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SRRAForms Update Log

 

Site Remediation Reform Act (SRRA) Forms
Update Log

Last Updated 9 October 2012

Quick Jumps to the Forms' Update Log
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 1.4 - 8/8/13
  • Name of Form revised.
  • Re-worded/added to the Note at top of form.
  • Section B: The word "Required" dropped from title, both questions re-written.
  • Section C: Questions 1, 4, and 5 removed, questions 2 and 3 combined into new question 1, new question 2 added.
  • Instructions re-written.
1.3 - 9/13/12
  • Bolded note at top of form and added "by the person responsible for conducting the remediation"
  • Section B: Added note to stop if you answer "no" to question 1. Do not submit form.
1.2 - 5/31/12
  • Added "and Remedial Action Workplan Approval" to name of form
  • Added new Section B "Remedial Action Workplan Required"
  • Renamed Section C from "General" to "Alternative Remedy"
1.1 - 5/7/12
  • Updated instructions
Alternative or New Remediation Standard and/or Screening Level Application

(Was "Alternative Soil Remediation Standard and/or Screening Level Application form")

2.2 - 8/27/13
  • Form entirely redesigned
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

1.6 - 6/4/2012
  • Removed version 1.6 "Annual Remediation Reporting Fee" form on 2/6/2013
  • Added new Section E "Prorated Fees" and updated instructions
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.
Annual Remediation Fee Reporting form (Online) 1.3 - 9/8/14
  • Updated fee amounts.
1.2 - 5/8/13
  • Removed reference to temporary LSRPs
  • Removed paragraph 6.H. Proration of Payment
1.1 - 12/11/12
  • Added option for permanent LSRP to paragraph 1 of MyWorkspace Setup.
1.0 - 5/29/12
  • New Document
Case Inventory Document Worksheet 1.3 - 6/25/14
  • Made drop down lists compatible with Excel 2007
  • Allow users to change the height and width of rows and columns.
  • Note: Could not allow formatting text within cell (bold, italics, etc.) as it interferes with the system's ability to automatically read the data.
1.0 - 11/4/09
  •  
CEA/Well Restriction Area (WRA) Fact Sheet form 1.5 - 8/19/13
  • Section C: Fixed error of a missing field for question 1
1.4 - 6/20/13
  • General: Removed "Permit" from name of form, added checkboxes for LSRP and Subsurface evaluator at top of form, moved "Exhibits" throughout form to the end of section B.
  • Section A: Expanded to 3 questions
  • Section B: Question 2 - changed instructions on form for direction of gw flow, added box for vertical depth in msl, added check boxes for units for horizontal extent of CEA; Question 3 - Added "expected expiration duration" and checkbox for indeterminate. New Question 4 - all exhibits.
  • Section C: "Projected" removed from section name, Future use question removed, two new questions added.
  • Section D: Question replaced.
  • Section F: Certification page for Person Responsible for conducting Remediation added.
  • Section H: Certification page for Subsurface Evaluator added.
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
Child Care Center/Educational Facility Remediation Form 1.0 - 1/27/14
  • New form
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
  • New Document
Confirmed Discharge Notification form 1.7 - 5/23/13
  • Section E: Added box for Historic Fill only; Changed "Date Discharge Notification to the Department" to "Date NJDEP Hotline called"
  • Section G: (Case type) arranged choices alphabetically; expanded choices for Federal case types; added "Historic Pesticides", "Due Diligence with RAO", and "other"; removed "Site is located within an economic development priority area" and "Not applicable"; changed "Government Entity" to "Spill Act Defense - Government Entity"
  • Instructions: Updated instructions to provide more information about combining cases and how to complete the form if historic fill is the only contaminated AOC at the site.
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 1.4 - 8/01/12
  • Added definitions for "industrial establishment, owner, and operator" to instructions
  • Section E: Removed "Absence of Contamination Acknowledgement" certification
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)    
Discharge to Ground Water Permit by Rule Authorization Request 1.0 - 9/17/12
  • New Form
