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Rev 2/23/2001 <br /> z Page 3 of 6 <br /> r <br /> l Oa Are there currently any registered or unregistered Yeso Unk <br /> storage tanks (above or underground) located on the <br /> N6 <br /> property2 <br /> 1 Ob Did you observe evidence or do you have any prior Yes No Unk <br /> knowledge that there have been previously any registered <br /> or unregistered storage tanks (above or underground) <br /> located on the property? <br /> t � <br /> Ila Are there currently any vent pipes, fill pipes, or access Yes Unk <br /> ways indicating a fill pipe protruding from the ground on <br /> the property or adjacent to any structure located on the <br /> property? <br /> 1 b Did you observe evidence or do you have any prior Yes Unk <br /> knowledge that there have been previously any vent pipes, <br /> fill pipes, or access ways indicating a fill pipe protruding <br /> from the ground on the property or adjacent to any structure <br /> located on the property? 0_o <br /> l2a Are there currently any flooring, drains, or walls Yes Unk <br /> located within the facility that are stained by substances � <br /> other than water or are emitting foul odors? <br /> 12b Did you observe evidence or do you have any prior Yes No Unk <br /> knowledge that there have been previously any flooring, <br /> • drains, or walls located with the facility that are stamed by <br /> substances other than water or are emitting foul odors? <br /> 13a If the property is served by a private well, or non- Yes No Unk <br /> public water system, is there evidence or do you have prior <br /> knowledge that contaminants have been identified m the <br /> well or system that exceed guidelines applicable to the <br /> water system? <br /> 13b If the property is served by a private well, or non- Yes No Unk <br /> public water system, is there evidence or do you have prior <br /> knowledge that the well has been designated as <br /> contaminated by any government environmentailhealth <br /> agency? <br /> h 14 Does the owner or occupant of the property have any Yes No Unk <br /> knowledge of environmental liens or govenunental <br /> notification relating to past or recurrent violations of <br /> ry, <br /> environmental laws with respect to the property or any <br /> facility located on the property <br /> 15a Has the owner or occupant of the property been Yes No Unk <br /> r informed of the past existence of hazardous substances or <br /> petroleum products with respect to the property or any <br /> facility located on the property? <br /> k Initials <br /> Ahs <br />