CONVEYANCE NOTIFICATION
GW2 Zone
(Name of current property owner) hereby notifies the public that the following described Area of Investigation (AOI), Louisiana Department of Environmental Quality (LDEQ) Agency Interest Number (list AI number), was closed with contaminant levels present that are acceptable for groundwater meeting the definition of a Groundwater 2 Zone, as described in LDEQ’s Risk Evaluation/Corrective Action Program (RECAP), Section 2.10. Groundwater within property boundaries, as identified in the attached form, contains contaminant concentrations that exceed drinking water standards and therefore should not be used as a drinking water source. In accordance with LAC 33:I., Chapter 13, if the groundwater use changes (e.g., a public supply well is placed in a Groundwater 2 zone or a domestic or agricultural well is placed in a Groundwater 3 zone; refer to Section 2.10), the responsible party shall notify the LDEQ within 30 days and the groundwater AOI shall be reevaluated to determine if conditions are appropriate for the proposed aquifer use.
This site was closed in accordance with the Louisiana Administrative Code, Title 33:I., Chapter 13. Additional information on the environmental conditions of this property is available in the Louisiana Department of Environmental Quality’s Electronic Document Management System (EDMS) filed under Agency Interest Number (AI) (list AI number). The EDMS is available online at or by visiting one of the Public Records Centers. For information or assistance, contact the Customer Service Center at (225) 219-LDEQ (5337) or toll free (866) 896-LDEQ.
A completed RECAP Conveyance Notice Form is attached.
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Signature of Property Owner or Their Authorized Representative[1]
Typed Name and Title of Property Owner or Their Authorized Representative
Date
(A true copy of the document certified by the parish clerk of court must be sent to the Remediation Division, Post Office Box 4314, Baton Rouge, Louisiana 70821-4314.)
[1]By signing this document, the person signing is certifying that he/she has actual authority to sign this conveyance notice and the actual authority to carry out the obligations contained in the notice, if any. Signing without actual authority may constitute the filing of false public documents under La.R.S. 14:133.