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
For forms related to RCRA, CERCLA, Federal Facilities, and Traditional Oversight, and Direct Oversight, click here.
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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.
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NJDEP Online Services |
Download
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Version & Date |
Changes Since Last Version |
Rule |
Annual Remediation Fee Reporting
Pay/Update Online (Requires Login, Service must be Certified by an LSRP)
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Instructions
pdf 144 Kb |
1.4 - 6/15/2015 |
See Update
Log |
7:26C-4.3 |
Confirmed Discharge Notification (CDN)
Submit Confirmed Discharge Notification Online. (Requires Login)
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FAQs pdf 200 Kb |
Instructions
pdf 173 Kb |
1.2 - 12/4/2018 |
See Update
Log |
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General Information Notice (GIN)
Submit General Information Notice Online. (Requires Login)
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FAQs pdf 200 Kb |
Instructions
pdf 177 Kb |
1.1 - 12/4/2018 |
See Update
Log |
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Authorization Form To Submit A Confirmed
Discharge Notification (CDN) or General Information Notice (GIN) through NJDEP Online
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Form
pdf 34 Kb |
Instructions
pdf 32 Kb |
1.0 - 10/11/2017 |
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LSRP Notification of Retention or Dismissal
Submit LSRP Notification Online. (Requires Login, Service must be Certified by an LSRP)
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Instructions
pdf 156 Kb |
1.2 - 02/14/2019 |
See Update
Log |
7:26C-2.3 |
Preliminary Assessment Report Service
Submit PA Online. (Requires Login, Service must be Certified by an LSRP)
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FAQs pdf 200 Kb |
Instructions
pdf 41 Kb |
1.1 - 8/21/2017 |
See Update
Log |
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Preliminary Assessment/Site Investigation Report Service
Submit PA/SI Online. (Requires Login, Service must be Certified by an LSRP)
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FAQs pdf 200 Kb |
Instructions
pdf 82 Kb |
1.1 - 8/21/2017 |
See Update
Log |
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Site Investigation Report Service
Submit SI Online. (Requires Login, Service must be Certified by an LSRP)
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FAQs pdf 200 Kb |
Instructions
pdf 67 Kb |
1.1 - 8/21/2017 |
See Update
Log |
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Remedial Investigation Report Online Service
Submit RIR Online. (Requires Login, Service must be certified by an LSRP)
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FAQs pdf 200 Kb |
Instructions
pdf 124 Kb |
1.4 - 2/27/2018 |
See Update
Log |
7:26E-4.9 |
Remedial Action Workplan Online Service
Submit RAW Online. (Requires Login, Service must be certified by an LSRP)
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FAQs pdf 200 Kb |
Instructions
pdf 205 Kb |
1.2 - 3/13/2018 |
See Update
Log |
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Remedial Action Report Online Service
Submit RAR Online. (Requires Login, Service must be certified by an LSRP)
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FAQs pdf 200 Kb |
Instructions
pdf 75 Kb |
1.2 - 2/27/2018 |
See Update
Log |
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Authorization
To Submit a Remedial Phase Report through NJDEP Online
Note: This form replaces the "Authorization
To Submit RIR, RAW, or RAR through NJDEP Online" and "Authorization to Submit the Remedial Investigation Report through NJDEP Online form".
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Form
pdf 162 Kb |
Instructions
pdf 135 Kb |
1.1 - 5/23/2018 |
See Update Log |
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Underground Storage Tank Notice of Intent to Close
Submit UST NOI Online. (Requires Login, Service must be certified by an LSRP)
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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
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Version & Date |
Changes Since Last Version |
Rule |
Cover/Certification Form
(Must be submitted with the forms listed below)
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Form pdf
286 Kb |
Instructions
pdf 148 Kb |
1.1 - 9/17/2018 |
See Update
Log |
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Preliminary Assessment/Site
Investigation form
Note: Paper PASI forms are no longer accepted. The PASI must be submitted via the PA/SI/PASI Online Services (above).
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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).
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7:26E-4.9 |
Remedial Action Workplan
form
Note: Paper RAW forms are no longer accepted. The RAW must be submitted via the RAW Online Service (above).
