Brownfields Site Information Form
We would love to hear your concerns of contamination on our Tribal lands!
Name
Your answer
Email Address
Your answer
Date
MM
/
DD
/
YYYY
Site Name and/or Location *
Your answer
Site Type
Property Owner
Your answer
Types of Contaminates
Estimated Size of Contaminated Area (SQ.FT)
Your answer
Health and Safety Risk
Your answer
Possible Intake of Contaminates
Comments/concerns
Your answer
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