Industrial Site Recovery Act (ISRA) Forms

Remediation Agreement Application

ISRA-012 (Rev. 09/2005)

Instructions for the Form

This application is to be used when requesting a Remediation Agreement from the Department to allow the ISRA triggering event to proceed prior to completing the standard ISRA administrative process. The Remediation Agreement specifies a time schedule for completion of ISRA requirements and necessitates the posting of a remediation funding source.

PLEASE READ THE FOLLOWING INFORMATION BEFORE COMPLETING AND SUBMITTING THIS FORM:

• A detailed cost estimate for the investigation/remediation of the site must be submitted to the Department. However, even if a cost estimate is submitted, if a completed Preliminary Assessment and/or Site Investigation has not yet been submitted to the Department OR has not yet been reviewed by the Department, then $100,000.00 is generally the minimum acceptable amount. This minimum amount may be increased based on the complexity and number of areas of concern. As the case progresses through the Preliminary Assessment/Site Investigation/Remedial Investigation/ Remedial Action phases, the remediation funding source amount should be decreased or increased as documented by the investigation. The Department may require a different amount based on the information known at the site.
• Acceptable types of a Remediation Funding Source are: a Self Guarantee, a Remediation Trust Fund, a Line of Credit, or an Environmental Insurance Policy. Information regarding these types of Remediation Funding Sources can be found at: http://www.nj.gov/dep/srp/regs/guidance.htm#isra It is strongly suggested that you review this information prior to submitting this application.

This application must be completed by the owner or operator of the industrial establishment and submitted with a certified check, attorney check, Money Order or a personal check (if received sixty (60) days prior to the issuance of the Remediation Agreement), made payable to "Treasurer, State of New Jersey”, in the amount of $1000.00 or $500.00 for an amendment. The application should be delivered to the following address:

New Jersey Department of Environmental Protection
Division of Remediation Support
Oversight Resources Allocation Element
Office of Accountability
401 East State Street, 5th Floor West
P.O. Box 028
Trenton, NJ 08625
FAX: (609)633-1439

APPLICATIONS SHOULD BE RECEIVED BY THE DEPARTMENT AT LEAST TWO (2) WEEKS PRIOR TO THE SCHEDULED DATE OF THE TRANSACTION.

Should you encounter any problem in completing this form, we recommend that you discuss this matter with a representative from the Office of Accountability. Submitting incorrect or insufficient application may cause processing delays and may cause possible postponement of your transaction.

If you require assistance with this application, please call the Office of Accountability at (609) 633-1464 between the hours of 8:00 a.m. and 5:00 p.m.