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Site Remediation Reform Act (SRRA) Forms

The Site Remediation and Waste Management Program SRRA Forms Page has been redesigned into 3 sections 1) NJDEP Online Services, 2) Remedial Phase Reports, Receptor Evaluation and CEA Forms, and 3) General Forms. This change was made to consolidate forms for which an NJDEP Online Service is available and to consolidate the remedial phase reports and related forms that can utilize the new "Cover/Certification Form" when multiple reports are being submitted at the same time. In addition, the content and names of some forms have changed as described below in more detail.

NJDEP Online Forms: This section now contains all the forms that are available for submission using NJDEP Online.

The Remedial Investigation Report Online Service (RIR Online Service) is now available. The RIR Online Service requires the upload/attachment of the RIR, Electronic Data Deliverable and some limited paper forms. IMPORTANT NOTE: The files for upload should be ready on your computer prior to starting the RIR Online Service. Also, to avoid confusion when browsing and choosing a file to upload, use file names that are specific to the case. This should include the Program Interest Number, case name and type of document (i.e. 164220_CaseName_CEA). The RIR Online Service Instructions include a comprehensive list of items you need to have in order to complete the submission. The RIR Online Service can only be completed using Versions 1.2 or 1.3 of the Case Inventory Document (CID) which was made available on June 10, 2014.

Training was provided for the CID and RIR Online Service in April 2014, and can be reviewed on the Department website at Online Services Handout and NJDEP Online Services and New Electronic Case Inventory Document Webinar.

Mandatory DEP Online Services: The Annual Remediation Fee Form and the LSRP Notification of Retention and Dismissal Form have been available as a DEP Online service since September 2012. Unless otherwise instructed by the Department, the use of these services became mandatory on January 18, 2013. The Remedial Investigation Report became mandatory on April 3, 2016.

Remedial Phase Report, Receptor Evaluation and CEA Forms: This section consolidates the remedial phase report forms and common form submittals that accompany the remedial phase reports. The common information fields of these forms have been moved to a new "Cover/Certification Form" to eliminate redundancy when submitting multiple remedial phase forms at one time. Instructions for completing this form accompany this new form on the Forms Page.

General: This section contains the remainder of the forms which do not fit into the above two sections.

In addition, several forms have been renamed as follows:

  • Name and Address Change Reporting Form is now "Site and Contact Information Update Form";
  • De Minimis Quantity Exemption Application Form is now "ISRA De Minimis Quantity Exemption Application Form";
  • General Information Notification Form is now "ISRA General Information Notification Form";
  • Remediation Certification Form is now "ISRA Remediation Certification Form"; and
  • Remedial Action Permit Transfer/Change of Ownership Application is now the "Remedial Action Permit Transfer/Change of Property Ownership Application".

Remediation Timeframe Notification Form was updated and posted October 23, 2014. This form is to be used to modify the applicable RIR regulatory timeframe and contains two additional checkboxes: "Extension Request" or "Lengthen the Remedial Investigation Report Timeframe".

Unless otherwise noted in Instructions, all form submittals are to be directed to the following address:

Bureau of Case Assignment & Initial Notice
Site Remediation and Waste Management Program
NJ Department of Environmental Protection
401-05H
PO Box 420
Trenton, NJ 08625-0420

Related Links

Disclaimer

Users of this information should not consider these materials the sole source of information sufficient in itself to dictate any outcome or decision on the remediation of a contaminated site but should refer to the Department's rules and guidance provided on SRP's web site.

 

