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NOV-30-2004 11:51 CONDOR EARTH TECH 209 532 0773 P.04 <br /> SUPPLEMENTAL QUESTIONNAIRE FOR AGRICULTURAL SITES <br /> Have you leased this land to anyone"for agricultural g"e No Unk <br /> purposes? <br /> If so,please provide contact information; <br /> Firm: <br /> C <br /> 3 Address: <br /> Phone: <br /> If the type of crap grown on the property was a standing tree,shrub,or bush: <br /> A. Was it pruned or trimmed annually? Yes No Unit <br /> B. Were the pnmings 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 /> Print Name Sign Name Daze <br /> E.14000LPrj14125K11Nh K\Supp1eme W Ag doc <br /> .RECEIVED TIME NOV, 30. 11 : 51AM <br />