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Home > Ag Chemicals & Fertilizers > Spills & Safety > Incident Response Unit > Guidance Documents > Agricultural Environmental Site Assessment (AgESA) (GD14) > Attachment 2 - Report Checklist

Agricultural Environmental Site Assessment (AgESA) Guidance Document Attachment 2


MDA INCIDENT RESPONSE UNIT AgESA REPORT CHECKLIST

Information to record for each completed checklist.

  • Site Name
  • Report Date
  • MDA project Number
  • Name of individual that performed the checklist and their dated signature

Checklist

Item Completed (Y/N) Location (p.#)
  1.  Environmental Database Search  
       a.  Search Firm Used (if any)  
       b.  Search includes AGSPILLS database, Site and 1/2-mile radius from perimeter  
       c.  Search includes Target Property and 1/2-mile radius from perimeter  
       d.  Discussion of MDA Incident files identified in the search  
       e.  Copy of search report provided in appendix  
  2.  MDA's WIMN Agricultural Case File Search  
       a.  Discussion of results in the report  
       b.  Copy provided in appendix    
  3.  County Spills Report Review/Case File Search    
       a.  Discussion of results in the report    
       b.  Copy provided in appendix    
  4.  Company Summary Report from MDA Data Practices    
       a.  Discussion of results in the report    
       b.  Copy provided in appendix    
  5.  Facility File Review from MDA Practices    
       a.  Discussion of results in the report    
       b.  Copy provided in appendix    
  6.  Site Visit    
       a.  Photos taken at the Site when ground surface uncovered    
  7.  List of Agricultural Chemicals Sorted, Handled, Mixed or Loaded (Past & Present)    
       a.  Review included previous owner/operator (if applicable), old MDA files     
       b.  Documentation provided in appendix    
       c.  Results table (include product names, EPA product ID numbers, active ingredients, quantities/volumes,
            units of measure and area(s) of the site)
   
       d.  Discussion of results in the report    
  8.  Interviews of Current and Former Employees Knowledgeable of the Site    
       a.  Discussion of results in the report    
       b.  Copies of phone notes, info., etc. provided in appendix (if applicable)    
  9.  Review of Available Historical Aerial and/or Street View Photographs of the Site     
       a.  Discussion of results in the report    
       b.  Copies provided in appendix    
10. High Risk Areas for Potential Agricultural Chemical Contamination (Past & Present)     
       a.  Identified and labeled on the Site Map(s)    
       b.  Listed and described in the report text    
11. Other Agency(ies) Review(s)    
      a.  Discussion of results in the report    
12. Data Gaps    
      a.  If any searches cannot be completed or data obtained, noted in report text    

AgESA Guidance Document
Attachment 1