OFFICIAL SITE OF THE STATE OF NEW JERSEY[vc_row][vc_column offset=”vc_col-lg-9 vc_col-md-9″ el_class=”order-2″][breadcrumb-shortcode][vc_column_text css=””]
CSRR Forms Library
The SRRA Forms Page is in four sections:
Unless otherwise noted in Instructions, all form submittals are to be directed to the following address:
Bureau of Case Assignment & Initial Notice
Contaminated Site Remediation & Redevelopment
NJ Department of Environmental Protection
401-05H
PO Box 420
Trenton, NJ 08625-0420
Forms without payments or online services can also be emailed to srp_submissions@deptest.nj.gov.
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Related Topics
- Instructions on How to Pay a Bill Online [pdf]
- Guidance Library
- Technical Consultation
- Unregulated Heating Oil Tank (UHOT) System Remediation Form (replaces “Unregulated Heating Oil Tank Questionnaire”)
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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CSRR Forms |
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|---|---|---|---|---|---|
| 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] | 1.4 – 6/15/2015 | Update Log | 7:26C-4.3 [pdf] | |
| Case Inventory Document Worksheet | Spreadsheet [xlsm] | 1.5.1 – 2/4/2021 | Update Log | ||
| Case Inventory Document Instructions | Instructions [pdf] | 1.6 – 1/26/2023 | Update Log | ||
| Confirmed Discharge Notification (CDN) Submit Confirmed Discharge Notification Online. (Requires Login) |
FAQs [pdf] | Instructions [pdf] | 1.6 – 10/15/2024 | Update Log | |
| General Information Notice (GIN) Submit General Information Notice Online. (Requires Login) |
FAQs [pdf] | Instructions [pdf] | 1.1 – 12/4/2018 | Update Log | |
| Authorization Form To Submit A Confirmed Discharge Notification (CDN) or General Information Notice (GIN) through NJDEP Online |
Form [pdf] | Instructions [pdf] | 1.0 – 10/11/2017 | ||
| LSRP Notification of Retention or Dismissal Submit LSRP Notification Online. (Requires Login, Service must be Certified by an LSRP) |
Instructions [pdf] | 1.3 – 11/22/2021 | Update Log | 7:26C-2.3 [pdf] | |
| Oversight Services | |||||
| Direct Oversight Submit Direct Oversight Documents online (Requires Login) |
Instructions [pdf] | 1.0 – 7/26/2023 | Update Log | ||
| Traditional Oversight Submit CERCLA, RCRA, DOD, DOE, EPA, or Chrome Submissions Online (Requires Login) |
Instructions [pdf] | 1.0 – 7/26/2023 | Update Log | ||
| Public Notification and Outreach Service Submit Public Notification and Outreach form Online. (Requires Login, Service must be Certified by an LSRP) |
Instructions [pdf] | 1.2 – 1/18/2022 | Update Log | ||
| Public Notification and Outreach Form | Form [pdf] | Instructions [pdf] | 2.3 – 9/1/2020 | Update Log | |
| Child Care PA, Clean PASI, or Clean SI Standalone Report Submissions Submit Child Care PA, Clean PASI, or Clean SI Standalone Report Online. (Requires Login, Service must be Certified by an LSRP) |
Instructions [pdf] | 1.1 – 8/17/2022 | Update Log | ||
| Preliminary Assessment Report Service Submit PA Online. (Requires Login, Service must be Certified by an LSRP) |
FAQs [pdf] | Instructions [pdf] | 1.3 – 6/7/2022 | Update Log | |
| Preliminary Assessment/Site Investigation Report Service Submit PA/SI Online. (Requires Login, Service must be Certified by an LSRP) |
FAQs [pdf] | Instructions [pdf] | 1.2 – 1/15/2020 | Update Log | |
