Laserfiche WebLink
ENVIRONMENTAL AL QUESTIONNAIRE <br /> TO BE COMPLETED BY OWNER/OWNER'S REP.,AND FORWARDED TO EARNEST F.SMITH <br /> AND ASSOCIATES;C111/11,ENGMERS FOR INCLUS"4 IN SURFACEISUB SURFACE <br /> CONTAMWATION REPORT. <br /> I.Date you acquiredproperty 12—7�-O lk APN�1 =�.? — 1 R Si Co. <br /> Z Use of property since accuusMon__��y�i <br /> 3.How many irrigation wells serve the property.—J-- Depth of well(s)if <br /> known <br /> 4_Do you have a permit to apply chemicals or firNlk6m to the parcel?1f yes,for what years <br /> Describe the p produced <br /> 5.Do you have any knowledge of arty of the following being present on the parcel under study? <br /> A.Any disposal Site,by brmw*esem owner,of fireis,:l dous materiahs,chemicals or any other <br /> substance considered a controlled substance by Localftak0ederail Law_ Yes No (If yes, <br /> please explain. <br /> B. Existing cistern,hand dug well or leach field,no longer in use.Yes No_ _ (If yes <br /> please locate on property for the field review which is to be completed after receipt oft&s form.) <br /> C.Statures that are considered unsafe by you or local authorities. Yes No ✓ <br /> D.FkxK&g of parcel in part,or whole. Yes No Ifycs,what years <br /> E.Contamination of air or soil fiom adjacent parvels Yes NO <br /> F_Failed septic system,drat required repair or additional wo& esY No ✓ If yes describe work <br /> done = <br /> G.A piorffiresent condition that may pr'dude of the parceks).Yes No <br /> H.A specific location where equipment ww&fueled.Yes No <br /> 6.Naive of former owner Do you know what use was <br /> made of the land by the ownx`I If go,please describe <br /> 7.Has the land been deep ripped shwe owned by you?Yes No <br /> 8.Are you aware of any peached water table*imgs or on occasion pools of water on site?Yes No,':�-- <br /> Conunents: <br /> 2A" ( I- io-o s p.�. Qom ,8"l <br /> ( , ���) l� lo I aa, �52zo <br /> 2 - - -6 2� <br />