Laserfiche WebLink
Rev. 2/23/2001 <br /> Page 1 of <br /> PHASE I ENVIRONMENTAL SITE ASSESSMENT <br /> TRANSACTION SCREEN QUESTIONNAIRE <br /> LN PROPOSED CSU STANISLAUS SCHOOL SITE <br /> This questionnaire has been prepared by Condor Earth Technologies, Inc. (Preparer) by request <br /> from Steve Breakfield of Stockton Unified School District (User) in order to obtain information <br /> regarding the proposed CSU Stanislaus School (Site). The objective of this questionnaire is to <br /> provide the User with information regarding the presence or likely presence of any hazardous <br /> substances or petroleum products on the property that may present a material risk of harm to <br /> +- public health or to the environment. Information provided by this questionnaire will be used to <br /> identify recognized environmental conditions existing on the Site that may or may not requite <br /> additional research. The questionnaire is provided on a voluntary basis by the respondent as part <br /> �. of a customary practice for conducting an Environmental Site Assessment on a specific parcel of <br /> real estate. Please respond to the best of your ability. To provide further information, please <br /> describe reason for any affirmative answers on a separate sheet of paper. <br /> RESPONDENT(CHECK ONE) <br /> LW Owner Occupant Preparer(during Site visit) <br /> Question Answer <br /> Ia. Is this Site used for an industrial use? Yes No) Unk <br /> .. lb. Is any adjoining property used for an industrial use? Yes Unk <br /> 2a. Did you observe evidence or do you have any prior Yes No) Unk <br /> knowledge that the property has been used for an industrial <br /> use in the past? <br /> 2b. Did you observe evidence or do you have any prior Yes 'No Unk <br /> knowledge that any adjoining property has been used for an <br /> industrial use in the past? <br /> 3a. Is the property used as a gasoline station, motor repair Yes Unk <br /> facility, dry cleaners, photo developing laboratory, <br /> junkyard or landfill, or as a waste treatment, storage, <br /> disposal, processing, or recycling facility(if applicable, <br /> identify which)? <br /> 3b. Is any adjoining property used as a gasoline station, Yes leo Unk <br /> motor repair facility, dry cleaners, photo developing <br /> laboratory,junkyard or landfill, or as a waste treatment, <br /> storage, disposal,processing, or recycling facility(if <br /> applicable, identify which)? <br /> 4a. Did you observe evidence or do you have any prior -Yes No Unk , <br /> knowledge that the property has been used as a gasoline <br /> station, motor repair facility, dry cleaners, photo developing <br /> •► laboratory,junkyard or landfill, or as a waste treatment, <br /> storage, disposal, processing, or recycling facility(if <br /> applicable; identify which)? <br /> �+ II11t1a1S , <br />