Exemption from Spill Act Liability Certification 1.1 - 4/2/2013
  • Changed "municipality" to "governmental entity" throughout form.
  • Sec B: New Section B added "Property Owner"
  • Sec C: Added 2 questions asking if work has been or will be conducted.
1.0 - 10/4/12
  • New Form posted date
Full Laboratory Data Deliverables form 1.5 - 9/13/12
  • Updated Tech Reg citations in the instructions under Applicability.
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 1.8 - 9/13/12
  • Section A: Removed Date
  • Added federal case question and instructions
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
1.3 - 12/11/2013
  • Removed check box for "Non-LSRP (Existing Cases)" from top of form.
  • Section A: Reworded some of the choices.
  • Section F: Section changed from "NJDEP Oversight Document" to "Existing Case". Questions changed.
  • Section G: Section deleted (Consultant Information).
  • Section H: (Other Funding Sources) added a box for "Entity(s) responsible for conducting the remediation".
  • Section I: Changed Name from "Scope of Work" to "Work Proposal".
  • Section J: (Cost Estimate) Removed "prepared in the format outlined in Part VI"
  • Section K: (Demonstration of Need For Loan Applicants) Small change in wording.
  • Section M: Non LSRP Certification deleted, Subsurface Evaluator certification updated.
  • Part II: (General Certification) Added "for a public entity, the contact person (administrator, township manager, etc.)".
  • Part III: New Part III added "Subrogation of Rights"
  • Part IV: Old Part IV "25% Matching RA Grant Certification" moved to Part V.
    New Part IV (Innocent Party Grant Certification) modified the certification language.
  • Part VI: Old Part VI "Cost Estimate Format" deleted.
    New Part VI "Municipal Questionnaire" formerly Part V.
    Deleted "note that projects may not start until after recie3ving NJDEP approval" from question 2.
  • Part VII: (HDSRF Application Checklist)
    Added "HDSRF Subrogation of Rights (Part III)", and changed "Scope of Work" to "Work Proposal" for many of the sub-categories.
    Removed "Copy of DEP approval letter …" from all sub-categories.
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  
HDSRF Child Care Facility Grant Application 1.0 - 4/25/2013
  • New Form
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
  • Grammar & punctuation
ISRA Certificate of Limited Conveyance Application 1.1 - 7/24/12
  • Section A. Remove Date and Sic Code
  • Section D. Added place for check number
  • Section E. Removed question "have you enclosed check" at end of RP certification.
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 version 3.0 "LSRP Notification of Retention or Dismissal" form on 2/6/2013
  • 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 Deed Notice (Appendix B for the ARRCS Rule)    
Model Termination of Deed Notice (Appendix C for the ARRCS Rule)    
Monitoring Well Certification Form A - As-Built Certification 1.0 - 9/7/11
  • New document.
Monitoring Well Certification Form B - Location Certification 1.3 - 2/26/13
  • Section C:
    Question 3, increased reporting accuracy of Lat/Long to 1/100 of a second
    Question 4, increased reporting accuracy of State Plane Coord to nearest foot
    Question 5, added Elev Top of Outer Casing, Elev of Ground, and Vertical Datum reference.
  • Section D: Added Firm Name and Certificate of Authorization #
1.2 - 9/12/12
  • Compressed form to 1 page
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 1.1 - 3/13/13
  • Form completely reformatted.
1.0 - 9/7/11
  • New document.
Out of Service Extension Request for an Underground Storage Tank System

(Was "Underground Storage Tank System Closure Notification / Extension Request form")

1.4 - 6/9/14
  • Changed Name of form from "Closure Notification - Extension Request of an Underground Storage Tank System" to "Out of Service Extension Request for Underground Storage Tank System"
  • Removed all mention of closure notification
  • Section D: Replaced "Piping Only" column with "Documentation Submitted (Site Investigation or Leak Detection Documentation)"
  • Added Certification for owner or operator
  • Updated instructions
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
Petroleum UST Fund Application (Regulated)

(Name change. Was 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  
Petroleum UST Fund Application (Unregulated)

