| Form (linked back to the SRRA Forms
page) |
Version & Date |
Changes Since the Previous Version |
|
7.5 Percent Cost of Remediation Summary and Certification |
1.0 - 5/7/12 |
NEW FORM
|
|
Alternative Remedy Application Form |
1.1 - 5/7/12 |
|
| Alternative
Soil Remediation Standard Application |
2.1 - 5/7/12 |
- Removed Non-LSRP and Subsurface Evaluator certification pages
|
| 2.0 - 1/10/12 |
- Form entirely redesigned.
|
| 1.4 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.3 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked.
|
| 1.2 - 1/12/11 |
- Section C: Developer Certification removed.
|
Annual
Remediation Fee Reporting form The changes
to this form include: General Instructions: Contamination area
language inserted; applicability language changed to include opt
in; check made out to Treasurer - State of NJ; Grammar & punctuation;
Section A: Citation change, removed state plane coordinates, removed
block & lots; Section B: Fee Billing Contact added; Section
C: Note edit describing regulated UST, Subtotal Fee line added;
Section D: Subtotal Fee line added; Total Fee line automatically
totals Subtotals from Section C and Section D; Section F: Developer
Certification removed. |
1.5 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.4 - 1/12/11 |
- New version number for splitting the instructions from the
form.
|
| Case
Inventory Documents Worksheet |
1.0 - 11/4/09 |
|
| Case
Inventory Documents Example Sheet |
1.1 - 1/12/11 |
|
| Guidance
for the Preparation of the Case Inventory Documents |
1.1 - 1/12/11 |
|
| CEA/Well
Restriction Area (WRA) Fact Sheet form |
1.3 - 5/7/12 |
- Removed Non-LSRP and Subsurface Evaluator certification pages.
- Form Name: Deleted "Permit" & added "Form" to the title.
- General Instructions: Added references/links. Clarified general submittal procedures.
- Section A: Changed to use Program Interest ID. Added five check boxes & updated instructions accordingly.
- Section B: Now starts at CEA Component Information. All later Section IDs changed. Added to instructions.
- Section B.1. (Contaminant(s)): Note (4) was updated.
- Section B. 2. (CEA Boundaries): Added check box to indicate if Block & Lot changed.
-
Exhibit C: Clarified form & instructions, added "Notes for GIS maps:" (Geologic Formation/Unit): Changed form & added information sources to instructions.
Now allows for multiple ground water flow directions & multiple water bearing zones.
(Ground Water Classification): Added information regarding Class III areas.
- Exhibit D: This is now the CEA spreadsheet. Send to new GIS email & put it on the CD.
- Section C. Exhibit F( Well Search Results): Added guidance to instructions.
- Section E: An exemption was added for form submittal, "Exhibit G" was deleted; VI information was added.
- Addendum: Modified to match changes to Section B.
|
| 1.2 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.1 - 1/12/11 |
- Instructions included, Citation edits, Mailing address for
completed form changed,
- Section A: #1 - reference to CEA changed to Exhibit A,
- Section C: Direction of GW flow requested, Exhibit E checkbox
for Historic Fill and one for all other information,
- Section D: Exhibit G table for requested information,
- Section E: SE signature page changed
|
| CEA/Well
Restriction Area (WRA) Spreadsheet |
1.0 -1/12/11 |
|
| Confidentiality
Request Form |
1.1 - 5/7/12 |
- Section B: Changed individual ISRA and UST fees options to a single fee.
|
| 1.0 - 9/7/11 |
|
| Confirmed
Discharge Notification form |
1.6 - 5/7/12 |
- Section B: Changed from "Person Responsible For Conducting the Remediation" to "Discharge Being Reported With This Submission".
- Section D: removed "Substance Released" table.
|
| 1.5 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.4 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.3 - 1/12/11 |
- Section D: Clarification for Substance Release table,
- Section G: Developer Certification removed.
|
| De
Minimus Quantity Exemption Application form |
1.3 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
- For the instructions: Under General Instructions, No. 4, the
statement that states this form should be submitted along with
the Individual Document Submittal was deleted.
|
| 1.2 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.1 - 1/12/11 |
- Typo fixed on pg. 5 of 5 of form
|
| Developer
Certification (Appendix A for the ARRCS Rule) |
|
|
| Full
Laboratory Data Deliverables form |
1.4 - 5/7/12 |
- Removed Non-LSRP certification page.
|
| 1.3 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.2 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.1 - 1/12/11 |
- Section D: Sampling Dates added;
- Section G: Developer Certification removed.
|
| General
Information Notification |
1.7 - 5/7/12 |
- Added instructions to top of form about submitting a revision/update.
