|
6.
<br /> %.+ ../:
<br /> ENVIRONMENTAL SITE ASSESSMENT QUESTIONNAIRE Page 2
<br /> L
<br /> 9.Is the property or any adjoining property used for an industrial use? Yes Unknown
<br /> 6. 10.To the best of your knowledge,has the property or any adjoining Yes N Unknown
<br /> property been used for an industrial use in the past?
<br /> 11.Is the property or any adjoining property used as a gasoline station, Yes <•r Unknown
<br /> motor repair facility,commercial printing facility,dry cleaners,photo
<br /> developing laboratory,junkyard or landfill,or as a waste treatment,storage,
<br /> disposal,processing,or recycling facility?
<br /> 12.To the best of your knowledge has the property or any adjoining Yes No Unknown
<br /> property been used as a gasoline station,motor repair facility,commercial
<br /> printing facility,dry cleaners,photo developing laboratory,junkyard or
<br /> landfill,or as a waste treatment,storage,disposal,processing,or recycling
<br /> facility?
<br /> 13.Are there currently,or to the best of your knowledge have there been Yes Q Unknown
<br /> previously,any damaged or discarded automotive or industrial batteries,or
<br /> pesticides,paints,or other chemicals in individual containers of greater than
<br /> 5 gal in volume or 50 gal in the aggregate,stored on or used at the property
<br /> or at the facility?
<br /> 14.Are there currently,or to the best of your knowledge have been Yes No , Unknown
<br /> previously,any industrial drwns(typically 55 gal)or sacks of chemicals
<br /> located on the property or at the facility?
<br /> 15.Has fill dirt been brought onto the property that originated from a Yes No Unknown
<br /> contaminated site or that is of an unknown origin?
<br /> r 16.Are there currently,or to the best of you knowledge have there been Yes No Unknown
<br /> previously,any pits,ponds,or lagoons located on the property in
<br /> connection with waste treatment or waste disposal?
<br /> 4 17.Is there currently,or to the best of your knowledge has there been Yes �' Unknown
<br /> previously,any stained soil on the property?
<br /> 18.Are there currently,or to the best of your knowledge have there been Ye., No Unknown
<br /> previously,any registered or unregistered storage tanks(above or
<br /> underground) located on the property?
<br /> r 19.Are there currently,or to the best of your knowledge have there been Yes No Unknown
<br /> previously,any vent pipes,fill pipes,or access ways indicating a fill pipe
<br /> protruding from the ground on the property or adjacent to any structure
<br /> located on the property?
<br /> 20.Are there currently,or to the best of your knowledge have there been Yes Unknown
<br /> previously,any flooring,drains,or walls located within the facility that are
<br /> stained by substances other than water or are emitting foul odors?
<br /> 21.Are there any domestic,irrigation or monitoring ells o the propertyry? Yes No Unknown
<br /> i {6 w(.1,
<br /> �- 22.If the property is served by a private well or non-public w�system, Yes Unknown
<br /> have contaminants been identified in the well or system that exceed
<br /> guidelines applicable to the water system or has the well been designated as
<br /> ` contaminated by any government environmental/health agency?
<br />
|