(Name change. Was 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  
Preliminary Assessment/Site Investigation form 2.0 - 6/9/14
  • Added PA, SI, and UST Unkno0wn Source Investigation checkboxes to top of form
  • Section B: Submission Status:
    Changed title from "Submittal" to "Submission"
    Added "PA only – No EDD" checkbox to question 1.
    Question 2: sorted list alphabetically, split RI/RAW into two lines, and added new column "Date of Previous NJDEP Approval"
  • Section C Site Use: Added “Other” to Intended Future Site Use
  • Section D Case type:
    Removed "TSCA" and "Other" from Federal Case types
    Added Question 1 "Is the party conducting remediation a government entity?"
  • Section E Public Funds: Added "Environmental Infrastructure Trust"
  • Section F General: Sections F, G, and I were completely reorganized into new Sections F) General, G) PA, and H) SI.
  • Section J Lab Data Question 6: changed "Comments" to "Provide the page number for the “Reliability of Data” section of the report"
1.7 - 3/25/13
  • (old) Sec B NJDEP Case Manager: Removed this section
  • Section B Submittal Status:
    Added question for method of EDD submittal.
    Added Technical Impracticability Determination to list.
  • Section D Case type: Alphabetized list. Expanded choices for types of federal cases, added "Spill Act Defense", removed "not applicable" and "Site is located within an economic development priority Area".
  • Section F General: Updated instructions for order of magnitude evaluation; Question 9 - added questions B and C: "Does the site contain any land use features..", and "Have the necessary land use permits been issued.."
  • Section G Site Info: Section G5 inserted new question b.7) "Are any soil analytical results greater than ... Criteria in an ESNR"
  • Section H Lab Data Added new Section H. Laboratory Data
  • Section I Alt STD: Added "ecological site specific goal"
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
Receptor Evaluation form 1.9 - 4/21/2014
  • Section E: Fixed mistake in question 10 and 11 in the "If Yes to #..."
1.8 - 1/27/2014
  • Section F:
    Changed question 4 to collect information about nearby surface waters and Trout production/maintenance.
    Added new questions 5, 6, and 7 about regulated land use features and LURP approvals.
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 2.0 - 6/9/14
  • Section B Submission: Changed title from "Submittal" to "Submission"
    Question 1: Added "Not Applicable – No EDD" checkbox.
    Question 2: sorted list alphabetically, split RI/RAW into two lines, and added new column "Date of Previous NJDEP Approval"
  • Section C Site Use: Added "Other" to Intended Future Site Use
  • Section D Case type: Removed "TSCA" and "Other" from Federal Case types
    Added Question 1 "Is the party conducting remediation a government entity?"
  • Section E Public Funds: Added "Environmental Infrastructure Trust"
  • Sections G:
    Question 1: added a place to list permit type and location in report
    Question 4 moved here from old Section I.
    Old questions 4, 5, 6, 7, 11, 12, 13 moved to Section H.
    Question 14 removed.
  • Section H: Questions 2 and 3 removed
    Question 4 moved to section G
  • Section I (old): Removed
  • Section I (new): Question 2: changed "Inhalation Pathway" to "Soil Remediation Standards"
    Added new question 4: "Was an interim standard used…"
    Question 7: removed "Immobile Chemicals List" and "Soil and Ground Water Analytical Data Evaluation"
  • Section J Alternative and Clean Fill Use:
    Question 4: changed from question about blending pesticides to "Will material be sent off-site for use as alternative and/or clean fill at a non-SRP site"
  • Section K Remedial Action Report Info:
    Added question 1: Did the remedy include a remedial action for soils?
    Added question 5: Did the remedy include a remedial action for ground water?
    Question 6: (old 4) changed from "Is an unrestricted use being proposed" to "Is a restricted use required?"
    Added question 9: Did the remedy include a remedial action for ESNRs?
    Removed NRD question
1.9 - 5/8/13
  • Section G: Question 14 - corrected mistake changed "11 or 12" to "12 or 13"
1.8 - 3/25/13
  • Sec B Submittal Status:
    - Added question for method of EDD submittal;
    - Added technical Impracticability Determination to the list
  • Section D Case Type: Added new Section D: Case Type;
  • Section G General:
    - Made Question 2b into Question 3.
    - Added Pesticides to question 7.
    - Added N/A box to Question 8.
    - Moved table from Question 11 to new item 14.
    - Added new Question 13 "Are ground water contaminants from the site discharging to an ESNR".
  • Section H Site Cond:
    - Added new Question 1: "Has dioxin been detected in any site media".
    - Removed dioxin from table in Question 2.
    - Changed "compound/element" to "contaminant" in Question 3.
    - Added "screening level" to questions 3 and 4.
    - Added ESNRs to GW and Soil columns in Question 5.
  • Section I Alt STDs: Added "ecological site specific goal";
  • Section J Applicable STDs:
    - Changed "compounds" to "contaminants" in Question 1;
    - Added table of compliance averaging methods to Question 2;
  • Section K Soil/Sed Reuse section renamed "Alternative and Clean Fill Use", section rewritten;
  • Section L RAR Info: Made question 1 from Section M a new question 12
  • Section M Misc: Removed section
1.7 - 8/23/12
  • Section L: Miscellaneous, Question #2, Fixed Yes/No box
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 2.0 - 6/9/14
  • Section B Submission: Changed title from "Submittal” to “Submission"
    Question 2: Added "Not Applicable – No EDD" checkbox.
    Question 3: changed from "Is CEA included?" to "Is a PBR required?"
