EP 1110-1-18
24 Apr 00
a. Site Description
SITE LOCATION
APPROXIMATE SIZE
TOPOGRAPHY
SITE USES
( )Forested ( )Open Terrain
( )Rural
( )Urban
( )Lake, Pond ( )Wetland
( )Ag Business ( )Commercial
( )Grassland ( ) Arid
( )Farming ( )Industrial
( )Hilly ( )Tillage
( )Ranching ( )Mining
( )Other_____________________
( )Military ( )Residential
( )Government ( )Recreational
( )Other______________________
CHEMICAL CONTAMINANT LISTING
Chemical Name
Conc. Range
Media: Air
Location
Quantity
Water, Soil
Expected
Type
Amount
Location
Surface/
Subsurface
H-2