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DocuSign Envelope ID: DE50C3DC-2C59-4045-8605-8480D42217C5 <br /> Environmental Services Proposal <br /> PEI Proposal P-1973 <br /> April 28,2016 <br /> Environmental Questionnaire for User <br /> The person who will use the Phase I ESA should provide the following Information. Please fill In this form to the best <br /> Of your ability,explaining any Yes answers oil a separate sheet of paper. Without these answers,our report would <br /> have to mote that the Phase One is Incomplete, and your Landowner Liability Protections could be at risk. Please <br /> complete and return with the Proposal Authorization Form. <br /> 1. Environmental Cleanup Liens. ASTM requires the User to check for environmental (lens that may be filed or <br /> recorded against the subject property under federal,tribal, state or local law. Failure to check for these Ilens <br /> could put your Landowner Liability Protections at risk, <br /> Would you like PEI to provide for an additional fee($300 per parcel)? 0 Yes 0 No <br /> Have you or your agent checked for these environmental cleanup liens? i -Yes ® No <br /> Are you aware of any such liens against the subject property? LA Yes 0 No <br /> Z Activity and Use Limitations(AULs). These include engineering controls(e.g.,slurry walls, caps) and land use <br /> restrictions or institutional controls(e.g.,deed restrictions,covenants)that may be In place at the site or filed <br /> under federal,tribal,state or local law, <br /> Are you aware of any possible AULs involving the subject site? LJ Yes 0 No <br /> 3. Specialized Knowledge. This Involves personal knowledge or experience related to the subject property or <br /> nearby properties, For example, if you are Involved in the sarne line of business as the current or former <br /> occupants of the property or an adjoining property,you would probably know of any chemicals,oll,clegreasers, <br /> gasoline,or other hazardous substances commonly used In that type of business. <br /> Do you have any specialized knowledge that might Indicate the past or <br /> present use of such substances on the subject or nearby properties? E1 Yes M No <br /> 4. Fair Market Value(FMV). A purchase price significantly below FMV may indicate an environmental problem. <br /> Please note that this question does not require an appraisal of the property, If the price Is significantly below <br /> FMV,the User should consider whether it might be because contamination may be present at the property. <br /> Is the purchase price significantly below fair market value? LJ Yes ONO <br /> 6, Obvious Indicators. This Involves past or present spills,stains,releases,cleanups,etc,on or near the site. <br /> Do you know of any obvious Indicators of possible contamination on or near the site? Q Yes 01 No <br /> 6. Common Knowledge.Please use a separate sheet if necessary. <br /> a. Describe the past uses of the property. wE <br /> b, Describe any specific chemicals that may have been present at the property: OWI%l <br /> C. Describe any other Information (spills, chernical releases or environmental cleanups) that may help us <br /> Identify possible contamination: <br /> Your Signature Ifs 6 D te: �' #of separate sheets attached: <br /> Printed Narne Ct , "•1 d �_ Explain Yes answers on a separate sheet. <br />