    Question 4: sorted list alphabetically, split RI/RAW into two lines, and added new column "Date of Previous NJDEP Approval"
  • Section C Site Use: Added "Other" to Intended Future Site Use
  • Section D Case type: Removed "TSCA" and "Other" from Federal Case types Added Question 1 "Is the party conducting remediation a government entity?"
  • Sec E Public Funds: Added "Environmental Infrastructure Trust"
  • Sections G, H, I(old): Questions in Sections F, G, and I were reorganized into Sections G and H; many questions were removed.
  • Section J(old) Applicable Stds: Removed
  • Section I Alternative and Clean Fill Use:
    Question 3: added "at an SRP site"
    Question 4: changed from question about blending pesticides to "Will material be sent off-site for use as alternative and/or clean fill at a non-SRP site"
  • Sec J Remedial Action Workplan Info:
    Changed Subtitle from "General" to "Permit Information"
    Question 1: changed from "Are NJDEP-approved permits required?" to "Does the site contain any land use features that have been impacted by remedial activities"
    Added question 3 about federal, state, or local permits
    Added question 4: Is a soil remedial action required?
    Removed question7: Is the proposed remedial action a presumptive remedy?
    Added question 9: Is a ground water remedial action required?
    Added question 11 about NAPL
    Changed subtitle from Ecological to ENSR
    Added question 12: Is a remedial action required for an ESNR?
    Added question 14: Was a soil gas investigation required?
    Removed NRD question
1.6 - 3/25/13
  • Section B Submittal Status:
    - Added question for excess alternative fill;
    - Added question for method of EDD submittal;
    - Added question to ask if a CEA proposal included.
    - Added technical Impracticability Determination to the list
  • Section D Case Type: Added new Section D: Case Type.
  • Section G General:
    - Added Pesticides to question 7; Added new Question 11: "Are ground water contaminants from the site discharging to an ESNR".
    - Added N/A box to Question 8.
    - Moved table in Question 10 to new item 12.
    - Added new Question 11: are contaminants discharging to surface water?
  • Section H Site Cond:
    Added new Question 1: "Has dioxin been detected in any site media"; Removed dioxin from table in Question 2; Changed "compound/element" to "contaminant" in Question 3; Added "screening level" to questions 3 and 4; Added ESNRs to GW and Soil columns in Question 5, added ESNR to migration pathway and exposure in Question 6
  • Section I Alt Stds: Added "ecological site specific goal".
  • Section J Applicable Stds: Changed "compounds" to "contaminants" in Question 1. Added table of compliance averaging methods to question 2.
  • Section K Soil/Sed Reuse section renamed "Alternative and Clean Fill Use", section rewritten.
  • Section L RAW Info:
    - Added new Question 2 "Are land use permits required..."
    - Made question 1 from Section M a new question 12.
  • Section M Misc: Removed section.
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 1.9 - 9/23/2014
  • Added note to instructions Section N concerning certification by owner.
  • Removed fees before 6/30/14.
1.8 - 6/16/2014
  • Added new fees effective July 1, 2014
1.7 - 6/9/2014
  • Updated following instructions:
    Added link in first line of instructions for the Monitored Natural Attenuation Technical Guidance.
    Section F, instruction 5: reworded and added GIS instructions.
    Section G, instruction 3: added Table 4 from MNA guidance
1.6 - 1/27/2014
  • Added LSRP and Subsurface Evaluator boxes to top of form
  • Section A: Added Blocks and lots and Federal Case Type.
  • Section B: Changed the title of the section;
    Moved Fee Billing Contact to its own section (C). Renumbered following sections.
  • Section C: Now fee billing contact
  • Section F: (CEA Info) Section completely rewritten.
  • Section G:
    (Monitoring Maint..) Question 1.a. added new questions 1) and 2); added N/A boxes to 3) and 4);
    Question 1.b. added fifth question about expected duration of active remediation;
    Added new question 2: has a Technical Impracticability Proposal been submitted;
    Reworded old question 2 into new questions 3 and 4.
  • Section H:
    (Financial Assurance) Dropped "Engineering Control" from title;
    Question 5 replaced with question about converting RFS to FA;
    Order of questions 6 and 7 reversed;
    Added "Loan or Grant" to list of FA Mechanisms in question 7;
    Added Name of Financial institution to contact information in question 8;
    Changed question 9 from a question to a statement.
  • Section I:
    (Land Use) Changed Name from "Property Use" to "Land Use";
    Added more choices to question one to match choices in question 2
  • Section J:
    (RE Eval) Added "Ecological Receptor" to list in question 1;
    Added new question 3: "Have any vapor mitigation systems been installed…".
    Added new question 4: "Have any POET systems been installed…".
    Added new question 5: "Are any potable wells that do not have a POET water system being sampled regularly …".
  • Section K: (Other Permits) Reworded question, changed title from "Other Remediation Permits" to "Other Remedial Action Permits"
  • Section N: (Current Owner) Changed title from "Current Owner of the Site - Co-Permittee" to "Current Owner of the Site Information and Certification"
  • Section O: Added Subsurface Evaluator Cert
  • Addendum:
    Updated Addendum to match changes made in main body of the form.
    Added Addendum B for additional property owners
1.5 - 6/19/12
  • Updated fee amounts
1.4 - 5/7/12
  • Removed Non-LSRP and Subsurface Evaluator certification pages.
1.3 - 1/18/12
  • GIS Instructions updated
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 DRAFT

