Environmental Questionnaire and Disclosure Statement
6. Is the site within 500 feet of a sensitive receptor (i.e. public water supply, watershed, or
private wells)? (if yes, please describe.)
As the owner or contract purchaser of the property, or as an officer or general partner of the present
owner of the property, (or the duly authorized representative of such owner), I am familiar with all of
the operations presently conducted on the property, have made a diligent inquiry into the former
uses of the Property, and hereby certify to and for the benefit of The First Bank of Greenwich that to
the best of my knowledge, information and belief the information disclosed above is true and correct.
Attest:
By:
L:\Admin\Commercial Application Package\Environmental Questionnaire and Disclosure Statement.docx