Environmental Questionnaire (Multi-Family and Mixed-Use Properties)
Af "Yes" ts checked for any ofthe following items, please attach copies of relevant documents, reports, et.
‘To the best of your knowledge:
Ts there asbestos curently in any ofthe construction materials of the improvements (eg thermal insulation,
scousticexilings, flooi
‘Ate asbestos reports available for this site?
For improvements constructed before 1978, i there lead-based paint on interior or exierior sures?
as the subject property, or any portion, been constructed over a landfill or other hazardous or municipal wasie
site?
‘Ate there or have there ever been any above or underground gasoline, diese, fue ol or other chemical storage
tanks or drums on the subject property?
Have the tanks, ifany, been registered and inspected/esicd for leakage? If fnspevied or esed, please alach a
copy of al results.
Have tanks been removed or have soil sumples been analyzed from the subject propery? Ifo, please aiach
‘copies of relevant report.
is the property ever been the subject ofan environmental assessment oF audit? IF30, please atach copies oF
reports).
Has there ever been any correspondence with federal, stale, of local aathoriies, or ny environmental Higation
‘or enforcement action taken concerning the subject property? I's, please attach documentation.
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as an asbestos or lead-based paint survey ever been conducted to assess the existence, type, location, or
contltion of asbestos or lead-based paint?
‘Aze you aware of any past, present, or contemplated future use ofthe subject property which may have resulied
‘or may result in the generation of storage of hazardous substances or wastes?
“Have areas affected by mold been identified or noted by occupants, workers, OF conkraciors atthe subject
property?
‘as a mold assessment ever been conducted fo assess the existence, typ, location, or extent of mold? 0,
lease attach report(s).
Has a radon assessment been conducted for the property? If so, please attach copies of report).
1s there any reason why this propery isnot currently in compliance with federal, state, or local environmental
Jaws and regulations?
Does vehicle maintenance otzaron te propery?
present, are vehicle maintenance ares regularly monitored To improper use?
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Does the subject property contain, oF i It affected by, the following:
Polychlorinated Biphenyl (PCBs) used in eletical transformer, et?
Sol setting, slipping, sliding, or ocer building Foundation problens?
Use solvents ike perchloroethylene (PCE), wrichloroethylene (TCE), oF lacquer thinner?
Flooding. grading, or drainage problems?
Traces ofconetete, asphalt, or other evidence Indieating prior commercial wie?
oredr oly soil, sresed vegetation, or other evidence of pills?
heen in wet areas?
‘Contamination of domestic water well of oer wale supp
Blevated levels of raion gas inthe structure or inthe neighborhood?
“Any ater potetial condition ofan environmental nature?
Ifo, pleaso describe ona separate allachment:
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‘Acknowledgement ai
The undersigned caries that the information provided in and given in connection with tis application Is tue and correct ws oF the date set forth
‘opposite the signature(s) on this application. The undersigned acknowledges that any intentional or negligent misrepresentatons of such information
Civil liability andor criminal penalties including, but not limited to, fine or imprisonment oF both, under the provisions of Title 18,
ss Code,