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ASTM Transaction Screen Questionnaire <br /> for the Phase 1 Environmental Site Assessment (E1527.13) <br /> & Environmental Transaction Screen Processes (E1528-14) <br /> In accordance; with ASTM Standard Process E1527-13 , the objective of an interview/questionnaire is to <br /> obtain Information Indicating Recvgni/ed Environmental Condition (RECs) in connection with the property. <br /> This questionnaire is to be completed by the current/past property owner, occupant or anyone with past <br /> knowledge concerning the property, either in written form or verbally, with questions asked by AGE or User <br /> (Client) designated parties. All questions should be answered to the best of the respondent's actual <br /> knowledge and must be answered in good faith . Explanations to any answers, especially "Yes" answers, <br /> should be made in the space following the question or on a separate sleet, noting the question number. <br /> Please be as 6ompiete as possible; if you do not know the answer to a question, please check unknown . <br /> Following the site visit, it may be necessary for AGE or the preparer to ask clarifying questions of the <br /> interviewee(s): <br /> AGE Project Name & Number: Howard Land company AGE Proieet No, 153594 <br /> Project Address' 161 EBst7ransponatlon onus, Ripon <br /> Interview type: ❑ :Verbal Q :Written <br /> Person Inteiviewed ; Date :. User/Ghent Information : <br /> Name: Name: Mr, Lloyd Fater <br /> Company: Company: 1 Al—1 1" /`\'7 <br /> Address: Address:_/� f!l/GT� �Ic !ate <br /> Contact Info; Contact Info: <br /> Relationshiplto property: Relationship to property: <br /> ❑ :current property owner ❑ :property seller/owner <br /> ❑ :formeriproperty owner [] : property buyer <br /> ❑ :property occupant [:financing entity <br /> ❑ :site m2nager ❑:other, list- <br /> ❑ This interview was performed by: OR El This interview was performed/administered by: <br /> Name: Name- <br /> Title: Address: <br /> of Advanced GeoEnviron mental , Inc. (AGE) <br /> phone: 800-511 -9300 Phone/fax: <br /> fax: 888445-8786 Relationship to property, list: <br /> itRelationship to user (client), list: <br /> The prepareIr represents that to the best of the preparer's knowledge the statements and facts made <br /> below are true and correct and to the best of the preparer's actual knowledge no material facts have <br /> been suppressed or misstated . <br /> (Preparer/interviewer) <br /> Signatu Dat <br /> l_ <br /> ( Interviewee, if available) <br /> ` SP ture Dat6 <br /> Advanced GeoEnvironmental , Inc. <br /> Phone Imp) 5114306 4 Fax (666) 44be7e0 • www.advgecenv.cnm <br />