- Section D: Renumbered questions.
|
| 1.6 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
- Check boxes were added to the title block to specify if this
was a new GIN or Revised/Updated GIN. If this was a revision/update,
then the ISRA Case Number and Program Interest Number is required
in Section A.
|
| 1.5 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.4 - 1/12/11 |
- Grammar & punctuation,
- Section J: Developer Certification removed.
|
Hazardous
Discharge Site Remediation Fund Application form
|
1.2 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.1 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
- New version number for splitting the instructions from the
form
|
| 1.0 - 5/21/10 |
|
| HDSRF
Application - Cost Estimate Format Spreadsheet |
1.0 - 5/21/10 |
|
| IEC
Response Action form |
1.5 - 5/7/12 |
- Removed Non-LSRP certification page.
|
| 1.4 - 1/19/12 |
- Section A: Removed "Mailing Address if different than
street address"
- Section C: Removed "Essential Utility Disruption",
Added questions 2 and 3
- Section E: Renamed first section from "Immediate Notification"
to "Information Submittal". Removed 14-day notification
check, added first 2 questions to "Information Submittal"
Removed "Date of spreadsheet submittal date".
Reworded questions in "1 – year IEC source control
report".
- Section F: Added a question about fed regulated USTs, changed
all questions from check boxes to yes/no questions.
- Section G: Changed "within 100’ of free product
(any type)" to "within 100’ of free product
(excluding diesel)"
Incorporated "free product type" question into other
questions
Changed "ground water –to-indoor air pathway"
to "vapor intrusion pathway".
- Updated instructions
|
| 1.3 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.2 - 2/25/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.1 - 1/12/11 |
- Grammar & punctuation,
- Section B: Case Manager section added,
- Section D: Fee Billing section added,
- Section E: Timeframe changes,
- Section G: “Rapid Action” wording changes,
- Section H: Developer Certification removed,
- Sec I: Non-LSRP and SE signature pages added
|
| IEC
- Potable Water Spreadsheet |
1.1 - 8/2/10 |
|
| IEC
- Vapor Intrusion Spreadsheet |
1.1 - 8/2/10 |
|
| ISRA
Alternate Compliance Option Application |
1.5 - 5/7/12 |
- Removed Non-LSRP certification page.
- Removed Section B. ISRA Alternate Compliance Fees and Section C. Expedited Review / Limited Site Review
|
| 1.4 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
- A new Section B was added with check boxes and list of fees
for ISRA Alternate Compliance Fee Types.
- Section E. Minimal Environmental Concern Waiver was
deleted.
|
| 1.3 - 1/11/11 |
|
| ISRA
Certificate of Limited Conveyance Application |
1.0 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
- Formatted to be the same format as the LSRP forms. It was
previously posted on the ISRA Forms Web Page.
|
| LNAPL
Free Product Reporting Form |
1.6 - 5/7/12 |
- Removed Non-LSRP and Subsurface Evaluator certification pages
|
| 1.5 - 1/31/12 |
- General: Removed the words "product" and "free product"
from form. Removed format restrictions for zip codes
- Section A: Changed title from "Site Location" to "Site
Name and Location". Changed Date triggered compliance with"
to "Date Remediation Initiated Pursuant to N.J.A.C. 26C-2"
- Section C: Replaced the word "product" with "NAPL"
through out section. Added several questions to item 2.
- Section C: Replaced the word "product" with "NAPL"
through out section. Added several questions to item 2.
- Section D: Replaced the word "Deviation" with "Variance"
through out the section.
- Section F: Removed the facility and responsible party sections
from subsurface evaluator certification.
