trie site? If so, please <br /> ary of the findings or he report(s). <br /> i , <br /> F' <br /> 4 ENAORSEMENT5: <br /> Part 2 <br /> As the present owner of the property or as an officer or general partner of the present owner of the <br /> property(or the duky authorized representative of such owner), 1 am familiar with all of the operations <br /> I presently conducted on the property, and hereby certify that to the best of my knowledge, <br /> information,and belief the information disclosed above is true and correct. <br /> G <br /> " � . Owner or Key Site Manager's Signature Date <br /> I <br /> Owner or Key Site Manager's Name (please print) <br /> ��Tjt-jecomipany <br /> 's <br /> k <br /> 4 <br /> ]fyou have any questions about ihia guesrionnaire,please conlaat Tine Cheney et P?)36.7-370167J.233. <br /> FiF <br /> i <br /> �4 <br />