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NOV-30-2004 11:51 CONDOR EARTH TECH 209 532 0773 P.02 <br /> f' <br /> SITE INFORMATION <br /> What is your relationship to the indicated Properties? OW IAC <br /> How long have you leased or owned the property? <br /> Is anyone Iirn��, the property or leasing the property? Yes No Unknown <br /> Who and/or for what purposes? ,�y�+ <br /> J <br /> Currently,- <br /> In. <br /> urrentlyrIn the past(historically): <br /> Havc pesticides/agricultural chemical been used on the property? If so, please also indicated <br /> approximately where the chemicals have been applied, stored, and/or mixed. <br /> Currently: <br /> In the past(historically): <br /> Has or does burning of agricultural material(or any other type of burning)takenlace on the property? <br /> Yes ' Unlmown <br /> Are there any wells on the property? es No Unknown <br /> Are there any septic systems on the property? Yes No Unknown, <br /> Are there any buildings on the property? No Unknown <br /> If there are any buildings, approximately how old aTe they? PAnAl) i 131►4& <br /> - Are there or have there been any above/underground storage tanks on the property? <br /> Yes /1 0� Unknown <br /> Is there any underground irrigation piping on the property? No Unknown <br />} <br /> For your convenience,please find a map attached to indicate specific areas_ <br /> i <br /> Signature and Date <br /> RECEIVED TIME NOV, 30. 11 :51AM <br />