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See Update Log |
7:26E-5.5 |
Remedial Action Report
form
Note: Paper RAR forms are no longer accepted. The RAR must be submitted via the RAR Online Service (above).
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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 |
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Model Response Action Outcome (Appendix D for the ARRCS Rule) |
Model
Document doc 126 Kb |
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Case Inventory Document
Worksheet |
Spreadsheet
xls 164 Kb |
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1.4 - 2/23/2017 |
See Update
Log |
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Receptor
Evaluation form |
Form
pdf 379 Kb |
Instructions
pdf 194 Kb |
2.4 - 12/3/2018 |
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 |
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CEA/Well
Restriction Area (WRA) Fact Sheet form |
Form pdf
173 Kb |
Instructions
pdf 142 Kb |
1.9 - 9/18/2018 |
See Update
Log |
7:26C-7.3 |
General Forms |
Download
|
Version & Date |
Changes Since Last Version |
Rule |
7.5 Percent Cost of Remediation Form
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Form pdf
190 Kb |
Instructions
pdf 162 Kb |
1.1 - 9/17/2018 |
See Update Log |
7:26C-4.10 |
Alternative or New Remediation
Standard and/or Screening Level Application form
(Name change. Was "Alternative Soil Remediation
Standard and/or Screening Level Application form")
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Form
pdf 162 Kb |
Instructions
pdf 157 Kb |
2.3 - 9/17/2018 |
See Update
Log |
7:26D-7.4 |
Alternative Remedy/Remedial
Action Pre-Approval Form |
Form pdf
195 Kb |
Instructions
pdf 186 Kb |
1.5 - 9/17/2018 |
See Update Log
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7:26C-5.3(c) |
Remediation
Standard Notification Spreadsheet |
SpreadSheet
xls 68 Kb |
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1.0 - 8/27/2013 |
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Case Creation Request form |
Form
pdf 158 Kb |
Instructions
pdf 148 Kb |
1.0 - 12/3/2018 |
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7:26C-1.7 |
Child Care Center/Educational Facility
Remediation Form |
Form pdf
522 Kb |
Instructions
pdf 207 Kb |
1.1 - 9/17/2018 |
See Update Log
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P.L. 2007 Chapter 1 |
Confidentiality
Request Form |
Form pdf
36 Kb |
Instructions
pdf 29 Kb |
1.2 - 4/1/2015 |
See Update Log
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7:26C-15.3 |
Developer Certification
(Appendix A for the ARRCS Rule) |
Model
Document doc 39 Kb |
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7:26C-4.7 |
Discharge to
Ground Water Permit by Rule Authorization Request |
Form pdf
211 Kb |
Instructions
pdf 207 Kb |
1.2 - 9/17/2018 |
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
234 Kb |
Instructions
pdf 137 Kb |
1.7 - 2/4/2019 |
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 326 Kb |
Instructions
pdf 175 Kb |
1.5 - 9/17/2018 |
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
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7:26C-11.2 |
Historically Applied Pesticides Deferral Request |
Form pdf
175 Kb |
Instructions
pdf 143 Kb |
1.1 - 9/17/2018 |
See Update Log
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IEC
Response Action form |
Form pdf
176 Kb |
Instructions
pdf 144 Kb |
1.7 - 9/17/2018 |
See Update
Log |
7:26E-1.11 |
IEC
- Direct Contact Spreadsheet |
Spreadsheet
xls 40 Kb |
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1.1 - 3/26/2015 |
See Update
Log |
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IEC
- Potable Water Spreadsheet |
Spreadsheet
xls 45 Kb |
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1.3 - 3/26/2015 |
See Update
Log |
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IEC/VC
- Vapor Intrusion Spreadsheet |
Spreadsheet
xls 80 Kb |
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1.3 - 3/26/2015 |
See Update
Log |
