Brownfield Site Survey Form
Use this form to provide details about a brownfield site so the site condition, history, risks, and redevelopment needs can be reviewed. Keep the title exactly as written: Brownfield Site Survey Form.
Site Identification
Site name
*
Site address or location description
*
Current site owner or organization name
Site Condition and History
Current site status
*
Vacant
Partially used
Abandoned
Under demolition
Actively used
Other
Previous land use/history
*
Suspected contamination concerns
Soil
Groundwater
Asbestos
Lead paint
Petroleum
Unknown
Other
Visible hazards or access limitations
Survey Details and Follow-Up
Survey Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Intended Future Redevelopment or Project Purpose
*
Supporting Documents or Attachments
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Additional Notes or Observations
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Should be Empty: