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Rev.6/26/12001 <br /> Page I of 5 <br /> C I Oa. Are there currently any registered or unregistered Yes No Unk <br /> storage tanks(above or underground) located on the <br /> property? <br /> I Ob. Did you observe evidence or do you have any priorYes No Unk <br /> knowledge that there have been vtously an re stered <br /> or unregistered storage tanks above r erground <br /> located on the property? <br /> 1 I a. Are there currently any vent pipes, fill pipes, or access Yes 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 Yes ONo 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 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 /> C 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 /> I Ja. If the property is served by a private well, or non- Yes No\ Unk <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- Yes CNo 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 YesNo 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 Yes No 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 /> Initials <br />