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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 />