NJDEP Online Services Download
Version & Date Changes Since Last Version Rule
Annual Remediation Fee Reporting
Pay/Update Online (Requires Login, Service must be Certified by an LSRP)
  Instructions pdf 144 Kb 1.4 - 6/15/2015 See Update Log 7:26C-4.3
LSRP Notification of Retention or Dismissal
Retain/Release Online. (Requires Login, Service must be Certified by an LSRP)
  Instructions pdf 32 Kb 1.1 - 5/8/2013 See Update Log 7:26C-2.3
Remedial Investigation Report Online Service
Submit RIR Online. (Requires Login, Service must be certified by an LSRP)
FAQs pdf 219 Kb Instructions pdf 124 Kb 1.2 - 4/4/2016 See Update Log 7:26E-4.9
Remedial Action Workplan Online Service
Submit RAW Online. (Requires Login, Service must be certified by an LSRP)
FAQs pdf 219 Kb Instructions pdf 83 Kb 1.0 - 11/17/2016 See Update Log  
Remedial Action Report Online Service
Submit RAR Online. (Requires Login, Service must be certified by an LSRP)
FAQs pdf 219 Kb Instructions pdf 92 Kb 1.0 - 11/17/2016 See Update Log  
Authorization To Submit RIR, RAW, or RAR through NJDEP Online Form pdf 33 Kb Instructions pdf 32 Kb 1.0 - 11/17/2016    
Underground Storage Tank Notice of Intent to Close
Submit UST NOI Online. (Requires Login, Service must be certified by an LSRP)
  Instructions pdf 39 Kb 1.0 - 10/03/2016 See Update Log 7:14B-9.2
Remedial Phase Reports, Receptor Evaluation, and CEA Forms Download
Version & Date Changes Since Last Version Rule
Cover/Certification Form
(Must be submitted with the forms listed below)
Form pdf 169 Kb Instructions pdf 37 Kb 1.0 - 4/1/2015    
Preliminary Assessment/Site Investigation form Form pdf 327 Kb Instructions pdf 46 Kb 2.2 - 5/27/2015 See Update Log 7:26E-3.1 & 3.3
Remedial Investigation Report form
Note: Paper RIR forms are no longer accepted. The RIR must be submitted via the RIR Online Service (above).
        7:26E-4.9
Remedial Action Workplan form Form pdf 143 Kb Instructions pdf 31 Kb 2.1 - 4/1/2015 See Update Log 7:26E-5.5
Remedial Action Report form Form pdf 188 Kb Instructions pdf 37 Kb 2.2 - 5/27/2015 See Update Log 7:26E-5.7
Response Action Outcome form Form pdf 79 Kb Instructions pdf 37 Kb 3.3 - 5/27/2015 See Update Log 7:26C-6.2 
Response Action Outcome Notices Word Document doc 28 Kb        
Model Response Action Outcome (Appendix D for the ARRCS Rule) Model Document doc 126 Kb        
Case Inventory Document Worksheet Spreadsheet xls 244 Kb   1.3 - 6/25/2014 See Update Log  
Receptor Evaluation form Form pdf 179 Kb Instructions pdf 44 Kb 2.2 - 10/7/2015 See Update Log 7:26E-1.12 
Well Search Spreadsheet Spreadsheet xls 155 Kb Instructions pdf 35 Kb 1.3 - 3/22/2012 See Update Log  
CEA/Well Restriction Area (WRA) Fact Sheet form Form pdf 109 Kb Instructions pdf 232 Kb 1.7 - 7/16/2015 See Update Log 7:26C-7.3
General Forms Download
Version & Date Changes Since Last Version Rule
7.5 Percent Cost of Remediation Form Form pdf 48 Kb Instructions pdf 32Kb 1.0 - 5/7/2012 See Update Log 7:26C-4.10
Alternative Remedy/Remedial Action Pre-Approval Form Form pdf 60 Kb Instructions pdf 41 Kb 1.4 - 8/8/2013 See Update Log 7:26C-5.3(c)
Alternative or New Remediation Standard and/or Screening Level Application form
(Name change. Was "Alternative Soil Remediation Standard and/or Screening Level Application form")
Form pdf 49 Kb Instructions pdf 40 Kb 2.2 - 8/27/2013 See Update Log 7:26D-7.4
Remediation Standard Notification Spreadsheet SpreadSheet xls 68 Kb   1.0 - 8/27/2013    
Child Care Center/Educational Facility Remediation Form Form pdf 409 Kb Instructions pdf 54 Kb 1.0 - 1/27/2014 See Update Log P.L. 2007 Chapter 1
Confidentiality Request Form Form pdf 36 Kb Instructions pdf 29 Kb 1.2 - 4/1/2015 See Update Log 7:26C-15.3
Confirmed Discharge Notification form Form pdf 100 Kb Instructions pdf 38 Kb 1.7 - 5/23/2013 See Update Log 7:26C-1.7
Developer Certification (Appendix A for the ARRCS Rule) Model Document doc 39 Kb       7:26C-4.7 
Discharge to Ground Water Permit by Rule Authorization Request Form pdf 91 Kb Instructions pdf 49 Kb 1.1 - 11/16/2015 See Update Log 7:26E-5.6
Exemption from Spill Act Liability Certification Form pdf 87 Kb Instructions pdf 27 Kb 1.1 - 4/2/2013 See Update Log 7:26C-1.4(f)
Full Laboratory Data Deliverables form Form pdf 109 Kb Instructions pdf 35 Kb 1.5 - 9/13/2012 See Update Log 7:26E-1.11, 14 & 15 
Hazardous Discharge Site Remediation Fund Application form
Note: See the SRP Financial Assistance HDSRF page for more information & guidance.

