(a) On or before March 31, 2005, the California Environmental Protection Agency shall develop a form that, upon approval of a response plan, shall be completed and submitted to the agency by a bona fide purchaser or innocent landowner who qualifies for immunity pursuant to this chapter. The form shall include, but is not required to be limited to, all of the following information:

1. (1) A description of the site, including its address and location.
2. (2) A description of the type and extent of hazardous materials releases and threatened releases identified for response at the site pursuant to a response plan.
3. (3) An estimate of the cost of the response action to be undertaken pursuant to a response plan.
4. (4) A description of the present and proposed use of the site, including current and potential future zoning and land use designations.
5. (5) A description of any land use restrictions, covenants, deed restrictions or other conditions imposed on the site owned by a party who qualifies for immunity pursuant to this chapter.
6. (6) A description and the concentrations of the release and threatened releases specified in paragraph (2) that will not be remediated pursuant to the response plan.