0.0 - 2/24/10  
Remedial Action Permit Application Form for Soils 2.0 - 9/23/2014
  • Added note to instructions Section L concerning certification by owner
  • Removed fees before 6/30/14
1.9 - 6/16/2014
  • Added new fees effective July 1, 2014
1.8 - 6/9/2014
  • Updated instructions in Section F, instruction 9: reworded and added GIS instructions.
1.7 - 1/27/2014
  • Added LSRP and Subsurface Evaluator boxes to top of form
  • Section A: Added Blocks and lots and Federal Case Type.
  • Section F:
    (Deed Notice..): Question 1: split first check box into two.
    Question 2 rewritten and moved to end of section (question 9);
  • Section G:
    (FA): Question 5 replaced with question about converting RFS to FA;
    Order of questions 6 and 7 reversed;
    Added Name of Financial institution to contact information in question 8;
    Changed question 9 from a question to a statement;
  • Section I: (RE Eval): Question 3: removed need to list buildings on form
  • Section J: (Other Permits): Reworded question, changed title from "Other Remediation Permits" to "Other Remedial Action Permits"
  • Section L: (Current Owner): Changed title from "Current Owner of the Site – Co-Permittee" to "Current Owner of the Site Information and Certification"
  • Section O: Added Subsurface Evaluator Cert
  • Addendum:
    Updated Addendum to match changes made in main body of the form.
    Added Addendum B for additional property owners.
1.6 - 7/24/12
  • Section B. Moved fee billing contact information from Section B. to New Section C. and renumbered subsequent sections
  • Section E. Updated question 1 and added question 2 (Was GIS Compatible map sent..) and 9 (Is Deed Notice for historic fill)
  • Section G.
    - Removed "Engineering Control" from title of section
    - Added "loan or grant" to question 6
  • Section H.
    - Made question 3 part of question 2
    - Added extra space for question 4
  • Section I. Added new Section I. Receptor Evaluation Summary
1.5 - 6/19/12
  • Updated fee amounts
1.4 - 5/7/12
  • Removed Non-LSRP and Subsurface Evaluator certification pages
1.3 - 1/18/12
  • GIS Instructions updated
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 1.5 - 6/16/2014
  • Added new fees effective July 1, 2014
1.4 - 1/27/2014
  • Section A: Added Blocks and lots and Federal Case Type.
  • Section B:
    Changed the title of the section;
    Moved Fee Billing Contact to its own section (C). Renumbered following sections.
  • Section C: Now fee billing contact
  • Section D:
    Changed title from "Co-Permitee" to "Former Property Owner/Co-Permittee".
    Added 2 questions
  • Section E:
    Changed title from "New Co-Permitee" to "New Property Owner/Co-Permittee".
    Removed question asking reason for transfer.
    Added 2 new questions
  • Section F:
    (Financial Assurance) Dropped "Engineering Control" from title;
    Split old question 2 into two questions;
    Question 5 "Is the estimate attached?" removed
    Order of questions 6 and 7 reversed;
    Added "Loan or Grant" to list of FA Mechanisms in question 7;
    Added Name of Financial institution to contact information in question 8;
    Changed question 9 from a question to a statement.
  • Section G:
    (Land use) Changed Name from "Property Use" to "Land Use";
    Expanded this section to match the permit applications.
  • Section H:
    (Other Permits) Reworded question, changed title from "Other Remediation Permits" to "Other Remedial Action Permits"
  • Section J: Added new section to provide certification for "Former Owner of the site".
  • Section K: Added new section to provide certification for "New Owner of the site".
  • Removed certification page for LSRP
1.3 - 6/19/12
  • Updated fee amounts
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
  • New form

