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State aflCalifonaia-California EnviromnlenDepartarent of Toxic Substances Control kat Protection Agency TIERED PERMITTING PHASE I ENVIRONMENTAL ASSESSMENT CHECKLIS U. ADDRESS OF FACILITY CONTACT PERSON: � STREET: 121 N.Guild Ave. i CITY: Lodi I STATE: CA. ZIP CODE,: 95240 li i SECTION IL FAC1TUTY HISTORY Instructions:Complete this section regarding facility history based on reasonably available knowledge ofthe facility.This scctiouwiti determine if hast operating pructiees aFtd significant historical evettt5 that occurred at the facility indicate potential areas of contaminationCurrent and past cmptoyees who . know about the facility's past operating practices can be an asset in completing this section of the checklist. es answers to these questions mean that careful attenti'&,-Jaiust.be paid to these rcas•and consid6rations when completing the facility walk-througll inspection, YES NO X t, Has an environniontal assessulent 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 thisexeutption. You [iced not release confidential assessments. However,if these reports indicate existing or potential contamivation,you must use the information relied on by the confidential report to help reach a conclusion in this assessment. X 2; To your knowledge,have areas orthe facility that contain hazardous niatcrials ever been flooded? 3. To your knowledge,has the facility ever been damaged by an earthquake that could X cause contamination? X 4. To your kuowledge,has the location for the facility ever been used for industrial purposes prior to its current use? If YES,then consider potential contamination from.the type of industry that the location was formerly used for. 5. To your knowledge,has there been any disposing of hazardous chemicals or hazardous X wastes in,on,of under the property? X 6. To your knowledge,has the facility ever bad electrical transformers,capacitors,or hydrautie equipment including,but not limited to elevators and auto lifts,at the facility which may have released PCBs or oil to the envirorunent? (Not including sulalt quaz)tities of fluorescent light ballasts and capacitors if these materials were.not disposed of or dismantled at tine facility) I:f YES,was the equipment ever tested for the presence cf PCBs? X 7. "fc your knowledge,has testing of any groundwater wells on the property ever revealed possible contarnitlaC on? X g, Do you have in your possession,or do you know of the exi stcnoe of any photographs, geophysical reports,analytical test data,and/or air sampling data that indicates the possible presence of hazardous materiats and/or waste in unwarranted or unexpected areas of tile facility? X 9. To your knowledge,has the facility ever had liquid/sludge containment area(s),surface inipoundment(s),collection pond(s),and/or lagoon(s)? Yl ease indicatetotal nunberofpages_ of DTSC 1151(GC/99)