Environment and
Sustainable Resource Development
Request for Scientific/Technical Information Routinely Available Under
the Environmental Protection & Enhancement Act (EPEA)
Client Information
Last Name (please print)
First Name (please print)
Name of company or organization (if applicable)
Mailing address
City or town
Province
Country
Email Address
Telephone (daytime)
Telephone (evening)
Postal Code
Fax Number
1. About the Public Information You Want to Access
 To request scientific / technical information relating to the environmental condition of a site, please complete
this form and fax or mail along with the $25.00 fee to:
Environment & Sustainable Resource Development
FOIP & Information Management Section
5th Floor, Great West Life Building
9920 – 108 St
Edmonton, Alberta T5K 2M4
Phone: 780-427-4429
Fax: 780-427-9838
 If records or information identified as public are available for purchase through an external agency, you will
be directed to that agency to obtain copies.
 Records not available under Routine Disclosure legislation can be requested under the Freedom of
Information and Protection of Privacy Act.
2. Fees
 A fee of $25.00 is required for each request.
Note: For property searches only one property per request.
 You may be required to pay fees for services if the total fee for providing you with the information is expected
to be greater than $150.00
o Search and Retrieval: $27.00 per hour (Search fee cannot be reduced if this service was already
provided)
o Copying - $25.00 per page
Note: Payment must be received before your application is processed. You can pay by VISA, MasterCard,
Cheque or Money Order made payable to Government of Alberta.
Nov, 2014
Request for Routine Disclosure - EPEA
© 2014 Government of Alberta
Page 1 of 3
Request for Scientific/Technical Information Routinely Available Under the Environmental
Protection & Enhancement Act (EPEA)
The following “Site Descriptors” (legal land description) are needed to search for information on a subject property:
3. Alberta Township System
Sample: SW Quarter - Section 10 – Township 52 – Range 25 – West of the 4th Meridian (Sw-10-52-25-W4)
Qtr
Sec
.
.
Twp
Rge
.
.
W
Qtr
.
Sec
Twp
Rge
.
.
.
.
W
.
4. Subdivision Plan
Plan
Block
Lot
5. Name of Company (ies) and / or Individuals Associated With The Site
List current and previous owner(s) of the site:
List current and former operators or occupants, including agents or managers of the site:
6. Other Particulars about the Site
Agricultural Land?
Commercial Land?
Any current development on the site?
Nov, 2014
Residential?
Industrial or other types of land use?
Or has the land use changed?
Request for Routine Disclosure - EPEA
© 2014 Government of Alberta
Page 2 of 3
Request for Scientific/Technical Information Routinely Available Under the Environmental
Protection & Enhancement Act (EPEA)
7. Time Frame of Search
Historical Search
Other:
Specify a specific time period for the search
8. Signature
Signature of Client:
Date:
Privacy Statement
The collection of personal information on this form is being managed in accordance with the Alberta Freedom of
Information & Protection of Privacy Act. As per Section 33(c) of the Act, “No personal information may be collected by
or for a public body unless that information relates directly to and is necessary for an operating program or activity of
the public body.” The personal information collected on this form will be used in the administration of Section 35 of the
Environmental Protection and Enhancement Act (EPEA), and under the authority of the Disclosure of Information
Regulation, Ministerial Order 23/2004 in order to provide you with access to public information. The personal
information collected is for the exclusive use of Environment & Sustainable Resource Development. Your personal
information will not be shared with any other public body or agency without your specific written consent. If you want
further details on how this information will be used, please contact the FOIP Office, Phone (780) 427-4429.
Nov, 2014
Request for Routine Disclosure - EPEA
© 2014 Government of Alberta
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