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Client Information Request Form <br />for Phase I Environmental Site Assessments <br />Site -Specific Information <br />A. Where is the Site located? <br />Address: <br />Legal Description: <br />B. Who is the current property owner? <br />Name: <br />Phone: <br />C. Who will provide access to the property and/or who is the Site contact? <br />Name: <br />Phone: <br />D. Has any previous environmental work been performed on the Site? Check all that apply. <br />❑ No previous environmental work has been performed <br />❑ Unknown <br />❑ Geotechnical/Soil borings <br />❑ Phase I Environmental Site Assessment <br />❑ Phase II Environmental Site Assessment <br />❑ Soil Vapor/Sub-slab Soil Vapor Investigation <br />❑ Radon Investigation <br />❑ Asbestos/Lead-based Paint Inspections <br />❑ Hazardous Materials Testing <br />❑ Other: <br />If previous environmental work has been performed... <br />When was it performed? <br />By whom? <br />Name: <br />Phone: <br />What were the results? <br />Are copies of the report(s) available? <br />❑ Yes ❑ No ❑ Unknown <br />E. Is a current Site plan available? If yes, please provide. <br />❑ Yes ❑ No ❑ Unknown <br />F. How large is the property (total acreage)? <br />acres <br />G. How is the property currently used? Check all that apply. <br />❑ Undeveloped ❑ Light industrial <br />❑ Agricultural ❑ Retail <br />❑ Residential ❑ Office Building <br />❑ Parking Lot ❑ Warehouse <br />❑ Commercial ❑ Other: <br />Revised 05/29/2018 Page 2 of 4 <br />