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08/31/2006 14:05 120954r"?7 MIRAMAR R.E. BROI—RS PAGE 03/08 <br /> TUE AUG 29, 2006 01:50./M .,,/ PACE 5 <br /> Surface and Subsurface Contamination Report questionnaire <br /> NOA Project Number: E06096A <br /> Property Location: 17 N. Hinkley Ave., Stockton, CA 95215 <br /> Page 5 <br /> NEIL O. ANDERSON It 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 <br /> Name: <br /> Address: <br /> Telephone: <br /> Year purchased: <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 /> A/�1141 <br /> 16rr� IV7- <br /> - /v <br /> 5. Please describe any other known past use(s) of property, and approximate dates of each use: <br /> /frnuhrrve(Wil'prresRans nbmrtth7s quasffonrx#re,plensP Cnntavt Thrn Chenm'nt 1.09t367�3707 nxt.233. <br /> — <br /> r <br />