Description: http://www.fws.gov/policy/fws_col.gifExhibit 1, 341 FW 3, Level I Survey


FWM#: 260 (new)
Date: June 28, 1996
Series: Real Property
Part 341: Land Acquisition
Originating Office: Division of Realty



A Level I Survey is required for all proposed real property acquisitions. The instrument to determine whether there may be hazardous substances or other environmental problems is the Environmental Site Assessment Level I Survey Checklist(Form F341-3X1). Completion of the Checklist, with appropriate documentation, is a relatively quick method to determine whether there are any potential environmental problems and whether a Level II and/or III Survey is required to comply with 341 FW 3 and 602 DM 2. An ASTM Transaction Screen Questionnaire prepared by professionals trained in ASTM standards, may be accepted for completion of Parts B, C and D of the Checklist. Duplication of an original ASTM form is a copyright infringement and is prohibited.

The Checklist deals with all hazardous substances and other environmental problems rather than hazardous substances in particular. At this early stage of analysis, it may be impossible to determine whether any remediation or other cleanup costs will result from the presence of a hazardous substance or some other environmental problem, and a Level II or Level III Survey may be necessary. In either case, the Checklist should help alert the Service to potential problems.

While not precluded, sampling is neither required nor recommended for a Level I Survey. Any sampling for a Level I Survey must be completed by an Environmental Contaminants Specialist or person with equivalent training.

If the answers to all questions are "No," "None," or "Not Applicable," the official responsible for preparing the report should certify that to the best of his/her knowledge, hazardous substances and other environmental problems, or their effects, are not present on the real estate in question.

A Level II or Level III survey may be required if (1) the answer to any question on the Checklist is "Yes" or when no response is given and there is insufficient information documented under Part E. of the Checklist to conclude that no additional investigation is necessary prior to proceeding with the acquisition of an interest in the real property in question, or (2) a bioassessment or sampling is needed to determine the presence, absence, or extent of a hazardous substance.

A. Definitions. See 341 FW 3.5

B. Time Limit. See 341 FW 3.8 C.

C. Areal Coverage. One Checklist can be used for the acquisition of a large number of contiguous or nearly contiguous parcels of real property, even if the interests will be acquired at different times, as long as the 1-year time frame between completion of the Level I Survey and acquisition of the real property is not exceeded. If this period is exceeded, then that portion of the real property not acquired within that time frame must undergo another Level I Survey.

D. Review and Approval (see 341 3.9 B. and 3.11). If there are no remediation or other cleanup costs estimated for funding by the Department as a result of the Survey and no further investigation is recommended, approval of the Survey by the Regional Director or his/her designee will constitute review and approval by the Service for the proposed real property acquisition for the purposes of 341 FW 3 and 602 DM 2.

If the real property acquisition may require Departmental funding for (1) hazardous substance or other environmental cleanup costs; or (2) potential liability risk, including remediation and other known and reasonably estimated costs associated with the acquisition, the Level I Survey must be submitted to the Regional Director or his/her designee, the Director, or the Assistant Secretary - Policy, Management and Budget for approval, depending on the estimated remediation or other cleanup costs.

E. Process of Submittal to PMB. If the remediation or other cleanup costs exceed $500,000, the Service must have the approval of the Assistant Secretary -- Policy, Management, and Budget prior to the real property acquisition. The Headquarters Division of Realty must submit a signed copy of the Survey through the Director and the Assistant Secretary - FW to the Assistant Secretary - PMB, Attn: Office of Environmental Policy and Compliance (see 602 DM 2.6 F.).

F. Documentation Required. Each Level I Survey should be supported by written documentation of sufficient detail to lead a reasonable person to the conclusions listed (see Form F341-3X1, section E.). This documentation can be a list of persons interviewed and written notes of conversations, descriptions of site inspections, maps showing the location of any NPL or state-listed hazardous waste sites, the cost analysis required under 341 3.6 B.2., etc.

G. Retention of Records. (See 341 FW 3.9 C.) All Surveys and documentation used to complete and support the conclusions reached in the Survey shall be maintained by the Service as a part of the permanent record of the real property acquisition. If after a Survey is completed, a decision is made not to acquire the real property, the results of this Survey should still be retained by the Service.
 

Environmental Site Assessment

Level I Survey Checklist

 

Instructions: Complete each section. When the answer is "Yes" or when no response is given in parts B., C. and D., provide documentation under Part E. Describe the distance if "Nearby" is checked and whether there is a known potential pathway for hazardous substances and/or other environmental problems on site. Attach a legal description and plat, topographic map, or other identification of the real property covered by this Survey.

Note: Any deletions or omissions from this form will render this Survey invalid.

A. Background Information

Bureau Name____________________Tract Name/No.____________________

Project Name_______________________________County__________________State____

B. Interviews: Interview owners, neighbors, county agents, etc. and any appropriate Federal authorities on past and present use, addressing the topics in Parts C. and D. below. (Attach documentation)

C. Site Inspection Screen: Note observance or knowledge of the following on site or nearby with checkmark:

                                                                                                    ONSITE   NEARBY
                                                                                                        YES          YES     NONE
1. Dumps, especially with drums or other
containers. (Read labels if possible;
do not open or handle! If no labels,
note identifying characteristics.)                                                     _____       _____   _____

2. Other debris: note type (e.g., household,
farm, industrial waste, etc.)                                                             _____      _____   _____

3. Fills: (note if possible cover
for dumps)                                                                                       _____       _____   _____