- Changed submission instructions to "Completed forms should
be sent to:"
|
| 1.4 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.3 - 2/25/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.2 - 1/12/11 |
- Grammar & punctuation,
- Section E: Developer Certification removed
|
| LSRP
Notification of Retention or Dismissal |
3.0 - 5/7/12 |
- Removed Section F. "OPT IN" Request.
|
| 2.9 - 2/16/12 |
- Section E. Item 7. Added "regulated tank closure" as a reason
to hire an LSRP
|
| 2.8 - 1/10/12 |
- Section E. Deleted question 5, added to question 8 (now 7)
asking the total number of AOCs for the site.
|
| 2.7 - 11/23/11 |
- Section B. Deleted "I have been hired to address an
area of concern or a full site"
- Section D. Changed citations for N.J.S.A. 58:10C
- Deleted question asking to "indicate relationship to
the site"
Inserted 7 new questions
- Deleted "current oversight mechanism" question
Deleted "Does the site involve or potentially impact a
childcare center,
school, or residence" question
- Instructions Updated instructions for Sections A, E and F.
|
| 2.6 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
- Section B was revised to clarify: Provide name of replaced/released
LSRP.
|
2.5 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 2.4 - 1/12/11 |
- General Instructions #1.b. and #4. Clarification of who is
to sign form,
- Section E: Child Care Center added as relationship to site,
- Section F: form must be submitted before LSRP can request
disbursement
|
| Model
Termination of Deed Notice (Appendix B for the ARRCS Rule) |
|
|
| Monitoring
Well Certification Form A - As-Built Certification |
1.0 - 9/7/11 |
|
| Monitoring
Well Certification Form B - Location Certification |
1.1 - 11/28/11 |
- General: Removed format restriction for zip codes
- Section C: Question 2 fixed entry box that didn’t work
|
| Name
and Address Change Reporting |
1.0 - 9/7/11 |
|
Negative
Declaration (Only required for cases initiated before 11/4/2009) |
1.3 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.2 - 1/12/11 |
- Section D: Developer Certification removed
|
Potable
Well/Indoor Air Sampling Notification form |
1.4 - 5/7/12 |
- Removed Non-LSRP and Subsurface Evaluator certification pages.
|
| 1.3 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.2 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.1 - 1/12/11 |
- Grammar & punctuation,
- Section D: Developer Certification removed
|
Sampling
Notification Spreadsheet |
1.0 - 2/4/10 |
|
| Preliminary
Assessment/Site Investigation form |
1.6 - 5/7/12 |
- Removed Non-LSRP and Subsurface Evaluator certification pages.
- Section B: added radionuclide reports list.
-
Section G: changed question 10 to specify if RI complete for AOCs or entire site
Added question 11 to ask if the AOCs were addressed within the regulatory timeframe.
- Section H: Added question H4.e. about Unknown Source Investigation.
|
| 1.5 - 1/10/12 |
- General: Removed format restrictions for zip codes.
- Section C: Added updated list of submittals, Added column
for Document Withdrawal.
- Section G: Added question 9 about ESNRs.
- Section I: Changed word "deviation" to "variance".
- Instructions updated.
|
| 1.4 - 9/7/11 |
Form
- Section K: Updated address on the 3 Section K pages Removed
the Block and lot, Owners Name, and Assigned Case Manager sections
on Subsurface Evaluator Certification page.
Instructions
- Instructions: Updated address.
|
| 1.3 - 2/25/11 |
|
| 1.2 - 1/12/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.1 - 2/26/10 |
- Grammar & punctuation,
- Section J: Developer Certification removed, Edits for fill-in
codes in Adobe Acrobat
|
| Public
Notification and Outreach form |
1.6 - 5/7/12 |
- Removed Non-LSRP and Subsurface Evaluator certification pages.
|
1.5 - 11/30/11 |
- General: Removed formatting for zip codes
- Section A: Changed "Date trigger compliance with Section
30…" to "Date Remediation Initiated Pursuant
to N.J.A.C. 7:26C-2:"
- Section B: Added new question 1, question 4 was incorporated
into question 2, "local health agency" was added
to question 6. Question 7 explanation expanded. Question order
was changed.
- Section D: Removed facility information, block and lot, and
owner information sections in the subsurface certification.
- Instructions: all sections updated.
|
1.4 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.3 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.2 - 1/12/11 |
- Section C: Developer Certification removed
|
| PUST
Remediation, Upgrade and Closure Fund Application form - Regulated
Tanks(Closes 6/30/2010) |
1.1 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
- New version number for splitting the instructions from the
form
|
| 1.0 - 6/8/10 |
|
| PUST
Remediation, Upgrade and Closure Fund Application form - Unregulated
Tanks (Including Residential Heating Oil Tanks) |
1.1 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
- New version number for splitting the instructions from the
form
|
| 1.0 - 6/8/10 |
|
| Project
Summary Sheet Spreadsheet |
1.0 |
|
| Receptor
Evaluation form |
1.7 - 5/7/12 |
- Removed Non-LSRP and Subsurface Evaluator certification pages.