| Site Investigation Report Service Submit SI Online. (Requires Login, Service must be Certified by an LSRP) |
FAQs [pdf] | Instructions [pdf] | 1.2 – 1/15/2020 | Update Log | |
| Remedial Investigation Report Online Service Submit RIR Online. (Requires Login, Service must be certified by an LSRP) |
FAQs [pdf] | Instructions [pdf] | 1.6 – 2/22/2022 | Update Log | 7:26E-4.9 [pdf] |
| Remedial Action Workplan Online Service Submit RAW Online. (Requires Login, Service must be certified by an LSRP) |
FAQs [pdf] | Instructions [pdf] | 1.4 – 2/22/2022 | Update Log | |
| Remedial Action Report Online Service Submit RAR Online. (Requires Login, Service must be certified by an LSRP) |
FAQs [pdf] FAQs & Flow Charts [pdf] |
Instructions [pdf] | 1.5 – 2/22/2022 | Update Log | |
| Response Action Outcome Online Service Submit RAO Online. (Requires Login, Service must be certified by an LSRP) |
FAQs [pdf] | Instructions [pdf] | 1.3 – 11/19/2025 | Update Log | |
| Authorization To Submit a Report / Form through NJDEP Online Note: This form replaces the “Authorization To Submit a Remedial Phase Report through NJDEP Online”. |
Form [pdf] | Instructions [pdf] | 1.4 – 9/17/2024 | Update Log | |
| Underground Storage Tank (UST) Facility Certification Questionnaire | UST Forms Page | ||||
| Underground Storage Tank Notice of Intent to Close Submit UST NOI Online. (Requires Login, Service must be certified by an LSRP) |
Instructions [pdf] | 1.1 – 10/15/2024 | Update Log | 7:14B-9.2 [pdf] | |
| Receptor Evaluation, CEA, and IANA Forms | Download | Version & Date | Changes Since Last Version | Rule | |
| Cover/Certification Form (Must be submitted with the forms listed below unless submitted online) |
Form [pdf] | Instructions [pdf] | 1.1 – 9/17/2018 | Update Log | |
| Receptor Evaluation form | Form [pdf] FAQs [pdf] |
Instructions [pdf] | 2.7 – 8/6/2025 | Update Log | 7:26E-1.12 [pdf] |
| Well Search Spreadsheet | Spreadsheet [xls] | Instructions [pdf] | 1.3 – 3/22/2012 | Update Log | |
| CEA/Well Restriction Area (WRA) Fact Sheet Form See the CEA page for more information |
Form [pdf] | Instructions [pdf] | 1.9 – 9/18/2018 | Update Log | 7:26C-7.3 [pdf] |
| Indoor Air Notification Area (IANA) Fact Sheet Form See the IANA page for more information |
Form [pdf] | Instructions [pdf] | 1.0 – 2/17/2026 | ||
| Vapor Intrusion Mitigation Monitoring and Maintenance Checklist | Spreadsheet [pdf] | 1.2 – 2/17/2026 | Update Log | ||
| Remedial Action Permit (RAP) Forms | Download | Version & Date | Changes Since Last Version | Rule | |
| How to Pay a Remedial Action Permit Bill Online | |||||
| Financial Assurance (FA) | |||||
| Remediation Trust Fund Agreement for FA – See N.J.A.C. 7:26C-5.4 for specific requirements | Remediation Trust Fund Agreement for FA [doc] | N.J.A.C. 7:26C-5.4 [pdf] | |||
| Line of Credit Agreement for FA – See N.J.A.C. 7:26C-5.6 for specific requirements. | Line of Credit Agreement for FA [doc] | N.J.A.C. 7:26C-5.6 [pdf] | |||
| Letter of Credit for FA – See N.J.A.C. 7:26C-5.7 for specific requirements. | Letter of Credit for FA [doc] | N.J.A.C. 7:26C-5.7 [pdf] | |||
| Environmental Insurance Policy – See N.J.A.C. 7:26C-5.5 for specific requirements. | N.J.A.C. 7:26C-5.5 [pdf] | ||||
| Surety Bond – See N.J.A.C. 7:26C-5.14 for specific requirements. | Surety Bond [docx] | ||||
