Response Action Outcome Form Page 2

Download a blank fillable Response Action Outcome Form in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Response Action Outcome Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

2. Contamination Remaining Onsite
Regional Natural Background Levels (above Direct Contact Standards) of Materials in Soil
Existing Classification Exception Area or Deed Notice from Prior Remediations
Soils Only RAO when Ground Water Contamination remains from that Area(s) of Concern or Site
Ground Water Contamination Not Yet investigated
Ground Water Contamination Due to Regional Historic Fill
Contamination Remaining Onsite Due to Off-site Contamination
Known Onsite Contamination Source Not Yet Remediated
Order of Magnitude Change to a Remediation Standard after approval of a Remedial Action Workplan
Order of Magnitude Change to a Remediation Standard after Approval of a Final Remediation Document
3. ISRA Specific Notices
ISRA Specific – RCRA Situations - Bureau of Case Assignment and Initial Notice Referral
ISRA Specific – Multi-Tenant Situations - Bureau of Case Assignment and Initial Notice Referral
ISRA Specific – Landfill Situations - Bureau of Case Assignment and Initial Notice Referral
4. Additions to Model Document
In-Service Railroad Line, Spurs and Sidings Not Remediated
Known Onsite Contamination Source Not Remediated - Historic Fill (RAO-A)
Soil Contamination From an Off-Site Source Not Remediated- General
Soil Contamination From an Off-Site Source Not Remediated - Diffuse Anthropogenic Pollution
Naturally Occurring Levels of Constituents in Ground Water
Historically Applied Pesticides not Addressed
SECTION E. REMEDIATION FUNDING SOURCE
1. Has a Remediation Funding Source been posted for this site pursuant to N.J.A.C. 7:26C-5? ....
Yes
No
If “Yes, check a. or b. below as applicable:
a.
This RAO is for the entire site and serves as notice to the NJDEP to return the Remediation Funding
Source posted for this site*.
b.
This RAO is for an Area of Concern only and (check one below):
Serves as notice to the NJDEP to decrease the Remediation Funding Source posted for this site*.
No adjustments to the Remediation Funding Source are requested at this time.
Note: If any box in a. or b. above identified with an asterisk (*) is checked, be sure to include the completed “Remediation
Cost Review and RFS-FA Form” available at
Response Action Outcome
Page 2 of 2
Version 3.3 05/27/15

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go
Page of 2