Orange County NC Website
DocuSign Envelope ID:4D07A756-4236-4526-A1 D2-89F0777755FB <br /> 111�G// Environmental Questionnaire for User <br /> Completion required for conformance with ASTM E 1527-13 <br /> Failure to provide this information <br /> may preclude CERCLA liability protections for the property purchaser. <br /> Please return completed form to ECS. <br /> Date: <br /> Site Name <br /> Name and Title of Person Completing Questionnaire (Please Print) <br /> Signature of Person Completing Questionnaire <br /> Name of Your Company (Please Print) Your Telephone Number <br /> ASTM E 1527-13 indicates — <br /> "Either the User shall make known to the environmental professional the reason why the User <br /> wants to have the Phase I Environmental Site Assessment performed or, if the User does not <br /> identify the purpose of the Phase I Environmental Site Assessment, the environmental <br /> professional shall assume the purpose is to qualify for an LLP to CERCLA liability and state <br /> this in the report." <br /> As the User of this ESA, what is the reason for conducting the Phase I ESA? If this question is <br /> unanswered, ECS will assume the reason for the ESA is to qualify for landowner liability <br /> protections to CERCLA liability. <br /> Please state reason for requesting ESA: <br /> Will you provide Property Title Records and a Legal Description to ECS? Yes ❑ No ❑ <br /> Will you provide a 50-year chain of title abstract to ECS? Yes ❑ No ❑ <br /> If"yes,"please send information promptly. <br /> 1a. Environmental liens filed or recorded against the site (40 CFR 312.25) — <br /> ASTM E 1527-13 states that the user should perform a review of recorded land title records <br /> and judicial records for environmental liens or activity and use limitations for the site. Please <br /> Environmental Questionnaire for User Page 1 of 4 <br />