- Section A: Added paragraph explaining purpose of form.
-
Section E: Removed "other existing conditions" from question 4 and made it a new question 2,
Changed language in old question 4: added "petroleum free product" to 30 ft check box and "non-petroleum free product to 100 ft check box.
- Question 7: changed "vapor intrusion sampling" to "soil gas sampling".
- Changed "NJDEP's Vapor Intrusion Rapid Action Levels" to "NJDEP's Rapid Action Levels" throughout section.
|
| 1.6 - 3/8/12 |
- Section A: Removed "No Change" check box and added
checkboxes to capture reason for submitting form
- Section C: Inserted new question 2. For Soil Migration Pathway
- Section D: Inserted new question 3. – "Has GW been
delineated to Applicable Remediation Standard?"
- Added new question 11. – "Has GW receptor investigation
been completed?"
- Section E: Inserted new question 2. – "Has GW contamination
been delineated to the vapor trigger?"
Divided last question into two parts.
- Section F: Expanded question 6. To indicate types of media impacted.
- INSTRUCTIONS
Revised instructions for Updates in General Instructions, and
added instructions for new questions in sections C, D, and E.
|
| 1.5 - 10/20/11 |
- Fixed broken hyperlink in form to EPA DNAPL Overview
|
| 1.3 - 2/25/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.2 - 1/12/1 |
- General Instructions. Timeframes: As detailed in the
Compliance Advisory Update, the proposed Mandatory timeframe
for submission of the initial RE form is 2 years. If remediation
was initiated prior to November 4, 2009 the initial RE Mandatory
timeframe is March 1, 2012; As detailed in the Compliance Advisory
Update, the proposed regulatory date has been extended to March
1, 2011 or one year after the initiation of remediation;
- Section A: Added if there were no changes to the form the
LSRP shall skip to Section G; Checkboxes for Initial Submission,
Interim Submission, or No Change added to Sections B, C, D,
E, & F,
- Section B: Questions 2 and 3 have been revised to follow formats
of other forms;
- Section C: Clarification in the instructions for high concentration
source materials has been added;
- Section D: The direction for action on an IEC has been removed
from the form and guides the LSRP to the website instead;
- Section E: The LSRP is now required to identify any structures/
sensitive populations on a scaled map. An option has been added
to indicate that no structures exist within the specified distances.
The direction for action on an IEC has been removed from the
form and guides the LSRP to the website instead. Several questions
have been changed to include the proposed vapor intrusion rapid
action levels and the indoor air results that fall between the
indoor air screening levels and the vapor intrusion rapid action
levels and the actions that need to be taken;
- Section F: The LSRP is now required to answer Yes or No to
the site conditions;
- Section G: Developer Certification removed
|
| Well
Search Spreadsheet |
1.1 - 2/18/12 |
- Table format changed to match new dataminer query
- Additional fields added under case information tab
|
| 1.0 - 1/12/11 |
- Headers & footers and ‘DRAFT’ watermark removed
to prevent errors when extracting data
|
| Remedial
Action Report form |
1.6 - 5/7/12 |
-
General Instructions: Modified instructions for submission of RE forms and Case Inventory Documents (CID)
Removed Non-LSRP and Subsurface Evaluator certification pages.
- Section B: added radionuclide reports list.
|
| 1.5 - 1/10/12 |
- Section A: Changed citation for "Date Remediation Initiated"
- Section B: Changed title to "Submittal Status", updated
Alternate Standard form name, replaced Annual Fee form with
Public Notification Form, and added withdrawal column
- Section E: Turned first 2 questions in General Section moved
to New Section "Scope of Remedial Action Workplan", and
added questions about total AOCs for the site and total AOCs
addressed in submittal. Removed question 7 about dioxin (dioxin
now included in section G.)
