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t <br /> r`g Rev 2/23/2001 <br /> Page 2 of 6 <br /> # 4b Did you observe evidence or do you have any priorYe No Unk <br /> knowledge that an ad oining property used as a gasoline <br /> statioi , otor re air facilit ry cleaners, photo developing <br /> laboratory,junyard of landfill, or as a waste treatment, <br /> storage, disposal, processing, or recycling facility(if <br /> applicable, identify which)? <br /> e 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 /> ` (l 9L) 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 �ye; <br /> No Unk <br /> h gal (208L)) osacks of chemicals located on the property or �-p 1 <br /> at the facility? 0 <br /> r 6b Did you observe evidence or do you have any prior Yes No Unk <br /> knowledge that there have been previously any industrial <br /> drums (typically 55 gal (208L)) or sacks of chemicals <br /> .� located on the property or at the facility9 <br /> 7a Did you observe evidence or do you have any prior Yes nNo 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 that fill dirt has been brought onto the property <br /> that is of an unknown origin? <br /> 8a Are there currently any pits,ponds, or lagoons located Yes No Unk <br /> on the property in connection with waste treatment or waste <br /> disposal? <br /> 8b Did you observe evidence or do you have any prior Yes N 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 /> 9a Is there currently any stained soil on the property,' Yes Unk <br /> 9b Did you observe evidence or do you have any prior Yes �—O Unk <br /> { • knowledge that there has been previously any stained soil <br /> on the property' <br /> 1 <br /> Initials <br />