Orange County NC Website
USDA - Natural Resources Conservation Services Landowner Hazmat Interview <br />9 <br />E.Other <br />1.Are you aware any past or current occurrences of anomalous vegetation (e.g., stressed or dead) on the <br />property? If yes, indicate the locations and approximate dates. Yes □ No □ Unknown □ <br />________________________________________________________________________________________ <br />________________________________________________________________________________________ <br />2.Are you aware of the presence of invasive or non-native plants on the property? If yes, please indicate the <br />locations and names (e.g., kudzu, Phragmites, cheatgrass), if known, and approximate area covered by the <br />plants. Yes □ No □ Unknown □ <br />________________________________________________________________________________________ <br />________________________________________________________________________________________ <br />a)If yes, has there been any attempt to remove or eradicate the invasive species? If yes, explain what <br />was attempted and if it was successful? Yes □ No □ Unknown □ <br />_________________________________________________________________________________ <br />_________________________________________________________________________________ <br />b)Have any vegetative control programs (e.g., along transmission lines, fence lines, rights-of-ways, or <br />pipelines) been done on the property? If yes, describe the program and types of activities. <br />Yes □ No □ Unknown □ <br />_________________________________________________________________________________ <br />_________________________________________________________________________________ <br />3.If not mentioned above, is there anything else that could indicate the presence of hazardous substances, <br />petroleum products or other environmental conditions that may affect the property? <br />Yes □ No □ Unknown □ <br />________________________________________________________________________________________ <br />________________________________________________________________________________________ <br />________________________________________________________________________________________ <br />INTERVIEWEE SIGNATURE: <br />INTERVIEWEE SIGNATURE <br />INTERVIEWEE NAME DATE <br />INTERVIEWER SIGNATURE: <br />INTERVIEWER SIGNATURE OFFICIAL TITLE <br />INTERVIEWER NAME DATE <br />DocuSign Envelope ID: 480AFBD4-654C-48FA-9CB8-F7C8D7E98DB2