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ENN''MO\MENTAL SITE INSPECTION QUESTIONNAIRE <br /> Page ^_ of 9 <br /> B. Former Site Uses <br /> 1. Describe the former site uses including dates where known. <br /> LtJ�I4 t -{6 to 2 T� i n (�-t )M I . AS �sr a�s r � — 2 <br /> S 2 Q i <br /> IIT. AD.IACENT SITE USES <br /> 1. Describe adjacent site uses and make note of any particular area of c�onc�e�rn�;, <br /> T``J7Est tQ(�rt S�P} am QLO U4JLJY.,Cb� / �� ' /�1��/1F";^ � <br /> '— y ✓✓✓✓ ll�o n D � ✓4 my _ _ <br /> Iv. SITE INSPECTION LN-FORMATION <br /> A. Crop and Pesdeides/Herbicides Used <br /> 1. Identify crops grown and pesticides or herbicides used on-site for The last five <br /> _ years, If available,attach a copy of/the County Pesticide Use Permit for the previous 5 <br /> k� kiVaW <br /> years. � <br /> CROPS PESTICIDEMERBICIDE CATEGORYRATE OF APPLICAT.0 V <br /> L=— <br /> ZOO� 06't6!d!OES TF3 6u:CT finpZ !T•h0 <br />