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Surface and Subsurface Contamination Report Questionnaire <br /> NOA Project Number: E06045A <br /> Property Location: 31450 Lone Tree Road, Oakdale, CA 95361 <br /> .. Page 5 <br /> NEIL O. ANDERSON ft ASSOCIATES, INC. <br /> ENVIROMENTAL QUESTIONNAIRE AND DISCLOSURE STATEMENT <br /> PART 2: OWNER INFORMATION <br /> (To be completed by Owner or Owner's representative) <br /> 1. GENERAL INFORMATION <br /> 1. Current owner of property <br /> _ �na,�tio•- C r u,I z <br /> Name: 0&j-v,, eS�� Kl� � Jit f <br /> Address: � IIL�(o �. Lo . z_ ) r 2�✓�J QCL�FJIC� P � S✓��/ <br /> Telephone: 7-05 /f� <br /> Year purchased: 'c.7 2 <br /> i .J <br /> 2. Previous owner(s)rrand contact information (if known):r <br /> Name: <br /> Address: <br /> 42C-<,Oa <br /> Telephone: <br /> Year purchased: <br /> 3. Other person with historical knowledge of property: <br /> i <br /> Name: <br /> Address: <br /> Telephone: <br /> i Relationship to property: <br /> 4. Please describe current use(s) of property: <br /> 5. Please describe any other known past use(s) of property, and approximate dates of each use: <br /> ` ) Iq�-1 Act%(-I - <br /> Ifyou have any questions about this questionnaire,please contact Tina Cheney at(209)367-3701 ext. 233. <br /> li <br />