PROPERTY ACQUISITION CHECKLIST
The Property Acquisition Checklist is to be used for acquisition of residential or
agricultural property, as well as vacant land costing more than $10,000.00.
1. Property Investigation performed by: ______________________________________
______________________________________________________________________
2. Date of Investigation: _________________
3. Property Location: _____________________________________________________
4. Physical Address: _____________________________________________________
______________________________________________________________________
5. Legal Description: _____________________________________________________
______________________________________________________________________
______________________________________________________________________
6. Type of Property:
_____ Commercial _____ Residential _____ Vacant (Undeveloped) _____ Agriculture
7. Description of improvements, if any: _______________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
8. Were pictures taken? _____ YES
_____ NO
If yes, please attach pictures.
9. Please attach an Owners & Encumbrances (O&E) Report from your local title
company.
10. Are there any liens against property? _____ YES
_____ NO
If yes, please attach copies of all lien statements with explanations.
Last revised 11/03/2006
11. Condition of Property: _________________________________________________
______________________________________________________________________
______________________________________________________________________
12. Check YES or NO for each item. On the property, are there:
YES
NO
Above ground storage tanks…………………….
____
____
Visible evidence of underground tanks………….
____
____
Fertilizer of chemical sacks……………………….
____
____
Sumps or pits……………………………………….
____
____
Electrical transformers……………………………..
____
____
Petroleum storage facilities………………………..
____
____
Trash or waste dumps or pits……………………...
____
____
13. If YES to any of the above, describe in detail:_______________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
14. Check YES or NO for each item. Do you find evidence on the property of:
YES
NO
Pits of shafts………………………………………….
____
____
Septic systems………………………………………
____
____
Standing discolored water…………………………
____
____
Discolored soil………………………………………
____
____
Distressed vegetation………………………………
____
____
Settling ponds……………………………………….
____
____
Last revised 11/03/2006
15. If YES, describe in detail: ______________________________________________
________________________________________________________________
________________________________________________________________
16. Check YES or NO for each item. Is there located on or immediately adjacent to
the property:
YES
NO
____
____
facilities………………………………...
____
____
Above or underground storage tanks……………….
____
____
____
____
____
____
____
____
of mining operations…………………………
____
____
Gravel pits……………………………………………..
____
____
Railroad track systems/switchyards………………
Gasoline or diesel fuel pumps or motor vehicle repair
Dry cleaning or other VOC-intensive plant facilities
(e.g., paint or varnish)………………………..
Fertilizer or chemical manufacturing or
processing facilities…………………………..
Petrochemical refining, blending preparation or
treatment facilities……………………………
Mine shafts or other evidence
17. If YES, describe in detail: ______________________________________________
________________________________________________________________
________________________________________________________________
18. Owner(s) of property to be acquired: _____________________________________
______________________________________________________________________
Last revised 11/03/2006
19. Aerial photographs were observed on MM/DD/YY depicting the following item(s) of
importance: ____________________________________________________________
______________________________________________________________________
20. Attach map or plot plan of property and adjacent property.
21. Record of conversations with occupants, if any, regarding above investigation:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
22. If property is a residence, is owner/donor on Medicaid? _____YES
_____ NO
23. Describe access to the property: _________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
24. Attach tax certificate from the County Treasurer where property is located which
verifies that the taxes are current.
25. Is environmental testing recommend?
_____YES
_____ NO
Last revised 11/03/2006