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Surface and Subsurface Contamination Report Questionnaire <br /> NOA Project Number: E06146A <br /> Property Location: 1018 at 1020 S. Carroll Ave, Stockton, CA <br /> Page 5 <br /> F'; NEIL 0. ANDERSON a ASSOCIATES, INC. <br /> ENVIROMENTAL QUESTIONNAIRE AND DISCLOSURE STATEMENT <br /> PART 2: OWNER INFORMATION <br /> (To be completed by Owner or Owner's representative) <br /> I. GENERAL INFORMATION <br /> 1. Current owner of property <br /> F, Name: �- <br /> Address: W CzA r <br /> j Telephone: 14>1 _ ca Lf Ll — 0L7 c, I <br /> FYear purchased: I <br /> 2. Previous owner(s) and contact information (if known): <br /> Name: Ke-r t rs yvl" r � v, <br /> Address: T5 Li cN p,, --CIL <br /> E <br /> Telephone: <br /> Year purchased: ? <br /> 3. Other person with historical knowledge of property: <br /> Name: <br /> F, Address: <br /> Telephone: <br /> Relationship to property: <br /> 4. Please describe current use(s) of property: <br /> 5. Please describe any other known past use(s) of property, and approximate dates of each use: <br /> '� s Ifyou have any questions about this questionnaire,please contact Tina Cheney at(209)367-3701 ext.233. <br /> F <br />