Laserfiche WebLink
ENVIRONMENTAL QUESTIONNAIRE <br /> TO BE COMPLETED BY OWNER/OWNER'S REP..AND FORWARDED TO EARNEST F. SMITH <br /> AND ASSOCIATES,CIVIL ENGINEERS FOR INCLUSION IN SURFACEISUB SURFACE <br /> CONTAMINATION REPORT. <br /> 1.Date you acquired pro " ;z /®�igl.:�- Sl Co. <br /> 1 Use of property since acquisition <br /> 3.How many irrigation wells serve the property: '�C e_ Depth of well(s)if <br /> known <br /> 4_Do you have a permit to apply chemicals or fertilizers to the parcel?Ifyes,for what yews <br /> Describe the products produced <br /> 5.Do you have any knowledge of any of the following being present on the parcel under study? <br /> A.Any disposal site, by former/present owner,of fuels,,hazardous materials, chemicals or any other <br /> substance considered a controlled substance by Locaf/StatelFederal Law. Yes—No- (If yes, <br /> please explain. <br /> B. Existing cistern,hand dug well or leach field,no longer in use.Yes No C (If yes <br /> please locate on property for the field review which is to be completed after receipt of this form.) <br /> C. Structures that am considered unsafe by you or local authorities. Yes No X <br /> D.Flooding of parcel in part,or whole. Yes No Ifyes,what years <br /> Ii Caruanirmtion of air or soil from adjacent parcels Yes No—_ <br /> F.Failed septic system,that required repair or additional worL Yes No _Ifyes desmbe work <br /> done <br /> G.A prion/present condition that may preclude developenwa of the patod(s}Yes Tb�_ <br /> H.A specific location wlrerz iY No_� <br /> 6 Nacre of former owner Do awmbetusewip <br /> nude ofdo by the owner? so <br /> , �y <br /> 7 . <br /> 7.Atu the deep ripped since owned by yo>tt rs No z_ <br /> L &Are yoo of any perched water table/Wngs or on oc=Ww pools of water on site?Yes No-Y�- <br /> Cot»mar� _ <br /> L <br /> ( ftgym) Deb <br />