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ENVIRONMENTAL QUESTIONAME <br /> TO BE COMPLETED BY OWNER/OWNER'S REP AND FORWARDED TO EARNEST F. SMITH <br /> AND ASSOCIATES,CIVIL ENGINEERS FOR INCLUSION IN SURFACEISUB SURFACE <br /> CONTAMINATION REPORT. <br /> 1.Date you acquired property APN: Si Co. <br /> 2. Use of property since acq <br /> irisition <br /> 3. How many irrigation wells serve the property: I of well(s)if <br /> lmown�G_u .t. <br /> 4.Do you have a permit to apply cbemicalT. fertilizers to the parcel?If yes,for what years.(fr s <br /> Describe the products produced <br /> 5. Do you have any knowledge of any of the following being present on the Parcel under study? <br /> a <br /> A. Any disposal site,by former/present owner,of fuels,hazardous materials,chb <br /> ernNor any other <br /> substance considered a controlled substance by LocayState/Federal Law. Ycs _(if Yes, <br /> please explain <br /> B.Existing cistern,hand dug well or leach field,no longer it)use-Yes <br /> No (TfYes <br /> please locate on property for the field review which is to be completed after receipt of this farm/.) <br /> C. Structures that are considered unsafe by you or local authorities. Yes No_ <br /> D. Flooding of parcel in part, or whole. Yes No_ _if Yes wirer Years <br /> E. Contamination of air or soil from adjacent parcels Yes _No� <br /> F. Failed septic system, that required repair or additional work Yes o_ If yes describe work <br /> done <br /> Preclude developemtm <br /> G. A prior/present condition that may Of the parcel(s)-Yes <br /> H. A specific location where equipment waslis fueled.Yes No Do you know what use was <br /> 6.Name of former owner <br /> trade of the land by the owner?if so, please describe <br /> rl 5 r c )2b 7 a,W r les ai 1 r <br /> 7.Has the land been deep ripped since owned by yotfl Yes_No_ _ <br /> 8.Ane you aware of any parched water table/springs or on occasion pools of water on site?Yes No—V <br /> Comments: <br /> ( /Rep. Si ) Date <br />