4. Unusual chemical odors                                                              _____        _____   _____

5. Above ground storage tanks: note type
(e.g., petroleum products, pesticides,
etc.) Estimate tank size___________.                                             _____       _____    _____

6. Chemicals/solvents storage: note where
(e.g., barn, residence, etc.)                                                             _____       _____     _____

7. Evidence of asbestos: note where
(e.g., fire proofing, acoustical
plaster, siding, or floor tiles)                                                         _____       _____     _____

8. Vegetation different from
surrounding area for no apparent
reason (e.g., bare ground)                                                              _____       _____      _____

9. "Sterile" or modified water bodies                                           _____       _____      _____

10. Oiled or formerly oiled roads (note
if no apparent damage)                                                                 _____        _____     _____

11. Oil seeps or other stained ground,
or discolored stream banks                                                         _____        _____      _____

12. Oil slicks on, or unusual
colors in, water                                                                          _____         _____     _____

13. Spray operation base: note type
(e.g., air strip, equipment parking area)                                     _____         _____     _____

14. Machinery/equipment repair areas                                       _____         _____     _____

15. Pipelines; major electrical equipment                                 _____         _____     _____

16. Electric transmission lines: pole-
mounted transformers, pad-mounted
transformers (note evidence of leakage)                                     _____       _____     _____

17. Underground storage tanks, stand-
pipes, constructed sites for
petroleum product storage                                                         _____         _____     _____

18. Evidence of oil and gas drilling
pads or holding ponds                                                               _____         _____     _____

19. Evidence of strip mining, hard rock
mining, or other extractive mineral
activity                                                                                     _____         _____       _____

20. Other environmental problems:
(see 341 FW 3.5 C.) Attach documentation                             _____         _____        _____

D. Record Searches: Coordinate with Division of Realty. Attach documentation to show that "appropriate inquiry" was made from "reasonably ascertainable" information (see 341 FW 3, Exhibit 4) for the following:

1. Past uses that might indicate potential
hazardous substance or other environmental
problems on site (CIRCLE any that are
applicable and document in Section E):                             None _____

Manufacturing; service station; dry
cleaning; air strip; pipeline; rail line;
facility with large electrical transformers
or pumping equipment; petroleum production;
landfill; scrap metal, auto or battery
recycling; military; lab; wood preserving.
Other (describe)______________________
 ___________________________________
___________________________________

2. Nearby land uses, especially upstream or
up gradient, or that might have had waste to
dump at site (see above list).                                             None _____
Identify:____________________________

3. Known hazardous substance sites in vicinity:
NPL, state site, or candidate site (check
with EPA or state EPA counterpart).                                 Yes _____ No _____

4. Agricultural drainage history: surface,
and/or subsurface drains.                                                   Yes _____ No _____

5. In acquiring land from another Federal
agency, that agency has notified the                                   Yes _____ No _____
Department of past or current presence
of a hazardous substance under section
120(h)of CERCLA (Superfund).                                       Not Applicable _____

E. Documentation and Analysis (Attached): Include all documentation for Parts A, B, and C above (e.g., detailed summary of site conditions; description of topography and other site features; list of records searched and findings; list of persons interviewed and comments; analysis; photos; etc.). Include conclusions by Environmental Contaminants Specialist, if any.

F. Certification (Preparer sign one and only one of the following)

1. I certify that to the best of my knowledge, no hazardous substances or other environmental problems are present on this real property, and there are no obvious signs of any effects of such substances or problems.

Signed_______________________   Print Name ____________________________

Date _______________________     Title __________________________________

2. The surveyed real property, or a portion thereof, contains hazardous substances or other environmental problems as determined by the environmental site assessment. The owner of that real estate has cleaned up or will clean up the hazardous substances or other environmental problems to bureau specifications (documentation of the owner's commitment, ability, and plan to clean up the property is attached). A Level II or Level III Survey is not required.

Signed_______________________   Print Name ____________________________

Date _______________________     Title __________________________________

3. On the basis of the information collected to complete this form it is possible to reasonably conclude that there is a potential for hazardous substances or other environmental problems, or the effects of hazardous substances or other environmental problems, to be present on this real property.

A Level II Survey is recommended _____

A Level III Survey is recommended _____

 

Signed_______________________   Print Name ____________________________

Date _______________________     Title __________________________________

4. On the basis of the information collected to complete this Survey it is possible to reasonably conclude that there is a potential for hazardous substances or other environmental problems, or the effects of hazardous substances or other environmental problems, to be present on this real property, but there is sufficient information documented to conclude that a Level II or III Survey is not necessary. The actual or potential remediation or other environmental cleanup costs or other monetary damages on this real property can reasonably expect to be $______________.

Signed_______________________   Print Name ____________________________

Date _______________________     Title __________________________________

G. Reprogramming

Reprogramming will______ will not______ be required.
 

H. Approving Official

Signed_______________________   Print Name ____________________________

Date _______________________     Title __________________________________

Form F341-3X1
 


For additional information regarding this policy, contact the Division of Realty. For more information about this Web page, contact Krista Bibb, in the Division of Policy and Directives Management.



Directives Home

PDM Web sites: Centralized Library of Servicewide Policies | FWS Forms | PDM Services

Privacy, Disclaimer and Copyright Information | Information Quality Act

U.S. Fish and Wildlife Service Home Page | Department of the Interior  | USA.gov  | About the U.S. Fish and Wildlife Service  | Accessibility  | Privacy  | Notices  | Disclaimer  | FOIA