HomeMy WebLinkAboutA008 - Real Estate Transfer - Groundwater Hazard Statement REAL ESTATE TRANSFER-GROUNDWATER HAZARD STATEMENT
PART 1 -TO BE COMPLETED BY TRANSFEROR
TRANSFEROR Name ELDON&PAULA GUGE
Address 211 GARDEN ROAD,AMES,IA 50010
Number and Street City,Town or P.O. State Zip
Social Security No.
TRANSFEREE Name_GUGE SUBDIVISION to Ames.Iowa
Address
Number and Street City,Town or P.O. State Zip
Address of Property Transferred
Number and Street City,Town or P.O. State Zip
Legal Description of Property A Reolat of the East One-half(E 1/2)of Lot Two(2) Emerald Subdivision to Ames Iowa
1. Wells(check one)*
8 There are no known wells situated on this property.
There is a well or wells situated on this property. The type(s),location(s)and legal status are state below.
2. Solid Waste Disposal(check one)
X There is no known solid waste disposal site on this property.
There is a solid waste disposal site on this property,but no notice has been received from the Department of
Natural Resources that the site is deemed to be potentially hazardous.
There is a solid waste disposal site on this property which has been deemed to be potentially hazardous by the
Department of Natural Recourses. The location(s)of the site(s)is stated below.
3. Hazardous Wastes(check one)
X There is no known hazardous waste on this property.
There is hazardous waste on this property and it is being managed in accordance with Department of Natural
Resources rules.
4. Underground Storage Tanks(check one)
X There are no known underground storage tanks on this property.(Note exclusions such as small farm and
residential motor fuel tanks,most heated oil tanks,cisterns and septic tanks,in instructions.)
There is an underground storage tank or tanks on this property. The type(s),size(s)and any known
substance(s)contained-are described below.
Information,if any,required by statements check above:
Attachment for Additional Information? Yes/No If so,number of pages
I HEREBY DECLARE THAT THE INFORMATION CONTAINED IN PART 1 OF THIS STATEMENT IS TRUE
AND CORRECT.
Signature: Telephone Number: _( )
PAR -TO BE COMPLETED BY RECORDER
Date of Instrument Instrument No.
Date of Recording City or Township
Deed R
County
Contract