- Section G: (old section F) added Surface Water column, dioxin,
and EPH
- Section H: (old section G) changed the word "deviation"
to "variance" through out section
- Section I: (old section H) Check boxes reworded to yes/no
questions
- Section J: First two questions moved to "Applicable Remediation
Standards"
- Section K: (old section J) questions 3 and 4 added to Ecological
section.
|
| 1.4 - 9/7/11 |
Form
- Section A: Removed Mailing Address line
- Section B: Added Remedial Action Report
- Section E: Question 1 - added space for total number of
contaminated AOCs. Added table for question 12. Question 2 -
Numbered two sub-questions, added place to answer second sub-question
- Section G: Change yes/no statement to a question
- Section J: Made question 4 part of question 3, renumbered
5 and 6.
- Section M: removed first section of subsurface evaluator certification.
Instructions
- Changed all instances of "Department" to "NJDEP".
- Section A: Added examples of NJDEP site ID numbers. Removed
mailing address only instruction
- Section E: Removed instruction to attach Section H2 of the
PA/SI form. Added requirement to identify All AOCs individually.
- Section G: Spell out Vapor Intrusion and Johnson & Ettinger.
|
| 1.3 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.2 - 1/12/11 |
- Citation edits, Grammar & punctuation,
- Section B: RAO Report changed to RAO letter,
- Section E: Renumbered,
- Section L: Developer Certification removed
|
| Remedial
Action Workplan form |
1.5 - 5/7/12 |
-
General Instructions: Modified instructions for submission of RE forms and Case Inventory Documents (CID)
Removed Non-LSRP and Subsurface Evaluator certification pages.
- Section B: added radionuclide reports list.
|
| 1.4 - 1/10/12 |
- Section A: Changed citation for "Date Remediation Initiated"
- Section B: Changed title to "Submittal Status", updated
Alternate Standard form name, replaced Annual Fee form with
Public Notification Form, and added withdrawal column
- Section E: Turned first 2 questions in General Section moved
to New Section "Scope of Remedial Action Workplan", and
added questions about total AOCs for the site and total AOCs
addressed in submittal. Removed question 7 about dioxin (dioxin
now included in section G.)
- Section G: (old section F) added Surface Water column, dioxin,
and EPH
- Section H: (old section G) changed the word "deviation"
to "variance" through out section
- Section I: (old section H) Check boxes reworded to yes/no
questions
|
| 1.3 - 9/7/11 |
Form
- Section A: Removed Mailing Address line
- Section B: Added Remedial Action Report
- Section E: Question 1 – Added space for total number of
contaminated AOCs. Added table for question 11.
- Section G: Spell out vapor intrusion.
- Section M: Removed first section of subsurface evaluator certification.
Instructions
- Changed all instances of "Department" to "NJDEP".
- Section A: Added examples of NJDEP site ID numbers. Removed
mailing address only instruction
- Section E: Removed instruction to attach Section H2 of the
PA/SI form. Added requirement to identify All AOCs individually.
- Section G: Spell out Vapor Intrusion and Johnson & Ettinger.
|
| 1.2 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.1 - 1/12/11 |
- Grammar & punctuation, Citation edits, Grammar & punctuation,
- Section E: Renumbered,
- Section F: Removed SW column,
- Section L: Developer Certification removed,
- Section M: 3 signature pages added
|
| Remedial
Action Permit Application Form for Ground Water |
1.4 - 5/7/12 |
- Removed Non-LSRP and Subsurface Evaluator certification pages.
|
| 1.3 - 1/18/12 |
|
| 1.2 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.1 - 1/12/11 |
- Citation edits,
- Section L: Developer Certification removed,
- Section M: Removed some Block and Lots on SE signature pg
|
Ground
Water Monitoring Plan Spreadsheet 
|
0.0 - 2/24/10 |
|
| Remedial
Action Permit Application Form for Soils |
1.4 - 5/7/12 |
- Removed Non-LSRP and Subsurface Evaluator certification pages
|
| 1.3 - 1/18/12 |
|
| 1.2 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.1 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.0 - 1/12/11 |
- Grammar & punctuation, Mailing address for form changed,
- Section E: Deed Notice – more information requested,
- Section G: Engineering Control – whole section changed,
- Section I: Developer Certification removed
|
| Remedial
Action Permit Transfer/Change of Ownership Application |
1.2 - 5/7/12 |
- Removed Non-LSRP and Subsurface Evaluator certification pages.