| Ground Water Monitoring Plan Spreadsheet for Ground Water RAP 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 [xlsm] | Instructions [pdf] | 1.1 – 12/4/2023 | Update Log | |
| Indoor Air Monitoring Plan Spreadsheet for Indoor Air RAP | Spreadsheet [xlsm] | Instructions [pdf] | 1.0 – 2/17/2026 | ||
| Model Documents | |||||
| Model Deed Notice (Appendix B of the ARRCS Rule) | Model Document [docx] | 1/21/2026 | Update Log | 7:26C-7.2 [pdf] | |
| Model Termination of Deed Notice (Appendix C of the ARRCS Rule) | Model Document [doc] | 1/21/2026 | Update Log | 7:26C-7.13 [pdf] | |
| Model Notice in Lieu of Deed Notice Example (Appendix 2 of the Soil RAP Guidance document) | Model Document [docx] | ||||
| Sample Notification Letter to Meet Requirements of N.J.A.C. 7:26C-7.2(b)2i (Appendix 3 of the Soil RAP Guidance document) | Model Document [docx] | ||||
| Resolution Concerning Notice in Lieu of Deed Notice Example (Appendix 4 of the Soil RAP Guidance document) | Model Document [docx] | ||||
| Written Agreement Concerning Notice in Lieu of Deed Notice Example (Appendix 5 of the Soil RAP Guidance document) | Model Document [docx] | ||||
| Model Table for Historic Ground Water Sampling Results by Monitoring Well (Appendix 1 of the Ground Water RAP Guidance document) | Model Document [xlsx] | ||||
| RAP Applications | FAQs [pdf] | 1.0 – 6/2023 | |||
| RAP Initial / New Media Component Application – Soil, Ground Water, and Indoor Air | Form [pdf] | Instructions [pdf] | 1.0 – 2/17/2026 | ||
| LSRP Supplemental Certification for Initial Soil RAP Application | Form [pdf] | Instructions [pdf] | 1.2 – 2/15/2024 | ||
| LSRP Supplemental Certification for Initial Ground Water RAP Application | Form [pdf] | Instructions [pdf] | 1.3 – 12/22/2025 | Update Log | |
| Notice of Incomplete (NOI) Initial Soil RAP Application Checklist (Note: The checklist should not be included with the RAP Application and RAR submitted to CSRR.) |
Form [pdf] | 1.0 – 11/2024 | |||
| NOI Initial Ground Water RAP Application Checklist (Note: The checklist should not be included with the RAP Application and RAR submitted to CSRR.) |
Form [pdf] | 1.0 – 11/2024 | |||
| NOI Initial Indoor Air RAP Application Checklist (Note: The checklist should not be included with the RAP Application and RAR submitted to CSRR.) |
Form [pdf] | 1.0 – 2/17/2026 | |||
| Remedial Action Protectiveness / Biennial Certification Form | Form [pdf] | Instructions [pdf] | 1.0 – 3/27/2026 | Update Log | |
| RAP Technical Modification Application – Soil, Ground Water, and Indoor Air | Form [pdf] | Instructions [pdf] | 1.0 – 2/17/2026 | ||
| RAP Administrative Changes Application | Form [pdf] | Instructions [pdf] | 1.1 – 3/3/2026 | Update Log | |
| LSRP Focused Permit IV Supplemental Certification for RAP Administratively Change Application | Form [pdf] | 1.0 – 2/17/2026 | |||
| RAP Contact Information Change Form | Form [pdf] | Instructions [pdf] | 1.3 – 2/17/2026 | Update Log | |
| RAP Application to Administratively Combine RAPs | Form [pdf] | Instructions [pdf] | 1.0 – 2/17/2026 | ||
| RAP Termination/Removal of a Media Component Application – Soil, Ground Water, and Indoor Air | Form [pdf] | Instructions [pdf] | 1.0 – 2/17/2026 | ||
| Termination of Deed Notice Form | Form [pdf] | Instructions [pdf] | 1.2 – 6/2/2022 | Update Log | |
