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DocuSign Envelope ID: 12E28A19 -47D1- 4964- 983E- 1BE3535E0848 HHHEMEMEMIll <br />Etc"!�* <br />Environmental Questionnaire for User �� 3 <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 ❑ <br />Page 1 of 3 <br />ECS to Provide for Additional Fee ❑ <br />