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%MW 1444 <br /> SUPPLEMENTAL QUESTIONNAIRE FOR AGRICULTURAL SITES <br /> APN 173-210-06 <br /> What is your relationship to the property? Lr Owner El Occupant <br /> ❑ Grower ❑ Other <br /> How long? k r <br /> ` Is the property currently used for any agricultural Yes Unk <br /> use? <br /> What type of crop? <br /> r <br /> Are there any pesticides currently being used on the Yes No Unk <br /> property? <br /> If yes,please list what types: <br /> Do you observe evidence or have any, prior Yes No Unk <br /> Ir. knowledge that pesticides were used on the <br /> property? LL �__^ ' <br /> Please Describe: na mal GtGr7 117UX (22 <br /> r <br /> Are any adjoining properties being used for an Yes No Unk <br /> agricultural use? <br /> If so,please indicate which ones: North South East West <br /> What types? <br /> L <br /> V <br /> Are there any pesticides currently being used on any Yes No Unk <br /> adjoining properties? <br /> ' If so,please indicate which ones: North South East West <br /> If yes,please list what types: <br /> Do you observe evidence or have any prior Yes No Unk <br /> knowledge that pesticides have been used on any <br /> adjoining properties? <br /> If so,please indicate which ones: North South East West <br /> Please Describe:normal L1G�lcu l�ral us& <br /> Initial <br /> r. <br /> P93916 East Main Street Development(Gmpe)V916 E Main Street Development Phase l\Correspondence\LettersVSupp.Ag. CL(- <br /> 06).doc <br />