The person providing the lists pursuant to this section shall also send to the municipal clerk of each municipality receiving the list a statement as follows:
"This list identifies [insert type] off-site conditions owned, leased or maintained by [insert name and address of provider] as defined in the "New Residential Construction Off-Site Conditions Disclosure Act," P.L. 1995, c.253 (C.46:3C-1 et seq.), which as of [date] have been identified as existing within [name of municipality]."
N.J.S. § 46:3C-5