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Advanced GetlEnvironmental, Inc. In[ctview: <br /> www.advgcoenv.coni [ Verbal <br /> ®j 'telephone: (800)511-9300 Rax: (209)467-1118 1 Written <br /> ASTM Transaction Screen Questionnaire <br /> Phase 1 Environmental Site Assessment(E 1527-05) <br /> & Environmental Transaction Screen (E1528-06) Processes <br /> This questionnaire is to be completed by the current owner, occupant or anyone with past knowledge <br /> concerning the property, either in written form or verbally,with questions asked by ACE or User(Client) <br /> designated parties. All questions should be answered to the hest ojthe respondents actual knowledge and <br /> must be answered in good Faith.Explanations to any answers,especially"Yes"answers,should be made in <br /> the space following the question or on a separate sheet,noting the question number. Please be a;complete <br /> as possible;if you do not know the answer to a question, please circle unknown(Unk). Following the site <br /> visit, it may be necessary for ACF:or the preparer to ask clarifying questions of the interviewee(s). <br /> Project Nante.Slte Address: Person(s)interviewed: Date: 10711113 _ <br /> -MLA-sA s Q?-oPO NJ Owner:314110 1 r J 1 Occupant: <br /> Tr&6V 4- " 4530 _ 1 1 — - _ -- <br /> r, Phone 0: _ b4 C---jt5L 3l- Phone a: _SD— x-59 -3111 _ <br /> Oto Lie y <br /> Client Information: oyer Site V WI by: Date: 41, t I t 3 <br /> r Name: P+.l.s_ Ba-e—& AGE Personnel: k lw-, <br /> Company: _ _ AGE Personnel: <br /> Address: cAvKe_ U �i�G�' — AGE Personnel: <br /> Site Repirritle: <br /> Phone d: <br /> 1 1 'rhis Interview was performed by: or ( J This Interview was performed/administered by: <br /> Name: /1 Co( � `— _ Name: <br /> Title: -4 11 <br /> +t.`h_s`�' Address. _ — <br />` .advanced GcoEnvironmental,Inc.(AGE) <br /> 837Show Road PhorctFAX 'N: <br /> Stockton,CA 95215 Relationship to site: <br /> (209)467-1006 FAX:(209)467.1118 Rela ion%hip to user(clicni): <br /> 1'he preparer represents that to the best of the preparer's knowledge the stateutents and facts made below are true and <br /> correct and to the beat of the to arer's actual knowledge no material facts have been suppressed or misstated. <br /> (Preparer%Interviewer) <br /> _ Signature Date <br /> (Interviewee, tfavailablc) <br /> Signature Date <br /> ldvmnnd GcnFavinmmcnial, tne. ASTM Pheae VrSA Qtorslionnn;m I t/2011 Page i of 60 <br />