|
| 1.1 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.0 - 3/4/11 |
- Form finalized
- Allows the Yes/ No Check boxes to be checked & unchecked
- Corrected Fee Amounts
|
| 0.0 - 1/12/11 Draft |
|
Remedial
Action Protectiveness/Biennial Certification Form - Ground Water
(Was "Remedial Action Protectiveness
Certification Form - Ground Water") |
1.3 - 3/8/12 |
- Removed Non-LSRP and Subsurface Evaluator certification pages.
|
| 1.3 - 3/8/12 |
- Form
Removed format restrictions for zip codes
- Section A: renumbered questions
- Section G: Question 2 - changed If "Yes" to If
"No"
- Section N: Question 1 - changed "F,H,I,J,K" to
"F,G,I,J,K"
Question 3 - changed "Check here if the answer to question
2 in
section G was answered "Yes" to
"Check here if the answer to question 2 in section G
was answered "No"
- Instructions
Changed all instances of "Department" to "NJDEP"
- Fixed incorrect section references within instructions
- General: Added address for Initial Notice
Added "GIS compatible maps shall be submitted as per instructions
found at
http://www.nj.gov/dep/srp/gis to srpgis_cea@dep.state.nj.us."
to Regulatory Requirements
- Section A: Added names of fields to bullet items
Renumbered questions
- Section J: Updated GIS links
- Section O: Added instruction explaining this section is not
to be signed by the LSRP or lawyer
|
| 1.1 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 0.1 - 3/4/11 Draft |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 0.0 - 1/12/11 Draft |
|
Remedial
Action Protectiveness/Biennial Certification Form - Soil
(Was "Remedial Action Protectiveness
Certification Form - Soils") |
1.6 - 5/7/12 |
- Removed Non-LSRP and Subsurface Evaluator certification pages.
|
| 1.5 - 3/8/12 |
- Updated GIS links in Instructions, Sections A.4 and J.1
|
| 1.3 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.1 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.0 - 1/12/11 |
- Grammar & punctuation, Regulatory requirements noted in
General Instructions #2 and Section I
- Section B: Checkbox if Current Owner has changed since last
submittal,
- Section K: LSRP Signature Page added
|
| Remedial
Investigation Report form |
1.6 - 5/7/12 |
-
General Instructions: Modified instructions for submission of RE forms and Case Inventory Documents (CID)
Removed Non-LSRP and Subsurface Evaluator certification pages.
- Section B: added radionuclide reports list.
|
| 1.5 - 1/10/12 |
- General: Removed format restrictions for zip codes
- Section A: Changed citation for "Date Remediation Initiated"
- Section B: Changed title to "Submittal Status", updated
Alternate Standard form name, replaced Annual Fee form with
Public Notification Form, and added withdrawal column
- Section E: small wording changes, expanded question about
number of AOCs to identify total AOCs for the site and total
AOCs addressed in submittal
- Section G: Check boxes reworded to yes/no questions
- Section I: changed the word "deviation" to "variance"
through out section
- Section K: added Question 2 "Is contamination in soils fully
delineated?"
- Section L: added Question 4 "Is contamination in ground
water fully delineated?"
- Section M: added new section- Ecological Receptors
|
| 1.4 - 9/7/11 |
Form
- Section A: Removed Mailing Address line
- Section B: Added more space for Permit Application List.
- Section E: Removed instruction to attach Section H2 of the
PA/SI form. Added space RI complete date and space for number
of contaminated AOCs.
- Section F: Question 1 added "at the time of remedial
investigation" Question 4 - removed "Co-mingled
on-site ground water plumes" and "Co-mingled ground
water plumes from both on-site and off site sources". Added
"Background ground water contamination".
- Section G: Added "DAF Modification", "Immobile
Chemicals List", "Soil and Ground Water Analytical
"Data Evaluation".
- Section H: Removed question 1.
- Section L: Rewritten, expanded to 3 questions plus 4 sub questions.
- Section M: Removed question 6 about clean fill.
- Section N: Changed question 2. to 1a. Added new questions:
2. (were additional AOCs ID), 5. (Has clean fill has been brought
onto the site), and 7. (Have past deficiencies/notice of deficiencies
been addressed).
- Section P: Removed first section of sub surface evaluator
certification.
