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DocuSign Envelope ID: EFACB3C4-C60B-416B-9CA1-B277DD2458EE <br /> mancm ;emmgtlpNlUl,ll mlil <br /> mNfl�i1ll1 <br /> 11114 NIuaiU�� 11 <br /> Environmental Questionnaire for User asno�mii°iiiii <br /> Completion required for conformance with ASTM E 1527-13. Failure to provide this <br /> information may preclude CERCLA liability protections for the property purchaser. Please <br /> return answered form to ECS. <br /> Site Name: <br /> Name and Title of Person Completing Questionnaire (Please Print): <br /> Signature of Person Completing Questionnaire: <br /> Date: <br /> Name of Your Company and Your Contact Number (Please Print): <br /> ASTM E 1527-13 indicates that, "Either the user shall make known to the environmental <br /> professional the reason why the user wants to have the Phase I Environmental Site <br /> Assessment performed or, if the user does not identify the purpose of the Phase I <br /> Environmental Site Assessment, the environmental professional shall assume the purpose is <br /> to qualify for an LLP to CERCLA liability and state this in the report." As the user of this ESA, <br /> what is the reason for conducting the Phase I ESA? If this question is unanswered, ECS will assume <br /> that the user's reason for the ESA is to qualify for landowner liability protections to CERCLA liability. <br /> Please state reason for having ESA performed: <br /> Will you provide Property Title Records and a Legal Description to ECS? <br /> Please select one: NO YES <br /> Will you provide a 50-year chain of title abstract to ECS? <br /> Please select one: NO YES <br /> Please Send Information Promptly <br /> (1a.) Environmental liens that are filed or recorded against the site (40 CFR 312.25). ASTM E <br /> 1527-13 states that the user should perform a review of recorded land title records and judicial <br /> records for environmental liens or activity and use limitations for the site. Please forward the <br /> results of the land title record and judicial record review. If you would prefer, ECS can obtain <br /> this information from a third party provider for an additional fee. Please let ECS know if you <br /> would like to contract ECS for this service. <br /> Please select one: Client to Provide ECS to Provide for Additional Fee <br /> Page 1 of 3 <br />