Form pdf 196 Kb

Instructions pdf 40 Kb 1.3 - 12/11/2013 See Update Log 7:26C-11.2
HDSRF Child Care Facility Grant Application Form pdf 40 Kb Instructions pdf 33 Kb 1.2 - 10/24/2016 See Update Log 7:26C-11.2
Historically Applied Pesticides Deferral Request Form pdf 47 Kb Instructions pdf 33 Kb 1.0 - 8/11/2016 See Update Log  
IEC Response Action form Form pdf 59 Kb Instructions pdf 36 Kb 1.6 - 3/26/2015 See Update Log 7:26E-1.11  
IEC - Direct Contact Spreadsheet Spreadsheet xls 40 Kb   1.1 - 3/26/2015 See Update Log  
IEC - Potable Water Spreadsheet Spreadsheet xls 45 Kb   1.3 - 3/26/2015 See Update Log  
IEC/VC - Vapor Intrusion Spreadsheet Spreadsheet xls 80 Kb   1.3 - 3/26/2015 See Update Log  
IEC Monitoring and Maintenance Checklist Word Document docx 20 Kb   1.0 - 3/26/2015    
ISRA Alternate Compliance Option Application Form pdf 59 Kb Instructions pdf 35 Kb 1.6 - 4/1/2015 See Update Log 7:26B-5
ISRA Certificate of Limited Conveyance Application Form pdf 58 Kb Instructions pdf 41 Kb 1.1 - 7/24/2012 See Update Log 7:26B-5.7
ISRA De Minimis Quantity Exemption Affidavit Application
(Formerly De Minimus Quantity Exemption Application)
Form pdf 65 Kb Instructions pdf 65 Kb 1.5 - 4/1/2015 See Update Log 7:26B-5.9
ISRA General Information Notification
(Formerly General Information Notification)
Form pdf 84 Kb Instructions pdf 33 Kb 1.9 - 4/1/2015 See Update Log 7:26B-3.2
ISRA Remediation Certification form
(Formerly Remediation Certification form)
Form pdf 61 Kb Instructions pdf 31 Kb 1.8 - 4/1/2015 See Update Log 7:26B-3.3 
Linear Construction Project Form pdf 60 Kb Instructions pdf 27 Kb 1.0 - 2/16/12   7:26C-16.2(a)2
LNAPL Free Product Reporting Form Form pdf 83 Kb Instructions pdf 40 Kb 1.6 - 5/7/2012 See Update Log 7:26E-1.10(b)
Model Deed Notice (Appendix B for the ARRCS Rule) Model Document doc 107 Kb       7:26C-7.2
Model Termination of Deed Notice (Appendix C for the ARRCS Rule) Model Document doc 96 Kb       7:26C-7.13 
Monitoring Well Certification Form A - As-Built Certification Form pdf 32 Kb Instructions pdf 21 Kb 1.0 - 9/7/2011 New Document 7:26E-1.6
Monitoring Well Certification Form B - Location Certification Form pdf 37 Kb Instructions pdf 24 Kb 1.3 - 2/26/2013 See Update Log 7:26E-1.6
Notice of Failure to Comply with a Mandatory or Expedited Site-specific Remediation Timeframe Form pdf 38 Kb Instructions pdf 25 Kb 1.0 - 4/27/2016 See Update Log 7:26I-6.8(c)
Out of Service Extension Request for an Underground Storage Tank System
(Name change. Was "Underground Storage Tank System Closure Notification / Extension Request form")
Form pdf 52 Kb Instructions pdf 34 Kb 1.4 - 6/10/2014 See Update Log 7:14B-9.1
Petroleum UST Fund Application (Regulated) (Closes 6/30/2010) Form pdf 329 Kb Instructions pdf 60 Kb 1.1 - 3/4/2011 See Update Log 7:26C-12.2
Petroleum UST Fund Application (Unregulated) (Including Residential Heating Oil Tanks) Form pdf 338 Kb Instructions pdf 61 Kb 1.1 - 3/4/2011 See Update Log 7:26C-12.2
Project Summary Sheet Spreadsheet
Note: See the SRP Financial Assistance Petroleum UST Fund page for more information & guidance.
Spreadsheet xls 60 Kb   1.0    
Public Notification and Outreach form Form pdf 60 Kb Instructions pdf 36 Kb 1.7 - 4/16/2015 See Update Log 7:26C-1.7
Remedial Action Permit Application Form for Ground Water Form pdf 222 Kb Instructions pdf 61 Kb 2.2 - 8/29/2016 See Update Log 7:26C-7 
Ground Water Monitoring Plan Spreadsheet
You may have to reset your macros security in Excel before it will open/work properly. To reset: In a
blank spreadsheet, go to TOOLS, MACROS, SECURITY. Set to MEDIUM. After that, open the spreadsheet,
and select the button that says - Enable Macros.
Spreadsheet xls 177 Kb   1.0 - 5/22/2012  

