City of Kent Environmental and Economic Enhancement (E-3) Program

Form 1: Request for Consideration/Site Application

If you are currently under EPA or BUSTR Enforcement Action you are not eligible for this program. If you have any questions about eligibility, please contact Bruce Bernel.

Person Making Request
Name:
Address:
City:
State:
Zip Code:
Phone Number:
E-mail:
Site Information
Site Location (Address or Intersection):
Site History:
Is there an underground storage tank (UST) currently on site?	Yes No I don't know
Is the site occupied?	Yes No
Current Owner of the Site
Name:
Address:
City:
State:
Zip Code:
Phone Number:
E-mail:
Other Information
Explain Nature of the Contamination (Why do you think the site is contaminated?):
Other:

Security Image: (Enter graphic characters into form field)