Form 1075-1 - Notice Of Potential Environmental Hazard (Caption as in Local Form 1007-1) NOTICE OF POTENTIAL ENVIRONMENTAL HAZARD TO: U.S. Environmental Protection Agency, Washington, D. C.; and Attorney General for the States of _______, _______, _______.
Pursuant to Local Rule 1075-1 for the United States Bankruptcy Court for the District of Minnesota, you are hereby given notice that the debtor named above filed a petition commencing a chapter _____ bankruptcy case on __________________, that commercial or industrial property of the estate may contain a hazardous substance as defined in Minn. Stat. ยง115B.02, subd. 8 or other applicable law, or that environmental contamination or a release or threatened release of a hazardous substance may exist on the property, that the hazardous substance is described as __________, and that the location of the property is __________. Dated: _______________________ _______________________, Debtor Signed Name, Address, Telephone and By: ___________________________ License # of Debtor's Attorney Its: __________________________ - - - - - - - - - - - - - - - - - - - - - - - Unsworn Certificate Of Service. I, _________________, declare under penalty of perjury that . . . (remainder same as Local Form 9001-1).
LOCAL RULE REFERENCE: 1075-1