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Page 2 <br /> Building Owner: Street Address: <br /> Date: City/State: <br /> Erosion Present Location <br /> Structural Damage Location <br /> Pipe Damage Location <br /> Leaking Compactors/ <br /> Containers Description: <br /> Petroleum/Chemical <br /> Sheen Description/Location: <br /> Dumped/Spilled <br /> Materials Description/Location: <br /> Burrowing _ <br /> Animals/Pests Description/Location: <br /> Fountains/Aerators <br /> Mosquitoes/Algae <br /> Safety/Hazard Areas Description/Location: <br /> Other <br /> Estimated total hours worked on job site: <br /> Equipment/Material Used: <br /> Comments/Additional Information: <br /> Contractor Team Lead Signature: <br /> Team Lead Printed Name: <br /> Everett Mall Plaza Parcel Ill Ketail Expansion Stormwater Site Flan Page 74 <br />