Date
PARCEL OCCUPANT
PARCEL Contact
PARCEL Address
PARCEL City/State/Zip
RE: LAND USE SURVEY FOR INVESTIGATION OF PETROLEUM RELEASE
RELEASE LOCATION (SITE): UST site name
site address
city, state
FACILITY ID# facility id #
Dear property owner and/or tenant:
consultant is conducting an environmental investigation on behalf of owner/operator name for the above referenced site to maintain compliance with the State Fire Marshal, Bureau of Underground Storage Tank Regulations (BUSTR). BUSTR requires a survey be conducted for every property within 300 feet of the site in order to determine the current and potential future land use of the immediate area. This investigation is being performed in an effort to protect your community’s soil and groundwater resources from contamination.
This letter is being provided to you because your property is located within 300 feet of the site referenced above. Please assist us in evaluating the land use of the area surrounding the site by answering the questions below and returning this letter within ten days using the enclosed postage-paid envelope. By providing this information you are helping us in making a well-informed and environmentally responsible decision regarding the soil and groundwater resources in your community. If you have any questions, please contact me by telephone at CONSULTANT Phone number.
Sincerely,
prepared by
preparer's title
Enclosure: Postage-paid return envelope
Please answer the following questions regarding your property at the above address:1) What is the current use of the property? Residential Business/Commercial Both
Name of business (if applicable):
2) How long has the property been used for the purpose described in item #1?
3) What is the property currently zoned as?
4) Does anybody currently live on the property? / YES / NO
5) Has anybody ever lived on the property? / YES / NO
6) Are there plans to allow anybody to live on the property? / YES / NO
Comments:
Signature of property owner or manager: / Date: