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r � <br /> Rev 2/23/2001 <br /> a Page 2 of 6 <br /> 4b Did you observe evidence or do you have any prior Yes No! Unk <br /> knowledge that any adjoining property used as a gasoline <br /> station, motor repair facility, dry cleaners, photo developing <br /> laboratory,junk-yard of landfill, or as a waste treatment, <br /> s storage, disposal, processing, or recycling facility(if <br /> applicable, identify which)? <br /> 5a Are there currently any damaged or discarded Yes No Unk <br /> automotive or industrial batteries, pesticides, paints, or <br /> other chemicals in individual containers of>5 gal (19L) in <br /> volume or 50 gal (190L) in the aggregate, stored on or used <br /> ' at the property or at this facility? <br /> 5b Did you observe evidence or do you have any prior Yes �No Unk <br /> knowledge that there have been previously any damaged or <br /> discarded automotive or industrial batteries, pesticides, <br /> paints, or other chemicals in individual containers of>5 gal <br /> (19L) in volume or 50 gal (190L) in the aggregate, stored <br /> on or used at the property or at this facility? <br /> 6a Are there currently any industrial drums (typically 55 Yes No Unk <br /> 3` gal (208L))or sacks of chemicals located on the property or <br /> at the facility? <br /> 6b Did you observe evidence or do you have any prior Yes /NO 3 Unk <br /> knowledge that there have been previously any industrial <br /> i drums (typically 55 gal (208L))or sacks of chemicals <br /> located on the property or at the facility? <br /> 7a Did you observe evidence or do you have any prior Yes �NO) Unk <br /> knowledge that fill dirt has been brought onto the property <br /> that originated from a contaminated Site? <br /> 7b Did you observe evidence or do you have any prior Yes No Unk <br /> knowledge thatfill dirt has been brought onto the property <br /> that is of an unknown origin? <br /> 8a Are there cui i ently any pets,ponds, or lagoons located Yes �No Unk <br /> # on tine property in connection with waste treatment or waste <br /> disposal? <br /> a 8b Did you observe evidence or do you have any prior Yes No+ Unk <br /> knowledge that there have been previously, any pits,ponds, <br /> or lagoons located on the property in connection with waste <br /> treatment or waste disposal? <br /> €�1 <br /> 9a Is there currently any stained soil on the property Yes �No, Unk <br /> 9b Did you observe evidence or do you have any prior Yes ;` No Unit <br /> knowledge that there has been previously any stamed soil <br /> on the property? <br /> initials <br />