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SUPPLEMENTAL QUESTIONNAIRE FOR AGRICULTURAL SITES <br /> MOUNTAIN HOUSE NEIGHBORHOOD,CA <br /> Have you leased this land to anyone for agricultural Yes No Unk <br /> purposes? <br /> If so, please provide contact information: Name: <br /> Firm: <br /> Address: <br /> Phone: <br /> If the type of crop grown on the property was a standing tree, shrub,or bush: <br /> A. Was it pruned or trimmed annually? Yes No Unk <br /> B. Were the prunings burned on site? Yes No Unk <br /> C. Were the prunings burned in one area? Yes No Unk <br /> D. If yes to A, B,C,then where on site were the trimmings burned? <br /> PA I s� GON-7ALE7— t U ZS 6I <br /> CPrint Namc Sign Name Date <br /> 11aMtmmain House,fianisNhase I Supplemental Ag.Questionnairc.doc <br />