Remedial Action Protectiveness/Biennial Certification Form - Ground Water

(Was "Remedial Action Protectiveness Certification Form - Ground Water")

1.6 - 6/9/14
  • Section A: All questions about CEA moved to Section G.
  • Section B: Billing contact info made into Section C.
  • Added "Changed Since Last Submission" and "Effective Date of Change" to Sections C,D, E, and F.
    Added "If same as Person Responsible…" to Sections D, E, and F.
  • Old Section F "IEC Conditions" removed.
  • Section G, H, and M combined into New Section G "Remedial Action and CEA/WRA Information", questions from Section A placed here.
  • Section I. Property Use and Section L. Land Use Disturbances combined into "Section H. Land Use, Changes, And Disturbances";
    Separated "School" and "Child Care Facility" and added "Road Right of Way" to questions 1,2, and 3.
  • Section I "Current or Planned Water Use…" (Old J): Added Community and Non-Community Supply Well to question 6.
  • Section J. Vapor Intrusion: Added question 7 about vapor intrusion engineering controls.
  • Old Section N. "Additional Remediation and Required Submittals": Removed.
  • Two new sections added: Section K. Financial Assurance, and Section M. Subsurface Evaluator Information and Statement.
1.5 - 10/5/12
  • Fixed defect in Section E. Email address entry box.
1.4 - 5/7/12
  • 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.nj.gov." 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
1.2 -
  • Added Section B - Fees
  • Added certification pages for Non-LSRP and Subsurface Evaluator
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
  • New form

Remedial Action Protectiveness/Biennial Certification Form - Soil

(Was "Remedial Action Protectiveness Certification Form - Soils")

