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ENVIRONMENTAL QUESnONNAIRE <br /> TO BE CONG I M BY OWNER/OWNER'S REP.,AND FORWARDED TO EARNEST F. SMITH <br /> AND ASSOCIATES,MIR ENGINEERS FOR INCLUSION IN SURFACE/SUB SURFACE <br /> CONTAMINATION REPORT. <br /> F, 1 � <br /> 1.Daft you acquired properly /Z ,9. APN: L'a� l - �/ `/ O G SJ Co. <br /> 2.Use of property since acgdd ion rQ 5 <br /> i-6c Z i4-1 <br /> 3.How many irrigation wells serve the pmpMy: /j/'k Depth of well(s)if <br /> lurown 3 r, I C. <br /> 4.Do you have a permit to apply chemicals or fertilizers to the parcel?If yes,for what yem--Z—V <br /> Describethe products produced <br /> 5.Do you hove aW knowledge ofany ofthe following being went on the parcel under study? <br /> A.Any disposal site,by bnncdp msent owmt,offix1s,,b zvmJkx s maOetiale,chemicals or any other <br /> substance considered a controlled sobstmm by Law. Yes No (If yes, <br /> please�P <br /> B. ExmbogcmkmbmWdugweflorhmwhWnoimme Yes No Cl yes <br /> please locab an property for the field review wldch m to be amWlftd ager noegrt of this form.) <br /> C. Stnr bes that are eomideed u 6 by yon er load mudwrities. Yes No \,/ <br /> D. Floodsrgofpaedn pmt,orwlale. Yes No ✓ Ifyes,witstyems <br /> E.Contamination ofair Cr sores from adhacmt I Yea .✓/ <br /> F.Failed septic systan,titer required repair or addiliamad Yes o <br /> _Ifydesctfime week <br /> done t- " es l�°gre5lelra <br /> G.A caodifi®ttintm aypo*mbdevd%mmmt pwtd(s).Yes No m <br /> It A spec Iocalion where Vadis furled.Yes <br /> 6.Ntmme of former owner r I S" -. Do you know wheat use was <br /> made of the�by the owsdt Tfso,please describe_.., /'f�::- r%�t�.�.�1�'E�^� <br /> 7- Has dw land bees deep ripped since owned by you?Yes Nom <br /> 8.Are you aware ofmy peened waths>itble oron aeavloo pools of weber on shies � <br /> Comments: <br /> �B C� ,3a7-4-3;. <br /> � _ kDrie ErxSs <br />