| General Forms | Download | Version & Date | Changes Since Last Version | Rule | |
| 7.5 Percent Cost of Remediation Form | Form [pdf] | Instructions [pdf] | 1.1 – 9/17/2018 | Update Log | 7:26C-4.10 [pdf] |
| 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] | Instructions [pdf] | 2.4 – 5/3/2021 | Update Log | 7:26D-7.4 [pdf] |
| Remediation Standard Notification Spreadsheet | SpreadSheet [xls] | 1.1 – 5/3/2021 | Update Log | ||
| Alternative Remedy/Remedial Action Pre-Approval Form | Form [pdf] | Instructions [pdf] | 1.5 – 9/17/2018 | Update Log | 7:26C-5.3(c) [pdf] |
| Brownfield Development Area Application Form Note: The Department is not currently accepting Brownfield Development Area (BDA) applications. See the Brownfield Development Area (BDA) Designation page for more information. |
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| Case Creation Request form Note: This form is for filing a (CDN) for Historic Fill only, or creating a case for Madden Subject Educational Facility, or creating a case where there is no Statutory or Regulatory Requirement, but remediation conducted for the purpose of obtaining a Response Action Outcome (RAO). |
Form [pdf] | Instructions [pdf] | 1.0 – 12/3/2018 | 7:26C-1.7 [pdf] | |
| Child Care Center/Educational Facility Remediation Form | Form [pdf] | Instructions [pdf] | 1.2 – 5/26/2020 | Update Log | P.L. 2007 Chapter 1 [pdf] |
| Confidentiality Request Form | Form [pdf] | Instructions [pdf] | 1.2 – 4/1/2015 | Update Log | 7:26C-15.3 [pdf] |
| Developer Certification (Appendix A for the ARRCS Rule) | Model Document [doc] | 7:26C-4.7 [pdf] | |||
| Discharge to Ground Water Permit by Rule Authorization Request | Form [pdf] | Instructions [pdf] | 1.2 – 9/17/2018 | Update Log | 7:26E-5.6 [pdf] |
| Exemption from Spill Act Liability Certification | Form [pdf] | Instructions [pdf] | 1.1 – 4/2/2013 | Update Log | 7:26C-1.4(f) [pdf] |
| Full Laboratory Data Deliverables form | Form [pdf] | Instructions [pdf] | 1.8 – 8/26/2021 | Update Log | 7:26E-1.11, 14 & 15 [pdf] |
| Hazardous Discharge Site Remediation Fund Application form Note: the CSRR Financial Assistance HDSRF page for more information & guidance. |
Form [pdf] | Instructions [pdf] | 1.5 – 9/17/2018 | Update Log | 7:26C-11.2 [pdf] |
| HDSRF Child Care Facility Grant Application | Form [pdf] | Instructions [pdf] | 1.2 – 10/24/2016 | Update Log | 7:26C-11.2 [pdf] |
| Historically Applied Pesticides Deferral Request | Form [pdf] | Instructions [pdf] | 1.2 – 11/21/2019 | Update Log | |
| IEC Response Action form | Form [pdf] | Instructions [pdf] | 1.8 – 1/6/2023 | Update Log | 7:26E-1.11 [pdf] |
| IEC – Direct Contact Spreadsheet | Spreadsheet [xls] | 1.1 – 3/26/2015 | Update Log | ||
| IEC – Potable Water Spreadsheet | Spreadsheet [xls] | 1.3 – 3/26/2015 | Update Log | ||
| IEC/VC – Vapor Intrusion Spreadsheet | Spreadsheet [xls] | 1.3 – 3/26/2015 | Update Log | ||
| IEC Monitoring and Maintenance Checklist | Form [pdf] | 1.2 – 2/17/2026 | Update Log | ||
| ISRA Alternate Compliance Option Application | Form [pdf] | Instructions [pdf] | 2.0 – 11/10/2020 | Update Log | 7:26B-5 [pdf] |
| ISRA Certificate of Limited Conveyance Application | Form [pdf] | Instructions [pdf] | 1.1 – 7/24/2012 | Update Log | 7:26B-5.7 [pdf] |
| ISRA De Minimis Quantity Exemption Affidavit Application (Formerly De Minimus Quantity Exemption Application) |