 

Remedial Action Permit Application Form for Soils Form pdf 199 Kb Instructions pdf 56 Kb 2.3 - 8/29/2016 See Update Log 7:26C-7 
Remedial Action Permit Transfer/Change of Property Ownership Application and Contact Information Changes
(Name change. Was "Remedial Action Permit Transfer/Change of Property Ownership Application")
(Name change. Was "Remedial Action Permit Transfer/Change of Ownership Application")
Form pdf 115 Kb Instructions pdf 45 Kb 2.0 - 8/29/2016 See Update Log 7:26C-7.11
Remedial Action Protectiveness / Biennial Certification Form - Ground Water
(Name change. Was "Remedial Action Protectiveness Certification Form - Ground Water")
Form pdf 258 Kb Instructions pdf 60 Kb 1.6 - 6/10/2014 See Update Log 7:26C-7.7
Remedial Action Protectiveness / Biennial Certification Form - Soil
(Name change. Was "Remedial Action Protectiveness Certification Form - Soils")
Form pdf 179 Kb Instructions pdf 52 Kb 1.7 - 6/10/2014 See Update Log 7:26C-7.7
Remedial Timeframe Notification Form pdf 58 Kb Instructions pdf 38 Kb 1.2 - 10/23/2014 See Update Log 7:26C-3.2
Remediation Cost Review and RFS-FA Form
Form pdf 110 Kb Instructions pdf 49 Kb 1.9 - 4/21/2016 See Update Log 7:26C-5 
Self Guarantee Application Form pdf 58 Kb Instructions pdf 34 Kb 1.3 - 6/12/2014 See Update Log 7:26C-5 
Site and Contact Information Update Form
(Name change. Was "Name and Address Change Reporting" form)
Form pdf 62 Kb Instructions pdf 46 Kb 1.2 - 4/1/2015 See Update Log  
Technical Assistance Grant form
See the Guidance for Technical Assistance Grants [pdf] for more information.
Form pdf 152 Kb Instructions pdf 35 Kb 1.3 - 5/25/2011 See Update Log 7:26C-10.5 
Vapor Concern (VC) Response Action Form   Form pdf 49 Kb Instructions pdf 35 Kb 1.3 - 3/26/2015 See Update Log 7:26C-1.15
Variance Identification Form Form