Prior to preparing and submitting this ESR, the user should carefully read the instructions, and associated IDOT policy (BDE Manual Chapter 27 & Local Roads Manual Chapter 20).

Submittal of the ESR initiates the Phase I environmental survey process, which typically takes a minimum of 6 months to complete. A Phase II environmental survey also may be required, which typically takes a minimum of 6 months to complete. Results of the environmental surveys must be completed in advance of the desired construction letting.

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B. REASON(S) FOR SUBMITTAL: (Check all that apply; includes Special Waste Level 1 Screening Criteria)
(ensure these checked boxes match with those above)
C. PROJECT DESCRIPTION: [255 character limit. If needed, use "Addl. Info" Memo to expand on this description.]


If the Special Waste box is checked in Section B above based on the type of work involved with the project, then Level 1 special waste screening fails and a PESA is required. Submitting this ESR intiates the PESA process. Optionally, you may proceed with a Level 2 special waste screening.

According to IDOT Policy, "due care" must be performed to determine whether regulated substances may be present on or adjoining a project. A PESA is IDOT's chosen initial and minimum method of demonstrating "due care". Thus, a PESA is required on every project where the Special Waste box is checked.

There are some select scenarios where the need for a PESA can be avoided and "due care" demonstrated based on the successful performance and documentation of a Level 2 Screening. The Level 2 Screening criteria have been carefully constructed and apply in project situations that are likely to pose minimal risk. If any response to Level 2 Screening questions in 2A below is "yes" or is undetermined, then a PESA is required.

Industrial and/or commercial property 0.25 miles
Other Environmental Conditions
(Please detail below.)1
Property & adjoining property
Crosses or otherwise involves railroad ROW
(Please detail below.)2
Property & adjoining property
State UST Property & adjoining property  
State LUST  0.5 miles  
State Voluntary Cleanup, Brownfield, or landfills 0.5 miles  
Federal NPL; NPL delisted, SEMS; SEMS NFRAP 1.0 miles; 0.5 miles; 0.5 miles; 0.5 miles, respectively  
Federal RCRA CORRACTS facilities; RCRA non-CORRACTS TSD facilities 1.0 miles; 0.5 miles, respectively  
Federal RCRA generators list  Property & adjoining property  
Federal RCRA Brownfield sites 0.5 miles  
Federal ERNS System  Property  

1 Other Environmental Conditions are identified through site reconnaissance and include situations that may negatively affect the property including the presence of, for example, illegal dumping, unknown containers, waste associated with "crack" or methamphetamine houses (i.e., discarded hazardous material on the outside of a property), battery  piles, paint spills, abandoned transformers, surface staining, vegetative damage, etc.

2 Crosses or otherwise involves railroad ROW, other than a single rail rural ROW with no maintenance facilities

In an effort to identify any property or condition that may negatively affect the project site or potential historical, industrial and/or commercial use, the following sources of information can be helpful while screening the project.

  Google - type aerial maps Extranet data Historic Aerial Photos Survey Books Other Files & Photos
  City Directories County Assessor Sanborn Fire Insurance Maps Plat Books  
  Other source (describe):

If any historical reference indicates the possible presence of a property or condition that may negatively affect the project site, then a PESA is required.

If all responses for database and site reconnaissance are conclusively "No," a copy of the ESR should be sent to the District Special Waste Coordinator to review and concur with the state right of way portion of the sign off. The local public agency is responsible for the special waste on the local right of way. Ensure the “Special Waste” box in Section A is checked.

The Level 2 District Sign-off is valid for a maximum of six months. If any response for database search and site reconnaissance is “Yes”, or if a database search or site reconnaissance is not performed or is inconclusive, then a PESA is required. See BDE Manual 27-3 for additional instructions.

After this Level 2 District Sign-Off has been completed, please email a screen shot of the form to the Central Office, BDE, Environment Section, Geologic & Waste Assessment Unit for processing.