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Particular matters—Environmental disclosure document—Illinois. ENVIRONMENTAL DISCLOSURE DOCUMENT FOR TRANSFER OF REAL PROPERTY
Seller: _______________ Buyer: _______________ Document No.: _______________ I. PROPERTY IDENTIFICATION A. Address of property: Street _______________ City or Village _______________ Township _______________ Permanent Real Estate Index No.: _______________ B. Legal Description: Section _______________ Township _______________ Range _______________ Enter or attach current legal description in this area: Prepared by: Name _______________ Company _______________ Address _______________ City _______________ State/Zip _______________ Return to: _______________ II. LIABILITY DISCLOSURE Transferors and transferees of real property are advised that their ownership or other control of such property may render them liable for any environmental clean-up costs whether or not they caused or contributed to the presence of environmental problems associated with the property. A. Property Characteristics: Lot Size: _______________ Acreage: _______________ Check all types of improvement and uses that pertain to the property: — Apartment building (6 units or less) — Commercial apartment (over 6 units) — Store, office, commercial building — Industrial building — Farm, with buildings — Other (specify) III. NATURE OF TRANSFER
B. (1) Identify Transferor: _________ Name and Current Address of Transferor: _______________ Name and Address of Trustee if this is a transfer of beneficial interest of a land trust: _______________ Trust No.: _________ (2) Identify person who has completed this form on behalf of the Transferor and who has knowledge of the information contained in this form: _________[Name, Position (if any), Address, Telephone No.]. C. (1) Identify Transferee: _________ Name and Current Address of Transferee: _______________ IV. NOTIFICATION Under the Illinois Environmental Protection Act, owners of real property may be held liable for costs related to the release of a hazardous substances. 1. Section 22.2(f) of the Act states: "Notwithstanding any other provision or rule of law, and subject only to the defenses set forth in subsection (j) of this section, the following persons shall be liable for all costs of removal or remedial action incurred by the State of Illinois as a result of a release or substantial threat of a release of hazardous substance: (1) The owner and operator of a facility or vessel from which there is a release or substantial threat of release of a hazardous substance; (2) Any person who at the time of disposal, transport, storage, or treatment of a hazardous substance owned or operated the facility or vessel used for such disposal, transport, treatment or storage from which there was a release or substantial threat of a release of any such hazardous substance; (3) Any person who by contract, agreement, or otherwise has arranged with another party or entity for transport, storage, disposal or treatment of hazardous substances owned, controlled or possessed by such a person at a facility there is a release or substantial threat of a release of such hazardous substance; and (4) Any person who accepts or accepted any hazardous substances for transport to disposal, storage or treatment facilities or sites from which there is a release or a substantial threat of a release of a hazardous substance." 2. Section 4(q) of the Act states: "The Agency shall have the authority to provide notice to any person who may be liable pursuant to Section 22.2(f) of this Act for a release or a substantial threat of a release of a hazardous substance. Such notice shall include the identified response action and an opportunity for such person to perform the response action." 3. Section 22.2(k) of the Act states: "If any person who is liable for a release or substantial threat of release of a hazardous substance fails without sufficient cause to provide removal or remedial action upon or in accordance with a notice and request by the agency or upon or in accordance with any order of the Board or any court, such person may be liable to the State for punitive damages in an amount at least equal to, and not more than 3 times, the amount of any costs incurred by the State of Illinois as result of such failure to take such removal or remedial action. The punitive damage imposed by the Board shall be in addition to any costs recovered from such person pursuant to this Section and in addition to any other penalty or relief provided by this Act or any other law." 4. Section 22.18(a) of the Act states: "Notwithstanding any other provision or rule or law, except as provided otherwise in subsection (b), the owner or operator, or both, of an underground storage tank shall be liable for all costs of preventive action, corrective action and enforcement action incurred by the State of Illinois as a result of a release or a substantial threat of a release of petroleum from an underground tank." 5. Text of the statutes set out above is subject to change by amendment. Persons using this form may update it to reflect changes in the text of the statutes cited, but no disclosures statement shall be invalid merely because it sets forth an obsolete or superseded version of such text. V. ENVIRONMENTAL INFORMATION A. Regulatory Information During Current Ownership 1. Has the transferor ever conducted operations on the property which involved the generation, manufacture, processing, transportation, treatment, storage or handling of "hazardous substances", as defined by the Illinois Environmental Protection Act? This question shall not be applicable for consumer goods stored or handled by a retailer in the same form, approximate amount, concentration and manner as they are sold to consumers, provided that such retailer does not engage in any commercial mixing (other than paint mixing or tinting of consumer sized containers), finishing, refinishing, servicing, or cleaning operations on the property. Yes _________ No _________ 2. Has the transferor ever conducted operations on the property which involved the processing, storage or handling of petroleum, other than that which was associated directly with the transferor's vehicle usage? Yes _________ No _________ 3. Has the transferor ever conducted operations on the property which involved the generation, transportation, storage, treatment or disposal of "hazardous or special wastes", as defined by the federal Resource Conservation and Recovery Act and the Illinois Environmental Protection Act? Yes _________ No _________ 4. Are there any of the following specific units (operating or closed) at the property which are or were used by the transferor to manage waste, hazardous waste, hazardous substances or petroleum?