Form [pdf] | Instructions [pdf] | 1.6 – 8/7/2019 | Update Log | 7:26B-5.9 [pdf] |
| ISRA General Information Notice for Confidential Submissions Only Note: Submit along with Confidentiality Form, all other GINs use online service above. |
Form [pdf] | Instructions [pdf] | 2.0 – 12/3/2018 | Update Log | 7:26B-3.2 [pdf] |
| ISRA Remediation Certification form (Formerly Remediation Certification form) |
Form [pdf] | Instructions [pdf] | 2.0 – 11/21/2022 | Update Log | 7:26B-3.3 [pdf] |
| Linear Construction Project | Form [pdf] | Instructions [pdf] | 1.1 – 9/17/2018 | Update Log | 7:26C-16.2(a)2 [pdf] |
| LNAPL Free Product Reporting Form | Form [pdf] | Instructions [pdf] | 1.7 – 9/17/2018 | Update Log | 7:26E-1.10(b) [pdf] |
| Monitoring Well Certification Form A – As-Built Certification | Form [pdf] | Instructions [pdf] | 1.0 – 9/7/2011 | Update Log | 7:26E-1.6 [pdf] |
| Monitoring Well Certification Form B – Location Certification | Form [pdf] | Instructions [pdf] | 1.3 – 2/26/2013 | Update Log | 7:26E-1.6 [pdf] |
| Notice of Failure to Comply with a Mandatory or Expedited Site-specific Remediation Timeframe | Form [pdf] | Instructions [pdf] | 1.0 – 4/27/2016 | Update Log | 7:26I-6.8(c) [pdf] |
| 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] | Instructions [pdf] | 1.5 – 9/17/2018 | Update Log | 7:14B-9.1 [pdf] |
| Petroleum UST Fund Application (Regulated) (Closes 6/30/2010) | Form [pdf] | Instructions [pdf] | 1.2 – 9/17/2018 | Update Log | 7:26C-12.2 |
| Petroleum UST Fund Application (Unregulated) (Including Residential Heating Oil Tanks) | Form [pdf] | Instructions [pdf] | 1.2 – 9/17/2018 | Update Log | 7:26C-12.2 [pdf] |
| Project Summary Sheet Spreadsheet Note: the CSRR Financial Assistance Petroleum UST Fund page for more information & guidance. |
Spreadsheet [xls] | 1.0 | |||
| Pre-Purchase Administrative Consent Order Certification | Form [pdf] | Instructions [pdf] | 1.0 – 9/2/2022 | Update Log | 7:26C-3.2 [pdf] |
| Remedial Timeframe Notification | Form [pdf] | Instructions [pdf] | 1.3 – 9/17/2018 | Update Log | 7:26C-3.2 [pdf] |
| Remediation Cost Review and RFS-FA Form | Form [pdf] | Instructions [pdf] | 2.2 – 9/23/2020 | Update Log | 7:26C-5 [pdf] |
| RFS/FA Model Financial Mechanism Language | RFS Guide Page | ||||
| Self Guarantee Application | Form [pdf] | Instructions [pdf] | 1.3 – 6/12/2014 | Update Log | 7:26C-5 [pdf] |
| Site and Contact Information Update Form For LSRP Contact Information changes, submit LSRP Contact Information Update Form. [pdf] |
Form [pdf] | Instructions [pdf] | 1.4 – 11/6/2025 | Update Log | |
| Summary Status Report Note: This form is not required to be submitted to Contaminated Site Remediation & Redevelopment |
Form [pdf] | 1.0 – 11/18/2025 | |||
| Technical Assistance Grant form Guidance for Technical Assistance Grants [pdf] for more information. |
Form [pdf] | Instructions [pdf] | 1.4 – 9/17/2018 | Update Log | 7:26C-10.5 [pdf] |
| Underground Storage Tank Forms | UST Forms Page | ||||
| Unoccupied Building to be Demolished – Certification Form | Form [pdf] | Instructions [pdf] | 1.0 – 11/17/2025 | Update Log | |
| Vapor Concern (VC) Response Action Form | Form [pdf] | Instructions [pdf] | 1.5 – 1/6/2023 | Update Log | 7:26C-1.15 [pdf] |
| Variance Identification Form | Form [pdf] | ||||
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