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IEC
Monitoring and Maintenance Checklist |
Form
pdf 150 Kb |
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1.1 - 3/16/2018 |
See Update Log |
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ISRA Alternate
Compliance Option Application |
Form
pdf 192 Kb |
Instructions
pdf 122 Kb |
1.8 - 9/17/2018 |
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 Notice for Confidential Submissions Only
Note: Submit along with Confidentiality Form, all other GINs use online service above. |
Form pdf
213 Kb |
Instructions
pdf 111 Kb |
2.0 - 12/3/2018 |
See Update
Log |
7:26B-3.2 |
ISRA Remediation
Certification form
(Formerly Remediation Certification form) |
Form
pdf 245 Kb |
Instructions
pdf 142 Kb |
1.9 - 9/17/2018 |
See Update
Log |
7:26B-3.3 |
Linear
Construction Project |
Form
pdf 181 Kb |
Instructions
pdf 129 Kb |
1.1 - 9/17/2018 |
See Update Log |
7:26C-16.2(a)2 |
LNAPL Free Product Reporting
Form |
Form
pdf 207 Kb |
Instructions
pdf 151 Kb |
1.7 - 9/17/2018 |
See Update
Log |
7:26E-1.10(b) |
Model Deed Notice (Appendix B for the ARRCS Rule) |
Model
Document doc 108 Kb |
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5/8/2018 |
See Update Log |
7:26C-7.2 |
Model Termination
of Deed Notice (Appendix C for the ARRCS Rule) |
Model
Document doc 98 Kb |
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5/8/2018 |
See Update Log |
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 |
See Update Log |
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
178 Kb |
Instructions
pdf 163 Kb |
1.5 - 9/17/2018 |
See Update
Log |
7:14B-9.1 |
Petroleum
UST Fund Application (Regulated) (Closes 6/30/2010) |
Form
pdf 382 Kb |
Instructions
pdf 169 Kb |
1.2 - 9/17/2018 |
See Update
Log |
7:26C-12.2 |
Petroleum
UST Fund Application (Unregulated) (Including Residential
Heating Oil Tanks) |
Form
pdf 396 Kb |
Instructions
pdf 185 Kb |
1.2 - 9/17/2018 |
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 |
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1.0 |
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Public
Notification and Outreach form |
Form pdf
173 Kb |
Instructions
pdf 144 Kb |
1.8 - 9/17/2018 |
See Update
Log |
7:26C-1.7 |
Remedial
Action Permit Application Form for Ground Water |
Form pdf
411 Kb |
Instructions
pdf 260 Kb |
2.5 - 9/17/2018 |
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.
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Spreadsheet
xls 177 Kb |
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1.0 - 5/22/2012 |
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Remedial
Action Permit Application Form for Soils |
Form
pdf 368 Kb |
Instructions
pdf 228 Kb |
2.6 - 9/17/2018 |
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")
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Form
pdf 263 Kb |
Instructions
pdf 181 Kb |
2.3 - 6/18/2018 |
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
407 Kb |
Instructions
pdf 245 Kb |
1.8 - 9/17/2018 |
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 321 Kb |
Instructions
pdf 216 Kb |
1.8 - 9/17/2018 |
See Update
Log |
7:26C-7.7 |
Remedial
Timeframe Notification |
Form pdf
192 Kb |
Instructions
pdf 163 Kb |
1.3 - 9/17/2018 |
See Update Log |
7:26C-3.2 |
Remediation Cost Review
and RFS-FA Form
|
Form pdf
251 Kb |
Instructions
pdf 207 Kb |
2.1 - 9/17/2018 |
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 103 Kb |
Instructions pdf 45 Kb |
1.3 - 10/18/2017 |
See Update Log |
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Technical Assistance Grant
form
See the Guidance
for Technical Assistance Grants [pdf]
for more information. |
Form pdf
184 Kb |
Instructions
pdf 124 Kb |
1.4 - 9/17/2018 |
See Update
Log |
7:26C-10.5 |
Underground Storage Tank Forms |
UST Forms Page |
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Vapor Concern
(VC) Response Action Form |
Form
pdf 163 Kb |
Instructions
pdf 141 Kb |
1.4 - 9/17/2018 |
See Update
Log |
7:26C-1.15 |
Variance Identification Form |
Form |
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