OFFICIAL SITE OF THE STATE OF NEW JERSEY

Complete all items in the application ; do not reference previously submitted documents filed with the State or any other government agency. Read each item carefully and answer as completely as possible. All attachments are to be labeled corresponding to the appropriate application section.  Make a copy of the completed application and all attachments. Retain the copy for your records. Changes in information must be reported to the DEP within 30 days. Mail the original application to:

NJDEP
RADIATION PROTECTION PROGRAMS
RADIOLOGICAL & ENVIORNMENTAL ASSESSMENT SECTION
P.O. BOX 420
TRENTON, NJ 08625-0420

• Complete Section A. BUSINESS INFORMATION
  • Input your businesses name, physical location, mailing address, primary and secondary individuals in charge of the business, contact information for each individual, which may include a telephone number and electronic mail address.
  • The business’s status as a corporation, limited liability company, sole proprietorship, partnership, or municipality, county, state, Federal, or other public agency.
  • The name and address of each owner, officer, general and limited partner, director, and principal shareholder.
  • For a corporation, the state of domestic incorporation, and the name and principal place of business of each parent corporation of the applicant and any branch names, addresses, and contact information.
• Complete section MITIGATION INFORMATION
  • Identify the individual(s) who will be installing the radon in water mitigation systems. List any training pertaining to water treatment that has been completed and the water treatment experience gained by this person(s). List all certifications and licenses including Master Plumber license which is required for any work done past the main valve of the house. For additional personnel, attach supplemental sheets which are labeled B.1.a, etc.
  • List any radiological instruments used if applicable.
  • List the labs certified for radon in water utilized by your firm to perform sample analysis after mitigation is complete. Include their state certification number.
  • Check each radon in water mitigation method employed by your company. Please provide attachments that specify the system (manufacturer, model, etc.) and the installation procedure used by your firm.
• Complete section C ATTACHMENTS
  • Submit a copy of a sample contract provided to clients stating all terms and Submit sample copies of all warranty information on the reduction of the radon level, and proper functioning of the equipment installed. If a firm warrants a job, the warranty must be honored and the precise coverage shall be explicitly stated in the contract offered to the client. Label these attachments appropriately.
  • Provide appropriately labeled copies of all information provided to the client regarding their system. This may include test results, safe operating instructions, energy costs and recommendations for disposal of activated carbon The approved radon mitigation business shall include the following statement in all radon in water mitigation contracts:

“This notice is provided to you by an organization or individual approved by the New Jersey Department of Environmental Protection to perform radon in water mitigation services. At some time in the near future, a representative of the Department of Environmental Protection may contact you to ask your permission to visit. The purpose of this visit would be to inspect the recently installed mitigation system.

Any questions, comments or complaints regarding the persons performing these mitigation services should be directed to the New Jersey Department of Environmental Protection, Attention: Radiological Environmental & Assessment Section, Bureau of Environmental Radiation, P.O. Box 420 Trenton, New Jersey 08625-0420.”

The Department, on or before the first day of each month, shall receive Monthly Radon in Water Mitigation Reports for work performed during the second previous month. For example, the report for mitigation systems installed during July is to be submitted by September 1. This monthly report is accompanied by instructions for your firm to follow. If you use a computer to store your data, contact the Radiological & Environmental Assessment Section to discuss the possible electronic transfer of your reports.

• Complete Section CERTIFICATION SIGNATORIES
  • The individuals completing the application must sign his or her name below the first paragraph. For a corporation, the application must be signed by a principal executive officer of at least the level of vice president below the second

Radon in Water Mitigation firms can fill out the voluntary monthly report and submit it as detailed below.

1. Name of Business: The name of your business should be entered here.
2. Address: Address of business in Item 1 should be entered here.
3. Enter the month and year that these systems were installed.
4. Owner: Enter the information about the owner of the property where mitigation was performed.
5. Building Type: Enter residential (R), non-residential (NR), school (S) or daycare center (D.)
6. Mitigation Method: Enter the type of mitigation system installed. Aeration methods include Diffused or Bubble (AD), Spray (AS), Tray (AT), Packed Tower (APT) . The Granular Activated Carbon method (GAC), Decay Storage (DS), and Other (with a short description) are other choices.
7. Date Installed: Enter the date that the mitigation system was installed.
8. Modification: Check this column if the method used differs from those submitted on your Initial Application for Radon in Water Mitigation Business. Please attach details about the modification.
9. Name of Installer: Enter the name of the individual who performed this installation.
10. Report Submission Date: Enter the date on which the report is submitted to the Bureau of Environmental Radiation