If there are "YES" answers to any of the above items and the transfer is other than a mortgage or collateral assignment of beneficial interest, attach a site plan which identifies the location of each unit, such site plan to be filed with the Environmental Protection Agency along with this disclosure document. 5. Has the transferor ever held any of the following in regard to this real property? a. Permits for discharge of wastewater to waters of the State. Yes _________ No _________ b. Permits for emissions to the atmosphere. Yes _________ No _________ c. Permits for any waste storage, waste treatment or waste disposal operation. Yes _________ No _________ 6. Has the transferor had any wastewater discharges (other than sewage) to a publicly owned treatment works? Yes _________ No _________ 7. Has the transferor taken any of the following actions relative to this property? a. Prepared a Chemical Safety Contingency Plan pursuant to the Illinois Chemical Safety Act. Yes _________ No _________ b. Filed an Emergency and Hazardous Chemical Inventory Form pursuant to the federal Emergency Planning and Community Right-to-Know Act of 1986. Yes _________ No _________ c. Filed a Toxic Chemical Release Form pursuant to the federal Emergency Planning and Community Right-to-Know Act of 1986. Yes _________ No _________ 8. Has the transferor or any facility on the property or the property been the subject of any of the following state or federal governmental actions? a. Written notification regarding known, suspected or alleged contamination on or emanating from the property. Yes _________ No _________ b. Filing an environmental enforcement case with a court or the Pollution Control Board for which a final order or consent decree was entered. Yes _________ No _________ c. If item b. was answered by checking Yes, then indicate whether or not the final order or decree is still in effect for this property. Yes _________ No _________ 9. Environmental Releases During Transferor's Ownership. a. Has any situation occurred at this site which resulted in a reportable "release" of any hazardous substances or petroleum as required under state or federal laws? Yes _________ No _________ b. Have any hazardous substances or petroleum, which were released, come into direct contact with the ground at this site? Yes _________ No _________ c. If the answers to questions (a) and (b) are Yes, have any of the following actions or events been associated with a release on the property?
10. Is the facility currently operating under a variance granted by the Illinois Pollution Control Board? Yes _________ No _________ 11. Is there any explanation needed for clarification of any of the above answers or responses? _______________ _______________ B. Site Information Under Other Ownership or Operation 1. Provide the following information about the previous owner or any entity or person the transferor leased the site to or otherwise contracted with for the management of the site or real property: Name: Type of business or property usage 2. If the transferor has knowledge, indicate whether the following existed under prior ownerships, leaseholds granted by the transferor, other contracts for management or use of the facilities or real property.
VI. CERTIFICATION A. Based on my inquiry of those persons directly responsible for gathering the information, I certify that the information submitted is, to the best of my knowledge and belief, true and accurate. _______________ Signature(s) _______________ type or print name TRANSFEROR OR TRANSFERORS (or on behalf of Transferor) B. This form was delivered to me with all elements completed on _________[date]. _______________ Signature(s) _______________ type or print name TRANSFEREE OR TRANSFEREES (or on behalf of Transferee) C. This form was delivered to me with all elements completed on _________[date]. _______________ Signature(s) _______________ type or print name _______________ LENDOR _______________ LENDOR REPRESENTATIVE _______________ TITLE
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