Instructions
- Changed all instances of "Department" to "NJDEP"
Changed mailing address
- Section A: Added examples of NJDEP site ID numbers. Removed
mailing address only instruction
- Section B: Added Remedial Action Report
- Section E: Removed instruction to attach Section H2 of the
PA/SI form. Added note that PA/SI is required for "entire
site" option. Added requirement to identify All AOCs individually.
- Section H: Removed question 1, renumbered questions 2a and
2b to 1 and 2.
- Section I: Spell out Vapor Intrusion and Johnson & Ettinger.
- Section L: Rewritten to match new questions.
- Section M: Removed question 6 about clean fill.
- Section N: Renumbered item 2 to item 1a. added new items 2,
5, and 7. Fixed link for list of regulated USTs
- Section P: Removed first 3 bullet items in Subsurface Cert.
|
| 1.3 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.2 - 1/12/11 |
- Grammar & punctuation
- Section O: Developer Certification removed
|
| Remediation
Cost Review/Estimate form |
1.1 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.0 - 3/25-11 |
- Form finalized
- Sec. F, item 5 removed
|
| 0.2 - 3/4/11 Draft |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 0.1 - 1/12/11 Draft |
- DEP Oversight checkbox added to top of form,
- Section C: additional checkbox
- Section D: more Mechanisms added
- Section I: new signature page for person establishing and
maintaining a remediation funding source added, 30 calendar
days after disbursement to submit, & shall not include ineligible
legal costs/legal fees on 3 signature pages
|
| Remediation
Certification form |
1.5 - 5/7/12 |
- Removed Non-LSRP certification page.
|
| 1.4 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.3 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.2 - 1/12/11 |
- Grammar & punctuation
- Section D: surcharge added
|
Remediation
Cost Review and RFS-FA Form
Formerly called: "Remediation Funding
Source - Self Guarantee Form" or "Remediation Funding
Source Form" |
1.2 - 9/7/11 |
- Changed name from: "Remediation Cost Review Estimate
Ver 1.1" to "Remediation Cost Review and RFS-FA Form
Ver 1.2"
|
| 1.1 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.0 - 3/25/11 |
- Form finalized
- Sec. B, item 3 added: Name of entity that entered into the
oversight document
|
| 0.1 - 3/4/11 Draft |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 0.0 - 1/12/11 Draft |
|
Remediation
TimeFrame Notification
|
1.0 - 5/7/12 |
NEW FORM
|
| Request
to Proceed Without Department Pre-Approvals (The Opt In form)
See the LSRP Notification of Retention
or Dismissal form. |
|
|
| Response
Action Outcome form |
1.8 - 5/7/12 |
- General Instructions: Modified instructions for submission of RE forms and Case Inventory Documents (CID).
- Section B: added radionuclide reports list.
- Section F: changed child care fee from $225 to $450.
- Section E: added checkbox for "Lease Hold Portion Only – Child Care Center Facility" to question 1.
- Added question 4 "Are there AOCs where an ROA has not been filed".
Instructions
- General instructions: Added item 4 indicating supporting document
must be submitted with the RAO. Added "Completed forms should
be sent to..."
- Updated instructions for Sections A, B, E, J, L
|
| 1.7 - 1/10/12 |
Form
- General: Removed formatting for zip code.
- Section A: Changed citation for "Date Remediation Initiated."
- Section B: Changed title to "Submittal Status", updated
Alternate Standard form name, replaced Annual Fee form with
Public Notification Form, and added withdrawal column.
- Section C: Added "Government" to current and future uses,
and deleted "Agriculture" from future use.
- Section E: Added 2 questions identifying total number of AOCs
for the site and total AOCs addressed in this submittal.
- Section I: New section "Applicable remediation Standards"
created out question 1.
- Section J: Changed the word "deviation" to "variance"
and added "or alternate vapor intrusion screening level",
and added question: "A site-specific screening level was developed
for the evaluation of the VI pathway."
- Section K: (old section J) changed the word "deviation"
to "variance" through out section.
- Section L: (old section K) question 3. changed "ground water
contamination not yet remediated" to "ground water contamination
not yet investigated."
Instructions
- General instructions: Added item 4 indicating supporting document
must be submitted with the RAO. Added "Completed forms should
be sent to…"
- Updated instructions for Sections A, B, E, J, L
|
| 1.6 - 9/7/2011 |
- Intro: Deleted introduction paragraph and note.