1.7 - 6/9/14
  • Section A: All questions about deed notice moved to Section G. Deed Notice Info.
  • Section B: Billing contact info made into Section C.
  • Added "Changed Since Last Submission" and "Effective Date of Change" to Sections C,D, E, and F. Added "If same as Person Responsible…" to Sections D, E, and F.
  • Old Section F "IEC Conditions" removed.
  • Section G changed to "Deed Notice/ DER Info", questions from Section A placed here
  • Section H. Property Use and Section I. Land Use Disturbances combined into "Section H. Land Use, Changes, And Disturbances",
    Separated "School" and "Child Care Facility" and added "Road Right of Way" to questions 1,2, and 3.
    Removed "Future Site Use Unknown" from question 2.
    Added "Other" to question 3.
    Most of the remaining questions have been rewritten.
  • Old Section J "Additional Remediation" removed
  • Three new sections added: Section I. Vapor Intrusion, Section J. Financial Assurance, and Section L. Subsurface Evaluator Information and Statement.
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 2.0 - 6/9/14
  • Sec A: Gave Case Tracking Number a full line and added "for this submission".
  • Sec B Submission Status:
    Changed title from "Submittal" to "Submission".
    Question 4: sorted list alphabetically, split RI/RAW into two lines, added column named "Date of Previous NJDEP Approval".
  • Sec C Site Use: Added "Other" to Intended Future Use.
  • Sec D Case type:
    Added "Other"
    Removed "TSCA" and "Other" from Federal Case types.
    Added Question 1 "Is the party conducting remediation a government entity?"
  • Sec E Public Funds: Added "Environmental Infrastructure Trust".
  • Sec G General (new): Moved questions from old section "Alternative Standard / Variances" here.
  • Sec H Site Conditions: Removed old questions 1, 2, and 3.
    Old question 4 moved to new Section G.
    New questions added about radiological, ordinance, free product, sediment, and ENSRs.
  • Sect H Applicable STDs:
    Question 2 - Changed "compliance with a pathway" to "compliance with the Soil Remediation Standards".
    Added new question 4: "Was an interim standard used…".
    Question 7 removed "Immobile Chemicals List" and "Soil and Ground Water Analytical Data Evaluation" choices.
  • Sec J Alt STDs: Section removed (questions moved to section G).
  • Sec K Historic Fill: Questions 1 and 3 combined and reworded.
  • Sec O Misc: Question 7 moved to section G.
  • Sec P Lab Data: Moved to after Section O Miscellaneous.
    Question 6 changed from comments area to “Provide the page number…”.
1.7 - 3/25/13
  • Section B Submittal Status:
    - Added question for method of EDD submittal.
    - Added question to ask if a CEA proposal included.
    - Added technical Impracticability Determination to the list.
  • Section D Case Type: Added new Section D: Case Type.
  • Section G Site Conditions:
    Added new Question 1: "Has dioxin been detected in any site media"; Removed dioxin from table in Question 2; Changed "compound/element" to "contaminant" in Question 3; Added "screening level" to questions 3 and 4, Added ESNRs to GW and Soil columns in Question 5;
  • Section H Applicable STDs:
    - Changed "compounds" to "contaminants" in Question 1.
    - Added table of compliance averaging methods to question 2.
  • Section I Background Conditions: Updated citations.
  • Section J Alt STD: Added "ecological site specific goal".
  • Section K Historic Fill: Updated wording of questions 1 and 2, combined questions 3 and 4, and updated instructions.
  • Section I GW Trigger: Updated citations.
  • Section M GW RI Info: Question 3.b. changed reference from Tech Regs to Guidance Document.
  • Section N Eco Receptors: Updated citation in question 4.
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

Remedial TimeFrame Notification

1.1 - 5/5/14
  • Fixed broken field in Section D, question 2.
1.0 - 5/7/12
  • New Form
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 1.7 - 9/23/2014
  • Changed instructions in Section D from "but excluding the estimated cost…" to "including the estimated cost…"
1.6 - 11/27/2012
  • Removed Pubic Notary Requirements from Sections E, F, and G.
  • Updated instructions for Applicability.
  • Added instruction to submit the Remediation Cost Review and RFS/FA form in Section D.
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"

