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Surface and Subsurface Contamination Report Questionnaire <br /> NOA Project Number: E05165A <br /> Property Location: 18700 River Rd., Ripon, CA 95366 <br /> Page 11 <br /> 2. Have pesticides, herbicides or other agricultural chemicals been mixed, ❑ Yes ❑ No <br /> formulated, rinsed, or disposed of on the property? if so, please <br /> describe the locations where such pesticides, herbicides or chemicals <br /> were mixed, formulated, rinsed, or disposed, and the type of <br /> pesticides herbicides or chemicals mixed formulated, <br /> rinsed or <br /> at <br /> q � n <br /> isposed oft each l cio . n <br /> �MIXec � t'Zc�c S -�,'c°xiII 11 `l <br /> 1Dt�c C� I `kc�c o )JQf o�s toccJZuj 'jhrCLtc , Opti <br /> — �h <br /> �'(� r�C <br /> PCokuc s <br /> 3. Has any soil or groundwater analysis been performed to detect ❑ Yes No <br /> pesticides, herbicides or chemicals used at the site? If so, please <br /> provide a summary of the findings or attach the report(s). <br /> ENDORSEMENTS: <br /> Part 2 <br /> As the present owner of the property or as an officer or general partner of the present owner of the <br /> property (or the duly authorized representative of such owner), I am familiar with all of the operations <br /> presently conducted on the property, and hereby certify that to the best of my knowledge, <br /> information, and belief the information disclosed above is true and correct. <br /> 0 er or Key Site Manager's Signature Dat <br /> �fl� I�`Maw►S <br /> '— Owner or Key Site Manager's Name (please print) <br /> 6w j"o C V�1� nA E'f C OW�JS� l��' PCWC11 <br /> Title, C mpa y <br /> If you have any questions about this questionnaire,please contact James Robinson at(209)367-3701 ext. 222. <br /> a.. <br />