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October 27,2011 <br /> FROM: Mr.and Mrs. Ralph and Dorothy Ruiz <br /> 5300 West Lehman Road <br /> Tracy,CA 95304 <br /> PROJECT: APN 253-310.45,5300 West Lehman Road-San Joaquin County <br /> SUBJECT: Surface and Subsurface Contamination Report Required by the San Joaquin County <br /> Environmental Health Department. <br /> Please use the back of this document,or separate paper if necessary. Please mail, e-mail or fax this document back <br /> to Chesney Consulting upon completion. Thank you. <br /> I. How long have you owned the property and is your ranch known by your name or any other name? Who <br /> were the prior owners and their length of ownership,if known? What activities have taken place and what <br /> is the proposed development of the property? <br /> Length of Ownership and Ranch Name(s): 1165 <br /> Previous Ownership to you,and length of ownership, if known: LAWAJOw� <br /> Activities/Proposed Development: #0AK ,5[j'E ,pjMpC49E.1 <br /> 2. Is there,or has there ever been to your knowledge,any type of above ground or underground storage tanks <br /> on the subject property,or any type of buried containers. Are there any septic tanks on the property? <br /> ,0 OA)E <br /> 3. Pleaseprovide a list of the pesticides that have been applied to the subject property acreage in the past three <br /> yyears(Use separate List if convenient). Are pesticides/herbicides mixed on the property before spraying? <br /> If so,where? How are pesticides/herbicides applied to the sub'ect property(ground,aerial)? Are there any <br /> wells(domestic and/or irrigation)on the property and do they Piave backflow prevention devices if used for <br /> filling of spray rigs? <br /> Pesticides/HerbicidesApplied: CU57CV4 h4KMF6 6L/ (21-H- 41e5 r7z) -16b S� <br /> Mixing Area Location(s)and Application Method: NON 1= <br /> Wells: ' d &w-:S n c Backflow Prevention Devices: <br /> 4. What fertilizers are applied to the property acreage? What amount of nitrogen fertilizer is applied, if any? <br /> C Usratit 6klPM LA 03 y orttcC of s <br /> 5. Are any hazardous materials stored,or previously stored on the property? If so,where? Are you aware of any <br /> hazardous material release on,or around your property? <br /> Hazardous Materials: /t)QAJE <br /> Hazardous Materials Release: /t/QNF— <br /> 6. Are there any easements through the property, or any underground pipelines? Ix!vJ <br /> Signed Date:1Q <br /> Thank you for your time. If there should be any stions, please give me a call. <br /> Sincerely, <br /> CHF,$NEY C SULTING <br /> Don Ches .,R. . <br /> Registered ivil Engine 4 <br /> 75479 <br /> Registered Environmen al Assessor 94675 <br /> Agricultural Pest Control Advisor#074363 <br /> P. 0. Box 3794 • IUrCoCk, CSL 95381 • Office (tog) 668-1403 ' Fax (tog) 668-2598 <br />