1.6 - 2/7/14
  • Sect C:
    Added checkbox for "Establishing any type of Remediation Funding Source"
    Added checkbox for "Establishing a Remediation Trust Fund for the May 2014 Remedial Investigation extension"
    Removed checkbox for "Cost Estimate Guidance which can be found on the Department's Website"
  • Sect E: Added new question 3 "If establishing a RTF …, the estimated cost to complete the remedial investigation"
  • Sect F:
    Question 1.b. added "or to complete the remedial investigation as applicable"
    Question 1.c. added "or to complete the remedial investigation as applicable"
1.5 - 5/6/13
  • Added subsurface and LSRP check boxes on front
  • Section B:
    - Added question about submitting GIN
    - Added question asking if site is in Direct Oversight
    - Added "For RFS Only (not FA)" notice for exemption question
    - Added Note at bottom of section
  • Section C:
    - Added "check all that apply"
    - Removed instructions to attach instrument for first two items
    - Added "Biennial Cost Review" and "Using RFS as FA" to list
  • Section D: Added question 3 about changing the amount of FA
  • Section E: Added estimated cost for FA
  • Section F: Renamed Section, added three questions about FA
  • Section G: Expanded question 2 into 3 questions and added new question 3
  • Section J: Added subsurface evaluator Cert
1.4 - 11/14/12
  • Section B: Added a list of possible exemptions from the requirement to post RFS.
  • Section D: Added boxes to indicate if the mechanism is for a RFS or RA for both initial and replacement mechanisms.
1.3 - 7/23/12
  • Removed options for Non-LSRP and DEP Oversight certification
  • Removed "No Changes Since Last Submittal" on all certifications
  • Section B: Added instructions to attach additional sheets if needed
  • Section C:
    - Added box for "Change in Remediation Funding Source or Financial Assurance Mechanism"
    - Removed contact information for person who prepared cost estimate
  • Section D:
    - Renamed "Current Mechanism" to "Initial or Existing Mechanism"
    - Added spaces in Replacement Mechanism to indicate provider (lender) for each choice
    - Removed questions 2 through 5
    - Added new question 2 for "Amount of remediation funding source or financial assurance posted"
  • Section E:
    - Provided link for cost estimate guidance
    - Added "Estimated cost to complete remediation" and "Full legal name of person who prepared the cost estimate"
  • Section G: Removed "Estimated remaining costs to complete the remediation"
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
  • New form

Self Guarantee Application

1.3 - 6/12/14
  • Updated definition of "Gross Payment" in instructions to include impairment charges.
1.2 - 5/22/14
  • Section B: Removed RP contact information, added separate date and name for each document/authority choice
  • Section C: Added Special Purpose entity
    Removed “Direct” from “Direct Parent Company” throughout form and instructions
  • Section F: Added “Intangible Assets” and “Tangible Net Worth” to question 1
    Reworded “net income” in question 2
  • Updated NJDEP address
    Updated instructions for all Sections
Request to Proceed Without Department Pre-Approvals (The Opt In form) See the LSRP Notification of Retention or Dismissal form.    
Response Action Outcome form 3.1 - 6/26/14
  • Section G: Added "Naturally Occurring Levels of Constituents in Ground Water" and "Historically Applied Pesticides not Addressed" to list of notices.
3.0 - 6/9/14
  • Sec A Site Name: Removed "Date Rem Initiated" and "State Plane Coord"
  • Sec B Submission:
    Changed title from "Submittal" to "Submission"
    Added checkbox for Fees are Paid in Full
    Sorted list alphabetically, split RI/RAW into two lines, and added new column "Date of Previous NJDEP Approval"
  • Sec C Site Use: Added "Other" to Intended Future Site Use
  • Sec D Case type:
    Added "Other" to list
    Removed "TSCA" and "Other" from Federal Case types
    Added Question 1 "Is the party conducting remediation a government entity?"
  • Sec E Public Funds (old): Removed
  • Sec E Scope of Rem: Added extent of rem (old Sec H)
    Removed two checkboxes for Child Care RAOs
  • Sec G Fees (old): Moved into Sec B
  • Sec H Extent of Rem (old): Moved into Sec E Scope of Rem
  • Sec F RAO Prep Checks: Removed question 5 "have all fees been paid?"
  • Sec J App Rem STDs: Removed
  • Sec K Media impacted: Removed
  • Sec L Alt STDs Removed
  • Sec G(new) RAO Notices:
    Added "Building Interiors Addressed"
    Removed childcare notices
    Added "Additions to Model Document" with 4 notices
2.0 - 3/25/13
  • Section B Submittal Status: Added Technical Impracticability Determination to the list.
  • Section D Case Type: Added new Section D: Case Type.
  • Section J Applicable STDs:
    Changed "compounds" to "contaminants" in Question 1.
    Added table of compliance averaging methods to Question 2.
  • Section K Media Impacted: Question 4 - added "site specific".
  • Section L Alt STDs: Added "ecological site specific goal".
1.9 - 8/23/12
  • Fixed page numbering error
1.8 - 5/7/12

Form

  • 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
Model Response Action Outcome (Appendix D for the ARRCS Rule)    
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
  • Grammar & punctuation
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
Variance Identification Form  1.0 - 7/11/12
  • New Form