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Surface &Subsurface Contamination Report Questionnaire <br /> Thelma E. Hieb Revocable Trust Property Page 4 of 10 <br /> Our Project Number: E07202A <br /> December 5,2007 <br /> NEIL O. ANDERSON &ASSOCIATES, INC. <br /> ENVIROMENTAL QUESTIONNAIRE AND DISCLOSURE STATEMENT <br /> PART 2: OWNER INFORMATION <br /> (To be completed by Owner or Owner's representative) <br /> I. GENERAL INFORMATION <br /> 1. Current owner of property Hieb ff _ i,, <br /> Name: --, I�rw ni,\e i eb <br /> Address: ( 0+40 a H0,01 ec La,r\-L LO C(A C <br /> Telephone: qjv� <br /> Year purchased: t� <br /> 2. Previous owner(s) and contact information (if known): <br /> Name: <br /> Address: <br /> Telephone: <br /> Year purchased: <br /> 3. Other person with historical knowledge of property: <br /> Name: <br /> Address: <br /> Telephone: <br /> Relationship to property: <br /> 4. Please describe current use(s) of property: ' <br /> �ra P� U�YX eJara2-- <br /> Ccs 44- <br /> 5. <br /> -- <br /> 5. Please describe any other known past use(s) of property, and approximate dates of each use: <br /> 6k V- SS <br /> go V-1 ro Ps / q coo s. <br /> 6 m pe- V 1�1 eu ro- l G(0v <br /> 902 Industrial Way•Lodi,CA 95240.209.367.3701•Fax 209.369.4228 ©2007 Neil O.Anderson&Associates,Inc. / <br />