new jersey department of environmental protection
site remediation program
srp home dep home

SRRAForms

  

Site Remediation Reform Act (SRRA) Forms

The forms required to comply with the Administrative Requirements for the Remediation of Contaminated Sites are contained on this web page. They will be provided as they finalized for use by the LSRP community. "Draft Forms for Informational Purposes Only" are included for your review. They are available at the bottom of this web page.

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

Bureau of Case Assignment & Initial Notice
New Jersey Department of Environmental Protection
Site Remediation Program
401 East State Street, PO Box 434
Trenton, NJ 08625

SRRA Forms

Related Links

Important Notices

Current Forms

NOTE: The below PDF froms are intended for the current versions (9.x or later) of the Adobe Reader. They might not be compatible with older versions of the reader. The Adobe Reader is available at http://get.adobe.com/reader/

help for using PDF documents

Form Interim Rule Version Download
Confirmed Discharge Notification form 7:26E-1.4  1.1 PDF 230 Kb
General Information Notification 7:26B-3.3 1.1 PDF 251 Kb
Remediation Certification form 7:26B-4.3  1.1 PDF 125 Kb
ISRA Alternate Compliance Option Application 7:26C-5    
De Minimus Quantity Exemption Application form 7:26B-5.9     
Negative Declaration * 7:26B-6.1     
Request to Proceed Without Department Pre-Approvals 7:26C-2.3   1.2 PDF 233 Kb
LSRP Notification of Retention or Dismissal 7:26C-2.3   1.0 PDF 243 Kb
Remediation Timeframe Extension Request 7:26C-3.2      
Annual Remediation Fee Reporting form 7:26C-4.2     
Document Submission form 7:26C-4.3     
Remediation Funding Source form 7:26C-5.8     
Remediation Cost Review form 7:26C-5.11     
Response Action Outcome form 7:26C-6.2     
Soil Remediation Permit Application form 7:26C-7.3     
Remedial Action Permit form 7:26C-7.8     
Technical Assistance Grant form (Draft version available below) 7:26C-10.5     
Hazardous Discharge Site Remediation Fund Application form 7:26C-11.2    
PUST Remediation, Upgrade and Closure Fund Application form 7:26C-12.2    
Developer Certification ** 7:26C-13.4     
Model Termination of Deed Notice ** 7:26C-13.4     
Alternative Soil Remediation Standard Application 7:26D-7.4    
Potable Well/Indoor Air Sampling Notification form 7:26E-1.4(e)    
Public Notification and Outreach form 7:26E-1.4     
LNAPL Notification form 7:26E-1.12    
IEC Response Action form 7:26E-1.14      
Receptor Evaluation form 7:26E-1.15     
Full Laboratory Data Deliverables form 7:26E-1.18     
Preliminary Assessment/Site Investigation form 7:26E-3.1 & 3.3 1.0 PDF 588 Kb
Remedial Investigation Report form 7:26E-4.8 1.0 PDF 450 Kb
Remedial Action Workplan form 7:26E-6.2 1.0 PDF 473 Kb
Ground Water Remedial Action Permit form 7:26E-6.3     
CEA/Well Restriction Area (WRA) Fact Sheet form 7:26E-6.3     
Remedial Action Report form 7:26E-6.7 1.0 PDF 440 Kb
Remedial Action Protectiveness Certification form 7:26E-8.4(c)    
       
* - not listed as a form but requires submission to the NJDEP
** - Appendices

Draft - For Informational Purposes Only

Technical Assistance Grant

Immediate Environmental Concern (IEC)

nj home njgreen business government services A to Z departments