2022-508-E-DEAPR-North Carolina Department of Agriculture and Consumer Services-Approval of NCADFP grant contract for matached funds in acquisition of conservation easement of Poteat family farm

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USDA - Natural Resources Conservation Services Landowner Hazmat Interview 6 a)If yes, has anyone done any radon, asbestos-containing materials, or lead-based paint surveys on the property? If yes, indicate whether radon, asbestos-containing materials, or lead-based paint has been identified in any onsite buildings. Identify the dates of the surveys, the structures, the results, and condition of the materials. Yes □ No □ Unknown □ _________________________________________________________________________________ _________________________________________________________________________________ 12.Is there current or past use of above-ground or underground storage tanks, including drums or other fuel containers, on the property? If yes, identify the tanks locations, installation dates, and the types and quantities of materials stored. If the tanks were removed, indicate the removal date and whether the lead regulatory agency issued a closure certification notice. Yes □ No □ Unknown □ ________________________________________________________________________________________ ________________________________________________________________________________________ a)If above-ground or underground storage tanks are or were used on the property, was there ever a spill or release of hazardous substances associated with the tank system? If yes, indicate the date and nature of the spill or release. Yes □ No □ Unknown □ _________________________________________________________________________________ _________________________________________________________________________________ b)If a spill or release has occurred related to an onsite tank system, was it mitigated to the satisfaction of the lead regulatory agency? If no, describe further actions that must be undertaken to address the spill or release. Yes □ No □ N/A □ Unknown □ _________________________________________________________________________________ _________________________________________________________________________________ 13.Are you aware of any hazardous substance or pollutant or contaminant spill or release, or other potential environmental problems on any adjacent or nearby properties? If yes, please describe (if known) the locations of the release, the type and quantities of materials involved, and the approximate dates. If known, also indicate the owner of the property where the release occurred. Yes □ No □ Unknown □ ________________________________________________________________________________________ ________________________________________________________________________________________ a)If there was a release of hazardous substances, petroleum products on any adjacent or nearby properties are you aware if the release was mitigated? Yes □ No □ N/A □ Unknown □ _________________________________________________________________________________ _________________________________________________________________________________ b)Are you aware of contamination or residual contamination on adjacent or nearby properties that poses a threat or may pose a future threat to the property? If yes, describe the threat or potential threat. Yes □ No □ Unknown □ _________________________________________________________________________________ _________________________________________________________________________________ c)Are you aware of any institutional controls, land use restrictions, long-term monitoring, or maintenance requirements in place on adjacent or nearby properties that affect the property? If yes, please describe and identify the adjacent or nearby property and the property owner. Yes □ No □ N/A □ Unknown □ _____________________________________________________________________________________ _____________________________________________________________________________________ DocuSign Envelope ID: 480AFBD4-654C-48FA-9CB8-F7C8D7E98DB2