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i <br /> i <br /> ENVIRONMENTAL SITE ASSESSMENT QUESTIONNAIRE Page 2 <br /> Fji <br /> r <br /> 9.Is the property or any adjoining property used for an industrial use? Yes No Unknown <br /> 10.To the best of your knowledge,has the property or any adjoining Yes No own <br /> property been used for an industrial use in the past? <br /> Fj 1 l.Is the property or any adjoin fng property used as a gasoline station, Yes No nknown <br /> motor repair facility,commercial printing facility,dry cleaners,photo <br /> developing laboratory,junkyard or landfill,or as a waste treatment,storage, <br /> disposal,processing,or recycling facility? <br /> 12.To the best of your knowledge has the property or any adjoining Yes No Unkno <br /> property been used as a gasoline station,motor repair facility,commercial <br /> printing facility,dry cleaners,photo developing laboratory,junkyard or <br /> landfill,or as a waste treatment,storage,disposal,processing,or recycling <br /> facility? <br /> Fj 13.Are there currently,or to the best of your knowledge have there been Yes No Unknown <br /> previously,any damaged or discarded automotive or industrial batteries,or <br /> pesticides,paints,or other chemicals in individual containers of greater than <br /> 5 gal in volume or 50 gal in the aggregate,stored on or used at the property <br /> or at the facility? <br /> 14.Are there currently,or to the best of your knowledge have been YesNo Unknown <br /> previously,any industrial drums(typically 55 gal)or sacks of chemicals <br /> located on the property or at the facility? <br /> 15.Has fill dirt been brought onto the property that originated from a Yes No wn <br /> contaminated site or that is of an unknown origin? <br /> 16.Are there currently,or to the best of you knowledge have there been Yes 4 Unknown <br /> previously,any pits,ponds, or lagoons located on the property in <br /> connection with waste treatment or waste disposal? <br /> 17. Is there currently,or to the best of your knowledge has there been Yes Unknown <br /> previously,any stained soil on the property? (�!p <br /> 18.Are there currently,or to the best of your knowledge have there been Yes a Unknown <br /> previously,any registered or unregistered storage tanks(above or <br /> underground)located on the property? <br /> 19.Are there currently,or to the best of your knowledge have there been YesNo Unknown <br /> previously,any vent pipes,fill pipes,or access ways indicating a fill pipe <br /> protruding from the ground on the property or adjacent to any structure <br /> located on the property? <br /> 20.Are there currently,or to the best of your knowledge have there been Yes aN � Unknown <br /> previously,any flooring,drains,or walls located within the facility that are <br /> 0 stained by substances other than water or are emitting foul odors? <br /> 21.Are there any domestic,irrigation or monitoring wells on the property? Yes No nkn <br /> 0 22.If the property is served by a private well or non-public water system, Yes No nknown <br /> have contaminants been identified in the well or system that exceed <br /> guidelines applicable to the water system or has the well been designated as i <br /> contaminated by any government environmental/health agency? <br /> F <br /> I <br /> i <br /> Fj <br /> Y <br />