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State of California-California Etvironmental Protection Agency Department of Toxic Substances Control TIERED PERAGTTING PHASE I ENVIRONMENTAL ASSESSMENT CHECKLIST 13. ADDRESS OF FACILITY C, �eOONTACT PERSON: C 4 4 r�PS A P-iw oh ✓7 � STREET: 2 ¢6 Ile." Z CITY: s 111-0 C Ir A A, STATE: CA ZIP CODE: 95Z d 6 i SECTION II:FACILITY HISTORY Instructions:Complete this section regarding facility history based on reasonably available knowledge of the facility. This section w7determineifpast operating practices and significant historical events that occurred at the facility indicate potential areas ofcontamination. Curre employees who know about the facility's past operating practices can be an asset in completing this section of the checklist. Yes answers to these questions mean that careful attention must be paid to these areas and considerations alum completing the facility walk-through inspection. YES NO 1. Has an environmental assessment and/or a site investigation report ever been completed for the facility? If this assessment meets the criteria for substituting for this checklist (see Instructions),use the Signature and Certification Page to record this exemption. You need not release confidential assessments. However,if these reports indicate existing or potential contamination,you must use the information relied on by the confidential report to help reach aoonclttsion in this assessment. 2. To your knowledge,have areas of the facility that contain hazardous materials ever been flooded? 3. To your knowledge,has the facility ever been damaged by an earthquake that could cause contamination? ✓ 4. To your knowledge,has the location for the facility ever been used for industrial purposes prior to its current use? IfYES,then consider potential contamination from the ✓ !Xpe of industry that the location was formerly used for. S. To your knowledge,has there been any disposing of hazardous chemicals or hazardous wastes in,on,or under the roe ? i 6. To your knowledge,has the facility ever had electrical transformers,capacitors,or hydraulic equipment including,but not limited to elevators and auto lifts,at the facility which may have released PCBs or oil to the environment? (Not including small quantities ✓ of fluorescent light ballasts and capacitors if these materials were not disposed of or dismantled at the facility) If YES,was the equipment ever tested for the presence of PCBs? To your knowledge,has testing of any groundwater wells on the property ever revealed �ssible contamination? e/ g- Do you have in your possession,or do you know of the existence of arty photographs, geophysical reports,analytical test data,and/or air sampling data that indicates the possible presence of hazardous materials and/or waste in unwarranted or unexpected +� areas of the facili ? 9. To your knowledge,has the facility ever had liquid/sludge containment area(s),surface im oundment s collection and s and/orI oon-s v DISC I I$t t06M) Ytaaso indicate total number of pages o(