- Section A: Removed "mailing adddress if different than
street address" Changed "Date trigger compliance with
Section 30 of Site Remediation Reform Act P.L." to "Date
Remediation Initiated Pursuant to N.J.A.C. 7:26C-2.2 or 2.3(b):"
- Section B: Expanded list of required submittals to match other
forms.
- Section F: Added Section F for child care fee
- Instructions: Updated version and date to match form
|
| 1.5 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
- 11 New check boxes added under Section J. 3. to reflect
the addition of the new “Groundwater Contamination due
to Regional Historic Fill” notice and “Child Care
Center Notices.” The “Child Care Center Notices”
check box consolidates/replaces three Child Care notices/check
boxes that have been deleted. Same notice changes made to
the RAO Shell Document.
|
| 1.4 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.3 - 2/9/11 |
- The Response Action Outcome (RAO) Form and Instructions have
been modified to solicit information regarding the existence
of a Remediation Funding Source (RFS) for the remediation for
which the RAO is being issued.
- Section K of the RAO Form will now identify in accordance
with N.J.A.C. 7:26C-5 whether a RFS has been posted and, if
posted, serve as notice (if applicable) to the Department that
all or part of the RFS needs to be returned. The RAO Form and
Instructions further provides a reminder that the "Remediation
Cost Review Form" must be included with the submission
if either a return or decrease in the RFS is being requested.
By completing this information, the Department will be able
to identify those cases where RFS needs to be returned or reduced
in a more efficient manner allowing for prompt return of the
RFS. The labeling of the sections of the RAO form following
the new Section K have also been adjusted.
|
| 1.2 - 1/12/11 |
- Grammar & punctuation,
- Section E: ISRA leasehold properties clarification;
- Section K: Developer Certification removed
|
Technical
Assistance Grant form
|
1.3 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.2 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.1 - 1/12/11 |
|
| Underground
Storage Tank System Closure Notification / Extension Request form |
1.3 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 1.2 - 3/4/11 |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 1.1 - 1/12/11 |
- Grammar & punctuation, LSRP signature page made consistent
with other forms
|
| Vapor
Concern (VC) Response Action Form |
1.2 - 5/7/12 |
- Removed Non-LSRP and Subsurface Evaluator certification pages.
|
| 1.1 - 1/19/12 |
- Section A: Removed "mailing Address if different than
street address"
- Section E: changed all questions from check boxes to yes/no
questions.
- Section F: Changed "within 100’ of free product
(any type)" to "within 100’ of free product
(excluding diesel)"
Incorporated "free product type" question into other
questions
Changed "ground water" to-indoor air pathway"
to "vapor intrusion pathway".
- Updated instructions for sections A, C, F and G
|
| 1.0 - 5/25/11 |
- Address change to reflect the new DEP mail codes.
|
| 0.2 - 2/25/11 Draft |
- Allows the Yes/ No Check boxes to be checked & unchecked
|
| 0.1 - 1/12/11 Draft |
- New version number for splitting the instructions from the
form
|
| |
|
|
| RAO
Shell Document |
1.4 - 5/25/11 |
- 11 Insert added to the RAO shell to address the condition
where ground water contamination is solely related to historic
fill and a Ground Water Remedial Action Permit is not required
for that contamination. This change was codified at N.J.A.C.6.2(g)4.
- Removed existing Child Care Center (CCC) RAO shell language
to reflect a new process of CCC license renewals. Consolidated
some of the CCC shell language into one notice for ease of use
by LSRPs since all the consolidated language is used in every
CCC RAO. Changes to the consolidated notice also reflects that
there is no impact to the CCC from an off site source(s), or
if there was an impact, it has been mitigated.
|
| 1.3 - 1/12/11 |
- ISRA leasehold properties clarification
|
| RAO
Guidance |
1.4 - 5/25/11 |
- 11 Instructions added to explain the use of a new notice titled
"Groundwater Contamination due to Regional Historic Fill."
This instruction explains the basis for this new insert. This
new insert has also been added to RAO Shell document included
as Attachment 1 of the RAO Guidance Document.
- Instructions added to explain how to issue a Child Care Center
(CCC) RAOs, how to address a new or relocating Child Care Center
(CCC) to a property that remained in continuous use as a CCC
and when to hire a LSRP.
|
| 1.3 - 1/12/11 |
- ISRA leasehold properties clarification
|